The Fight to Save the NHS Goes On

The Unison Health Care Conference 2012 was held from April 23-25 in Brighton. As WWIE pointed out last week, the conference took place at a crucial time for all working in the health service in Britain. Over the last year since the last conference, the union has been one of the main forces in the massive organised opposition to demand that the Coalition government drop the Health and Social Care Bill. The bill was eventually rail-roaded through Parliament to get the Royal Assent on March 27. At the conference, delegates discussed how to continue the resistance to the implementation of the Act which is aimed at further opening up the NHS to further fragmentation and handing over provision and commissioning of services to the private sector monopolies. The conference theme Our NHS Our Future captured the need at this time to safeguard the future of the NHS, take forward the resistance of health workers and professionals and plant the alternative that a health care is a right that must be given a guarantee and publicly provided to meet the needs of all.

Moving a composite motion on the new Act and privatisation, Maddy Nettleship of Gateshead health branch asked: "How can we organise from here? That is the important question. Health workers at all levels are not reconciled to what the Act will mean. The struggle to prevent the NHS becoming totally controlled in the interests of the big health monopolies will surely continue. There is also great anger and bitterness about the arrogant use of power by the ConDem government against the will of the people. They reasoned without an effective opposition in Parliament and with a guarantee of being in power till 2015 that they could just ride roughshod over the public good. And as you know despite all the opposition that resulted in over 180,000 people signing the e-petition against the Bill and many thousands on paper petitions. All sections of the people are opposed to this."

Maddy noted that “before the Bill has become law, as we have been told earlier in the conference, Virgin Health Care has taken over the whole of Surrey’s community services and Devon's paediatric service. Circa have taken over Hinchingbrooke Trust and living up to their name they are circling like vultures over other so-called failing Trusts".

She continued: “Up and down the country individual Trusts are attacking our terms and conditions, trying to move towards local pay bargaining that will benefit no-one, but the health monopolies waiting to move in. With the business model in place mergers will become the norm – we know in our area in Gateshead it is likely our trust will be gradually eaten up by Newcastle, and that is already happening to our paediatric service. In our Trust, we have had one of the main movers in privatisation McKinsey Consultants in over the last few weeks. The Trust is not telling us how much this costs because it is commercially sensitive but we know that it is costing thousands. We found out this week that McKinsey has told the directors to take a 5.8% increase. This is when as you know we are facing a three-year pay freeze and that is because they are introducing the business model to incentify the directors to make cuts that affect the people under them. Already with only the welfare of our patients at heart we are feeling the brunt of the cuts that are masquerading as efficiency savings.

“But what is certain is that we, together with our local communities, will oppose the government health reforms every step of the way. The opposition has been shown clearly as the Bill has passed through Parliament and will not disappear. Some people say that this was the last chance to save the NHS. But for us it is a chance to sum up what has been achieved in the development of the movement to safeguard the future of the NHS. The movement, the movement for the alternative has grown and grown over the last two years and shown that there is an alternative to the wrecking of the NHS and the whole social economy that has been carried out by the ConDems. Roughly every eight weeks over the last year we have demonstrated outside of our Trust raising the profile of the opposition to the Bill as has happened throughout the country. Actions such as these must continue, locally, regionally and also nationally finding new ways of organising.

“We must put forward that the real alternative is to stop using the economy to pay the rich and invest in health care and other social programmes. All of us together with our local communities must continue to declare that health care is a right and that this right has got to be given a guarantee. We must fight nationally, regionally and locally united to defend all those who oppose the coalition’s mission to privatise the NHS and do the bidding of the health monopolies no matter what party they are in, or what organisation they are in. No still means No! Our Hospitals! Our NHS Our Future!”

Examining the services that private “any qualified providers” are already looking at in just one trust, Pat Davies of the PT 'B' sector committee noted that, "again, this government is targeting most vulnerable groups in society with AQP”.

But there is an alternative, as Roger Nettleship of South Tyneside health noted.

Although the prime minister had "thrown a grenade into the NHS" to fragment it and wreck it, the Coalition government has no legitimacy. "The challenge for the whole movement for the workers’ opposition is the fight for the alternative. It is about building the resistance and organisation that undermines and overthrows the monopoly dictate in Parliament and throughout society. This alternative does not accept health care being turned into a commodity in a health market. Health care is not a commodity; it is a need that must be provided for. The alternative does not accept that any government has the right to champion the claim of the monopolies over the claim of the public. Our alternative is that public right must prevail throughout society over monopoly right."

