Working for an Employer May Be Dangerous to Your Health, Part Seven: The National Day of Mourning in Canada and the Social Causes of Injury, Disease and Death

On April 28 is the National Day of Mourning in Canada to commemorate those workers who have suffered disease, injury or death at work. However, unions rarely if ever raise the issue of how effective such a day of mourning is for addressing the health and safety problems that workers experience. Why do more or less 1,000 workers die every year at work and around 600,000 experience injuries or disease (Bob Barneston (2010), The Political Economy of Workplace Injury in Canada).

For example, I listened to the “Welcome to the Toronto & York Region Labour Council’s Day of Mourning ceremonies” for 2021 (https://www.youtube.com/watch?v=zl-7e8Ta-H8&list=LL&index=14). In none of the presentations do the presenters attribute problems of health and safety to the structural situation of the persistent need to accumulate capital at the expense of workers’ health and safety.

One of the ways in which the health and safety of workers who work for an employer has been jeopardized is the administrative shift in the capitalist government’s definition of the causes of dangers to health and safety. Government or state representatives defined health and safety problems in purely technical terms, ignoring the social causes of dangers to the health and safety of workers.

From Tom Dwyer (1991), Life and Death at Work: Industrial Accidents as a Case of Socially Produced Error, page 26:

Conflict over the weakness of safety laws proceeded [in England], especially from the 1870s when workers were able to achieve greater parliamentary representation. Through an examination of the content of regulations, we can see that workers’ social demands were largely ignored as, increasingly, solutions to problems emerged in important political compromises that were channeled technically. … The vision that the state lent to the prevention of accidents was overwhelmingly based on the development of technical criteria, while social criteria were, with some notable exceptions, given little attention.

The shift from defining health and safety dangers from social causes to technical causes led to the increasingly bureaucratic or administrative definition and treatment of the problem; this in turn contributed to the fragmentation of workers’ organization and struggle of the workers in relation to the social power of the class of employers.

From Tom Dwyer, Life and Death at Work: Industrial Accidents as a Case of Socially Produced Error, page 27:

The attention of unions was increasingly channeled away from the worksite and toward legislative change to be conquered through the efforts of members of Parliament sympathetic to the workers’ cause. The power of the bureaucracy grew as industrial problems became increasingly subject to political control through their transformation into administrative questions.

This view of the shift towards governmental administration of problems and away from class organization and class struggle is consistent with the view of a more general shift towards a capitalist government that administers laws–public administration.

From Mark Neocleous (1996), Administering Civil Society: Towards a Theory of State Power, pages 106-107:

In fact, the theoretical ‘problem’ over the relationship between struggle and
structure only arises by separating them and thus being faced with the necessity of syncretically syncretic • \sincretic=characterized or brought about by a combination of different forms of belief or practice] drawing them together again, or at least positing a causal relationship. But, as Werner Bonefeld [a Marxist theoretician] writes, structures are a mode of class antagonism and thus both the result and premise of class struggle. This is true of the capitalist state generally and specific institutional developments of that state. For the other moment of the making of the English working class was the (re)making of the modern state. Far from being supine [which means: failing to act or protest as a result of moral weakness or laziness], in the process of struggle the working class forced the emergence of new state structures – of political administration- and through these a reordering, far more fundamental than that forced by the bourgeoisie in its struggle, of the relation between state and civil society [capitalist society apart from the government or state]. The British state, faced with struggling classes, pre-empted revolutionary change by subsuming class struggle under the state through the development of administrative structures and mechanisms. The development of the state can be traced to the incorporation of working-class struggle into its very structures, as increasing elements of civil society found themselves structured, restructured and submerged. With typical flexibility and a seemingly endless ability to adapt itself, the British state responded by creating a space within itself for this purpose. Thus, although the working class was constituted by the state, the state itself was constituted through class struggle. The working class was both constituted by and constitutive of the structures of political administration and state power. (To put this another way: we need a conception of the working class not only as subjected, but also as subject.) The only way to incorporate the English working class was for the state to be altered accordingly, new (administrative) forms emerging which could then be used against the working class. Political administration, then, acts as the fulcrum around which both the working class and the modern state were ordered. Just as humans ‘by their own toil keep in existence a reality which enslaves them in ever greater degree’, so the working class in its struggles produce the real structures which then enslave it. Poulantzas [a Marxist political theoretician] rightly claims that ‘struggles are inscribed in the institutional materiality of the state, even though they are not concluded in it; it is a materiality that carries the traces of these muted and multiform struggles.’

