Building Campaign Alliances Against Privatisation, Fragmentation and Cuts in the NHS

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2011 Health Care Service Group Conference
3 April 2011

This Conference confirms UNISON’s total opposition to the ConDem Coalition’s White Paper – “Liberating the NHS”.

If implemented, this would lead to the destruction of the NHS as we know it. The coalition government has no democratic mandate for its attacks on the NHS. It was not in any election manifesto and there has never been any public demand or support for the privatisation of clinical care.

Conference notes that last April we could not have predicted the massive, fundamental damage that the coalition government would do to the NHS. Although Conference feared that a Conservative win would mean a marked shift towards further privatisation and marketisation, we did not foresee just how deep and how severe the cuts and changes would be – all introduced with the support of the Liberal Democrats.

The government has no mandate for these changes as they were not included in the Conservative manifesto and the Liberal Democrats specifically campaigned against severe cuts in public services during the general election.

Before the general election David Cameron promised to protect NHS spending and afterward the Coalition Agreement “Our Programme for Government” promised to guarantee health spending increases in real terms over the length of the parliament. David Cameron also ruled out any major reorganisational changes within the NHS before the general election saying “And this of all times, the last thing the NHS needs is a big internal, high-cost and high-risk reorganisation”. And again it was highlighted within the Coalition Agreement that this would be detrimental to the NHS and to patients.

Conference welcomes UNISON’s Health Service Group campaign, ‘Our NHS Our Future’, which aims to make the case for properly-funded, publicly-provided local services at national, regional and local community level and condemns the Government’s White Paper ‘Equity and excellence: Liberating the NHS’.

The White Paper sought to abolish Strategic Health Authorities and Primary Care Trusts, handing over £80 billion of public money to GPs in an ill-thought out set of proposals with little detail on how the new 500 or more GP consortiums that would take over from the PCTs would be regulated or developed. The government has also failed to address concerns about workforce planning and training of staff in an increasingly fragmented health service, with the potential to leave staff without up-to-date skills and patients with a poorer service.

The White Paper further proposed that all NHS Trusts should move to foundation trust status by 2013 with hospitals moving towards a social enterprise model of employee-led or community-based ownership. Members are already fearful of what these moves will mean for their terms and conditions when foundation trusts are given greater autonomy over setting local pay.

Conference is aware of the overwhelming messages of caution and criticism of the White Paper from groups including: The Patients Association, British Medical Association, The Kings Fund, Royal College of General Practitioners (RCGP), RCN, RCM. However it was UNISON that actually turned words into action in seeking a judicial review of the White Paper arguing that the government acted wrongly in failing to consult not only on the principles within the White Paper but also on how they should be implemented. Even though UNISON was refused the review, the judge agreed that they were right to raise the issues of lack of consultation, especially as the White Paper claims to want to empower patients, the public and staff over how the NHS is run.

GPs are now boldly speaking out against the white paper as Clare Gerada, chair of the RCGP, representing Britain’s 40,000 family doctors, has clearly stated she thinks these proposals mark the end of the NHS as we know it and the introduction of GP commissioning will only lead to greater competition between hospitals.

Patients needing non-emergency treatment are having operations postponed or cancelled, waiting lists and times are soaring, and some treatments are no longer being provided by the NHS at all. Inevitably people who can afford it, or have adequate health insurance, will turn to the private sector.NHS patients will be pushed to the back of the queue in favour of fee-paying customers.

Staff, like patients, are paying for the obsession to reduce the national deficit and for the profligacy and economic mismanagement of the banking and finance industry. This financial crisis was not of our making, but we are being forced to accept pay and pension cuts and increased workloads. Meanwhile, Private Finance Initiative schemes continue to bleed the NHS as if a funding artery has been severed.

Conference is alarmed at the Government’s aim to move all NHS providers and commissioners away from the public service and ownership ethos and believes that the public needs to be made fully aware of the possibility that the NHS as we currently know it may not exist in a few years’ time.

Conference believes that in order to do this we need to develop as far reaching a campaign as possible to make sure that health staff, patients and the public are aware of what is at risk if we do not act together as one. We should be fighting these cuts and must not fall into the trap of sacrificing our terms and conditions for a so-called guarantee of no compulsory redundancies. The example of Ireland shows that pay cuts and acceptance of worse conditions provide staff with no guarantee against job cuts and redundancies when the banks want billions of Euros in a bail-out.

Conference stresses that there is a need to develop an effective campaign by building alliances across communities and across UNISON, with health workers, patient groups and charities that are all worried about the direction in which we are headed. We need to build on the vision for the NHS that we debated and championed at last year’s Health Conference, ensuring that we develop a broad alliance with shared values with patients and the community. Our vision must challenge the current orthodoxy in the coalition government that promotes competition and the market – instead our vision will be based on the founding principles of the NHS. We will have to continue to protest and demonstrate against this destruction of the NHS. There must be more support for branches to help them to inform, organise and mobilise members to actively challenge cuts. Branches need information as soon as possible about successful protests elsewhere, and especially about jobs and services which have been saved. The best way we can get the Government to listen is by creating the loudest and strongest voice – one that wants to protect the values and founding principles of the NHS.

Conference therefore calls on the Health Service Group Executive to work with the National Executive Council and the wider union to:

1.Under the Million Voices umbrella continue to promote the “Our Future our NHS” campaign, work with Keep Our NHS Public, Health Emergency and patient groups and campaigning organisations that produce information about what is hap