Bulletin of the BR No.12: Resume the Offensive Within the Hospitals, Work for All, Less Work, For the Proletarian Right to Health

 

March 1981

Today assessing the situation in our sector, in order to reorganize and give force and continuity to the antagonism expressed in the past, means first to analyse recent years and in so doing, coming to grips with those aspects which have resulted in difficulties and setbacks in the development of antagonistic proletarian organizations and struggles.

To make a pretence of ignoring, for example, the brutal offensive which the state and the bosses are waging against the conditions of life and organization for the entire proletariat (the most recent examples are the 24000 in casa integrazione at Fiat and the periodic campaigns of extermination against every form of dissent) is tantamount to cutting the legs before beginning to walk.

The bourgeoisie is compelled to plug the holes in a system of production rendered ever more fragile by a crisis which has now assumed a constant and irreversible character. In this breathless run it must nip in the bud and even before they manifest, every expression of the most basic proletarian needs.

This attack has two fundamental components: the weapons of mobility and militarization.

Mobility is to be understood as an instrument for the division and dismemberment of the composition of the class not simply the more efficient use of labour power for productive objectives. In the plans of the bosses we function as “transients” and we must be ever more available and flexible, ready to move anywhere and most of all docile facing the application of this instrument which constitutes the obstacle to the actualization of class unity: the pulverization of autonomous proletarian organization.

But if mobility becomes the means to increase proletarian stratification, militarization is the weapon which is intended to annihilate the proletariat and its capacity for struggle.

To grasp that today militarization is the decisive weapon for the imposition of the projects of restructuring, to understand how it has become daily practice and permeated the whole of society, means to take account of a transformed situation, because the margins within which you could delude yourself that the interests of the class could be advanced, the “democratic spaces”, the contradictions within the bourgeoisie, have been transformed or wiped out by the crisis.

Now it is not only we who assert, but reality which demonstrates everyday that the entire bourgeois apparatus is consolidated around a project of political and physical annihilation of the proletariat and its organization.

Taking account of all this therefore means to take a step forward, out of the forced stasis, within which the autonomous organization and antagonistic movement of the class has stagnated in our sector.

In Autumn 1978 the hospitals saw the development of a strong antagonistic movement determined to give battle to what today are the central points of restructuring in the healthcare sector.

Already at that point the government and the unions spoke of the single multipurpose nurse (a jack of all trades robot), of the reestablishment of private medicine and of creating new barriers to adequate medical care for proletarians; in summary they put the finishing touches on the so called healthcare reform.

We the hospital workers immediately gave a very clear response: NO to the robotization of nursing through job combinations (professionality), a substantial increase in base pay (10000 monthly), reduction of the work week to 36 hours, refusal of cuts to the healthcare budget, hiring of new staff and construction of new hospitals.

On these foundations, the autonomous class movement organized the permanent assemblies, an expression of our will to fight to the finish. Internal processions were organized in the departments to prevent the head nurses from intimidating the workers and to hunt scabs, municipal demonstrations were organized culminating in the massive Florence demonstration of 30000.

All the hospital workers remember well the response of the state to the hopes, the needs, the program expressed by our movement: a brutal response which was immediately articulated on the military and political levels.

In all the permanent assemblies there appeared detectives, unionists and police.

The detectives put the most combative workers on file to pass their names to hospital management; the unionists tried to demoralize the workers waging psychological terrorism by predicting immanent police repression; the police broke up the assemblies weapons in hand, chasing the workers all the way into the wards. And finally the judiciary intervened accusing us of aggravated fraud (they really said that!), because timecards were stamped without working, and singled out the names of proletarians in struggle passed to them by the hospital administrations.

The internal processions in the hospitals were confronted with the fixed stationing of armoured cars in the workplaces.

They remember the hospitals in that time: according to the degree of police presence, there were one, two, three or more armoured cars, without counting the entourage of plainclothes cops and DIGOS who dispersed into the alleys and wards to identify moments of propaganda and struggle.

The internal processions were handled in the same way (applicable to all is the example of the procession at the Pio Istituto which was dispersed by the police with extreme and cold blooded violence). Thus, hundreds, thousands of hospital workers were intimidated, monitored and imprisoned.

