We translated this discussion paper from comrades in Germany. It first summarises the historic European nurses’ movements of the late 1980s. This is followed by an assessment of the inner dynamics and limitations of the movement. The comrades then look self-critically at their own political interventions in the movement and their initiatives since then. The text concludes with thoughts on the general global development of the health industry. If you want to dive deeper into the subject you can read this interview with a nursing comrade. A longer text on the French movement in 1989/90 can be found here.

The movement 

Even before the mid-1980s, there had been militant mobilisations in hospitals – but the broad Western European movement since the mid-1980s represents a new stage in terms of both quantity and quality. 

In the second half of the 1980s, a movement developed throughout Western Europe in the care sector, with France as a focus. There had been precursors since the mid-1980s and often the first workers who took the initiative were not from the ‘central professional groups’, the nurses, who were central in terms of numbers. It was rather groups like trainees protesting against low trainee wages, or students and auxiliary health workers, who were fighting for better contracts and wages. But from 1987 onwards, there was a European chain reaction. It began in England as early as February 1987, reached its peak in France in the summer/autumn of 1988 (in terms of the momentum of the movement, but also organisationally with the new, so-called ‘coordination’ of struggling workers), and began in Germany at the end of 1988, as well as in Belgium, the Netherlands and Italy. 

• England in 1988/89 

‘The first nationwide strike in the NHS, led by nurses…’ In England, this was already the fourth cycle of struggle after 1972/73, 1979 and 1982. By 1979 at the latest, when the Thatcher government came to power, the focus was on the financing of the NHS, funding cuts and privatisation. The tax-funded NHS became a battleground between the state and the workers (solidarity strikes and picket lines in ‘both directions’: miners and car workers in front of hospitals – health workers in front of mines and car factories). 

At the end of 1988, almost 50 per cent of NHS workers were nurses, numbering almost 600,000. Half of them were members of the RCN (Royal College of Nursing), which was partly a trade union (at that time with an anti-strike statute) and partly a professional association, while 250,000 were members of the two more traditional trade unions, NUPE and COHSE. Forty-three per cent of nurses are so-called fully trained registered nurses. Seventeen per cent were enrolled nurses with shorter training, 24 per cent were assistants, and 16 per cent were in training. Wages were poor, with 40 per cent of the total workforce earning what was officially deemed a ‘low wage’ at the time. Registered nurses with 10 years’ experience earned the starting wages of firefighters or police officers. At the end of the 1980s, a quarter of the positions were reportedly vacant. 

The Thatcher government had introduced a kind of automatic wage adjustment system in 1982, which was supposed to compensate for inflation, but which was not implemented several times in the following years. This system was introduced ‘in exchange’ for a ban on strikes. Despite this ban, in January 1988 there was a 24-hour wildcat strike in Manchester by 26 registered nurses and 11 auxiliary nurses. The specific reason for this was the government’s proposal to combine the improvements in the pay structure proposed by the trade unions, based on criteria such as qualifications and professional experience, with the abolition of special allowances (e.g. for night shifts). In the days that followed, there were protests across the country, with demonstrations at almost 40 clinics in London. In February 1988, 3,000 people demonstrated in London and besieged Parliament, with 6,000 nurses nationwide reportedly taking part in protests. In the weeks that follow, there are repeated ‘work-to-rule’ actions and rolling ‘two-hour strikes’ in various London hospitals. In March 1988, there was a nationwide day of action, with a demonstration in London involving almost 100,000 people and over 50,000 in Glasgow. The unions had demanded a 20 per cent pay rise, and after the mobilisations, the government agreed to an average of 15.3 per cent, with large variations depending on status, experience, qualifications, etc. The higher pay was therefore linked to the nurses’ demand for better recognition of experience and qualifications (new clinical grading structure). The bottom line was that for most nurses, the agreed outcome meant that they still earned less than comparable professions. And it meant cementing new divisions according to ‘qualification’ without any certainty that the higher pay would actually be implemented in an environment of budget cuts in the NHS. Working conditions and staffing levels were not addressed at all. When the consequences of the agreements leaked out during the course of the year, isolated protests broke out again at the end of 1988. 

