Developing a UNISON Vision for the NHS

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2005 National Delegate Conference
1 March 2005
Carried as Amended

Conference notes that, despite the record levels of investment going into the National Health Service (NHS), many NHS patients and staff are failing to experience the improvements that should be occurring. Too often, there exists a gap between the rhetoric about the positive changes that are supposed to be taking place in the NHS and the day-to-day realities on the front line.

In particular, Conference notes with concern the following developments:

1)the growing number of NHS trusts suffering from severe budget deficits;

2)trusts being forced to send up to 15 per cent of patients to be treated by private sector providers, leaving NHS wards padlocked up and NHS services starved of cash;

3)the difficulties being experienced by some foundation trusts;

4)the financial pressures being imposed by the new payment by results system, under which hospitals have to align their prices with a set national tariff.

Conference reaffirms its commitment to an NHS that is free at the point of use and provided within the public sector, in which there is equality of access for all patients and staff are treated fairly.

Conference considers that, if the extra money invested by the government in the NHS is to be well spent, politicians and managers must make the most of the insights and experience of staff working in the NHS. This applies to all NHS staff, whatever their role or seniority.

Conference further notes the importance of patient and public involvement in order to ensure that NHS services fully meet the needs of the patients and communities they serve. Conference regrets the government’s recent decision to abolish the commission for patient and public involvement in health, and the government’s decision to wind up the patient forums in acute trusts, leaving only those based in Primary Care Trusts. Conference believes that these changes will seriously weaken the current system of patient and public involvement, and calls on the government to ensure that patients and the public are provided with the structures and resources that they need to give them an effective voice in the NHS.

Conference is disappointed that, although many of the negative predictions made about foundation trusts are now beginning to be fulfilled in practice, the government is persisting in pushing ahead with expanding the number of foundation trusts, even opening up foundation status to Mental Health Trusts. In particular, Conference notes with alarm the concerns reported in the National Audit Office’s recent progress report on the NHS cancer plan that foundation trusts could pose a risk to the operation of cancer networks by refusing to cooperate with other trusts.

Conference also has serious concerns regarding the government’s policy of giving GP practices the right from April 2005 to hold an indicative budget, and fears that this is merely a step on the road towards real, devolved practice based budgets along similar lines to the old GP fundholding arrangements. Conference considers that the move to practice based commissioning will increase transaction costs in the NHS, will widen inequalities in patient treatment, and risks encouraging some practices to compromise the quality of patient care in order to cut back on costs.

Conference calls on the National Executive Council, together with the Heath Service Group, to:

a)develop a UNISON vision for the future of the NHS;

b)campaign to ensure that funding arrangements for the NHS remains through direct taxation;

c)campaign against the continued introduction of markets and competition into the NHS, highlighting the risks to patient services;

d)vigorously oppose any steps by the government or health trusts to introduce any further co-payment or charging for health services;

e)continue to support branches in opposing applications for foundation status;

f)form alliances at local and national level with other organisations and bodies, including with other trade unions and patient groups.