IN THE HOSPITAL SECTOR THE NEW CONDITIONS WITHIN WHICH THE STRUGGLE MUST BE ABLE TO DEVELOP ARE DECISIVE FOR THE CLASS MOVEMENT

This new phase has two main characteristics:

1: the impossibility in the context of the current structural crisis of capital for the state to make a compromise with the needs, tensions and basic points of a worker program through a policy of reformist integration.

2: the armed intervention of the state in the processes of restructuring as the political opponent of class autonomy and consequently an apparent defiladation of the immediate opponents of the proletarian struggle.

It is in this context and under these changed conditions that the 1978 movement of struggle ran aground, and it is this leap, this necessity for the bourgeoisie of annihilating every proletarian need and interest, of transforming every struggle into a question of “life or death” for capitalism, which still today makes it difficult to retake the initiative and restore strength, maturity and continuity to what was expressed in that cycle of struggle. It is of no use to anyone to nurse the wounds and look nostalgically to the past.

From this, from what it represented, it is necessary to begin from changed conditions, from a project of restructuring which has passed from words to deeds, from relations whose balance has tipped in favour of the bourgeoisie (it is no invention by anyone that over the last two years in the hospitals, the struggle has had a hard time maintaining a degree of continuity and stability).

It no longer makes any sense to continue to assert the correctness of “legal” forms of organization of struggle (as collectives, coordinations and so on). Defending this position means not having understood that when our struggle assumes a definite and concrete form, it is immediately constituted as a struggle which puts the total plan of anti-proletarian restructuring in question.

The imperative for the bourgeoise of annihilating every form of class need and interest becomes a vital necessity for the continued perpetuation of its rule and it exerts its strength to the maximum in order to do this. Those who don’t comprehend this, who don’t grasp that organizational forms which only exist and vegetate in legality accomplish nothing for the proletarian struggle, are opportunist even before they are delusional.

All the most conscious proletarians and class vanguards must act decisively to come to terms with this reality, if they want to be capable of facilitating the rebirth and the renewal of the struggle against restructuring under the prevailing conditions. It is necessary to build a stable organization of struggle, protected as much as possible from the blows of repression, which implements a worker program by all means at the level of the current confrontation and within its relations of force.

It is important not to fall into adventurism, while being aware that the worst adventurism is that of those, who pinned down by repression, want to continue fighting in the old way, as if nothing has happened.

Adventurism is organizing the struggle around certain objectives without adequately preparing the workers for the consequences the implementation of these objectives entail in terms of the struggle for power.

It is the behaviour of those who disseminate slogans which are correct from a strategic standpoint, like the reduction of work hours, without understanding that it is not a question of a simple demand, but of an objective which if implemented in this period puts the current relations of production and power completely into question.

The balance of force between the proletariat in the hospitals on the one hand and the government, the region, the unions, the hospital administrations on the other is not favourable to the former in the current conjuncture; the defeat of 1978 still weighs heavily on all of us, without even taking into account the slow but concrete advance of the project of restructuring.

It is a question of returning to the line of proletarian organization first of all creating the CLANDESTINE RESISTANCE UNITS as a point and network of discussion, organization and struggle around the content of a worker program which decisively settles accounts with the ongoing process of restructuring which had its first major moment of application in the contract signed last June.

We don’t see the CRU as grouplets of “old comrades”, pissed off vanguards of struggle, who after 1978 want to advance the struggle by other means. In this stage of transition to class war, the problem of “means” is not resolved by unilateral substitution but with the rich heritage of proletarian struggle.

We say: proletarians must fight restructuring with all means. The major problem is elsewhere and concerns how to organize the processes of struggle. It is necessary to decisively grasp that the struggle against restructuring and militarization IS A STRUGGLE FOR POWER and not for demands. FOR EXAMPLE WE DON’T DEMAND THE ABOLITION OF OVERTIME, WE MUST BUILD THE STRENGTH AND THE CAPACITY TO IMPOSE IT.

Obviously this changes the mode of fighting and consequently of organizing. We communists in the BR propose that the proletarians in the hospitals organize into CRUs in relation to power as the first stable form of proletarian organization and of permanent class mobilization. Structures which are capable of synthesizing the needs and tensions of the class into programs of struggle, organizing the resumption of the struggle from clandestinity, because today this is the only possible way to fight the processes of restructuring and be prepared to handle the armed repression which these processes require for their implementation.