In winter 2022/23, there were widespread, nationwide nurses’ strikes and protests for the first time after more than thirty years. Only the RCN, which had become dominant and was still closely associated with registered nurses, achieved the necessary turnout in the strike votes. Otherwise, mobilisation was hampered by trade union disputes and the emergency staffing requirements (‘derigation’) imposed by the RCN and employers during the strikes. Wage increases remained well below inflation. In December 2024, there were further strikes in the NHS, this time by porters, cleaners and kitchen workers – mostly in outsourced/privatised companies. Often with the demand ‘to bring them back inhouse’. Average nurses’ wages in the NHS remain significantly below German wages. 

• France 

‘There were five, now there are thousands…’ In France, as later in Germany, the nursing crisis was initially declared from the state institutions and attempts were made by workers to organise a response. In 1988, similar to England, France had 300,000 ‘qualified nurses’, 200,000 auxiliary nurses and 125,000 nursing assistants, but only 5 per cent were unionised. In 1987, UNASIF was founded as an umbrella organisation of professional associations, dominated by the management structures of clinics and schools. In March 1988, a demonstration with 3,000 people took place in Paris. That same evening, a group of nurses drew up demands and made initial contact lists. Two days later, a handful of nurses from various Parisian hospitals met, which was something like the beginning of coordination. Leaflets were distributed in hospitals, a meeting with 80 people from the Paris region took place in April, further contacts were made during the summer break, a plenary meeting with 500 people was held in September – and at the end of September 1988, a demonstration with over 20,000 nurses was followed by a plenary meeting with 2,000 people. In mid-October, the largest nationwide demonstration took place in Paris with 100,000 people. Prior to this, the first nationwide coordination meeting had taken place at the Sorbonne, with 9,000 delegates from 400 hospitals and 48 cities. The trade unions were pushed to the back in the demonstrations, and there were repeated physical clashes between the trade unions and the coordination group. Politically, the trade unions criticised the corporatism of the nurses (‘focusing their demands primarily on their own professional group’), while at the same time negotiating with the Minister of Health. The Minister did not allow the coordination group to participate in the negotiations, but repeatedly ‘received’ them. 

At the end of October 1988, the unions sign the government’s proposals: the Barzach decree (relaxation of the selection process at schools, previously A-levels) is withdrawn; after 20 years of service as a nurse the transition to the medical profession is possible; 50 per cent payment for strike days; 500 francs wage increase; people reach the highest pay band in terms of seniority after 17 instead of 24 years; new co-management structures are established. 

In the weeks that followed, there were regional demonstrations, with another 30,000 in Paris (‘Health concerns us all’). In November 1988, the Coordination decided to found a legally recognised association and to organise a Europe-wide demonstration for the  1st of May 1989. The ‘original cell’ of the coordination group (Il-de-France) is unable to push through proposals for a ‘more militant’ approach. At the end of 1991, there were mobilisations against a health reform (introduction of ‘flat rate payments per treatment’ and strict budgets, centralisation of care in large hospitals, privatisation, reduction in the number of beds, etc.). Three trade unions emerged from the coordination, two of which exclusively organise nurses and the CRC-health, a section of the CFDT trade union. In contrast to 1988, when the conditions of one professional group dominated, everyone was affected by the consequences of the ‘reform’, but at the political level, there is no unification of the struggles against a ‘reform project’. The government was responding with different offers for the different trade unions/professional groups. Only nurses were receiving additional financial bonuses and were promised the creation of 5,000 new jobs. 

• Germany  

‘500 DM for everyone…’ This was the almost universal demand of the assemblies that sprang up in many cities in Germany in 1988/89. In Germany, there were 320,000 full-time nurses positions in hospitals in 1990. After reaching a low of less than 300,000 in 2007, the figure increased to 391,000 in 2023. During this period, approximately a quarter of hospital beds have been cut, while at the same time the number of patient cases has increased by a quarter (with a drastic fall during Corona) and the length of patient hospital stay has halved. 

