Convergence, tous et toutes ensemble, resistons, all together we can resist

La Maternite des Lilas

On September 23d, an important demonstration was organized in front of the Minister of Health in Paris. The demonstration was organized by the movement Convergences of the hospitals fighting against Hosterity (Convergences des hopitaux en lutte contre l’Hosterity), which gathers together personnel from public hospitals associated with numerous associations defending women’s reproductive rights. They coined the term hosterity to indicate the strong correlation between the disassembling of the public hospital and the austerity measures that have shattered public services throughout Europe.

The neoliberal grip on the European population through the implementation of austerity measures has opened the way to uncontrollable privatization of hospitals and health care services. In Germany, Greece, the Netherlands, Spain, France and beyond, public hospitals are sold to private firms or health care systems. In particular, the French health care service, once praised for its efficiency and quality, has been the target of a series of neoliberal restructurations.

In 2012, the Chairman of the European Bank, Mario Draghi stated that the European Social Model was gone. What he meant was that under the aegis of neoliberal ideologues the rhetoric of needed reforms was going to force a drastic change for the public and its services. The immediate target has been the reproductive health sector, followed by other health care services.

The story of the maternity hospital of les Lilas epitomizes the gendered techniques employed to disassemble a solidarity system and the need for an active and political convergence of resisting forces. And so the Convergence movement was created.

On September 23d the women of the maternity hospital arrived with their now famous banderole that says, “La maternité des Lilas vivra”. The Maternity hospital of Les Lilas will live. The determination of its personnel is remarkable. They know first hand the accounting manipulations that have strangled their department and have denounced this attack on public health care. Giving birth is free of charge by national law, and so the way to attack this principle was to create administrative constraints and force many local maternity departments to close down and send women to maternity “factories” with fewer and fewer midwives and ob-gyn.

I talked with head of the department Marie Laure Brival and the midwives and the nurses, and the members of the supporting collective. In 2009, said Marie Laure Brisal, the budget for the necessary renovations was agreed on by the experts and signed by the Minister of Health. Then, under the same government, the restructuration of the health administration created the conditions through this new health plan for a retroactive review of this budget. The goal was to create big health structures in which ob-gyn departments had to be rearranged in factory-like structures with fewer personnel, and more deliveries and other reproductive services. In France, maternity hospitals take care of delivering babies as well as contraception and abortion services since both are what women need.

The maternity hospital les Lilas is located in a populous suburb of Paris and provides personal non-threatening service to women. The dedication of the staff to the comfort of women has been a model for many.

“Our fight has been going on for the past four years and has taken a national dimension, we receive support from everywhere. They even come from beyond the French borders from all over Europe” said Marie Laure, adding, “They fought with obstinacy and elegance.” When candidate to the presidency of France, Francois Hollande gave his support to the fight and promised that Les Lilas would remain open. “Unfortunately,” said Maris Laure Brival, “Political statements do not last long.”

The midwives told me that they were exhausted. Besides providing an excellent and peaceful environment, they have to organize and continue the actions in every way possible. I talked with women who have been patients there and all explained that it was a memorable experience.

Having just won a battle with the guarantee that they will not be absorbed by a bigger structure, they still have to obtain the complete funds to continue to put women first in a maternity hospital.

The bureaucratic structure Regional Health Authority have been operating since April 1 2010, Although they were presented as a necessary tool to enhance the health care system efficiency, their real function was to rationalize in a financial/accounting manner the delivery of care, in other words reduce social expenditures.

The American for-profit health care system is becoming the norm. The most universal systems are being transformed with the usual neoliberal tools that have the capacity of turning social responsibility into a violent arithmetic of profitability and deficits reduction. With this logic, the rhetoric of competitive enterprise and dehumanized factory production is applied to places of care.

In this context the struggle of the maternity hospital des Lilas is emblematic of the fight of women against the impoverishment of their lives with an overall continuously contested reproductive rights and health. Women are enormously affected by austerity measures or hosterity. First, they fill the ranks of poor workers, an expanding category. Women are overwhelmingly employed in care facilities, 49.8% of the public sector employment in France. In addition, when public care services are curtailed, women become unpaid care providers with all the consequences that implies. Finally, the restructuration of the reproductive health structures that are being pushed with this Hosterity represents an enormous set back for the entire health care system.

