- Conference
- 2010 Health Care Service Group Conference
- Date
- 10 December 2009
- Decision
- Carried
Conference welcomes the massive amounts of extra funding the NHS has received in recent years after decades of under-investment, and continues to support the centralised funding of our health service.
Conference notes the importance of the NHS during the recession and the fact that, unlike other countries such as the USA, in the UK losing your job does not affect your ability to access healthcare. In particular, areas such as mental health will see greater demand for services as people struggle to come to terms with job losses and financial hardship. Conference therefore believes it is right that the NHS is an important part of UNISON’s Million Voices campaign.
Conference notes with alarm, however, the new pressures on the NHS as a result of the recession and the response of political parties. Although health policy is devolved, initiatives such as the Operational Efficiency Programme will have an impact across the UK, as will decisions on public sector pay.
Conference acknowledges that areas protected by the Labour government, such as public sector pensions and national pay bargaining, are threatened by other parties. But Conference is concerned that which ever parties are in power, it is likely there will be a demand to cut supposedly “back office” staff as a first move, with the parties (particularly in England) competing over who can offer the biggest safeguards to frontline staff. With plans to claw back billions of pounds, however, it is also clear that all parts of the NHS will share the pain of the recession at some point.
This is in addition to the year on year cash releasing efficiency savings of 3% which trusts have found increasingly difficult to absorb.
Conference reiterates its assertion that this recession was caused by the greed and irresponsibility of those working within the under-regulated banking sector, not by health workers or others in the public services.
Further, Conference believes that a slash and burn approach of cutting services and jobs is not the way for the NHS to respond to the recession. Cutting staff is short-termist and often counterproductive, with the NHS losing money if it is forced to hire greater numbers of agency staff, and if service quality drops, remedial work is more expensive than getting the treatment right first time. As we have seen with hospital cleaning, fewer staff leads to increases in infections – not only deadly in terms of patient safety, but also costing the NHS money.
Conference believes that targeting cuts at support staff, such as those working in catering or administration for example, is also a bogus solution. These jobs are vital to the smooth-running of the NHS and the front-line delivery of services. The NHS always works most efficiently when the team ethic is preserved.
As health workers, Conference knows that there is scope elsewhere for the NHS to operate more efficiently. For example, some operating theatres have particularly efficient ways of working, while others struggle with very rigid procedures. Much can be gained through collaboration and sharing best practice, and the innovative approaches embodied by initiatives such as the Expert Patients Programme and the Productive Ward Programme demonstrate alternatives. Reducing lengths of stay and minimising pre-operative bed days are areas which can save money.
Above all, Conference believes that the NHS needs to harness the ideas and creativity of its own staff by channelling their ability to improve efficiency. The work of the NHS Social Partnership Forum has demonstrated what can be achieved at local level when employers and staff work together to raise efficiency and reduce costs. But so far too few employers have made use of the potential in Agenda for Change for embedding new ways of working.
Conference is also concerned at the prospect of the tighter financial situation being used as an excuse to privatise parts of the NHS or to expand the use of private sector shared services. As the experience with ISTCs and PFI has shown, such experiments actually cost the NHS money in the longer-term and must be resisted.
In fact, areas where money could be saved include ridding the NHS of the millions wasted on private sector management consultants. Similarly, the commercialisation of commissioning in England has increased costs through the extra bureaucracy necessary to administer the market.
Finally, Conference believes that in rising to meet these challenges, the organising agenda is imperative. Improving recruitment and union density must be both a goal to be achieved as the recession puts increased pressure on workers, but also a tool to help the union build in strength and resist these threats.
Conference therefore calls upon the Health SGE to:
1.work with the wider union’s Million Voices campaign to highlight the importance of the NHS in the recession and to remind the public that cuts to staff and services have a direct impact on standards of patient care
2.defend staff at all levels against job cuts and reassert the importance of the team in healthcare
3.resist the privatisation of parts of the NHS and the wider use of private sector shared services
4.encourage greater take-up by employers of the full benefits of Agenda for Change in terms of embedding new ways of working
5.promote the work of the UK social partnership forums in demonstrating what savings can be achieved by partnership working in NHS workplaces.