However, it all started in 1985/86 when trainees took action against cuts in trainee wages. In the summer of 1988, the nursing crisis was declared from above, the ÖTV (public sector trade union) held its first demonstrations, with 10,000 people in Munich in November 1988, and in December with 8,000 people in Essen, coming from North Rhine-Westphalia alone. In March 1989, with the support of the DBFK professional association and many hospital, school and nursing service managers, 20,000 people were mobilised nationwide in Dortmund’s Westfalenhalle. At the same time, the first independent assemblies were formed, some with and often without trade unions. In many cities, assembly structures were formed, some of which existed for months and often attracted around a hundred people from the outset. In the spring of 1989, these structures gave rise to nationwide demonstrations. In May 1989, over 50,000 people took part in the ÖTV warning strike. The result was a collective agreement with a 10 per cent wage increase, linked to shift models and night shift hours. At the time, we wrote that only a minority would receive this. In retrospect, this was inaccurate: most ‘normal’ colleagues will have met the conditions (three shifts and at least four nights per month) and thus also received the 10 per cent increase. A good portion of the (political) activists, who tended to work less and/or part-time, did not meet these conditions. After the collective agreement was concluded in the summer of 1989, the independent assemblies slowly ran out of steam. The groups that were more firmly established in the companies often ended up in skirmishes with management over the implementation of the collective agreement, and in isolated cases there were still ‘work-to-rule’ weeks, for example in Kiel. The groups that tended to operate outside the clinics were unable to maintain the ‘momentum of the movement’. 

In the 1990s, the number of nursing staff was initially increased significantly through a statutory regulation. This regulation was then abolished towards the end of the 1990s, not coincidentally almost parallel to the introduction of a new health care insurance system. Staff reductions began at the end of the 1990s and intensified after the introduction of a flat-rate payment per case system in 2004. In 2005, another reform of the collective contract system took place, resulting in a patchwork quilt of various collective contracts in the health sector: some hospital workers are part of the federal public sector contract, others of the municipal contract, others have in-house collective agreements and there are now many hospital companies without collective agreements due to increasing privatisation. 

Broader mobilisation began again around 2015 with the (organiser) campaigns for relief collective agreements by Ver.di trade union. At the end of 2024, an article in the Badische Zeitung examined wages in the social professions in comparison with other skilled workers in Baden-Württemberg: Between 2013 and 2023, the median wages of skilled professions rose by 27 per cent, with nursing professions at the top with a 36 per cent increase and metalworking at the bottom with 22 per cent. Did ‘trade union consciousness’ make it possible to significantly increase wages (for some of the workforce in hospitals!) without being able to take action on the ‘second front’, which we called the ‘white factory’ at the time, meaning, the intensification of work, the segmentation into different jobs, the ‘industrialisation’ of care?! 

 

Inner cohesion and limits of the movement 

The women’s movement

The nurses’ movement cannot be understood without the ‘second women’s movement’, the second wave feminism that preceded it. In terms of class politics, the industrialisation of reproductive work meant better conditions for struggle, ‘wages for reproductive work’. 

Profession and/or proletarianisation!? 

The myth of ‘fulfilling work with people’ no longer appealed to these women, especially when it was used to justify round-the-clock drudgery for low wages. At the same time, from the end of the 1970s onwards, work on the wards required a mix of cleaning/washing and a thousand other things, plus increasingly ‘technological medical activities’. The movements were led by young, well-educated women who no longer accepted that wages and social recognition were based primarily on cleaning and washing. 

Strike experiences?

Because working conditions and wages were compared with those of other workers, nurses also took their cue from the latter’s forms of struggle, which is why the question of strikes was often at the centre of discussions. When people talk or talked about ‘strikes’, this concealed extremely confusing activities: sometimes it meant protests, sometimes actual strikes in operating theatres and wards on ‘emergency staffing’ levels, which were often no worse than during normal non-strike days. There were also ‘work-to-rule weeks’ in which medical and/or administrative work was left undone. Strike participation in clinics was often high because many nurses attended the pickets who were officially  ‘off duty’. In 2016, Ver.di trade union, together with external organisers, developed the strategy of ‘patient strike-outs’: which basically means, that wards are ‘emptied’ over a period of two to three weeks after handing in a strike notice and coming to an agreement with the hospital management. During this period no new patients are admitted and patients are transferred to other wards. Is this a ‘strike’?

Nurses or health workers?

Initially, in all countries, professional nurses’ associations played an important role. This situation formed the basis of the so-called corporatism of the nurses’ movements. For example, nurses in France felt it was a further demotion when the entry requirements for training were to be lowered due to staff shortages. At the same time, they did not see this as a way of distinguishing themselves from others: on the contrary, they saw it as an attempt to stand up for uniformly well-trained, universally deployable nursing care – against attempts to divide this work into subgroups (which has now become a reality). In England, many workers saw the NHS as ‘their health service’, which seems to facilitate joint struggles with other group of health workers. In France, other professional groups also established their own coordinations, and there were repeated debates about merging them, but in the end they remained separate. In Germany, it remained most clearly a ‘nurses only’ movement. 

