Marketisation of the NHS

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2006 Health Care Service Group Conference
22 April 2006

Conference notes that government policy in all of the four UK countries has led to the continuing privatisation of NHS services. Conference recognises the escalating competitive commercial market that is developing and welcomes the work of UNISON in providing advice and guidance to its members on the implications of the Government’s policies of NHS marketisation. These policies include:

·Payment by results, which will promote wasteful competition between NHS providers and create perverse incentives, encouraging providers to focus their attention on the patients that are the most profitable to them;

·The extension of Foundation Trust status to cover ambulance and mental health trusts and the lowering of the bar for applications for Foundation status to hospital trusts with only two stars. This is despite evidence of existing Foundation Trusts running up financial deficits, and the difficulties experienced by some, in managing the effects of Payment by Results;

·The continued use of the Private Finance Initiative, and the growing use of the Local Improvement Finance Trust model in primary care.

·The outsourcing and ‘off-shoring’ of secretarial work (for example by tapes or dictation to computers using voice-recognition being transcribed by agencies and/or by workers in countries with low wages.)

Conference believes that these policies will lead to higher costs and will undermine the fundamental principle that every person should have equal access to high quality, local and comprehensive NHS services. The introduction of market forces will put pressure on staff to prioritise commercial interests above those of patients, and will impede professional collaboration and the sharing of best practice.

Conference also notes with concern the attempts by the private healthcare industry to lobby for the introduction of a system of co-payments, under which NHS users would be charged for part of the cost of the healthcare services they receive. Conference considers that this would breach the fundamental principle that NHS care should be free at the point of use, and calls on the Government to unambiguously rule out any extension of co-payments in the NHS.

Conference believes nursing services that are required by the vulnerable people that are patients in continuing care for the elderly units, cannot be provided in the private sector, which can be clearly seen by admission to geriatric receiving wards. The skills required to nurse these patients do not exist in the private and voluntary sectors. Moreover, conference is concerned that these practices will result in a two tier level of service where ability to access quality continuing care will be made on the ability of the patient to contribute financially towards their care and their living costs.

Conference notes the numerous innovative services developed and implemented by NHS staff since the publication of the NHS Plan. Conference reasserts that the best way to increase patient choice and improve services is by investing in in-house NHS services, and by promoting a culture of collaboration rather than one of commercial competition and private profit.

Conference recognises the excellent work being done by Keep Our NHS Public at a national level and by the many local campaigns uniting health and other trade unions and community groups. Conference calls upon the Health Service Group Executive to work with the NEC, Labour Link, GPF, UNISON’s other service groups and Keep Our NHS Public nationally and locally to:

1.Continue to campaign against the increasing privatisation of all health services.

2.Highlight the negative consequences of NHS marketisation, for both patients and NHS staff.

3.Provide health branches with resources and support to resist privatisation initiatives and to protect staff pay and conditions, trade union recognition and facilities, and investment in workforce training and development.

4.Press the Government to enter into meaningful discussions with the trade unions to look for ways of further improving the responsiveness and convenience of NHS services for patients, without recourse to the introduction of market mechanisms or the involvement of the private sector.

5.Publicise the threat to Administrative & Clerical jobs of outsourcing and off-shoring, urge branches and members to resist this form of privatisation, and support them in campaigns to do so.

6.Support Branches involved in lawful disputes.