Organizers expect at least 15,000 workers throughout Colombia’s public hospital system to join a national strike on Monday, according to the president of the national health workers union (ANTHOP).
In an interview with Colombia Reports, Hector Alviz Gaviria said the number would be much higher, if not for measures being taken by the union to ensure that emergency care runs at full capacity and basic services continue to function at a responsible level.
“This is not an isolated problem,” he said, “it’s not that a few hundred nurses have some minor complaint. Right now we have a crisis facing up to 90% of all health employees in this country, from the hospital administrators to the sanitation staff.”
As in the case in the other striking sectors, the problems facing the health sector are various and interconnected, including issues as straightforward as owed backpay of salaries, which has caused “thousands of workers and their families to go months without a full paycheck,” and issues as complicated as inadequate and ineffective channels for public funding and restricted access to alternative sources of credit, the combination of which has put 500 public hospitals across the country in immediate risk of bankruptcy.
Health workers have been vocal opponents of Santos’ health reform policy, which they claim “privatizes health care and puts more and more public money in the hand of wasteful, corrupt private intermediaries,” like the private intermediary payment services (called EPS services) that owe Colombian hospitals an estimated $2.5 billion in unpaid treatment compensation. But the underlying motivation for the upcoming work stoppage is a “fundamental lack of job security.”
“What’s forcing us to go on strike is the need to reclaim the rights that have been taken from us little by little,” said Alviz. “As soon as we can sit down with the government and establish labor security, dignified employment, formalization for health workers, we won’t need to cause any problems […] but right now our attempts to talk to the government go unanswered, so we will do what we must to guarantee the constitutional rights of the workers who serve the Colombian public with dignity every day.”
According to Alviz, as many as 300,000 public health workers are currently contracted under what is legally referred to as “provisional employment.” That in and of itself, he says, is a violation of fair labor practice. Exacerbating matters, though, is a law recently passed by the Colombian government that would convert various previously protected positions to provisional status, and convert many provisional workers to even more tenuous forms of employment.
The provisional status exists as part of the statutes governing the “constitutional right to work” afforded to all Colombians. “Official positions” in the public sector, by law, function according to fixed career tracks, with extensive benefits and legally guaranteed labor-organizing rights. But “provisionality,” as it is referred to, allows the government to hire workers on a temporary basis, outside of the protections outlined in the public labor code. In theory, it exists to help the government put people to work faster, and was considered an important measure in a country with traditionally high unemployment levels.
But in practice, at least in the health sector, provisionality is a tool to “rob workers of their dignity and their families of their financial security,” according to Albiz.
“Right now, you have people, lots of people, who have been working for 10, 15, even 20 years as provisional workers. Yes or no: if you’ve been working somewhere for 10 years, it’s because you’re doing a good job? Am I wrong? If not, [you] would be fired, because provisionality let’s [the government] do that.
So what you have are thousands — thousands and thousands – of workers that have been supposedly filling a vacancy for a decade now, some of them having their contracts extended every few months, with few guarantees on their benefits or even their pay, no collective bargaining rights and no guarantee that they won’t be fired whenever the government feels like it […] and some of them aren’t even getting the money they’re owed for what they’ve done […] and if they protest, the government says they will be fired, because [the workers] do not have that right [to protest].”
Because provisional employees are not given collective bargaining rights under the statute, he explains, the government claims they cannot legally go on strike. And indeed, earlier this week, the Minister of Labor issued a vaguely worded warning to hospital employees planning on joining the national work stoppage on Monday, who he claims, because of their vital role in civil society, are legally prohibited from shutting down hospital services, and therefore face legal reprisals for striking, including the potential termination of their contracts.
“It’s reprehensible for the government of what is supposedly the oldest democracy in Latin America to threaten such a basic human right [to protest],” said Alviz, who insisted that the stipulations of Colombia’s recent free trade agreement calling for the formalization of public labor and the protection of protest rights have not been adhered to, and added that, “we are not asking anyone to take action against the physical structures [of the hospitals], or encouraging them to damage the equipment. We have told our members to stay onsite and, in a peaceful manner, reclaim their rights to protest and their rights to labor stability […] what’s more, we have guaranteed the continuing function of urgent and emergency services so as not to effect our responsibility to good service and […] the workers will be onsite if and when they are needed.”
It’s “criminal,” he said, for the government to both avoid dialogue and deny the right to protest.
“There are workers who are owed up to 60 months of backpay […] when [the government] isn’t paying the salaries it owes, when the government has refused to negotiate or to review the labor statute […] they haven’t left us any option. We’ve met with the Minister of Labor, with the Minister of Health, with representatives in the Senate of the Republic, the Congress of the Republic […] we’ve manifested our intention and our desire to avoid […] it having to get to this situation in which we find ourselves now. How then, can they tell us now we can’t protest?”
Discontent has been stirring in the health sector for quite some time, especially after at least two years of what representatives of other sectors have called “empty negotiations” and what Alviz himself called “the government’s games.” The pattern is common among the groups participating in the August 19th protests: dialogue with the government opens as demonstrations intensify, and breaks down just as soon as the protesters go back to work.
But the situation has become “desperate” recently, as Alviz described it, because of laws passed over the course of the last year that potentially shift an estimated 95% of administrative staff from “official” to “provisional status” and a similar proportion of provisional employees to fixed three or four month contracts, as opposed to the undefined running contracts they currently have.
“In a single pen stroke,” said Alviz, referring to the most recent measure, “the government has taken away what little labor rights we already had.”
What has become an acute problem now is actually over a decade in the making. Despite four key Constitutional Court rulings over the past 15 years that strike down or strengthen existing provisions to benefit provisional workers, Alviz says the government has delayed implementing court mandates favorable to its health sector employees, passed laws that circumvent or contradict judicial rulings and blatantly ignored court orders in some cases, as was this case when a recent 2012 ruling obligating hospitals to maintain a minimum percentage of “official” employees was dismissed by the Minister of Health, who said the decision would lead to the worst financial disaster in Colombian history.
What reforms the government has made to the public health system, moreover, have been costly for organized labor. According to internal union data collection, the health sector now has 20% of the “official” employees it did in 1999. Over the same time period, there has been a roughly 2,000% increase in the dependence on provisional labor. The average tenure of the more than 300,000 provisional employees working in hospitals across the country is close to eight years. In a process that has “sped up” since President Juan Manuel Santos began implementing his health care reforms, the health sector has lost 81,000 jobs through closings or restructurings, and 360 union organizations because of it. Union enrollment is down 62%, and collective bargaining has diminished by 85%. Workers make 25% of what they once did, and are owed, on average, $9,000 a year by the government.
“It’s the erosion of our right to represent ourselves and stand together for better conditions,” said Alviz.
The health workers, he said, “did not want it to get to this point,” but are prepared to “maintain the strike until we receive the urgent dialogue we have been asking for.
We are tired of the government wasting our time, and we cannot continue to live like this, so unsure of our future.”