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The strike by 2,000 Kaiser Permanente mental health professionals in Northern California continued into its fourth day Thursday. These psychologists, therapists, chemical dependency counselors and social workers are striking back over years of deteriorating working conditions in San Francisco, Fresno, Sacramento and San Jose.
A central issue emerging in the strike is the need for workers to break out of the lockout imposed by the National Union of Health Care Workers (NUHW) and expand the fight against health care workers not only at Kaiser Permanente, but throughout the medical system. .
On Thursday, it was announced that 50 Kaiser mental health professionals in Hawaii would join the strike on August 29 due to insufficient staffing. A report yesterday in Court News wrote: “Hawaii health giant’s accreditation faces ‘corrective action’ after clinicians file complaint documenting long wait times for mental health appointments. National Committee for Quality Assurance investigators concluded these access issues are ‘a potential risk to patient safety’ and said ‘Kaiser’s previous efforts to improve access have been largely ineffective’.
This is a welcome development, but it raises the question of why more Kaiser workers aren’t being called in as well. Kaiser has about 149,000 health care employees plus 16,000 physicians in California. About 700 Kaiser operating engineers in Northern California, who went on strike for three months last year, continue to operate without a contract.
Last November, tens of thousands of Kaiser health care workers, mostly nurses, were poised to strike, only for the union to call it off at the last minute and force a sales contract with sub-inflationary wage increases and no staffing guarantees. . Nurses opposed to the sabotage of the war by UNAC/UNHCP (United Nurses Association of California/Union of Health Care Professionals) formed a follow-up committee to fight to give the war new leadership outside the union bureaucracy.
There is an opportunity for a powerful unified movement of health care professionals against the unending assault on public health. However, this requires a fight by health care workers against the isolation of their strike by health unions.
Al, a mental health professional, told him WSWS that “burnout” was consuming the profession.
“We can’t give the care we want to give,” he said. “We want to get patients appointments in time so we can meet their medical needs, but we can’t do that. We don’t have enough people and meetings are three weeks, even a month, or a month and a half out. We just don’t have the staff for it. We are out of resources and we need more. We are all stretched so thin and people are leaving fast.”
Many of these professionals experience severe mental difficulties that require immediate care, including suicidal ideation.
Al explained how overstaffed it is. “We are working non-stop. I mean, there’s no time for anything. Barely breathing for lunch.”
Cindy, another striking worker, told him WSWS, “Patients’ access to mental health is really poor.” She continued, “People are not seeing each other as regularly as they should. People can get appointments, but it takes a while. Return appointments are four to six weeks, so if someone is in crisis, that’s not good.”
She said turnover was a big problem. “We don’t have enough mental health workers. they [Kaiser] can’t keep them. They can attract them, but they don’t last long. The turnover is really high.” Cindy explained that it was because of the working conditions. “There is not enough time. You can’t see patients when you want to see them. It’s not a good work environment.”
She also participated in the 2019 strike. She said since then, “nothing” had changed and “it’s actually gotten worse.”
Cindy raised the demand that doctors be given more time for documentation. She explained that they needed more “documentation time, better access to appointments and more doctors so we can address the demand.” She continued, “Demand has never been higher, but supply has never been shorter. I don’t think this is necessarily specific to Kaiser; I know it’s almost everywhere.”
She also noted the effect of the pandemic on their working conditions, including the need to write more CPS (Child Protective Services) reports and the incidence of more cases of domestic violence.
Sarina, another mental health professional, explained how difficult it was for anyone, except in the most severe cases, to get help. Speaking of her teenage patients, she said: “If they’re not suicidal but they’re not functioning, for example, [if] they’re severely depressed and can’t even go to school, we might not see them for six to 10 weeks because they’re not suicidal. So we can’t fit them into our schedule.”
Then, Sarina explained, their manager will tell the clinicians, “Well, if you need to see the patient, book it in your time off or book it in your documentation time (time set aside for clinicians to document health of their patients for official purposes)” They are effectively being asked to take on extra work without pay, completely suffocating them. Sarina continued, “Now we’re adding more patients and then we’re adding more work … that now we have to we do after work. So doctors are forced to stay outside of work hours to complete their notes.
“We are burning and leaving. Kaiser talks about having 200 doctors; they hired 200, but 400 have left. The work environment is not stable. … We’re not replacing these doctors who are leaving so that patients don’t have access to care — it’s all intertwined. I’m very angry about it.” The work environment was so bad, she said, “It’s almost hostile.”
There are many resources to meet these requirements. In 2019, the sum of the 25 highest executive salaries at Kaiser Permanente was over $55 million. California is home to 186 billionaires, including Google co-founder Larry Page and Facebook CEO Mark Zuckerberg, some of the richest people on earth.
Having gone on strike several times during her career, Sarina said: “There is not much difference between the last strike and now. I mean, there are small changes, but minimal.”
All workers WSWS spoke to agree with the need for an extended strike by all Kaiser employees, putting patient care and work environment issues front and center.
Charles, another health care worker, whose name we have changed for anonymity, told him WSWS that an organization in turn fighting for common action outside the union would be wonderful. “I really like the idea,” he told us, “that you said of thinking outside of our union, outside of the box in some ways and collaborating with other workers.”
“I think we should all hit,” Sarina said. “Because, I think, in general, the Kaiser system is broken. It’s a billion dollar industry, but they can’t put their resources into helping their most acute patients?”
Sarina said she was “absolutely” in favor of a joint strike with other Kaiser workers. “I think our entire Bay Area team and Northern California team would go on strike with everyone else.”
Al said Kaiser Southern California mental health workers “should do the same” and go on strike. Asked about a next movement fighting for joint action, he replied: “That’s a good idea that I haven’t thought of until now.”
Ashley, another worker, said there needs to be concerted action across the workforce. “Different departments are facing similar issues that we are fighting for. The Kaiser would be happy with the status quo. I think the more people we have, the more changes.”