Nurses and other health care workers in Ukraine haven’t been paid for months as the capitalist rulers there press their attacks on the wages and job security of the working class in the midst of Moscow’s invasion. The government is using restrictions on strikes and protests imposed during the war to push a 2018 “reform” aimed at moving to privatization of the country’s nationalized hospital system. These International Monetary Fund-backed measures have led to the closure of hospitals, staff cuts, speedups and lowered wages, which were started before Russian attacks began to ravage the economy, power supplies and health care facilities.
Ukrainian working people, in cooperation with the country’s armed forces and territorial militia, continue to mount courageous resistance, pushing back Moscow’s bloody attack. But they are hampered by the profit-driven actions of the Volodymyr Zelensky regime.
Ukraine’s Ministry of Health began implementing reforms in July, where hospitals outside of conflict zones would be paid only by the number of services provided to patients. After the Russian invasion hospitals had been assured regular monthly federal payments would continue. But this has been replaced by a new, decentralized “money follows the patient” scheme to tighten the screws on both the health service and the workers.
About 80 medical staff protested Nov. 7 at the Ivano-Frankivsk infectious diseases hospital to demand payment of back wages. As a result of the nurses’ action, their August and September salaries were paid.
Successive governments in Kyiv have been driving to break up the health and education systems, which have been public and free since the Bolshevik Revolution in 1917. This continued after the implosion of the Soviet Union and Ukraine’s declaration of independence in 1991. But since then, the IMF, Washington and other imperialist governments have sponsored “restructuring” and the health system has been run down.
Kyiv’s aim, by transferring “ownership” to local managers, is to advance toward privatization and make profitability the law of the health system. Under these capitalist market reforms, each hospital director is made fiscally responsible for staff numbers and wages. This has meant 36 workers have lost their jobs at the Ivano-Frankivsk hospital this year.
Unpaid wages are a long-term problem in Ukraine. Between January and October, back wages owed to workers totaled 1 billion hryvnia ($27.2 million), according to the Federation of Trade Unions of Ukraine. Less than half of this has since been paid. Working people also face widespread joblessness from Moscow’s attacks on factories and infrastructure and inflation of 30%.
The new scheme is hitting hardest at specialized clinics, like that at Ivano-Frankivsk, as well as hospitals in small rural communities. This disdain for the needs of country people is common to capitalist rulers the world over.
In the U.S., beginning Jan. 1 the Joseph Biden administration is offering cash incentives for rural health facilities, which service 46 million people, on the condition they end all inpatient care. Patients are meant to be kicked out within 24 hours or transferred to larger facilities. But for many, those hospitals deny them entry. Over 180 rural hospitals have closed since 2005.