- Conference
- 2010 National Delegate Conference
- Date
- 16 February 2010
- Decision
- Carried as Amended
Conference notes that alongside extra funding and improved levels of care, recent years have seen a continuation of government policies to extend the marketisation of the English NHS and to create a larger role for the private sector. It is highly likely that this trend will continue whatever the outcome of the 2010 general election.
Conference recognises that the biggest current threat to the NHS comes from the Transforming Community Services initiative which, by enforcing the separation of commissioner and provider functions within primary care trusts, will create a greater service delivery role for private companies and new organisations such as social enterprises.
Conference does, however, welcome the policy shift from the Labour government that the NHS is their “preferred provider” of care – a shift that was brought about by the determined campaigning of UNISON, working through the NHS Social Partnership Forum with the TUC and the other NHS Together trade unions.
In contrast, Conference notes the policies of the Conservative party that favour an “any willing provider” model of care to benefit private companies, and that would set up an unaccountable super-quango in the shape of an independent board to oversee the NHS.
Conference notes the importance of the NHS during the recession and in the tough economic times ahead. However, Conference is also extremely concerned that the country’s financial problems are being used as an excuse to target “back office” staff with job cuts or privatisation through the expansion of private sector shared services. Conference believes that such jobs are vital to the smooth-running of the NHS and the front-line delivery of services. Furthermore, the experience of independent sector treatment centres and contract cleaning has shown that such experiments actually cost the NHS money in the longer-term and must be resisted.
Conference is deeply concerned that NHS managers were being ordered by the last Labour Government to make £15 billion in savings, placing services under threat. For many NHS Trusts, funding has already been lost through exorbitant fees being paid for hospitals built under the Private Finance Initiative which cost the NHS £4.18 billion per year. The total cost of these facilities will be £60 billion, five times the cost of building them. These deals are a dead weight around the neck of the NHS and typical of the impact of commercialisation.
Conference is deeply concerned that NHS managers were being ordered by the last Labour Government to make £15 billion in savings, placing services under threat. For many NHS Trusts, funding has already been lost through exorbitant fees being paid for hospitals built under the Private Finance Initiative which cost the NHS £4.18 billion per year. The total cost of these facilities will be £60 billion, five times the cost of building them. These deals are a dead weight around the neck of the NHS and typical of the impact of commercialisation.
Conference further notes that social care-style personal health budgets are now being piloted in the NHS. Across different UNISON sectors Conference supports many of the principles of personalisation, such as early intervention, independent living and greater control for patients or service users in determining the services they need. However, the consumerist approach embodied by personal health budgets could threaten the founding principle of the NHS that care should be free at the point of need by encouraging patients to pay to “top-up” their NHS care. It will also create problems and uncertainty for staff, and will lead to a market of many competing providers for patients needing care for long-term conditions and other treatments.
Conference notes that the market approach to healthcare has not been adopted in all parts of the UK. Scotland and Wales have both opted for alternative means of improving the NHS based around moving away from using the private sector and integrating commissioning and provision.
Conference resolves to continue UNISON’s well-established policy of opposition and resistance to privatisation and NHS marketisation across the four countries of the UK, regardless of which party or parties are in power.
Further, Conference resolves to continue defending the NHS as a publicly funded, publicly provided and publicly accountable universal healthcare system, whatever the political make-up of the next government.
In doing this, Conference recognises the importance of the NHS Constitution, which is designed for England but whose principles have been endorsed by the devolved administrations. The Constitution codifies the values of the NHS and provides a barrier to any future government wishing to dismantle a healthcare system that is free at the point of need and funded by direct taxation.
Finally, Conference recognises that there is a growing debate within the NHS about the possibility of a larger role for mutual or cooperative approaches to healthcare. Equally, questions persist about the perceived “democratic deficit” within parts of the NHS, now that increasing levels of funding and decision-making are devolved to the local level and away from direct ministerial accountability. Conference remains sceptical about the way in which mutualism has been used to justify policies to promote foundation trust status and social enterprises – and attempts to impose cooperatives on staff will fail – but Conference believes that a proper debate about governance, ownership and accountability is overdue.
Conference therefore calls upon the National Executive Council to:
1)Reaffirm UNISON’s policy of opposition and resistance to the drive towards the marketisation and fragmentation of England’s health services, and continue campaigning for integrated healthcare to be delivered by the NHS;
2)Continue monitoring developments across the devolved administrations, share intelligence and highlight policies and practices which underpin the vision of a public NHS;
3)Defend the continued role of partnership working in the NHS;
4)Continue to work with the NHS Together trade unions and sympathetic patient/community groups and the involvement of UNISON retired members as a large group including the Keep Our NHS Public campaign of potential budget holders to exert political pressure on the government as necessary;
5)Highlight the importance of the NHS during a cold financial climate and remind the public that cuts to staff and services have a direct impact on standards of patient care;
6)Monitor the development of personal health budgets to ensure that proper piloting and evaluation must take place before any consideration is given to widening their use, with union involvement and the involvement and the involvement of UNISON retired members a