The ‘white factory’

However, the movement also polemicised against the hospital becoming a ‘white factory’. We always wanted to emphasise the aspect of cooperation between different groups of hospital workers (cleaners, porters, nurses etc.), or rather the potential opportunities for struggle that this offered – and not the ‘moral’ aspect of the hospital becoming a factory. This was never successful, or at most only in the area of the wards, which is why we used the term ‘ward staff’ to describe those who worked together to get the work done and could therefore also fight together. Within the movement, however, the nurses emphasised their particular ‘accumulation of functions’ in this context: cleaning, washing, caring, telephoning, organising, nursing, giving injections… 

We can say that the movement failed on this second front, against the ‘white factory’ – or rather, it failed to turn the cooperation within the ‘white factory’ into a basis for joint struggle. Looking back from today’s perspective, it can be said that demands such as those for ‘better care’ could be used by management to enforce measures of restructuring – for example, with quality certificates or new industrial standards. These could be used to intensify work in hospitals and enforce new hierarchies. The reference to one’s particular profession became both, a means of avoiding certain tasks and a means of enforcing better wages.  

The meetings

The meetings in Germany could be roughly divided into two categories: a) meetings initiated by groups that were reasonably well established in the hospital and which at least attempted to link the mobilisation back to the workplace; and b) meetings that consisted of ‘dissatisfied’ individuals from different care homes or clinics. Here, the dynamic of a movement often developed (too quickly?) without reflecting on the actual isolation of people in the workplace. 

 

What we tried to do politically and organisationally 

By the mid-1980s at the latest, the (‘partially autonomous’) movement in Freiburg was in decline, especially the squatters movement. In contact with Operaism and the collective Wildcat, a group formed that, guided by the concepts and ideas of militant investigation, focused on the University Hospital of Freiburg – the so-called ‘clinic group’. I myself joined shortly after beginning my nursing training. Previously, I had been part of the jobber scene, and after the fire at the autonomous social centre AZ in 1985, I was part of a group that attempted to reoccupy the building several times and was also involved in other activities, such as the anti-nuclear protests at Wackersdorf or against the construction of a new runway, the so-called Startbahn protests. For the ‘clinic group,’ doing jobs in the hospital kitchen, in the laboratory, at the gate, in community service, in nursing training, as a guard on the ward… were the basis for working together. 

The ‘Anti-NATO Group’ had circulated a paper to the Freiburg left around 1986. The aim was to respond to the incipient crisis of the ‘autonomous left’ and to prevent that the scene would lose its revolutionary aspirations. Essentially, the proposal consisted of an alliance of existing groups (Schwarze Katze (anarcho-syndicalists, renters union, prison support group etc.). 

The ‘clinic group’ criticised this ‘organisational solution’ of the proposal, because we thought that merely networking left-wing activities that lacked an actual base or roots was too superficial. Instead, we suggested taking a step back and examining the wider social reality that we were facing at work and beyond. Ergo, we wanted to first launch the concept of such an inquiry at the clinic, and at a later date, when there actually was something to network, the proposal of the ‘Anti-NATO Group’ could be discussed again.  

After the class composition of the region had been examined in a ‘regional analysis’, papers on the cooperation in the various areas of the hospital (kitchen, laboratory, nursing) were drawn up. However, the decisive factor was the momentum of the Europe-wide mobilisation of nurses at the time. This experience was later used by organising an event with a colleague from France, which translated into a broad leaflet campaign within the local health sector. To the surprise of all of us at the time, around a hundred colleagues from different care homes and clinics attended the first meeting. This structure remained active until the early 1990s. Leaflets and campaigns against the so-called Second Gulf War were the last actions of the group, at least for a while. In between, there were various experiences in many cities, regional and national meetings. These meetings were dominated by ‘movement-oriented’ groups, and there were only a few attempts to be active ‘at work’ in the hospital directly. The bottom line was that we had more discussions within the left than with our colleagues. This was due to the dynamics of the nurses’ movement, which collapsed relatively quickly after the demonstrations and the ÖTV (public sector union) warning strike at the end of 1989.  

“Just as the factory, as the most developed point of productive cooperation, enables the highest rates of surplus value, so too does the hospital allow for the most rational production of ‘health’” (Wildcat 44 1988). 

