In the six university clinics in the state of North Rhine-Westphalia, no one wants to be a patient at the moment. Jochen A. Werner, medical director at the University Hospital Essen, speaks of an “emergency situation” and a “endangered patient welfare”. Reason for the state of emergency: The Verdi services union is on strike for the eighth week in a row in the six university clinics in Germany’s largest federal state.

At the same time, one does not want to work as a nurse or in the transport service in the six clinics at the moment. “The transport service is so understaffed that there are sometimes no oxygen bottles in the operating rooms,” says Katharina Wesenick, Verdi’s regional department head. She calls for relief for the nursing staff through a shift-specific minimum staffing and a collective agreement for all groups in the university clinics in North Rhine-Westphalia.

The fact that the conflict between hospital management and nursing staff is not limited to a single federal state was shown on Wednesday at the start of the Health Ministers’ Conference in Magdeburg. The health ministers of the federal states want to discuss how to proceed in the corona pandemic and digitization in the health sector together with Federal Health Minister Karl Lauterbach (SPD) for two days.

However, the beginning was superimposed by a demonstration by the Verdi union. Around three hundred to four hundred protesters marched through the city in Saxony-Anhalt with banners and chants for more personnel.

Protest rallies have accompanied the Health Ministers’ Conference in recent years. But after two and a half years of the pandemic and the increasing shortage of staff in the care sector, the conflicts in the health sector have escalated drastically – and could soon break out across the board.

In addition to overburdened public hospitals, there is also a risk of conflict in psychiatric and private hospitals. Verdi complains about 162,000 job vacancies in hospitals nationwide, of which 70,000 jobs would be missing for nursing staff alone.

Protest posters by nurses and trade unionists can currently not only be seen in Magdeburg and at the university clinics in North Rhine-Westphalia. “I want to be there when patients become more important than profit again,” wrote one protester on her sign, which she and around two dozen fellow campaigners walked through Bad Salzuflen in North Rhine-Westphalia a few days ago. The addressee of the protest is the private clinic operator group Ameos from Switzerland, which operates 103 hospitals at around 50 locations in Switzerland, Germany and Austria.

According to Verdi, strikes are currently being prepared at two German locations of the Ameos Group, and there were two days of strikes at the Bad Salzuflen location last week. As with the university clinics in North Rhine-Westphalia, this planned strike is also based on wage disputes. The Ameos management has so far not wanted to meet the Verdi demand for a collective agreement for all employees at the level of the public service.

It is unclear when and to what extent the strikes will take place. The Ameos Group emphasizes that patient care is “secure at all times”. The company did not want to comment on the ongoing negotiations with the Verdi union.

But it is not only in the general hospitals that things are fermenting. Non-medical staff in psychiatric wards also complain that they are increasingly reaching their limits. In the run-up to the conference of health ministers in Magdeburg, Verdi federal board member Sylvia Bühler criticized the blatant shortage of staff in psychiatric institutions.

“The personnel requirements in psychiatry are being systematically violated.” Bühler appealed to the health ministers to tackle this problem “both in the interest of the mentally ill and of the employees”.

Last year, three psychiatric specialist clinics of the private operator Asklepios in Brandenburg experienced that criticism can also lead to strikes in the field of psychiatric wards. Again and again, the non-medical employees stopped working there for several days in protest.

The reason for the uproar: Asklepios paid its employees in Hamburg significantly higher wages than in eastern Germany. At the end of November, Verdi and Asklepios finally agreed on a wage increase and a corona bonus.

Federal Health Minister Karl Lauterbach had a calming effect on the frustration of the health workers on Wednesday with a speech in front of the protesters. Lauterbach announced that he would introduce needs-based staffing in nursing and that he wanted to present the key points for a corresponding law before the parliamentary summer break.

Verdi federal board member Bühler welcomed Lauterbach’s initiative as a “big step towards more staff and relief in the hospital.” employees has arrived.”

It is still unclear whether Lauterbach’s commitments will have an impact on the strikes in North Rhine-Westphalia. There, the conflict at the university clinics that have been struck continues to show itself in full severity. “The effects of the strike are fatal. At the University Medical Center in Essen alone, we were unable to carry out 1,700 operations on time,” says Werner, Head of the Essen Clinic.

“So we either had to postpone these surgeries or cancel them altogether. In addition, we sometimes had to close up to 500 beds because of the strike,” said Werner. Verdi, on the other hand, announced that it would aim to end the strike this week. At the same time, several employment groups have not yet been able to agree on a collective agreement.

Both sides agree on what has led to the current conflicts in the healthcare sector. “The problem of the nursing shortage has been delayed since the 1990s. This is a nationwide problem that has not yet been solved, for which we are now footing the bill,” says Werner, head of the clinic. “It is absolutely clear that care needs relief and that you have to build up staff, if you can get the nursing staff at all.”

The service union Verdi also sees the fact that hospitals were obliged in the 1990s to be self-financing and to operate as profit-oriented companies as the origin of the nursing shortage. “When hospitals have to make a profit, management often asks where to make savings. These savings usually relate to the treatment of patients and staff,” says Verdi. And is certain: “The current shortage of skilled workers will lead to further upheavals.”

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