A report by the China Labour Bulletin documents 10 years of violations and critical issues in healthcare. The COVID-19 pandemic exposed and aggravated existing systematic issues and unresolved disputes, such as unpaid wages, violence against staff by patients and family members, excessive workloads, and disparities.

Beijing (AsiaNews) – China Labour Bulletin (CLB) on Monday released a lengthy report detailing the violations and abuses against medical staff over a 10-year period (2013-2023), a trend that has worsened recently.

The study looks at the worrying condition of healthcare workers in China, including doctors and nurses, both male and female. It found that sex was not major differentiating factor.

The situation got worse with the onset of the COVID-19 pandemic in 2020, and was aggravated two years later, when the government scrapped its zero-COVID policy.

The report documents cases of unpaid wages, overwork, unfair treatment, poor safety in health facilities (with deaths and killings), poor labour relations, and unreliable trade unions.

Due to the difficulties and limitations in data collection, the report focused on the country's hospitals. It documented 62 cases involving issues related to wages, social insurance, housing fund in arrears, representing 45.9 per cent of the total.

Most of the protests involved private hospitals (almost 60 per cent); among these, around 70 per cent were ungraded hospitals or hospitals without known grades.

The COVID-19 pandemic exposed the world in which Chinese health workers operate, starting with the death on 7 February 2020 of Li Wenliang, a Wuhan ophthalmologist, the first prominent figure to be struck down by the virus, which set off alarm bells about the danger posed by the mysterious new pneumonia that was already affecting and killing scores of people.

Li’s case illustrates the sacrifices made by health workers, who over the following years, faced deadly risks due to the implementation of strict measures against the disease and their subsequent sudden lifting.

At the end of 2022, demands and pressures on health workers increased nationwide with the abrupt decision by Chinese authorities to change course and terminate the zero-COVID policy, more concerned about the devastating effects of lockdowns on the economy than of public health.

Struggling to maintain regular services, doctors and nurses have faced excessive workloads, occupational hazards, life-threatening risks, as well as wage cuts and even non-payment of wages and social insurance benefits.

There is a common thread in the various protests that broke out over this decade, especially in 2022-23, namely the lack of effective labour representation for medical staff, leaving them no choice but to make their demands public hoping for a show of solidarity from the public.

Since official health workers’ unions – which are part of the All-China Federation of Trade Unions (ACFTU), the only labour organisation authorised in the country – failed to represent their members, the latter have had to deal on their own with the problems in the system, resulting in protests, some of them serious.

By collecting and analysing cases of collective action by workers in the health sector and their online requests for help, the China Labour Bulletin was able to draw a picture of the sector, one that is disturbing.

According to experts, the problems are linked to systemic issues and a lack of protection, which are conducive to violent attacks and incidents involving patients or family members.

In addition, health workers complain of negligence or lack of attention by hospital administrators and government departments in cases of violence by patients. Added to this is the lack of support and safety.

In cases where protests have been reported, the response has been to crack down on doctors and nurses who complain, going so far as to arrest protesters.

In May 2022, Yu Xiaobao, vice president of the private hospital management branch of the China Hospital Association, also revealed that more than 2,000 private facilities have gone bankrupt since the onset of the pandemic due to reduced patient visits and greater pandemic prevention and control workload.

Two years later, the legacy of this continues to affect health workers today. For example, on 3 November 2023, a group of doctors from the Ruzhou Maternity and Child Health Hospital in Henan held a protest, saying that they had not been paid their wages for more than a year. Their social insurance benefits and housing provident funds had also not been paid.

Local authorities responded by saying that the decline in births, the impact of the pandemic, and other factors drastically cut into the hospital’s business, leading to a sharp drop in income and a delay in wage payment.

However, it would be inaccurate to attribute labour problems in the health sector and related issues only to SARS-CoV-2. In reality, the pandemic emergency simply lifted the lid from long-standing problems.

For this reason, experts want to see a series of measures to reinforce the system, like guaranteeing the right of workers to join unions that represent their interests and defend their rights vis-à-vis management.

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• china
• healthcare
• workers
• covid-19
• pandemic
• rights
• protests
• union
• patients
• violence