Fruitful as a hypothesis, this claim above was not critically examined in the course of events. Today, it seems to me that cooperation is indeed something else. In the factory, the workers’ knowledge is expropriated, but it is recognisable to the workers in the ‘new machine’. In the hospital, on the contrary, it seems to me that the ‘knowledge gap’ between nursing and medicine/doctors is growing ever wider. There is collaboration between cleaners, nurses and doctors, but is there cooperation!? The hospital is not a factory. Ultimately, it remains a service, one treatment after or next to another. On one hand, it is clear that a hospital only functions with nursing, doctors, technical services, the kitchen, laboratories etc.. On the other hand, work in the hospital happens more ‘together’, rather than in actual cooperation. 

The impact of the German reunification in 1989 on the nurses’ movement remain unclear to me. On the one hand, it is clear that this event overshadowed everything else (e.g. the important Berlin nursery strike at the time!), but on the other hand, the gatherings and political debates in the hospitals had already subsided significantly. The reunification primarily had an effect on the political left. Quite a few people from the movements of the 1980s had ended up working in social or care services, where they played a role with their experience. But after 1990, after the nurses’ movement and the ‘Wende’ (reunification), for many people their jobs actually became their career (studies, further training…), and with the national reunification, the political focus shifted even further away from class struggles. 

Against the backdrop of the movement at the time, organising itself was not difficult, but we never talked about building an ‘organisation’. The gap between movement and revolution wasn’t an explicit topic. If anything, the topic only came up in discussions with the left, who often asked what the point of it all was (‘Yes, great, women, nurses, healthcare, super important, but what does that have to do with revolution…?’). Otherwise, we thought, or rather just did: expand, grow, build a network of activists… start at the ‘right points’. 

All attempts in the years and decades that followed to start new initiatives remained minoritarian. Many former activists had withdrawn from politics or had joined the trade union Ver.di. After 2010, in response to the effects of DRGs and increasing privatisation, new ‘independent workplace groups’ emerged in various cities, mostly consisting of individuals. A supraregional discussion did not get off the ground, and most of these groups are now Ver.di workplace groups. 

From around 2015 onwards, there has been a (strike) movement in large hospitals around the so-called relief collective agreements (better staffing ratios). In 2020, nursing care will be removed from the flat-rate payments, which simply means that additional nursing staff will be financed by the health insurance funds. The care budget set up for this purpose has been increasing year on year since 2020, which is one reason for rising health insurance contributions. One could say that private hospitals are hiring more staff, or ‘producing more’, financed ‘by us’ – see below. 

Between 2019 and 2023, the number of nursing staff in hospitals in Germany grew by 13.5 per cent (6.5 per cent in the health sector overall). The patient case numbers from 2019 will no longer be achieved, which causes hospital reform strategists to lament about the decline in productivity and to say that the labour market has become an ‘employee’s market’. The ‘reformers’ want to change this with hospital reform and outpatient care: fewer centralised hospitals and the development of an outpatient sector that is largely private. The nursing budget introduced by Spahn is to be abolished. This budget is a form of cost recovery for hospitals’ nursing costs, as health insurance companies have to finance additional nursing positions and the extra costs due to wage increases from collective agreements. ‘Those who reimburse costs instead of results will always incur more costs,’ complain the reformers. In fact, the care budget has risen by 10 per cent annually since 2020. At the same time, the ‘relief movement’, which was able to secure higher wages and better conditions (primarily for nurses) in perhaps 25 large hospitals, seems now to be over or at least beyond its peak. We have to prepare for broad attacks. Whether we will be able to counter these attacks in the hospital sector/healthcare system in terms of class politics seems unclear, to say the least. 

 

Healthcare industry 

“The three rent-based industries and ‘oligarchic groups’ insurance/real estate/finance (FIRE), military complex (MIK) and gas/oil/mining (OGAM) dominate today’s ‘post-industrial financial capitalism’. They derive their profits/rents from the privatisation of healthcare, education, transport, mass media…” (according to Hudson). 

The share of healthcare expenditure in GDP has risen continuously almost everywhere, only Corona was a qualitative leap. According to the WHO, the share is around six per cent in middle-income countries, seven per cent in low-income countries and over ten per cent in high-income countries. 

