On the 20th of November 2024, 85% of public hospital workers went on strike. They are complaining about net wages of 3 Euros an hour for junior doctors, 12-hour shifts, endless waiting lists for patients and gross underfunding of the public healthcare system. As a result, young doctors and nurses are going abroad and people in Italy are unable to get appointments with specialists. Those who can afford it are turning to the private healthcare system. With friends from Labournet.tv we subtitled <a href="https://en.labournet.tv/general-strike-hospital-workers-italiy">this short film</a>.
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Film – General strike of health workers in Italy, November 2024

Conversation with a nurse from Chicago

Introduction
My name is Nick. I&#8217;m a registered nurse here in Minneapolis, Minnesota and the United States. Right now I work in the community. I work with a number of day programs for adults with developmental and intellectual disabilities. Previously, I was doing some community vaccine work, and before that, I worked in a hospital, at the University of Minnesota, on the West Bank. There I was in the float pool, meaning I was working in five different units, from medical surgeries, to rehab, to our emergency room. I left the hospital a few years ago. It just wasn&#8217;t safe, unfortunately. The moral injury was high. I wasn&#8217;t able to deliver the kind of care that I felt I needed to deliver to patients. I was a steward within the Minnesota Nurses Association. I&#8217;m no longer officially a member of the Minnesota Nurses Association, but I&#8217;m still highly active in organizing around labor and keeping track of what&#8217;s going on, trying to improve things for nurses. I also have a podcast, <a href="https://soundcloud.com/socialistnewsandviews/tracks">Socialist News and Views</a>, that comes out every Thursday here in Minneapolis.
The national health system
I work on contract for a third party company. I work in day-programs that are run by private non-profits. They don&#8217;t really have enough work for a nurse for a full time position, which is why I work on contract with different non-profits. This company I work for is run by nurses. They don’t provide benefits or proper contracts, but they try to run the service as well as they can. That doesn&#8217;t excuse the fact that we don&#8217;t have a well-organized and well-run health care system in this country. It&#8217;s very piecemeal. Everything is done in pieces, and we&#8217;re seeing more and more of that with the cuts that Trump is making to the little bit of a framework for public funding of health care that we have in this country. This influences the health care system even in Canada, where people are now supposed to call ‘tele-health medicine’ when they have basic issues, but the calls are answered by outsourced workers in the US.
Recent health workers struggles
There was a big strike in 2022, we had 15,000 nurses walking out. That was in the Twin Cities, which is Minneapolis and Saint Paul. It was around staffing. They did win some concessions but there was a push from the union bureaucracy to go back to work. At the beginning, there was a process put in place to try to work on staffing but it didn&#8217;t really have any teeth to it. The union then tried to focus on the political level, they had an occupation of the Capitol, but there was no force to it, it ended up being mostly full-time staffers from the union. The rank and file was not properly mobilized. One of the big local players, Mayo Health Care, intervened and said that if the state changes anything to the regulation of staffing, they would leave the federal state. Our governor, Tim Walz, intervened, who was getting a little attention lately because of the things going on with ICE in Minneapolis. Basically he gave Mayo Health Care a carve out. With staffing issues, the most immediate way to address it is in the moment. When I was a steward and I saw that we are massively under-staffed, I sent an email right away and I signed 5 or 10 fellow workers on to it. I would send it to management and say that staffing is not safe.
Migrant workers and protests in Minnesota
As far as migration overall, the number of immigrants in Minnesota is actually significantly smaller than in a lot of other states. I think they said it was like 1% of the population. But we do have a very diverse population. We have the largest Somali population, outside of Somalia, including Somali Americans that were born here. The Somali community has a huge amount of self-organization that has added strength to our movement here against ICE in the Twin Cities, for example amongst Amazon or Uber workers. 
