In 1813, Representative Lloret and Martí said: “The poor peasant and the simple soldier are the two classes most filled with pain and misery in the state. And it really is they who maintain the monarchy and the luxuries of the few individuals who integrate it,” and gives way to the beneficial funds. In 1900, human life began to have a monetary value (there were precedents in Europe in the previous century) and excessive mortality is considered as the greatest cost of the twentieth century, due to the reduction of productive working days and spending on police and charitable care.

Our public health is not an altruistic instrument in the service of life, but a machinery for effectively maintaining the productive forces, which is the character that has marked its existence. The achievements/granted are the result of the class struggle and the welfare state is adapted to anesthetize the class struggle.

This whole apparatus is maintained with a strict, vertical and submissive structure, so that when capital has to squeeze profit the path is as smooth as possible. Osakidetza is no exception:

Parallel to the implementation of the OSIs (Integrated Health Organization), the focus of control, investment and power is placed in hospitals and Primary Care, the logical basis of quality health care, is undervalued. In the OSIs, a hierarchical structure is established which is part of the Basque Government itself (PNV-PSEE) with clear private interests, as shown by the usual revolving doors. From the dome high positions are appointed to maintain hospital control. Nobility is formed by service heads, the final link in the power chain. This link sees that it has enough capacity to give places to its acholites, accept the prebends of pharmacists, tighten the workers... because they feed on the elite of a class system and believe that they are intangible and indispensable. An important fact: service managers are the pistons of the private health engine.

Everything that happened at the Donostia Hospital has revealed the struggle of the internal powers. When the heads tell the powers that they give up the banners and strikes, they are screaming loud and clear: “We belong to your group.” When they see their share of power and market safe, they will return to their silent, functional and interested work, which is also involved in the privatisation process. Do they have a very clear place in the war against workers, and we workers and patients?

In the fight for public, community, free, universal and quality health, patients and staff (cleaning services, technicians, doctors, nurses, auxiliaries, administrators, cellors) should be the center of decision and action. To achieve this, we must intervene in social relations of production, and it is our obligation to organize ourselves to make health a real tool of social justice. And together with health, all those factors that determine education, housing, care and material living conditions cannot be separated from this mobilization.

Marta Macho, anesthesiologist