“All they want is money!” The deliberative theory approach to the inclusion of nurses’ self-interests in the 2016 strike in the Children’s Memorial Health Institute in Warsaw

Abstract

The Polish healthcare system suffers from a growing deficit of nurses, whose population is ageing at an alarming rate. This deficit is correlated with the relatively low social, economic and political position of this female-associated profession. A looming crisis requires comprehensive, sustainable and long-term solutions, which could be achieved with deliberative governance, an approach that re-evaluates the dominant models of health policy-making and the way they process legitimate self-interests. This paper examines some of the challenges to the inclusion of nurses’ self-interests into public deliberation and policy-making. It is based on an analysis of the 2016 nurses’ strike at the Children’s Memorial Health Institute in Warsaw. The example will lead me to some political theory considerations that support the recent rehabilitation of self-interests within deliberative democratic theory as well as a systemic appreciation of the role of strikes. Using the original framework of three inputs of governance (emotions, self-interests and expertise), I present a theoretical synthesis of the three identified non-deliberative strategies for the treatment of self-interests: compartmentalisation, instrumentalisation and officious exclusion. In the end I argue that the difficulty in solving many health problems in Poland might come primarily from faulty policy-making practices that enforce suboptimal solutions.