Conference agreed and voted to continue and intensify the Our NHS Our Future campaign, working with other organisations and pushing the case that there is an alternative.

The Unison leadership is calling for a national demonstration for the alternative coming out of the conference, which keeps open a space for the working class and people and the Workers’ Opposition to develop the resistance and plant the alternative.

Conference reaffirms its complete opposition to the Government’s Health and Social Care Bill.

Conference believes that the Bill is the biggest threat to the English NHS in its 64 year history. Despite minor changes made by the so-called “listening exercise”, the fundamental dangers of privatisation, fragmentation, instability and inequity remain. The Bill will turn the NHS into nothing but a source of profit for the big health monopolies.

Conference notes the following major threats in the Bill:

a) the abolition of the private patient income cap, meaning NHS patients arelikely to have to wait longer for treatment, endangering the principle that access is based on need rather than ability to pay;

b) the use of wholesale competition in the NHS with the regulator able to enforce competition law in the style of the utilities regulators;

c) a much greater role for private companies in both the provision and commissioning of care;

d) the Secretary of State will be able to abrogate responsibility for the NHS, with implications for the maintenance of comprehensive, free and consistent NHS services;

e) attempts to address transparency, democracy and involvement are far too weak.

For NHS staff, Conference notes that the Bill represents a major threat to job security and also to terms and conditions. The Government predicts 13,000 redundancies and has completely failed to acknowledge the need to retain national workforce structures for terms and conditions, pay and bargaining, with encouragement for employers to break away from Agenda for Change.

In addition, Conference notes the threat posed by the accompanying move to using the Any Qualified Provider (AQP) policy. Conference believes this will lead to a greater role for private companies in delivering health services and threatens the jobs and terms and conditions of UNISON members, as a more unstable market environment is created and government claims that TUPE is unlikely to apply under AQP. Further, Conference notes the need for UNISON to be able to respond with local campaigns to the threat posed by AQP.

Although the Bill and the “Liberating the NHS” white paper relate to the NHS in England, the impact they could have on undermining pay and bargaining structures could affect UNISON members across the UK. There is also the potential for parties within the devolved nations looking to emulate some of the damaging changes in the Bill, in the way that ideas such as PFI (private finance initiatives), Payment by Results and Independent Sector Treatment Centres have been exported in the past. Conference resolves to fight the Bill every step of the way in Parliament by continuing to campaign for the Bill to be scrapped and by seeking amendments to rid the Bill of its worst excesses.

Conference notes the successes of UNISON’s Our NHS Our Future campaign in bringing the dangers of the Bill to a much wider audience and in galvanising opposition to the Government’s plans.

If the Bill becomes law, Conference notes the importance of mounting local challenges against the implementation of Government plans where possible and monitoring the impact of changes in terms of the expanding role of the private sector and the impact on NHS patients and staff.

Conference also notes that some foundation trusts are already beginning to threaten to break away from Agenda for Change and to increase the money they make from private patients. Conference believes that this justifies UNISON’s ongoing concerns about forcing hospitals to move to foundation status. Conference also believes, however, that with virtually all hospitals due to become foundation trusts within the next two years, now is the time for UNISON to increase its influence within these bodies as a means of blocking moves that could threaten NHS patients and staff terms and conditions.

Conference therefore calls on the SGE [Service Group Executive] to:

1. thoroughly condemn the Bill and its effects;

2. continue and intensify the Our NHS Our Future campaign against the Health and Social Care Bill;

3. work with other organisations to continue to have days of action, locally, regionally and nationally;

4. take these issues to our members and to the public and explain there is an alternative;

5. oppose the Government’s move to using AQP to deliver services;

6. develop an organising strategy to meet the new challenges for the union presented by AQP, particularly in the science, therapies and technical sector where services and staff are already being affected;

7. monitor and challenge the local implementation of government plans; and

8. encourage UNISON members to become active in the staff membership constituencies of foundation trusts, as a means of influencing plans that could harm staff and patients.

38 Health Group Executive
38.1 National PTA Sector and National PTB Sector
39 Gateshead Health