France: Following the SNCF Mechanics' Struggle, The Fight in the Hospitals Shows the Way

In spring 2019, a crisis on an unprecedented scale was sparked in French hospitals. The emergency services went on strike in massive numbers. Barely three months from its beginnings on 18 March, in the Saint-Antoine Hospital in Paris, it had spread to around a hundred establishments all across France by July. The movement will not stop spreading as long as the situation remains untenable. In September, the number of emergency services on strike was 239, or more than half of all services. This mobilisation has not died down and even rose to 267 services on strike in mid-October.

The reasons for the strike

The situation in these services is disastrous in terms of lack of staff, increases in working hours and lack of funds. As in the rest of society, the situation is dictated by the drive to profit. This means working in a situation of permanent understaffing… Patients left uncared for have been found dead (e.g. the death of a 55 year old patient found in the emergency ward of the hospital during the night of the 17-18 December; an 11 year old boy found dead shortly after leaving the emergency ward in the Privas Hospital in Ardèche on 6 May; a 56 year old man found dead in the waiting room of the emergency ward in Perpignan; a woman in her sixties who died in the emergency ward in Cochin Hospital on 15 February; etc...). In these hospitals, the drive to efficiency is criminal. It is the symbol of the decay of capitalist society that introduced competition, or more plainly the pursuit of profit, into the domain of care for sick and elderly people.

For several decades now, governments in all countries have been demolishing their public health services (like they have other public services) and imposed financial requirements upon them. Added to this is the fact that the emergency services have become veritable asylums of modern times, crumbling under the weight of growing poverty in society.

The self-organisation of the movement outside the unions has allowed it to develop

A member of the Inter-Emergency Ward Collective (Collectif Inter-Urgences, CIU)(1), Hugo Huon, said in an interview, "We had three meetings with them (the nurses) before deciding, ‘Ok, we’re going ahead’. The four hospitals, Tenon, Lariboisière, Saint-Louis and La Pitié are joining Saint-Antoine" and have joined the movement.(2) They created the Collective from emergency service staff of all grades, which developed links with the district, but it came up against the unions every time. The Collective then organised alone and called a demonstration in its name on the 6 June, which was a success. Since then the unions have not stopped hounding the Collective.

Before the summer, relations with the unions soured. Hugo Huon explains that, “You could say that they [the unions] originally wanted nothing to do [with us], but as soon as the movement was launched, they absolutely wanted to get involved and impose themselves on it.”(3) In reality, this is a constant, the unions prevent the movement from developing but when they are absent, as they are in this case of the hospitals, they chase after it with the aim of steering it back into the garage. Here, the Collective was well prepared, knew how to organise relays throughout the country and took things into its own hands. This was the reason for its initial successes compared to previous struggles.

On this solid basis of struggle, an Inter-Hospital Collective (Collectif Inter-Hopitaux, CIH)(4) regrouping staff equally from the whole medical hierarchy, was founded in September to support the emergency staff movement and spread it to all professionals in public hospitals, in association with the representatives of the patrons. The struggle is also spreading to the whole health sector, notably to the “EHPADs” (care homes).

Only through this autonomous organisation outside the frameworks of trade unionism and corporatism in the health sector has this CIH been able to develop up to now. Only by extending it to other sections of professionals can it achieve the realisation of its demands.

The latests decisions of the striking workers and the attempts at recuperating the movement

The movement finds itself at a pivotal moment and to make it spread it will have to go beyond the framework of the public hospital alone, at a moment when numerous sectors are taking up struggle, in the repair workshops of SNCF, the firefighters, etc...

Several hundred doctors and nurses in the CIH decided on Thursday 10 October to organise a “big demonstration” on the 14th November in Paris “to secure an emergency plan for the public hospital”.

The first general assembly of the recently created Collective took place in the capital, at the Pitié-Salpêtrière Faculty of Medicine. Two motions were put to a vote and adopted unanimously. The first was to take up the demands that the striking emergency workers and the unions have been fighting for nearly seven months, notably an “immediate net monthly wage rise of 300 euros” and “halting the removal of hospital beds”.

The second contained a clarification on the “methods of action” and a call out to join the movement of firefighters on the 15 October and an assembly on the 29 October, in the event of a vote on the first reading of the social security budget in the National Assembly, then a “big demonstration” on the 14 November, hopefully “with the support of the population”.

So no calls to strike, nor even a “journée morte”(5) as the unions and striking emergency workers announced nonetheless at the beginning of October. However, the IHC proposes a “cease in coding” of medical acts(6), which would deprive the hospitals of a large part of their financial resources. “It is a political act, not a technical one. We are not playing anymore, we must put an end to the hospital business,” said André Grimaldi, former head of diabetology at Pitié-Salpêtrière, in its defence.(7)

And now? In the face of governments which cannot approve anything but poverty, the solution is the generalisation of struggles, taking them into our own hands through our struggle collectives from the outset without the unions. They do not share our agenda and reveal themselves to be more and more useless and disruptive of any class organisation every day.



(1) Website:, social media:

(2) Interview with Hugo Huon, one of the founders of the CIU, from 30 July.

(3) ibid.

(4) Website:, social media:

(5) “Journée morte”, or "dead day", is an on-the-spot strike, where workers may turn up to work but don’t do anything.

(6) Which allows payments for medical procedures to be made by social security.


Monday, November 25, 2019