- Conference
- 2009 National Delegate Conference
- Date
- 23 February 2009
- Decision
- Carried as Amended
Conference congratulates health workers on their hard work, which coupled with increased government funding, has brought about a continuous improvement in the services that patients can expect from the NHS.
Waiting times have been reduced to a maximum of 18 weeks from referral to treatment in England, with waiting lists at an all-time low across the UK. And treatments and care for cancer, stroke and heart disease, to take three examples, have all improved dramatically.
Despite these improvements, Conference also notes that the NHS, particularly in England, remains threatened by a number of different challenges and dangers.
Conference notes that the UK government – in common with the main opposition parties – continues to favour policies which actively encourage the market and the increasing use of the private sector in the delivery of services. This has become increasingly pronounced in the field of English primary care in the last 18 months, with the local NHS now under renewed pressure to break off provider functions to create opportunities for social enterprises and the private sector.
Conference believes that this stance is particularly regrettable at a time of global financial crisis where governments across the world have been forced to recognise the importance of nationalisation in keeping economies afloat and services running. Indeed the fact that some private sector organisations have postponed entering the health sector due to the credit crunch, demonstrates our view that companies cannot be trusted to deliver the health needs of the population.
Conference acknowledges, however, that the dogmatic attachment to markets and the private sector is not the case in all parts of the UK. In Scotland, for example, hospitals have now been banned from contracting out cleaning and catering services to private firms. And in Wales, NHS reorganisation will effectively end the internal market and replace it with a more integrated system.
In England the development, following Lord Darzi’s Next Stage Review, of the first NHS Constitution should, at the very least, act as a bulwark against the attempts of any future governments to dismantle an NHS that is free at the point of need and funded by direct taxation. The renewed emphasis within the Darzi review on training and apprenticeships is positive.
However, Conference cannot accept other aspects of Darzi’s recommendations, including the fact that they have allowed for the development of social care-style personal health budgets. Conference supports moves to provide patients with the most personalised and appropriate care, but does not believe that the consumerist approach embodied by personal budgets and direct payments is the right way to provide this.
Conference also deplores all those initiatives labelled as improving access to medicines that create a two-tier system in which patients who can afford to “top-up” their NHS care with private funding will be allowed to do so with no detriment to their NHS entitlement. Conference believes that such decisions threaten the founding principles of the NHS and calls upon the union to retain its firm and principled position in this area.
Similarly, Conference notes that the proposed European Commission directive on cross-border healthcare that this union has campaigned against would, if implemented unamended, lead to greater health inequalities both within and between EU member states, and place an increased financial and administrative burden on the UK NHS that it can ill afford in the current climate.
Conferences notes that after NHS budgets allowed for service improvement, there is now an increasing drive for cash releasing efficiency savings that threatens to undermine them and reverse this trend. The financial squeeze comes at a time when the prospect of mergers and acquisitions in the English NHS is already increasing as foundation trusts look to build their power and “failing” NHS hospital managers become susceptible to replacement by the private sector.
Conference therefore calls upon the National Executive Council to:
1)Continue campaigning to highlight the negative consequences for both patients and staff of NHS marketisation and the growing role this gives to the private sector, and oppose the pro-marketisation policies of government or opposition parties;
2)Promote close working between the four countries of the UK to monitor developments in the devolved administrations, share intelligence and showcase practices which adhere to the vision of a publicly-funded NHS with services delivered by directly-employed staff;
3)Continue to develop stakeholder coalitions in support of UNISON’s position including other unions and community/user groups;
4)Lobby the government to ensure that if personal health budgets are to be used, proper piloting and evaluation must take place before any consideration is given to widening their use, with union involvement in the evaluations;
5)Continue to oppose and monitor closely the new system in which “top-up” payments are permitted and work to ensure that this does not undermine the founding principles of the NHS;
6)Work with UNISON’s International Committee, MPs, MEPs, and other unions and partners to oppose the European Commission’s proposed directive on cross-border healthcare.