This insight can be strengthened and tightened by positing political administration as a specific form of working class struggle, by following Adorno [a Marxist critical theorist] in arguing that administration acts as a process of subsumption, a mechanism for ordering and covering over. ‘Administration’ has feudal origins referring to the management of the estates of the dead; hence ‘the administration of wills’.67 I am arguing that we think of political administration as state management of the struggles of the working class. By subsuming struggle, political administration is ‘working-class power post festum [after the fact]; working-class political victories captured and formalized at their moment of triumph.’68 In these administrative structures the state appropriates and nullifies the struggle of the working class; as such they are the fossilized remnants of class struggle; they are the subsumption [meaning: of including under another, usually something more general] of struggle – working-class struggle abolished and preserved. Born of the struggle of the working class these structures are then left with the task of administering that same class, a task performed in relation to both collective organizations of the working class and its decomposed elements known as ‘citizens’. It is therefore through the very process of struggle that the working class, and not its ‘aristocratic’ elements, now most definitely of civil society, also finds its struggles incorporated into the state, transformed into administrative structures and turned against it. Thus in its struggle to become a class of civil society, the class discovers itself also to be a class of the state.

The administration of the health and safety of workers by the capitalist government or state channeled workers’ struggles in this area into a redefinition of the nature of the causes of health and safety issues, away from social causes–such as the very nature of the power of the class of employers and how they, directly or indirectly, use workers for purposes over which workers have no control (see The Money Circuit of Capital) and which is inherently connected to the possibility of disease, injury and death.

If the capitalist government is adept or skillful at channeling worker discontent into new administrative forms, then issues must be addressed in such a way that the capitalist government cannot accommodate them (see, for instance, my argument for a generous universal basic income that erodes the market for the hiring and firing of workers, A Radical Basic Income as a Radical Reform).

In relation to health and safety issues, strong workers’ organizations at the local level (not just unions and union reps), coupled with increasing links between workers’ organizations across industries, would be a necessary step in preparing workers to resist forms of class struggle that include legislative changes that define problems as non-social and, correspondingly, shift solutions to the redefined problems by means of administrative means.

To achieve this, would it not be necessary to abandon all talk of “fair compensation,” “fair wages,” “fair contract,” “Fair labour laws save lives,” “decent work,” and so forth? Such phrases paper over the real and persistent threat of disease, injury and death that workers face. Opposition to such phrases, of course, is hardly sufficient. Is not opposition to such cliches necessary, though, if workers are going to initiate a movement dedicated to addressing the social causes of their own sufferings.

Health Care: Socialist versus Capitalist Nationalization

Since the coronavirus and health care are undoubtedly on the minds of many people throughout the world, I thought it appropriate to do a bit of research on socialist health care versus present capitalist health-care systems.

Health care even in a nationalized context can easily be an expression of oppression and exploitation. The idealization of nationalization often goes hand in hand with an argument that we need to extend public services in health and education (as Sam Gindin has argued). However, nationalized health care can easily become an oppressive experience for workers (as well as patients). From Barbara Briggs (1984), “Abolishing a Medical Hierarchy: The Struggle for Socialist Primary Health Care,” pages 83-88, in the journal Critical Social Policy, volume 4, issue #12, page 87:

GPs AND SOCIALISM

Socialists have traditionally argued for state control of key areas of the economy and of the provision of welfare services such as health and education. Socialist health workers have argued for general practitioners to become salaried employees of the Area Health Authorities, along with the ’ancillary workers’, instead of continuing to enjoy the independent self-employed status that they insisted on to protect their status when the NHS [National Health Service of the United Kingdom] was set up.

But the NHS, the largest employer in the country, has shared with nationalised industries the failure to demonstrate any evidence of ’belonging to the people’: because of the backing of the state it has proved a ruthless and powerful employer, keeping the wages of unskilled and many skilled workers also at uniquely low levels; time and again, union members seeking improvements in pay and amelioration of very poor working conditions have been defeated. Nor has the NHS shown any kind of effective accountability to its users. Public spending constraints have hit the NHS not only by causing a decline in working conditions and in the services provided, but also by imposing even more centralised planning priorities based on the need to save money whatever the cost.

This situation likely characterizes the Canadian public health-care system as well.