On the other hand clandestinity doesn’t mean isolation from the masses and sheltering in the defensive as is alleged by those who need an alibi to justify their own opportunism, on the contrary it means having the capacity to represent the immediate and historic interests of the class without opportunistic disguises, all of them intended to avoid enemy reprisal. We have never claimed that clandestinity is a synonym for the untouchability of individual comrades. This conviction held by many proletarians in the past is the poisonous fruit of a kind of idealism and is the product of the counter revolutionary propaganda work of the mass media. In this stage the clandestine forms of proletarian organization, are a necessary and indispensable condition to ensure full autonomy politically and within the struggle to the class organization to be constructed, and not a “solution” which makes the conflict less harsh for proletarians.

And this is the only possible way to recreate that capacity for struggle which the new conditions have destroyed in the old forms of organization. Taking a clandestine character in relation to power means being able to organize and fight for our needs, without being easily identified by the enemy, without running the risk of the struggle being obstructed by the first gusts of repression as in the past, otherwise it will be always and only the bourgeoisie who will determine on what, how and to what point the struggle is waged.

Regroup in the underground, creating a clandestine network of discussion and organization among the hospital workers which is able to relaunch the struggle against anti proletarian restructuring in the hospitals in an effective manner: only in this way can the possibility of struggle be implemented in the new conditions.

ORGANIZE IN RESISTANCE UNITS CLANDESTINE IN RELATION TO POWER, TO FIGHT FOR OUR NEEDS IN THE NEW CONDITIONS.

Comrades, after the season of struggles in 1978, which can be characterized as the first great moment of hospital worker’s resistance to the bosses programs for healthcare policy, and as an expression of their own needs, the process of anti-proletarian restructuring in our sector continues to advance slowly but inexorably. This has its primary cause in the necessity for the bourgeoisie of raising capital for investment in the big multinational enterprises, cutting expenditure in other sectors like health and social service provision to the maximum.

This is the point of departure for the Pandolfi plan when it asserts that cuts to public expenditure, and in our case to healthcare expenditure, are one of the necessary and indispensable conditions for the containment and management of the crisis. It is no longer possible for capital to allocate significant amounts to public health, continuing in the welfare and self legitimization policy which characterized its approach in the expansionary period: it no longer has the option of making its own laws of accumulation compatible with the needs and demands of the proletariat. The Healthcare Reform and the National Healthcare Plan translate this urgent necessity into a real project in the healthcare sector: REDUCING all expenditure and in any case not spending a lira more then was spent in 1977. And this is the philosophy, the watchword which traverses the entire national healthcare plan, a PHILOSOPHY OF IMMISERATION AND ANIHILATION, we call it!

If on the one hand this policy strikes at us, the hospital workers as restructuring, as workplace hazards, as increase of productivity through the intensification of exploitation past the limits of endurance, increasing workload and rhythm and hiring ever fewer staff, more generally but not for all that less concretely, it strikes at the entire proletariat. And actually the necessity of reducing all expenditure in the healthcare sector, conjoined with capital’s viewpoint on health, that is on the cost of a bed, the cost of a sick proletarian, of a drug treatment, of a hospital worker, could not but end up as a policy of genocide towards the proletariat.

-reduction in free services and worsening in quality of those which remain through the freeze on hiring in hospitals and the intensified exploitation of our labour (as we know well in the departments there are no more than one or two nurses for 50, 60, 70 and more patients).

-total freeze on the construction of hospitals and therefore of new beds.

-ever increasing reduction in the chance of entering hospital for “treatment” through the creation of phantom filtration structures (like the day hospitals) which in fact impede recoveries.

-increase in the costs which must covered by patients in drug treatment (with various tickets).

And this is the assistance which the democratic healthcare reform provides.

Closely interconnected with the implementation of these objectives is the official introduction of private medicine (approved in the last contract) and of payment within the hospitals, which aside from rewarding the anti-proletarian zeal of the medical bigshots and increasing their mafia and patronage network power over proletarians in the hospitals, ensures a concrete possibility of treatment only for those who can afford to pay a load of cash. For everyone else, for proletarians, hope for treatment remains only when one is already more dead then alive (and this is clearly shown by the deceased acceptance of admissions).

These are the concrete policies which the bourgeoisie through the Healthcare Reform, the National Healthcare Plan and the Regional Healthcare Plans is implementing, finalizing and carrying out. Its response to the crisis, its attempt to preserve these production relations unaltered rapidly translates into the worsening of our conditions.