Last week, the demonstrators reaffirmed that health and social protection are not for sale. The convergence is broad. Other movements were represented from the struggle against austerity measures in Greece to the Spanish struggle for reproductive and health rights. Solidarities are being formed against the fragmentation of the civil society that characterizes the neoliberal order with its rhetoric of competition. Marie Laure Brival took the microphone and ended her speech with Tous ensemble resistons (all together we can resist) and the crowd repeated it several times. We are not competing we are cooperating against the neoliberal order!

Les Lilas, and women everywhere, are under attack

In France, women’s health and autonomy are under attack. When Francois Hollande ran for office, he made great promises. He promised that the maternity hospital “Les Lilas,” would not close down after having been the target of the conservative financial restructuration. Now he’s backtracking, and women’s reproductive rights are likely to be compromised.

The maternity hospital “Les Lilas” is located in a diverse area in the North of Paris. Les Lilas was built in 1964 with the feminist agenda to serve women’s needs. A privately run not-for-profit hospital, Les Lilas serves and participates in the public health care system. Les Lilas has historically been the symbol of women’s struggles for reproductive rights.

Today, the team of medical staff offers, with equal enthusiasm, obstetrical, gynecololical and abortion services to all women regardless of their social status or ethnicity. Their approach is integrative, making women’s needs and desire a priority. The feminist and militant aspect of the care they deliver departs from the current trend of cutting public services, including health care.

During the Sarkozy years the idea of profitability was extended to medical care. This was new for the French health care system. Sarkozy’s administration introduced a tariff arrangement that relegated care behind accounting. Now, President Hollande, having forgotten promises to save Les Lilas, has submitted the hospital to the same neoliberal profit motive.

Les Lilas needed funds for necessary renovations. These renovations were delayed making the hospital more dependent on credit for financing. Then, a tariff system was implemented devaluating abortion, which is a great part of its activity. Basically, the tariff devalued all health care services offered to women. This conjunction of devaluations typifies how women’s lives are undervalued in general.

Then, more regulations came to unfairly impose medical services upon Les Lilas, which forced the maternity hospital to invest money it did not have. These measures increased the hospital’s debt.

Across France, these conditionalities have forced many maternities to regroup, turning hospitals into “usines a bébés,” or baby factories.

When Les Lilas first needed some renovations, it had no debt. In fact, it was financially stable and had agreements to secure the future. With a debt forced upon it, the services provided to women are only measured in financial terms. With that shift, the hospital loses value.

The community, women and men, have joined together to counter this evolution. A collective committee has been formed; the staff of Les Lilas has been active using many media to show what this struggle means. Demonstrations have been organized with the support of many feminist and political groups. The last demonstration gathered 3000 people.

Isabelle Louis, of the French Movement for Family Planning and a member of the collective committee, told me that the negotiations with the regional health authority were difficult. Although the fund for renovations had been promised, the health authority now argues that running a deficit makes the delivery of that fund impossible. They use a new language of neoliberal accounting to confuse negotiations. The people used to be the actors and now they have become the developers. Isabelle Louis remarked how this neoliberal economic language has negated the social. This language talks of indicators of success, progress, and realization to respond to deficit with efficiency. However, this language has no term to analyze the health and well-being of the women who rely on “Les Lilas.”

Isabelle met with socialist Claude Evin, former minister of health and now general director of the regional health agency. He admitted that his obsession is to build more retirement medical homes than maternity hospitals. Of course, retirement facilities, unlike maternity hospitals, are part of a great market open to private investments. Isabelle has found the solution, “Let’s deliver babies in retirement medical centers!”

This tale is exemplary of the massive undertaking of neoliberal ideology on public systems. Women are under attack. In France, the progressive health care system and the reproductive health policies are threatened. France today, the United States yesterday, tomorrow … ? All of us, everywhere, need to pay attention to these signs.

 

(Photo Credit: La Maternité des Lilas Vivra)