The strongest growth within the OECD countries was recorded in the United States, where the share rose to 17.5 per cent in 2023 – up from 8 per cent in 1980. In Germany, the figure is 12.8 per cent in 2020, compared to 8 per cent in 1980. In Switzerland, the figure is 11.9 per cent in 2020, compared to 6.4 per cent in 1980; in the UK, it is 12.2 per cent in 2020, compared to 5.1 per cent in 1980; and in France, it is 12.1 per cent in 2020, compared to 6.9 per cent in 1980. In the USA, a ‘hospital industry’ has been developing since the 1980s. Historic turning points were the failure to introduce statutory national health insurance after the Second World War and concepts such as managed care/health maintenance organisations, which are ultimately special forms of a private insurance system. 

Since the 1970s, the differences between ‘profit/not-for-profit’ clinics have been disappearing and capital intensity has been increasing: one study speaks of a 40 per cent increase between 2000 and 2010, compared to approximately 20 per cent in the economy as a whole. Specifically, in the USA, for example, there are over 25 MRI machines per million people – in the OECD, the figure is 11. The same study reports a net/real increase in capital stock per worker from $25,000 in 1980 to over $80,000 in 2010. Obamacare is throwing even more money into the market via private insurance companies and, as a result, via private co-payments due to insufficient policy benefits. 

In Germany, in addition to the ‘classic areas’ of medical technology, pharmaceutical medicine and the relatively new areas related to the fitness industry, the privatisation of clinics and nursing homes is booming. Almost 40 per cent of hospitals (though not in terms of number of beds) are private, and with over 40 per cent, Germany has the highest proportion of private nursing homes in Europe, with rapidly increasing activity from private equity companies. The German mix of an ageing population and solid tax and social security financing is considered a good investment environment. Investors in the healthcare industry talk about ‘defensive growth’: over the last 20 years, for example, the MSCI World Health Care Index has grown by 11 per cent, comparable indices for information technology are already at 18 per cent. However, while the IT sector has slumped by as much as 60 per cent at points, the Health Index has only fallen by up to 13 per cent. 

In Germany, the first healthcare industry conference was held in 2005, and a ‘health satellite account’ has been set up within the national accounts for GDP since 2009. Roughly summarised, all the figures in this account are on the rise: more spending, more money in the system, increasing share of GDP, more jobs, more patient cases in hospitals, ever higher private (additional) payments, more fitness chains, more medicines, more profits. 

In the health sector, many capitalist companies make profits, for others it is costs mediated by the state. For the capitalist state itself it is politically contested costs for the reproduction of the working class. The ‘objective’ challenges arising from these contradictions had been on the table since at least the mid-1980s. We denounced the slogan of ‘cost containment in healthcare’ as propagandistic groundwork for the expansion/privatisation of the healthcare sector: new forms of productive work, ‘health’ is to be consumed and ‘purchased’, while at the same time the reproduction costs of the workforce are not to rise. In Germany, this is the debate about social labour costs, or rather about expenditure on statutory health insurance (GKV). GKV expenditure remained below 7 per cent of GDP for decades, reaching 7.3 per cent shortly before the coronavirus pandemic. In absolute terms, it has risen from €180 billion in 2013 to over €240 billion in 2023. Since the first ‘Cost Containment Act’ in the mid-1970s, these contribution rates have been repeatedly adjusted, the GKV’s catalogue of services reduced and co-payments introduced. Nevertheless, cross-financing from the overall budget is rising steadily (from €14.5 billion in 2019 to €21.5 billion in 2022). 

Movement against the healthcare industry?! 

In addition to these ‘objective’ challenges, ‘subjective challenges’ have also been on the table since the mid-1980s. At the time, the looming ‘structural reform’ was simultaneously confronted with a new subjectivity, a wave of struggle. Even during the first mobilisations, the necessary questions arose: can the struggles become a catalyst for further class struggles or will it remain a ‘nurses’ movement’? With our initiative back then we had tried to ‘pack everything together’: we mobilised in retirement homes, nursing homes, clinics, company canteens etc.. In working groups we discussed subjective problems ‘at work’ and wages, but also about the division of labour in the health care system, strikes and the concept of illness. When the university hospital was to be ‘half-privatised’, we focused on ‘worker power in the workplace’ in our leaflets, because this was the only way to actually prevent the change in legal form, and because we didn’t care what the boss’s name was. Too purist an approach, but what would have been the alternative, more ‘organisation’!? What could that have meant!?