ICE is meant to discipline and intimidate a workforce, including plenty of people that aren&#8217;t even immigrants like what we said. A judge here stated that the Department of Homeland Security and Immigration had failed to comply with 96 legal requirements. They&#8217;re operating well beyond even the law of bourgeois democracy. These are not just workplace raids. They are driving up in the middle of traffic and running somebody off the road and pulling out their guns and breaking their window and dragging them out through the window.
Resistance is forming against this. I can&#8217;t overstate the number of normies, or average, regular people, that were getting right into the movement against ICE. We didn’t see that to the same extent during the George Floyd rebellion or Occupy. I saw many people that had never done anything before, really coming out to protest. We need to get rid of ICE and we need to get 4,000 people out of ICE custody. The resistance against ICE is part of daily neighbourhood life. When they say that Alex Pretti was at a protest, that’s actually not true. He wasn&#8217;t at a protest. He was right in his own neighborhood, right outside of his own house, defending people in the street that are coming under attack. There&#8217;s plenty of people that wouldn&#8217;t even go to a protest, but that are out in the streets, defending their own neighborhoods. 
At the county medical center they&#8217;ve been dealing with a lot of ICE related stuff. ICE brought in people that they had abducted or that they were detaining. There was even a case where they brought a guy to the hospital, and they tried to say that he ran headfirst into a wall on his own. Not surprisingly, the nurses had to dispute that claim because it&#8217;s completely nonsensical, as he had multiple blunt force trauma to his head. Health workers on the front-line have to deal with these things, which results in a collective politicisation. I&#8217;m a certified public health nurse. I keep saying that ICE has caused a public health crisis. We got people that haven&#8217;t left their house in weeks, people hiding out, people not going to school, not going to work.
The general strike against ICE
On the 23rd of January we had a general local strike. On that day 700 businesses closed. These were many small businesses that closed because their employees weren&#8217;t going to come to work or because they only had a couple employees or no employees and they wanted to show support. There were 80,000 people in downtown Minneapolis that would have been working that day. That was a pretty significant number. A lot of people have said that it wasn&#8217;t really a general strike because the trade unions were not going on strike. There&#8217;s some truth to that. Unfortunately, we&#8217;re going to have to work with the conditions of American labour laws. So yes, the local transport didn’t shut down, though many people called in sick. And the bigger warehouses kept operating. But there&#8217;s a lot of people that are getting a political education, right now, every single day. ICE and the resistance against it has definitely been a point of conversation everywhere. They see that we are having a fascist government.
One of the outcomes of the general strike against ICE is a workers&#8217; assembly. It&#8217;s been organized by a number of organizations. We&#8217;ve had these worker assemblies before in the past, but I think potentially we have so many new people coming in. Some unions are backing the assembly, like the Communication Workers of America, which is headed by a strong, long time Minnesota activist and organiser. We have the Minneapolis Federation of Educators. We got the DSA. There&#8217;s a worker solidarity circle. And the Health Care Workers for Palestine. Building these connections within different healthcare organisations, between nurses and the support staff and between different sectors is going to be hugely important. 
This workers’ assembly took place and gathered together 400 workers. Some who are activists in their unions, some who are not in unions, and many who are in political organizations like The Democratic Socialists of America or Black Cat Workers Collective. Discussion was concerned the signing on to an upcoming rent strike being called by tenants organizations and one resolution calling for a “February 27th: Mass Day of Action for Eviction Moratorium.” One resolution that passed was for supporting a “National Day of Solidarity and Care for our Youth” as well as a resolution to endorse National Day of Action on May 1st called by the May Day Strong coalition and to organize for May 1st: No Work, No School, No Shopping in our unions, workplaces and communities. 
<a href="https://docs.google.com/document/d/1JQkoHyASQMjm3xpqw4ziUU4GDqntWzSlmOqhpjIxdng/edit?usp=sharing">Here</a> also are the links to the workers assembly packet of information that was made available before the assembly and shared with those who attended. And the <a href="https://docs.google.com/document/d/1Cq06MIPmwSFojk_HrisbQslrxkp-G7qDrdj5WsFgrC0/edit?usp=sharing">minutes</a> from that meeting.
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Report from a nurse in Minneapolis

