Using the Unions: Healthcare Struggles in Italy and Spain between Trade Unionism and Self-Organization

The healthcare sector has been profoundly impacted by global neoliberal restructuring which, in turn, has provoked campaigns of resistance from workers and users. Scholars' investigations of this resistance to have focused on unions' struggles in the workplace, user campaigns relating to access as well as instances of self-organized healthcare provision. This paper adopts a new focus – self-organized groups of healthcare workers and users which strategically use union resources. Our findings show how these groups, while emerging independently of unions and often framing unions critically, nonetheless rely on unions both in workplace-related struggles and campaigns regarding access to services. We identify three main purposes for which these groups use unions – expertise, institutional and legal resources, and publicity – and argue that these strategic uses are related to the phase of demobilisation in which social movements find themselves. As well as providing new insights into a distinctive feature of organizing within the healthcare sector, our research contributes to the literature on workers' self-organization and to labour revitalization studies by showing how and why self-organization and trade unionism interact.