A word about the Canadian health-care system. One inadequate view on the Canadian health-care system is the social-democratic or social-reformist perspective, which certainly exists in Canada. One definitely inadequate view considers the Canadian health-care system to be socialist (Mary E. Wiktorowicz, pages 264-262, “Health Care Systems in Evolution,” in Staying Alive: Critical Perspectives on Health,
Illness, and Health Care (2006), page 243):

In many ways, national health insurance symbolizes the great divide between:
liberalism and socialism; the free market and the planned economy (see Box 10.1).

Nationalized health care in no way represents the great divide between liberalism and socialism. An apparently critical form of the analysis of health care–but in reality a variant form of social democracy or social reformism–looks at the inequality in access to health care, according to level of income. Thus, in the edited work Health Promotion in Canada: Critical Perspectives (2007), Denis Raphael, in his article (pages 106-122) “Addressing Health Inequalities in Canada: Little Attention, Inadequate Action, Limited Success,” refers to levels of income as the major social determinant of the level of health. Since income inequalities in Canada are increasing, it follows that health inequalities are also increasing. However, this view defines a social determinant purely in terms of level of income–a typical social-democratic or social reformist method (I will deal with this issue in another post). As Glenn Rikowski (2001) points out (“After the Manuscript Breaks Off: Thoughts on Marx, Social Class and Education”, though, level of income is used instead of social class, or rather level of income is often used as a substitute by the social-democratic left:

… we witness the virtual abandonment of the notion of the working class…. Most people who analyse social class today do no such thing; rather, they have social inequality and stratification in view.

This use of the level of income to evaluate access to adequate health care is useful to a certain extent, but if it is the prime definition of class and inequality, it is far from adequate. It ignores entirely the source of income and exaggerates differences within the working class rather than a shared economic and social situation of being employees (or unemployed or temporary employees) and subject to a hierarchy of power at work (of course, managers are also subject to control from above, but in general it can be safe to assume that they form part of the middle class if not subordinate members of the ruling class).

The situation of the British NHS is typical of what happens when so-called socialist principles are realized in a capitalist context. Two socialist principles in particular fall by the wayside. From Bob Brecher (1997), (pages 217-225), “What Would a Socialist Health Service Look Like?,” in the journal Health Care Analysis, volume 5, issue #3, page 219:

These principles are: (a) that there by a reasonable degree of equity in respect of outcome concerning the distribution of basic resources, and (b) that people treat each other as ends and not merely as means. The first may perhaps be understood as a political and economic dimension of socialism, while the second constitutes a moral and social element.

The first principle considers that social equity is itself a good in itself or an end at which we should aim. The second principle considers that people deserve to be treated as people in all circumstances and not just outside work or as “consumers.” This second principle, of course, can never be realized in a capitalist society since human beings are necessarily treated as things or objects to be used as means by a class of employers (see The Money Circuit of Capital).

Health care would be just that: health care–not health service. From Brecher, page 221:

‘Service’ implies server and served; consultant and client; provider and consumer. But none of these describes the sort of relationship between carer and person carefd for that the two principles outlined suggest. To take the example of the NHS again: despite the intentions of its founders, it was the connotations of service–by turn beneficently providing for patients and ‘servicing’ them as though they were objects–which helped provide amply justified dissatisfactions with the resultant shortcomings of the NHS treatment: and these have been used to undermine its founding principles. The combination of professional paternalism, especially in respect of senior doctors; an inability or unwillingness to treat people rather than their symptoms; and an attitude of ‘servicing’ and being ‘serviced’ all helped alienate people from what was supposed to be ‘our’ NHS, enabling successive conservative governments to turn what was at its inception at least a ‘social’ health service into an expliictly anti-socialist one. … these are not accidents of the British context: such terms and the attitudes and mores they describe are inimical to a socialist structure, based as that must be on considerations of equity and respect.

It is important to emphasize, as Brecher points out, that the assumption that nationalization is somehow socialist without further ado itself contributes to the Conservative backlash and the emergence of neoliberalism. By indulging the social-democratic or social-reformist left, with their talk of “decent work,” “fair contracts,” “fair share of taxes,” “$15 Minimum Wage and Fairness,” and the like, the so-called radicals have in reality contributed to the neoliberal backlash. What is needed is not indulgence of such talk, but continuous critique of such talk. What is needed is a critical attitude towards the so-called “left” and its associated idealized institutions.