To this policy of genocide against the proletariat, from the standpoint of capital, a policy of “limited assistance for a few”, we oppose our standpoint, a need expressed over ten years of struggle.

WE IMPOSE THE PROLETARIAN RIGHT TO HEALTH

When today the words of the triannual Healthcare Plan are beginning to become the reality which can be read in the June contract, we feel them weighing on us more and more everyday within the hospitals. What the bosses, the state and the union bigshots have signed is not just the usual trash contract, but takes the form of a restructuring contract, of a “tactical” program within the comprehensive program of restructuring in healthcare.

It is not just a sellout of the legacy of struggle, a bunch of bullshit as in the past. By virtue of the objectives it contains, it is in the vanguard of advancing the process of anti-proletarian restructuring.

The final goal of the contract is the same as that of the triannual Healthcare Plan: cutting healthcare costs through renewed productivity. In this context the unions are recognized as enforcers of the capitalist programs in all respects (in case this was not yet clear to anyone), articulations of the bourgeoisie within the class with the objective of annihilating and nullifying proletarian consciousness and identity.

Mobility and professionality, the central elements around which the contract is constructed, become the primary means for the containment of healthcare costs through the intensification of exploitation. The Healthcare Plan and even more the contract just signed are explicit in asserting that professionality must be understood as the “necessary modality for the comprehensive restructuring of services” and when they state that the “the adjustment of the workforces can be implemented while keeping a strict connection between the initiative of requalification and workforce expansion.”

IT CAN’T BE CLEARER THAN THIS!!!

The professionality they are seeking to push through now is not as the union jackals claim a condition for the improvement of healthcare services, rather an attempt at the physical and political destruction of the proletariat in the hospitals. We all remember how in the previous period the struggle over tasks [mansionario-contractually specified duties of an employee] was one of the most successful forms of resistance and one which was a great cause of annoyance for administrations compelling a rigidity in their usage of our labour power. It is mainly as a response to this practice of resistance that the bosses and their union flunkies have now started tooting the horn of professionality, promoting as an improvement in care provision, when everyone knows that hospital workers have always performed all the tasks, qualifications or not.

The only difference is that before in moments of struggle, they could rebel, refusing the assemblage of tasks, now “professionalized” with a title, that kind of spontaneity in the conduct of struggle becomes much more difficult. The “professionalized” and “multipurpose” nurse, regulated once and for all in her productive capacity, can and must be moved into every “gap”, anywhere there is a workforce shortage.

In this way the difference between the new professional workers and the old figure of the professional nurse of some years ago becomes very clear. The first are already among the superexploited who endure a huge workload in exchange for a wage incentive which ends up gradually nullified by inflation; the second were the “special cases” [mosche bianche], a quantitatively narrow group assigned to “clean” tasks and in the past, first of all to control and in some cases to command the great mass of dequalified workers.

In the plans of the bosses the “adjustment of the workforce schema” doesn’t mean new hires and the possibility of making shifts more endurable, but entails a reduced personnel which is mobile and “professionalised” and experiences a greater workload and a huge array of assigned tasks. This all amounts to a noteworthy increase in the environmental dangers and the extreme precarity in which we are forced to work.

In fact aside from the dangers of the work in certain sectors like radiology and radiotherapy that remain in first place when it comes to the dangers of hospital work, workplace risk has an increasingly structural character which encompasses all departments and tasks without “privileging” anyone. And this is one of the prices which the bourgeoisie makes us pay to be able to implement the reduction in healthcare and welfare expenditure.

The concrete aspects which everyday affect this situation more and more are known to all proletarians in the hospitals:

A: workload and pace of work

We find ourselves working in wards where the amount of assistance required by those with serious illnesses and in need of treatment is ever increasing while the workforce is cut closer and closer to the bone. Consequently, our constant physical efforts, from the perspective of our own health, over time result in occupational illnesses.

B: absence of materials

The precarious positions in which we are forced to work due to an absence of resources significantly increase the risk of contracting illness: we know very well what it means to perform wound care or clean the ill without gloves or even without the use of appropriate disinfectant, we are familiar because the savings are made at our expense! And this concerns not only our health but also that of proletarians who are already taken ill: in the precarious hygienic situation in which they are held, they most of the time end up contracting other illnesses: intersecting infections are the trend of today!

