Japan: health cuts and outsourced supply chains left a health system under-prepared

Abstract

36 | International Union Rights | 27/1-27/2 FOCUS | UNIONS, WORKERS’ RIGHTS, AND THE COVID-19 PANDEMIC Japan: health cuts and outsourced supply chains left a health system under-prepared The Japan Federation of Medical Workers’ Unions (JFMWU) represents 7 national unions and 47 prefectural unions in health and care sector in Japan. Since our formation in 1957, we have promoted campaigns and struggles for enough staffing and better working condition of medical doctors, nurses and care workers as well as for providing decent and better health care. Japanese health systems have been suffering from chronic understaffing, then we are working under the pandemic of COVID-19. Long working hours JFMWU has conducted a survey in every five years on working condition of nurses. The most recent one from 33,402 corresponded found that 71.7 percent says they have chronic fatigue, 67.5 percent says they have health concerns, 74.9 percent thinks to quite their job. These reasons are; 47.7 percent responded they have hard working condition due to understaffing, 30.0 percent responded their wage is low and difficult to take enough holidays. We also conducted nightshift work survey every year, and we found 39.3 percent nurses are working in 2-shift. And at 2-shift workplaces, 39.3 percent experience more than 16-hour work. Japanese nurses generally have more night-work than other countries, and 46.0 percent experiences less than 8-hour interval between shifts. To achieve safe and decent health and care, we have committed to promote strong campaign for better working condition and sufficient staffing. We demand ‘8-hour work day’, ‘more than 12-hour interval’ and ‘32-hour work week’, as well as more medical staff and better social security system. Reduction in designated medical institutions and community health offices Since the 1980s, the Japanese government has maintained its policy to reduce medical expenditure from the public budget, under the name of ‘administrative reform’ or ‘structural reform’. In recent years, Prime Minister Abe promoted so-called ‘Social Security System Reform’ in order to restore a balanced budget and to reduce social security expenditure. The number of beds for special infectious disease in 1998 was 9060 beds at 409 hospitals across Japan, but it is now only 1869 beds at 407 hospitals. It is important to note that 94 percent of these beds belong to public or government hospitals. The number of the public health offices was more than 850 in 1990s and now we have only 472 offices in 2019. Working conditions of medical workers under the pandemic When the Ministry of Health, Labour and Welfare issued a notice to request medical institutions to be ready for the COVID-19, JFMWU conducted an emergency survey for mostly public hospitals in March where we represent those workers. Even rather big and supposedly wellequipped institutions reported their concern and anxiety to respond to the outbreak, since they do not have sufficient medical staff and specialised facilities for dealing with infectious diseases. They have been forced to close loss-making sections such as TB sections, and do not have enough Personal Protective Equipment (PPE) and technical skills to treat infectious disease. Some hospitals say they accept COVID-19 patients while they stop certain surgery or outpatient department. In April, we experienced shortages of PPE at hospitals. According to the survey from 152 hospitals in 35 prefectures, we found some serious cases, both for safety and health of patients and health workers and sustainability of the hospitals. Some workers have only 1 mask per week. Another PPE and N95 mask are used repeatedly. Raincoat or garbage plastic bag are used for PPE. Sharp decrease of inpatients has huge impact for financial situation of hospitals and clinic, and there is a threat to cut wage and lump-sum payments in the coming months. Hospital workers have experienced discrimination and prejudice in community. JFMWU issued statements on these serious problems and demanded the governments to take immediate action. The Ministry reported 428 thousand COVID-19 inpatients, of which 222 thousand were hospitalised, The global supply chain system for PPE - based on neoliberal ideology - is clearly not working Shinobu Morita is President of the Japan...