Organising health workers

Issue: 145

Sam Strudwick

Jane McAlevey, Raising Expectations (and Raising Hell): My Decade Fighting for the Labor Movement (Verso, 2014), £9.99

Jane McAlevey’s book, Raising Expectations (and Raising Hell), on the American labour movement is inspiring. This is a gutsy account of building union organisation with a real feel for life on the shop floor. She brings her own wealth of organisational experience to bear to argue how rank and file mobilisation is central to winning.

Through a series of disputes she gives an account of how to organise, how to identify workplace leaders and what it means to be part of a union. Above all she argues that activists and militants need to raise their expectations in order to build a movement that can win. Given the debates on the centrality of the working class, this book is a refreshing antidote to the idea that we need to look to alternative modes of struggle. As someone who experienced the highs of workers’ struggles during the 1970s and 1980s, I felt McAlevey gave a great insight to real struggle.

McAlevey is a full-time organiser for the Service Employees International Union (SEIU), a healthcare and public services union representing over 2 million members across the United States, Canada and Puerto Rico. She argues for the need to build confident, collective organisation and that strike action is key to uniting workers and the community in struggles that can win against the bosses.

McAlevey is relentless in her criticism of sweetheart union deals with the bosses in order to gain union recognition, and membership deals in exchange for keeping down militancy:

To me, organising means bringing workers into a deep personal engagement with their union, their fellow workers, their boss, their community and all of the social and political issues that shape their lives. Most labour leaders today think that ideal is not possible in the self-centred, plugged-in, globalised country this country has become.

One dispute in which she played a leading role was the health workers’ struggle against Universal Health Services (UHS), a Fortune 500 company and one of the fastest growing private hospital employers in the US. In her account McAlevey gives a real taste of what victory looks like:

Everyone crowded in and the meeting began. The atmosphere was electric… I was interrupted by shouting: ‘Did we get 100 percent retroactivity [backdated compensation] for every worker? ‘Yes, 100 percent retroactivity for every worker’. The room exploded. ‘Did we win the new wage scale for just the nurses or did we also win it for the techs?’ ‘What do you think?’ And the room exploded again. People were crying; I was smiling from ear to ear.

This approach to struggle is a lesson for health workers here who are fighting to defend our NHS and a decent pay rise. The book uplifts the spirit and gives you a real feel for workers fighting and struggling. McAlevey argues that “the biggest problem facing unions today is the lack of relationship between the union base—meaning the members—and union leaders.” She put principle into practice by taking rank and file workers into her own meetings with managers and recognising the prime role of women workers in health and the public sector.

McAlevey describes how one official coached her to always bring some nurses along to the bargaining meetings. McAlevey took his advice very literally. As they both left one such meeting the official burst out laughing, “Ahh, Jane, when I said always bring some workers along to bargaining, I didn’t mean the whole damn hospital.”

McAlevey gives a strong account of the union hierarchy and the obstacles they put in the way of workers’ success. However, if I have a criticism it is that the contradictory character of the union bureaucracy is missing. This can lead to the conclusion that “if only” the union leadership realised that the union’s best interests were served by building the collective bargaining power of the rank and file, the problem would be solved. Alternatively, all the rank and file need to do is organise themselves, ignoring the bureaucracy. This, however, leaves the door open to precisely the bureaucratic manoeuvres she complains of. McAlevey herself documents the sell-out by the leadership of the SEIU, the health and government workers’ union, and their attacks on militant union officers.

In the face of the bureaucracy’s aversion to shopfloor militancy, McAlevey argues for the development of “organic workplace leaders”. However, she sees little role for the left. She argues for a strategy based on identifying “natural” leaders, regardless of their politics, arguing that these should be individuals who command respect and who are involved in their local communities; so they may be active in their local church, for example, or even initially hold “anti-union” attitudes.

It is, of course, true that workers can change in struggle, and any rank and file strategy worthy of the name should aim to involve wide layers of workers. However, this is not a substitute for building a left in the unions that can exert pressure on the union bureaucracy, challenge the leadership when necessary and form an independent political force.

As a result McAlevey does not address how to generalise and deepen initiatives the bureaucracy can support. For example, she refers to the American fast food workers’ struggles as “press events and opportunities for liberals to wash away their guilt”. Rather than embracing action by any section of workers, she tends to draw artificial distinctions between workers who have power and those who do not.

McAlevey can also tend to downplay struggles over wages. She rightly argues that workers want more than pay increases but also “a safe place to live, meaningful work, control over their lives, more time off, clean water and clean air”. However, there is no contradiction in fighting both for wages and for wider social issues.

Nonetheless, despite these criticisms, this book remains a great tribute to rank and file struggle and militant workplace organisation, and is well worth reading. Although I found the beginning a bit hard going, I persevered and it just got better and better; so much so that I just wanted to go into the hospital where I work, stand on a table in the canteen and shout—“Everybody Out!”