Choice, Equity and Accountabiilty in the NHS

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2004 National Delegate Conference
2 March 2004
Carried as Amended

Conference applauds the work of the union in campaigning against the introduction of foundation trusts and highlighting the marketisation of the NHS. Conference applauds in particular the sustained campaigning through the Labour Link which led to the overwheling rejection of foundation hospitals by the 2003 Labour party conference. Conference also recognises the important role played by our partners in the campaign, including MPs, campaign organisations and community groups. Our task must now be to maintain and increase pressure on the government, in line with the Labour conference decision, to discard without delay its whole unpopular and divisive foundations hosptials strategy.

Conference reaffirms its opposition to the introduction of foundation trusts. Foundation trusts will lead to greater inequality in the NHS, attracting extra resources at the expense of non-foundation trusts.

In addition, Conference notes with extreme concern warnings from NHS managers that, because so few people have registered to become foundation trusts members, foundation trusts could be susceptible to takeover by extremist far right groups such as the British National Party (BNP). Such an outcome would be anathema to all of the values of the NHS, and would make a mockery of the aim of giving communities greater control over their local hospitals.

Conference supports the goal of ensuring that all NHS patients have fast and convenient access to high quality, publicly funded services that are responsive to patient needs. Conference believes that, up and down the UK, NHS staff are already striving hard to achieve this: bringing down waiting lists; putting patients at the heart of decision-making; and developing new and innovative ways of providing services. Conference welcomes the steps the government has taken to better enable staff to build on this progress, for instance by working together with UNISON to give staff improved access to training through the NHS university.

However, Conference opposes the government’s determination to continue its privatisation of the NHS by giving all NHS patients in England, who need elective treatment, a choice of provider at the point of GP referral, including the option to go in to a private sector hospital. Together with the introduction of a new NHS financial system in which money will follow the patient, this will result in the creation of a competitive commercial market in the NHS, in which hospitals compete against each other and the private sector for the most profitable patients.

Conference believes that rather than the ability to choose a hospital, what NHS patients really want is the knowledge that they have a high quality local hospital with high standards of care at which they can receive fast and appropriate treatment should they need it.

Conference further considers that patient choice of hospital at the point of referral, if implemented without safeguards, could lead to a similar increase in inequalities as has been seen as a result of the policy of choice in schools. There is a danger that the hospitals that are most popular may seek to cherry-pick the most profitable patients, creating a situation in which, far from the patient choosing the hospital, the hospital chooses the patient. Meanwhile, hospitals that lose patients could be trapped in a cycle of downwards decline, struggling to maintain services on ever decreasing amounts of funding.

Conference therefore calls upon the National Executive Council, together with the Health Service Group Executive, to:

1)support branches in campaigning and their individual fights against the introduction of foundation trusts and continue to work to prevent the potential negative effects of foundation trusts, such as increased inequalities between hospitals and poaching of staff;

2)seek to ensure that control of foundation hospitals is not seized by far right organisations such as the BNP;

3)collect evidence from the experience of the first foundation trusts, in time to inform UNISON’s submission to the commission for healthcare audit and inspection’s review of the foundation trust policy in 2004-2005;

4)raise with government concerns about the potential detrimental effects of the introduction of patient choice at the point of GP referral which could lead to greater inequalities in NHS services for patients;

5) develop a non-market based agenda for NHS improvement, drawing on the experience of NHS reform in the devolved nations.