Last Friday in his first speech to a health care organization since his October election, John Sweeney, the new president of the AFL-CIO, laid out a set of guidelines for labor-management cooperation in hospital restructuring in the kind of blunt terms that have come to characterize his leadership of the 13 million member labor federation.

"I can't think of a place where management needs labor as a partner more than in public health," he told the California Association of Public Hospitals in San Francisco.

"Our unions know that we face drastic cuts in funding, no matter how successful we are at lobbying, and we know that means we all face tough choices. But we will not sit silent seeing families ripped from their roots while many of the experts who got us into this mess in the first place exclude us from the decisions affecting our future."

Calling for health care workers to be treated as "full partners" in developing proposals for hospital restructuring, he said principles guiding labor would be in the best interest of public hospitals as well as workers and consumers. "We want serious consideration of alternatives to privatization and closures, such as the creation of public health authorities," he said, after predicting that 1.7 million health care workers stand to lose their jobs if Republican cuts in Medicare and Medicaid are adopted.

"We want restructuring proposals to recognize the rights of health care workers and their unions, as well as the right of unorganized workers to unionize without management interference or coercion. And we want communities, as well as workers and their unions, fully involved in deciding strategies and tactics for the actual restructuring plans."

Sweeney coupled his guidelines with a re-statement of labor's commitment to public health. "We cannot and must not allow the violent forces now battering our health care system to damage our mutual commitment to the mission of public health," he said. "And that mission is to provide high quality medical care to everyone who needs it, no matter how poor they are, no matter how old, no matter how sick, no matter what color and no matter what their immigration status."

Sweeney, who for 15 years was president of the Service Employees Union, which represents 475,000 health care workers, used the recent Los Angeles County fiscal crisis as an example of the difficulties faced by unions representing health care workers.

"Early on, we offered to cooperate and we were willing to help get federal and state relief if worker and consumer issues could be addressed. Unfortunately, the county manager tried to close us out of the decisions and we had to spend weeks and weeks in the streets and in the media to get our concerns addressed."

Sweeney said that after elected county officials took control and created a special task force, union needs were addressed and he was able to successfully press the Clinton Administration for help. But, he said, the county is now being unreasonable in making the union re-sign its own members in 29 clinics that are being privatized as a part of the Los Angeles County restructuring plan.

"To preserve bargaining rights for the workers who are our members, you made us go door-to-door and have them sign union cards. We signed up a majority in six of the first seven clinics. Now we ask that you sit down with us and help figure out a way to continue union representation without having to drain our treasury and exhaust our organizers."