And this is how the bourgeoisie intends to economise, intensifying exploitation, making us available to be moved anywhere and to once and for all and forever carry out the auxiliary, generic and professional tasks in the wards, defacto obstructing the workforce plan.

The entire discourse of professionality also connects perfectly to that around “dehospitalization” policy. The most clear example of how this is being implemented now is the hospitalization period for surgery patients, previously you would see: 1) a period prior to intervention which consisted of diagnostic investigation; 2) the period of the intervention itself; 3) the post operative period in which the patient was rehabilitated and discharged. Now the first and third period are offloaded to the polyclinics which are considered “filtration structures” (and we know very well the minimal, if not non.  existent levels of assistance these structures offer patients).

The much vaunted “preventative public health policies” which the Healthcare Reform entails translate only into a greater restriction of the already deplorable levels of assistance which were previously guaranteed.

Corresponding to the reduction in the number of admissions and the worsening of the already precarious state of patient services is a progressive reduction in employed staff and requalification (with all the effects this entails for us) in a forced march of hospital workers who can be utilized in the most functional way within this new organization of the health “services” system.

It is obvious how the restructuring within the hospitals on the one hand, and all those economic and political factors which result in worsening living conditions for those of us who work within the hospitals, as well as the broader restructuring of the organization of the healthcare system, with all the effects induced by this in terms of worsened health services for sick proletarians, and the increasing impossibility of decent and free treatment, are two sides of the same coin.

PUT DIFFERENTLY: “PROFESSIONALITY”=GREATER QUALIFICATION OF “MEDICAL SERVICES”!!!

To implement these criminal projects the union-boss apparatus uses the blackmail weapon of a differential wage policy with incentives of a million per annum for requalified nurses, therefore linking professionality to the wage (read still greater exploitation) and thus to workers willingness to spend years of school outside of working hours so as to finally be squeezed harder then lemons.

After we have fought for years for a drastic flattening of the wage scale, as a means towards greater class unity and to satisfy the needs of the entire hospital proletariat, here is the brutal response we are given in the latest contract: increase of wage differentials (by fully two levels) in order to facilitate greater professionality in worker qualifications, which is to say greater exploitation and heavier workloads to which the workers are called to submit. The discourse is crystal clear: if you don’t want to become a superexploited robot, if you want recognition for tasks effectively performed, without undergoing three years of extorted, sacrificed brainwashing in the school of professional requalification, if you reject all this, you will continue to stay at 4^th level starvation wages throughout your natural life.

Professionality and mobility must now be combatted as the worst enemies, as the maximum point of exploitation of the proletariat in the hospitals.

Around these elements which have become the core of the implementation of the restructuring process in the hospitals there rotate an array of aspects and elements which are certainly not of secondary importance: the requalification and professional training schools, the overtime, the introduction of forms of work typical of part time positions etc.

A: the different professional training and requalification schools assume an increasingly significant role within the sectoral programs of restructuring. The forced march “professionalization” of the proletariat in the hospitals from now on has an element of operation and implementation through these schools which actually constitute the mechanism by which the state seeks to repurpose in “productivist” terms which is to say superexploit, the entire hospital proletariat. But as well as having this vital function of selection, ideological and political retardation and control in relation to the hospital proletarians to be qualified, these so called schools make up one of the biggest networks of black labour [lavoro nero] which is available to capital on the national level. The specific planning for these “schools” occurred on the international level in Strasbourg where the basic operational elements of these institutions was established: a three year term of study which is divided in turn into a theoretical and a practical (exploitation of interns in the hospitals) course of study for an aggregate total of 4600 hours. With the pretext of “learning a profession” thousands of young proletarians, the so called “trainees”, are squeezed like lemons in the hospital wards in which they are forced to WORK (not study!) as much and in some cases more then the workers already hired.

These proletarians face the worst blackmail: relentless mobility (when personnel are lacking in a department, the trainees are rushed in to fill the gap, this applies to strikes as well); if the auditors who compile the shift schedules know that trainees are available on a given day, they immediately busy themselves cutting the “excess units” in that department. Their vulnerability comes from the extreme precarity of their role, which is expressed in selection, in the expulsion from school of those who display defiance, in an extremely strict control of the activity of every individual, and in the demand for a detailed file on every proletarian.

