Public Health Not Private Profit! (IWA Statement for April 15 Global Day of Solidarity for Public Health)

Public Health Not Private Profit!

International Women’s Alliance  Netherlands Chapter

April 15, 2020

In countries across the global North, the coronavirus pandemic has revealed the deep crisis of capitalism and its failure to protect the lives of people over protection of the economy.  The past few weeks have seen governments around the world rolling out huge economic packages to protect the economy as lockdowns, quarantine and stay-in shelter orders cause the economy to slowly grind to halt.  This is juxtaposed with healthcare systems being overwhelmed and lacking resources they need, from ventilators to PPE (Personal Protective Equipment).

After years of neoliberal offensive on healthcare, beginning in the 90’s with the purple coalition and deepening austerity measures the past ten years under Rutte’s command, we are left with a system completely unprepared for a crisis of this scale. Different measures have caused the public health care system to crumble and succumb to profit motivated health care and market forces, turning healthcare into a product.

Public health care will probably always be one of the largest cost items in the national budget, for which the Dutch government pays from our tax money. New policies allow hospitals to make profit and have turned it into the sole strategy for them to survive. Many smaller hospitals that were providing essential neighborhood care went bankrupt in the face of competition.  With small hospitals disappearing, access to healthcare becomes a problem, showing itself in the evident lack of IC beds in the times of crisis in smaller towns.

Everyone in this country is required to take out health insurance. And though we pay a monthly premium, the initial €380 of healthcare one accesses in a year, falls under the ‘own risk’ deductible.  You can also choose to have a lower monthly premium and pay a higher deductible.  Those with less monthly income are more likely to opt, a risk of paying higher bills if they then have to access substantial health care during the year. This money is essentially profit for health care insurance companies, that then has no other designation than to be used to invest by these companies to further their profits.  If you need to be tested for covid-19, you will pay from your own risk deductible.

In thuiszorg or home care sub-sector 75,000 people have lost their jobs due to budget cuts in recent years. Home care has been minimalized and, in many ways, completely eliminated, leaving responsibility for our elderly largely with the family and depending on informal care.

Home carers in the Netherlands are amongst the current front liners, the people that take care of the elderly and disabled in their homes, as well as domestic workers who take care of their homes. Previously, some tasks of domestic work fell under home care as well, but these were split off from specified and controlled as health care activities in pursuit of efficiency. Health care and domestic workers, although caring for the same people are no longer formally or institutionally facilitated to keep in touch with each other.

In 2015, the responsibility for organizing home care was moved from a national and public level to the level of the municipality, under the WMO law for ‘societal support’.  If you need the home care, you apply with the municipal authorities to get a health worker assigned to you. The municipality outsources this to companies who run care at a neighborhood level.

Health and domestic care professionals who were previously contracted and working for a national public health care system are forced into precarity, into becoming freelancers working for companies and care institutions, stripped from their rights, pension and sick leave. Home care is essential work for a minimum wage under a government that continues to add regulations and control, and leaves those receiving care changing carers regularly as companies send employees elsewhere, preventing long term care relationships forming.

In 2019, 140,000 unfulfilled job offers in the health sector was the highest amount since 20 years. It has led to health care workers being over worked, under huge stress and now facing a serious crisis with the coronavirus pandemic.  Hospitals are understaffed and under resourced: on March 31^st the FNV reported that only 30% of health care workers no longer felt safe at work due to lack of Personal Protective Equipment, workers also feel there is a clear lack of guidelines in place for handling the crisis.  This system is not working for patients or workers.

The International Women’s Alliance Netherlands chapter expresses its solidarity to health care workers and joins the ILPS Global Day of Solidarity in demanding Public Health Not Private Profit! We assert the following calls

• Mass testing now!
• Provide all frontline workers with adequate PPE!
• Transparency of cases and developments and clear guidelines for healthcare workers
• Swift action and shelter for women and children facing domestic violence
• Guarantee income and livelihood of people instead of bailouts for big business

IWA NL calls on women’s organizations to support these demands and mobilize creatively on- and offline to express these demands.  Additionally, we salute the struggle and resilience of women around the world in the tremendous challenges they face during this time.  We recognize the contributions of women on the frontlines on healthcare, a sector whose workforce is 70% women. We express our deep gratitude for all the domestic and social reproduction labour which women have been doing invisibly for centuries, now brought into sharp focus as our homes (for those of us who have one) are our sites of resistance and care work is centered and essential for the endurance of our communities and society as a whole.   Let us care for each other and gather the lessons of this time of crisis, and militantly resist towards liberation of all women and oppressed peoples!