What is needed is critical and hence democratic analysis and discussion of health-care systems. What is absolutely unnecessary is the defense of flaws in various social systems. If we are going to create a socialist society worthy of human beings, we need to be honest about the inadequacies of current social structures and systems.

Working for Employers May Be Dangerous to Your Health, Part Five

In Dwyer’s book, Life and Death at Work: Industrial Accidents as a Case of Socially Produced Error, in a passage quoted below, he argues that so-called accidents at work are socially caused but, historically, have been defined otherwise–as technical problems, for example, or as a result of individual mistakes.

In the passage below, he notes that health and safety issues should be identified and resolved according to need, with the priority being on the most destructive threats to health and safety. However due to the drive towards maximum profit at the expense of workers as mere things to be used to that end (see The Money Circuit of Capital), such a priority is often shelved in favour of solutions that agree with the interests of employers and those in political power.

From Tom Dwyer, Life and Death at Work: Industrial Accidents as a Case of Socially Produced Error. New York: Springer Science+Business Media, pages. 26-27:

Accident Prevention as Political Rationality

One might suppose that problems should be attacked according to
need: accidents provoked by different technically defined causes kill and
injure at dissimilar rates, and from a socially rational viewpoint the most
destructive of these should be the first to be treated. It appears, how ever, that accidents were singled out for treatment on the basis of rational
criteria developed within the economic and political spheres. In
the former case [the economic sphere] the commercial availability and viability of the products of scientific and technical development appears to be an important factor. In the latter [the political sphere], prevention appears to be primarily concerned with those accidents identified as having important political consequences–disasters constitute a prime example.65 In other words, it appears that early safety legislation was formulated neither as a function of needs
ascertained through a form of social rationality nor as a function of a
perception that accidents result from the operation of social forces within
the workplace. Reference to the social world is precluded in developing
criteria of need and strategies of prevention.

Unions often address the issue of health and safety through shifting focus from the worksite itself to legislative measures. From Dwyer, page 27:

The attention of unions was increasingly channeled away from the
worksite and toward legislative change to be conquered through the
efforts of members of Parliament sympathetic to the workers’ cause. The
power of the bureaucracy grew as industrial problems became increasingly
subject to political control through their transformation into
administrative questions.

Legislature measures may indeed address some health and safety concerns, but as just indicated, by shifting focus away from the worksite, legislative measures often transform the question to an administrative level. This shift is consistent with the shift in the nature of the capitalist state from legislative measures to administrative measures (see Mark Neocleous, Administering Civil Society: Towards a Theory of State Power).

Legislative measures are thus insufficient for addressing health and safety issues since they are transformed into a form of administrating workplace relations that are less directly subject to the control of workers.

What is needed, at least in part, is what Jane McCalevey, in her book No Shortcuts: Organizing for Power in the New Gilded Age argues calls deep organizing at the worksite itself. Worker organization and solidarity at the worksite is required. Organized worker opposition at the worksite needs to be developed as a culture. Supplementary tactics (such as those suggested by the International Workers of the World (IWW) should also be integrated; a march on the boss, for instance, where a group of workers face the immediate supervisor with an issue that concerns them, provides workers with a collective means that solidifies their workplace power.

However, this view definitely needs to be linked to a general critique of the power of employers as a class–which is what McCalevey does not do. She argues, incorrectly, if workers are organized at the workplace level, that organization or structure is the same as worker agency, or the idea that workers’ nature as persons is taken into account. However, the peculiar nature of capitalist relations is that what is produced by workers is used by the class of employers is used as a means to exploit, to oppress and to use workers for the purposes of the employers. The class issue cannot be resolved at the level of the workplace since the class issue is much, much wider than any worksite.

The attempt to shift to a legislative focus at least expresses the impossibility of resolving the exploitation, oppression and use of workers by employers solely at the level of the workplace.

What is needed to address health and workplace issues, then, is deep organizing at the workplace with a general critique and movement against the power of employers as a class. In this way, the real health and safety needs of workers can more adequately be addressed.

Should not the issue of the health and safety of workers be a priority? Is it? Can it be when a class of employers exist? Can it be when human beings are treated as means for the benefit of employers?

Should not union members call to account their union reps concerning the impossibility of adequately protecting workers in the face of the power of employers?

Should not workers begin to organize to end that power in order to make health and safety a priority at work?