Analysis, Articles

Workplace organisation or ‘spectacular actions’: Nurses struggles in Eastern Europe

Over recent years nurses have been at the centre of the class struggle in Eastern Europe. In this country, Bulgaria, this led to the formation of an independent nurses’ union, SBMS. In other countries though nurses have also been involved in struggles, currently in Poland, and recently in Croatia. In the Czech Republic nurses also embarked on a series of independent actions. Now, as the struggle in Bulgaria seems to have died down, at least for the last moment, we feel a need to draw some sort of balance sheet from these struggles here in Bulgaria, and the tactics and strategies used in them.

To this end, we recently hosted a meeting between nurses from the Independent Sisters Initiative (KKN) in the Czech Republic and some local members of SBMS in order to try to understand bthe strengths and weaknesses of the struggle. SBMS seems to be in a very weak position at the moment. Despite having a reasonably large paper membership, about 800 people, it seems to have very weak organisation on the ground, to be suffering from a spate of victimisations, and to be having deep financial problems due to fighting a long running stream of court cases against this victimisation. The mood inside seems to be one of demoralisation. The Czechs, on the other hand, seemed to be very confident about the position that they were in, and even though there have been the natural ebbs and flows in their struggle, they did not seem at all demoralised, but rather optimistic.

After a brief summary of past events, and the current situation in each country, KKN outlined their principles of operation. These are threefold, namely; self organisation, struggling from below, and making real pressure not merely making abstract demands of the state. The main reaction from the colleagues from SBMS was how all three of these principles were in complete contrast to what had happened here. If we contrast the methods of organisation used here with those used in Czechia there seem to be huge differences. The key to organisation there seemed to be people getting together in their workplaces to organise to deal with issues that directly concerned them.

Contrary to this, the local organisation with SBMS seemed to come after they had created a national organisation. The organisation as a whole came about not from people self organising at the base, but from people being mobilised around a small group running a campaign. Members weren’t actively working together to create a new organisation, but rather a mass being pulled along by a small group with little control over which direction they were being pulled in. Of course, we have to start from where we are now. There is no point in wishing we were starting from somewhere else.

The nurse struggle in Bulgaria started with this small group of nurses in Sofia organising demonstrations. That’s how it happened. It’s not, though, a healthy model for organising from the base. It’s not a model that relies on workers’ initiative, and the collective intelligence of the mass. Rather it relies upon a clique doing things, and every one else following behind them. People in the ‘Conflict’ group connected with this website, and the nurses’ bulletin ‘Medical Alarm Clock’ consistently argued for building this sort of base organisation, and for holding a national meeting to not only discuss strategy but also to set up a democratic structure where the membership of the union had control over the polices, strategy, and tactics adopted by the union.

The second of their points was focused on ‘struggling from below’. Again there was a difference in focus from what happened here. The focus of the struggles in Bulgaria was on making a national campaign based around national demands. Whereas the struggle in Czechia was based around nurses taking action over situations that immediately concerned them in their own workplaces. Here, we found that when nurses initiated there own actions in hospitals, such as in Sliven and Karlovo where nurses actually won strikes. This ties together with the first point in that to deal with these sort of issues on the ground, you need strong organisation on the same ground. It was in these small strikes (a topic that we will deal with in another article) that real victories were won. These real victories, however local and however small are the key to building workers’ confidence.

The type of issues that struggles are built around ties into the final point of the Czech nurses. SBMS built its campaign around a list of demands on a national scale. These went from the ambitious to the absolutely impossible. We can shout for the removal of the profit motive from healthcare as loudly as we want, but in the current climate, it is certainly not going to happen, and it doesn’t matter whether we organise large scale national demonstrations, or have a small group of people running around on rooftops. It still isn’t going to happen. Whereas if the movement is based around strength at the base fighting for issues against their immediate management for winnable demands, it seems that gains, however small, can be made, and it is upon these small gains that we can begin to build self organisation and worker confidence.

The SBMS approach seems to be a ‘spectacular’ approach. There is a national organisation, there have been large demonstrations, and negotiations between the leadership and the Prime Minister even. However, there does not seem to be much at all in the way of self organisation in the the hospitals on the ground. While large demonstrations are all very well, and can provide people with a feeling of togetherness and solidarity, at least momentarily, this vanishes when nurses go back to their own hospitals, and feel the isolation, and lack of support from their own colleagues. While running around on top of the rooftops of state buildings in Sofia may attract the eye of the media, and public for ten minutes, it too fails to do anything to build this organisation at the base level, and watching one of the leaders of the new union negotiate with the Prime Minister live on an internet feed only increases the feelings of passivity and reliance upon others to do it for you rather than a feeling that you can do it for yourself.


For those of us in Varna who had previously been involved in ARK, these discussions seemed very relevant not only in that they dealt with the same sort of issues we had been discussing ourselves but also in that they also pointed towards answers to the questions that we had been asking.

You can find here a long article describing our activity over the past few years, and raising the issue of how to move forward. These questions come to the core of the focus of this group; How to build workers’ power, self activity and confidence today. These are questions that are not only being asked by us. Across the world small groups are struggling to provide answers to the to the same problems. Elsewhere on this site [link] we review a book written about the struggles of immigrant workers in London. It too is focused on the problems of worker self organisation. Not all of the answers are clear today. The working class has been in defeat for a long time now. It seems clear though that the way forward will come from organisation at the base. Developing a new strategy to meet the needs of the current situation can only come from the lessons of the actual struggle in the workplace. We hope these discussions can start to develop on that.

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