And at the end of the month there arrives (not even promptly) payment in the form of a so called “study allowance” (from 80 to 180 thousand lira) which is really the miserable wages of the labour extorted from them. The massive recourse to this form of miserably paid superexploitation, the numerical weight of these proletarians employed as jacks of all trades in all the departments and in all the tasks is such that without them many hospitals would stop functioning.

In this way the hospital administrations ensure, that over and above the cushion provided by overtime the “gaps” in the workforce plan, the shortfall of personnel made permanent in all sectors by the hiring freeze sanctioned by the Triannual Healthcare Plan and perfected in the most recent contract are covered. For the trainees rebelling against this state of affairs almost always triggers exclusion from the study program through a “convenient” or “lucky” failure on their exams. This most often means returning to their home town (the courses are not available in all regions and are especially lacking in the South) without a chance of finding work or being thrown back into a marginal condition of extremely precarious income in the villages or ghetto districts.

The full measure of threats and violence to which these proletarians are subjected has on the one hand  provoked and continues to provoke a spontaneous and irreducible antagonism to restructuring and to all the representatives of the command and control imposed upon them and on the other has enabled the administration to use their labour power on more then one occasion to replace workers in struggle, to divide and fracture their front and thereby more easily repress their movement.

The capacity to read within the program of struggle of the proletariat in the hospitals the needs and tensions expressed by this element has become a fundamental and necessary step in the construction of new relations of force and power within the hospital.

B: The use of an enormous mass of overtime hours (the recent contract does not even set a maximum limit and instead introduces a provision on the possibility of forcing workers to perform obligatory overtime), which starting with the hospital workers supplementing a shit wage, enables healthcare administrations to cover the chronic personnel deficiency in the departments, without having to hire even one more proletarian (a recent investigation made by the bourgeoisie themselves admitted that the overtime hours worked over the course of a year in Roman hospitals amounted to 7000 new jobs!!!).

C: Lastly the possibility of using part time labour in some cases appears for the first time in the June contract. Leaving aside the demagogic and mystifying justifications with which they have filled heads on part-time work (it would allegedly allow for more free time), this form of labour is one of the filthiest means of exploitation, which does not ensure even a minimal subsistence existence.

Why give eight hours worth of pay to those working in jobs which can be done in four hours by skilfully increasing our workload and pace? We certainly can’t accuse the bosses of not knowing how to calculate for themselves and judge in their own benefit!

FIGHT PROFESSIONALITY, FIGHT MOBILITY, FIGHT OVERTIME, TOOLS USED TO INTENSIFY EXPLOITATION AND MAINTAIN THE HIRING FREEZE, FIGHT THE WAGE DIFFERENTIATION POLICY, A TOOL OF DIVISION AND BLACKMAIL AGAINST THE PROLETARIAT IN THE HOSPITALS.

Within the wards we are witness to a return to power, arrogance and assertion of control over us by the healthcare administrators, inspectors, head nurses etc.

Everyday we see more of these miserable enforcers of anti-proletarian policies gearing up to implement the capitalist directives for restructuring of healthcare with a capillary network of command and control in the hospitals.

There is no doubt they are intensifying their control over us, especially during the night shifts which are the most crushing, these ghosts suddenly materialise to check if we are working, with systematic checks of our timecards and for absenteeism, always ready to record, suspect and submit to disciplinary proceedings the “dangerous” elements, those who don’t bow before the boss passively accepting barbaric exploitation.

In carrying out this work, these scum find a worthy friend and ally in the union. The union bosses, the grave diggers of proletarian struggle, are not paid just to continually give us an earful on the “beauty” of productive efficiency (it is no surprise to us that for them the exploitation of us workers seems “beautiful”!), we see them actively circling the halls identifying and singling out these who seek to organize and fight for their own needs and rewarding through the spiderweb of power those who have been built up in the hospital on our backs, those who keep up with their game of subtle division and nullification of class consciousness.

All these elements who staff the bureaucratic, administrative and command apparatus of the hospitals, who every time are to be found alongside the medical barons who see their clientistic and mafia power put into question by the proletarian struggle, are one of the foundations along which the resumption of productivity and the intensification of exploitation advances.

They are the healthcare managers first and then the inspectors who plan the shifts and assign the overtime, the people to command, the workload and pace within the hospitals and the departments. They are the authors of the transfer letters which are now becoming a daily practice and which make the workers into spinning tops.

They are those who we always confront as the immediate counter-power when we fight and organize for our needs.