We document a letter that we have received from a doctor in Spain. He explains why he decided not to join a local strike of doctors. In general we are supportive of collective actions of fellow workers, but we have to analyse whether a particular collective action strengthens or weakens the solidarity amongst the wider workforce and whether its goal contributes to or hampers the development of class unity.
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Good evening friends and colleagues at Vital Signs,
I am writing from Spain. I am a Resident Physician in Internal Medicine at a tertiary hospital in Spain. The reason for my email to you is to present, through some points, my position regarding the medical strikes that have been happening for the past few months.
I want to emphasize that my position is based on class consciousness (not caste) with internationalist principles; in short, a (materialist) class analysis of the medical strike in Spain. I would appreciate your comments and contributions regarding my point of view. A big hug, always fraternal, supportive, and internationalist.
MY POSITION ON THE NEW STRIKE
 This week another strike begins. It&#8217;s called by the same old players: unions that have long proven their function is not the victory of the working class, but the management of discontent so that nothing structural changes. I won&#8217;t attend. And it&#8217;s not due to lack of awareness of the problem — quite the opposite, that&#8217;s precisely why I&#8217;m not going — but due to an excess of class consciousness.
<ol>
<li> I won&#8217;t walk hand-in-hand with reformist unionism</li>
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CCOO, UGT, SMA, CESM, and the corporate medical unions have spent decades showing that their role is to mediate between capital and labor in order to stabilize exploitation. They call 24 or 48-hour strikes, knowing full well that:
<ul>
<li style="font-weight: 400;" aria-level="1">Minimum services guarantee the system doesn&#8217;t stop. &#8220;Negotiating pressure&#8221; is an empty ritual.</li>
<li style="font-weight: 400;" aria-level="1">The result will be, as always, some crumbs they&#8217;ll present as a &#8220;historic victory&#8221; while the pillars of the system (disguised 24-hour shifts, MIR precarity, division between categories) remain intact.</li>
</ul>
I won&#8217;t participate in that theater. A strike that is born conditioned by its own conveners isn&#8217;t a strike: it&#8217;s a mechanism for deactivating collective anger.
<ol start="2">
<li> I won&#8217;t play into the hands of the right and far-right</li>
</ol>
Vox and the PP have openly positioned themselves in favor of this strike. Not because they care about public healthcare — which they&#8217;ve systematically cut and privatized — but because they&#8217;ve seen an opportunity to:
<ul>
<li style="font-weight: 400;" aria-level="1">Fish for votes among a discontented group with high symbolic mobilization capacity.</li>
<li style="font-weight: 400;" aria-level="1">Pit the medical collective against the Government, even though that same Government is just one face of the same capitalist system they defend.</li>
<li style="font-weight: 400;" aria-level="1">Use legitimate discontent to fuel their narrative of confrontation and their reactionary project.</li>
<li style="font-weight: 400;" aria-level="1">Any strike that has Vox and the PP as natural allies is a contaminated strike. Not because the conveners are fascists, but because their struggle, being exclusively corporate and isolated, can be easily co-opted by the right for their own ends. And that, for a conscious worker, is unacceptable.</li>
</ul>
<ol start="3">
<li> Cheap political opportunism stinks from a mile away</li>
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When you see Vox and PP leaders posing with medical unionists, when you hear their speeches about &#8220;defending professionals against the ideological government,&#8221; it stinks. It stinks of partisan use of workers&#8217; pain. Their goal isn&#8217;t to improve public healthcare, but to weaken the government to advance their agenda of cuts, centralization, and exclusion. And there are unions willing to play that game just to maintain their share of power.
<ol start="4">
<li> So what to do?</li>
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Not joining this strike doesn&#8217;t mean folding your arms. It means:
<ul>
<li style="font-weight: 400;" aria-level="1">Explaining to colleagues why this strike won&#8217;t change anything.</li>
<li style="font-weight: 400;" aria-level="1">Building organization from below: assemblies in healthcare centers, real debates about our conditions, alliances with other healthcare workers (nurses, nursing assistants, orderlies) and with social movements defending public healthcare.</li>
<li style="font-weight: 400;" aria-level="1">Preparing the ground for when discontent erupts again — and it will — but this time without intermediaries, with an organization that can&#8217;t be co-opted by union bureaucracy or the right.</li>
</ul>
<ol start="5">
<li> The context they hide: capitalist crisis and counter-revolution</li>
</ol>
To understand why these reformist struggles are a dead end, we have to look beyond the healthcare sector. Global capitalism is going through a structural crisis (overproduction, tendency of the rate of profit to fall, exhaustion of the long expansionary cycle). This isn&#8217;t just another recession: it&#8217;s the manifestation of the historical limits of the capitalist mode of production. The ruling class&#8217;s response across Europe is preventive counter-revolution: cutting rights, generalized precarity, strengthening the police state, and pushing the far right as a battering ram to break the last dikes of working-class resistance.
In this context, reformist and corporate &#8220;strikes&#8221; play a tragic role:
<ul>
<li style="font-weight: 400;" aria-level="1">There is and will be no revolutionary rupture from this perspective, because their leaders don&#8217;t even contemplate it.</li>
<li style="font-weight: 400;" aria-level="1">But there&#8217;s no revolutionary defeatism either: they don&#8217;t assume the only way out is direct confrontation with the system, and so their &#8220;defeats&#8221; (the crumbs they achieve) become lessons in powerlessness for the class: &#8220;strikes don&#8217;t work,&#8221; &#8220;better to negotiate,&#8221; &#8220;every man for himself.&#8221;</li>
</ul>
This combination is lethal. On one hand, they deactivate any possibility of working-class offensive at a time of crisis when capital is weakened but united. On the other, by not proposing a revolutionary alternative, they leave the class ideologically disarmed, paving the way for frustration to lead to individualism or, worse, to reactionary solutions (like supporting the far right that promises &#8220;order&#8221; and &#8220;privileges&#8221; for some). 
That&#8217;s why this strike is a double trap:
<ul>
<li style="font-weight: 400;" aria-level="1">For those who believe in it: it teaches them you can&#8217;t win, when in reality what can&#8217;t win is this way of fighting.</li>
<li style="font-weight: 400;" aria-level="1">For those who ignore it: if we don&#8217;t build an alternative, its failure becomes ours.</li>
</ul>
The only consistent response in this period of crisis and counter-revolution is twofold: 
a). Relentlessly point out the limits of these reformist struggles, showing they&#8217;re functional to the system they claim to fight.
b). Build revolutionary organization that, starting from concrete struggles, elevates them toward a horizon of rupture: the abolition of wage labor, workers&#8217; control of production, healthcare as an unconditional right and not a commodity. 
<ol start="6">
<li> Conclusion</li>
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I won&#8217;t join this strike because it&#8217;s not my strike. It&#8217;s the strike of reformist unionism that has brought us to where we are. It&#8217;s the strike applauded by the right that wants us precarious. It&#8217;s the strike that doesn&#8217;t unite all healthcare workers, but divides them. And it&#8217;s, above all, a strike that ignores the historical moment we live in: a moment where patches are no longer enough, where capitalism shows its cruelest face, and where the only way out is the revolutionary organization of the working class. 
I&#8217;ll keep fighting, but outside their theater. Building something that can truly be called workers&#8217; power.
 
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Film – General strike of health workers in Italy, November 2024

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Report from a nurse in Minneapolis

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