Report Release: Unprotected yet Unyielding: The Decade Long Protest of China’s Healthcare Workers (2013 2023) 09 September 2024

Download the full report as a PDF here.

On 9 September, China Labour Bulletin released an extensive report documenting the last ten years of healthcare workers' rights violations, taking a case-based approach to understanding how workers have been owed wages, overworked, treated unequally, suffered from unsafe working conditions and ultimately unheard and not well represented. In the current environment, China's official trade union, the All-China Federation of Trade Unions, has to begin truly representing healthcare workers' interests.

The working conditions of healthcare workers in China were exposed when the COVID-19 broke out in Wuhan in early 2020. The death of whistleblower Dr. Li Wenliang on 7 February 2020 in Wuhan exemplifies the types of sacrifices made by healthcare workers, who had continuously faced life-threatening risks over the next few years as China's pandemic-prevention measures were implemented and then dropped across the country. At the end of 2022, China's sudden withdrawal of its pandemic-prevention measures further added to the demands of healthcare workers nationwide. Struggling to maintain regular services, healthcare workers were facing excessive workloads and occupational risks, as well as reduced salaries and even non-payment of wages and social insurance benefits, and sometimes life threats.

_{Photo: on October 24, 2018, hospital temporary staff went on strike demanding social insurance and equal work equal pay, in Jianli town, Hubei province.}

China Labour Bulletin has been documenting labour rights challenges in China since 2011 in a public database (the Strike Map). The number of cases we collected for hospitals stabilised from 2013 onwards, with a total of 135 cases recorded from 2013 to 2023. These cases involve various issues such as unpaid wages and social insurance, demands for "equal pay for equal work" by informal workers, performance pay and subsidy problems, work safety concerns, and hospital restructuring issues. These cases and data from our Strike Map serve as the foundation of this report. In addition, we also refer to media reports, scholarly articles, and surveys conducted by social organisations to explain the systemic problems in the healthcare sector that contribute to labour rights challenges.

China Labour Bulletin's database contains collective action cases since 2011 in our Strike Map and individual cases of worker grievances in our Workers' Calls-for-Help Map since 2020. Our data related to healthcare workers' collective actions and requests for help are mainly from doctors and nurses in hospitals - rather than primary healthcare institutions, clinics, cosmetic centres or other healthcare institutions - possibly due to biased sampling of online information or the fact that hospital staff account for more than 60 percent of all healthcare professionals in the country. Due to these limitations in data collection, this healthcare report will concentrate on the working conditions of doctors and nurses in China's hospitals.

By compiling cases of healthcare workers' collective actions and their online pleas for help, China Labour Bulletin aims to shed light on the labour rights situation of healthcare workers to the general public, policymakers, and trade union organisers. We argue that the frequent occurrence of labour rights issues in the healthcare sector is related to systemic problems and changes in China's healthcare system. The lack of a genuine representative for the healthcare workers during these changes has led them to resort to protests or seeking help online. China's healthcare unions in hospitals and the sectoral unions at ACFTU need to establish an effective and constant mechanism between labour and management in hospitals, which will allow the participation of multiple stakeholders and help resolve labour disputes.

Download the full report as a pdf here.

Note: The Chinese version of this report was published in February 2024. Readers can access the Chinese version here. Some hyperlinks in this report are in Chinese, and all hyperlinks are saved in archive.today.

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