The strike by the Vårdförbundet (Swedish Association of Health Professionals) is over. However, the nurses, biomedical analysts and midwives have no reason to celebrate.

The conflict has been going on since April and has escalated in several stages: first a blockade of new hires and overtime (not insignificant for occupational groups with a lot of overtime), then a strike, and finally additional groups, and increased numbers, on strike.

In addition to 'good pay progression', the main demand has been a reduction in working hours (amounting to 15 minutes a day), as well as stricter regulation of overtime and continuous holidays during the summer.

Strikes among nurses and in the health sector in general are unusual in Sweden and the dispute has received a lot of public attention and support, perhaps because it was fuelled by the slogan "save healthcare" – the conditions of those working in the health sector will ultimately be the conditions of all those in need of care.

However, when an agreement was finally reached and the strike was called off on Friday 28 June, the results were meagre.

• The general 15-minute reduction in working hours did not materialise;
• A reduction in working hours for those working only nights Monday to Friday, but not weekends, which are basically schedules that no one has;
• A reduction in working time for those on rotation (in three shifts with night work)
• Nothing for the others (which is cunning of the employers as they are crying out for people who want to work nights);
• Still no guarantee of summer holidays;
• Wage increases below the average for other occupational groups, the so-called "industry mark" of 3.3% (they got 3.05).

There is now, of course, a great deal of dissatisfaction among the strikers and a certain sense of surprise among the general public: why did it come to this, why settle for this?

To try to answer this, we need to find out: what did the dispute actually look like, how did the balance of power develop?

And: what is the role of the Vårdförbundet, and trade unions in general, when workers are fighting?

Full-scale strikes that completely shut down workplaces are naturally difficult in the healthcare sector, but it would still not have been difficult to take out more workers than they did and, above all, to hold out longer. The same applies to the blockade against overtime, which, if extended, would have put considerable pressure. There was an outspoken understanding of the strike, as well as the fighting spirit. At the same time, we know that this type of conflict is doomed unless it spreads and more workers become involved in the form of their own strikes or sympathy actions. A couple of unions have posted pictures on social media with the text "we back the Vårdförbundet", but that's all.

There have been no concrete sympathy actions, and the Vårdförbundet has not appealed for any either. At some local meetings it has emerged that Kommunal (the union organising assistant nurses) was prepared to take sympathy action but that "the issue had to come" from the Vårdförbundet – which it obviously did not, and that says as much about both unions.

Which brings us to the question of trade unions in general. In the early days of the labour movement, unions were the organised expression of the struggles workers were already fighting in the workplace. Although from the outset they were strictly for the betterment of conditions within capitalism, there was some room for struggle and control by the workers who belonged to them. Already in the early 20th century, however, they became more and more an integral part of the state and, with the First World War, a fully integrated, and institutionalised, part of the bourgeois state, as did the whole of the 'reformist' (which soon could not even be described as 'reformist' any more) labour movement.

Trade unions function primarily as a disciplinary mechanism and as a valve. By organising workers, controlling them and sometimes boasting about various 'demands', they give the impression that they are the ones fighting for us in the workplace (and the only ones doing so). In reality, they neither can nor want to. This has nothing to do with 'wrong leaders' and no, the union is not 'what we make it' – it is what it is. And it is not a fighting organisation!

Time and time again there is some pressure (or there is some other obscure reason, e.g. to justify their existence) that makes them need to go into conflict, usually half-heartedly and with meagre results. In this respect, the Vårdförbundet is no different from other unions, although not even seeking sympathy measures or extending the strike may seem particularly important.

However, this does not mean that struggle and strikes are pointless – quite the opposite! But we have to take the fight into our own hands and keep control of it. We can go out on so-called "wildcat" strikes together with our fellow workers and there we can control the scope, demand sympathy measures (or carry them out ourselves, independently, without the union). Of course, this is a big issue and easier said than done. But we have to start somewhere. For example, by creating groups outside of the unions in our workplaces, and making contacts with others who are doing the same. At present, this kind of organising is unlikely to achieve much more than putting pressure on both unions and employers, but it does provide fighting experience for the future.

The future, yes. Today we are vanishingly few, but all revolutionary forces must push for such forms of struggle, and in a future stage of higher level of class struggle we have to fight to make it general and organised. This in turn requires this minority to form itself into a revolutionary organisation – a party for want of a better word. Not as a government but as a guide and a tool for the fighting working class.

Because let's be honest – if we're going to "save healthcare", we have to save it from capitalism! For not just good care, but a whole world, worthy of all people.