And it is against this command and control apparatus that the proletariat in the hospitals and its vanguards must be able to deal a heavy blow finding the maximum extent of strength and unity,

WE FIGHT AGAINST THE MEDICAL BARONS AND THE RESTORATION OF COMMAND IN THE HANDS OF THE HEALTHCARE MANAGERS AND THE INSPECTORS WITHIN THE HOSPITALS

And it is in this struggle against these central aspects of restructuring in the hospitals that proletarian organization and the antagonistic movement of the proletariat in the hospitals can and must find its maturity.

It is around these points that we, communist militants of the BR propose to resume the offensive within the hospitals. And it is within this offensive that our hopes, our dreams which for years have shouted in the streets and for which we have relentlessly struggled, regain life and real form within a strategic perspective. They don’t remain mere illusions and dreams but live with ever greater force. And they are imposed with ever greater force as irrenunciable objectives of our program within the perspective of overcoming the repulsive capitalist relations of production, of production based on exchange value.

WORK FOR ALL, LESS WORK!

IMPOSE THE PROLETARIAN RIGHT TO HEALTH!

However, it is necessary to avoid confusion.

We do not think that it is possible today (if it ever was!) to construct new relations of force with programs of struggle which always more closely resemble alternatives to the union platforms (to be negotiated with who, then?), rather then moments of the real construction of proletarian antagonism within a perspective of power.

Who thinks otherwise (and even if not thinking it, does it!) has taken the fireflies for the lanterns!!

In that way all you get is the effect of the problems, and the concrete objective of their resolution is not posed.

We can no longer deceive ourselves, much less anyone else, that the proletarian right to health, the reduction of working hours, the problem of unemployment are objectives which can be accomplished through agitation and formal insertion within a “revolutionary” pseudo platform, nor that their resolution is a matter of a brief period and can be achieved once and for all by a single struggle, however wide ranging and intense it might be.

Today the state of irreversible crisis reached by the capitalist mode of production leaves no more “mediating” spaces for the accomplishment of these objectives. Today the bourgeoisie is equipped to land increasingly hard blows at the proletariat, at its living conditions and its forms of organization (and the 24000 in paid redundancy at Fiat, which was passed despite a month of continual hard struggle is an illuminating example).

Even the scraps which were conceded to the proletariat in the past to suffocate its economic and political needs are becoming a memory of the good ole days.

Every proletarian need, any struggle for its implementation at the level reached by the crisis, is no longer absorbable within the capitalist programs and in fact is opposed antagonistically and in terms of power to the current mode of production. The only thing which the bourgeoisie can offer the proletariat is the misery of exploitation, an ever more expansive condition of income precarity, marginalisation and the violence of its military apparatus.

Really accomplishing (not going in circles with dust in your eyes), the objectives of work for all and less work, the imposition of the proletarian right to health, means one thing: the destruction of this mode of production…COMMUNISM!!

And it is perfectly well known that the world being as it is, the one way not to accomplish this are the platforms more or less alternative, more or less “revolutionary”. Keeping this in mind, we must fight and organize to impose these objectives, creating relations of force which are increasingly favourable to the proletariat.

Keeping this in mind, we must transform the tensions, needs and hopes which live everyday in the wards, in the departments, in the hospitals, and the daily resistance to restructuring (like the task lists and the thousand other forms of resistance) into moments of offensive and demands for power.

And it is within this program, within which spontaneous antagonism and proletarian creativity finds its strength, that it is possible to construct the levels of permanent mobilization of the hospital workers and the articulations of armed Proletarian Power within the hospitals.

It is on this terrain and within this perspective that the Clandestine Resistance Units must emerge and grow as the first elements of stable class organization with an orientation to power, which proves itself on the terrain of the struggle against restructuring.

AGAINST MOBILITY, PROFESSIONALITY AND OVERTIME, INSTRUMENTS USED TO INTENSIFY EXPLOITATION AND MAINTAIN THE HIRING FREEZE

AGAINST THE WAGE DIFFERENTIATION POLICY, AN INSTRUMENT OF DIVISION AND BLACKMAIL AGAINST THE HOSPITAL PROLETARIAT

AGAINST THE POWER OF THE MEDICAL BARRONS AND THE RESTORATION OF COMMAND BY THE HEALTHCARE MANAGERS AND THE INSPECTORS WITHIN THE HOSPITALS