By Leopoldo Tartaglia - Labor Notes, March 22, 2020
Italy is the Western European country where the coronavirus pandemic spread first and where its tragic effects are being felt the most. As of March 17, the official data say 26,062 have tested positive in Italy for COVID-19, 12,894 have been hospitalized—including 2,060 in intensive care—and 2,503 have died.
The epidemic exploded in the richest and most industrialized regions of northern Italy. Lombardy is the most affected, followed by Emilia Romagna and Veneto.
Lombardy and Veneto are examples of one of the fundamental issues called into question by the pandemic crisis: the adequacy of the Italian health system, in particular the public one. Italy still has one of the best public health systems in the world. The health reform of 1978 established a universal and free health system, available to all citizens, financed by general taxation.
But this reform came at a time when the Italian Communist Party still existed and the Christian Democratic governments still had to deal with unions and the political power of the workers' movement. Since then, and with particular virulence since the late 1990s, three phenomena have overlapped which have weakened the system dramatically (even if, thanks to union struggles, they have not completely destroyed it): (1) the regionalization of the national health system, driven by agitation in the Northern Regions for secession; (2) the privatization of many health services, particularly in these regions; (3) European and national "austerity" policies that produced cuts in public spending and to worker pensions, cuts which have strongly affected public health.
In the last ten years, public health spending has been cut by 37 billion euros overall, with a huge reduction in hospital beds and a continuous drop in medical, nursing, and ancillary medical personnel. Today, there are probably no less than 50,000 doctors and 50,000 nurses missing from public health. The pandemic has highlighted the great shortage of intensive care facilities: in Italy there are 5,000 beds in ICU units for 60 million inhabitants. In France, with a few million more inhabitants, there are 25,000; in Germany there are 30,000 serving 80 million inhabitants.
The regionalization and the continuous cuts to state resources earmarked for health services—which are divided among the regions on the basis of "historical expenditure"—have led to the collapse of the public health system, especially in the Southern regions which, fortunately, are still to date the least affected by the pandemic. The drastic limitations on people's internal mobility should help limit the spread of contagion in these areas.
EMPLOYERS WANT PRODUCTION TO CONTINUE
In this context, workers and unions immediately mobilized to demand policies and procedures from the national government, regional governments, and employers which would guarantee the health and safety of workers and do the utmost to limit the spread of the virus.
The bosses, especially Confindustria (the General Confederation of Italian Industry, the largest employer association) but also small businesses (which are very common in the productive fabric of northern Italy), have insisted on the maximum functioning of all economic and production activities, including logistics and distribution, while asking that the emergency health measures imposed by public authorities not be mandatory, but simply recommendations.
They have insisted that the decision-making authority should remain in the hands of the companies, in a unilateral form, without any consultation with the unions on either a corporate or territorial level. The governors of Lombardy and Veneto have been "wavering" because on the one hand the drama of the situation in their regions required drastic measures to close down activities and oblige people to stay in their homes, but on the other hand they were subjected to strong pressure from their electoral base, companies, and small entrepreneurs who did not want to cease their economic activities in any way.
The turning point occurred on March 11, when the national government issued a decree that imposed the shutdown of a series of production and service activities and "required" everyone not to leave their homes except for proven reasons of “necessity.” But herein lies the problem: it is evident that essential public services and the whole agri-food chain—from production to retail distribution—should continue their activity, but why must other economic sectors continue their work, when the general precaution to slow down the spread of the virus is to sequester yourself in the house? And for those called to continue to work, what safety precautions for their health and the health of others exist at work? Suffice it to say that even in hospitals and health centers, with exhausting work shifts and scarce staff, there are not masks, gloves, overalls, or other necessary protective equipment for everyone!