Commissioning a Patient Led NHS

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2006 Health Care Service Group Conference
21 December 2005
Carried as Amended

Conference applauds UNISON’s campaign opposing the changes outlined in Nigel Crisp’s letter of 28 July 2005 “Commissioning a Patient Led NHS”. This has included:

·UNISON’s successful motions to the TUC Congress and to the Labour Party Conference

·Working through the Labour Link in order to achieve an Early Day Motion, signed by 120 MPs, calling on the Government to withdraw its proposals for PCT reconfiguration pending further consultation

·The establishment of a new coalition of trade unions, patient groups, voluntary organisations and others to campaign against the changes set out by Commissioning a Patient Led NHS, and to develop positive alternative ideas for delivering further improvements in primary care

·National negotiations on an HR framework to manage the workforce implications of the reconfiguration of PCT and SHA boundaries

·The production of a newsletter for primary care staff explaining the changes and what UNISON is doing in response, linked into UNISON’s primary care recruitment and organising campaign.

Conference notes that many of the changes contained in “Commissioning a Patient Led NHS” were announced without prior warning or discussion, and deplores the Government’s failure to consult with the trade unions beforehand through the Department of Health’s Social Partnership Forum.

Conference affirms its opposition to the outsourcing of primary care services to alternative providers, including the private sector, and to the proposal to introduce more “contestability” into the provision of primary care. Conference considers that these changes will diminish the quality of care by increasing fragmentation, and will result in worse pay and conditions, and less investment in training, for staff. Conference welcomes the statement by Patricia Hewitt that Primary Care Trusts will not be forced to outsource clinical services, but believes that there should be a presumption in favour of the retention of primary care services within the public sector.

Conference also affirms its opposition to the process for the reconfiguration of PCT and SHA boundaries announced in Commissioning a Patient Led NHS. Conference believes that this was primarily driven by the Department of Health target that PCTs must achieve 15% savings in management and administration costs, and that it runs the risk of disrupting PCT commissioning structures and of creating PCTs that are more remote from the communities that they serve.

Conference notes that the campaign against the ‘Nigel Crisp’ letter led to some back-tracking by the government, removing the requirement for PCTs to divest themselves of provider services. However, the white paper ‘Our Health, Our Care, Our Say’ and other Dept of Health guidance (such as ‘Health Reform in England: update and next steps’ and ‘The NHS in England: operating framework’) make it clear that primary and community health services in England are still open to takeover by the private, voluntary and not-for-profit sectors.

Conference calls on the Health Service Group Executive to work with the NEC, other UNISON service groups, Labour Link, the GPF, branches and regions to:

a)Support UNISON members and branches affected by the reconfiguration of PCT and SHA boundaries;

b)Campaign against the outsourcing of primary care services to external providers, in particular the private sector;

c)Campaign against any extension of the role of the private sector or of contestability to the PCT commissioning function;

d)As part of this campaigning work, publicise the different ways that primary and community health services are being threatended with privatisation not only in England but throughout the UK.