Our NHS Our Future

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2011 Health Care Service Group Conference
2 December 2010

Historically NHS reorganisation brings with it many challenges and is often coupled with significant job losses. However major NHS reorganisation taking place concurrently with the impact of the comprehensive spending review is a recipe for disaster. The national nursing sector is deeply worried about the impact that this will have on our patients, the profession and our colleagues. At a time when the NHS has made real improvements to the service and patient care there is a real risk that this will take us back to the bad days of the 1980’s when patients died whilst waiting for surgery, when survival rates for cancer, cardiovascular and other conditions were poor.

We do not believe it’s in our patients’ best interests nor the service’s to go back to those days. We are proud to work in the NHS and have pride in the contribution we make to patient care. The false and broken promises of the Tories and Lib Dems are unacceptable to us. No decision about you without you, the NHS protected, front line jobs protected all carefully orchestrated smoke and mirrors.

NHS organisations are cleverly hiding actual job losses simply by not replacing staff when they leave, if the posts remain empty for long enough they fall off the books as if they never existed. Some employers are using skill mix reviews as a means to save money. It’s important that we do look at this to ensure that we have the correct number of people with the right skills to care for a changing patient group. However this isn’t what’s happening – what takes place is often an ineffective skill mix review which is driven by reducing costs and is normally based on the principle of role substitution. The effect can be a reduction in the number of band 6 posts, which leaves less experienced staff to pick up the workload without having access to meaningful support in clinical settings.

The false message that patients and the public have been given that NHS funding is protected is immoral. The cost of proving NHS services increases year on year, simple hospital equipment such as dressing packs go up yearly. By far the biggest cost is our drugs bill. We recognise the vital contribution which the pharmaceutical companies contribute to science and the development of new medicines, however their profit is obscene, and the licensing laws hold us and the service to ransom.

We are appalled at the way in which some of our colleagues are described as highly paid bureaucrats. Administrative staff are vital to enabling us to undertake our jobs effectively. Good managers support staff to develop, inspire team working and support us to work effectively. However we do recognise that the NHS has relied on highly paid external consultants and on occasions they help to provide an external health check. However more often than not their reports simply tell us what we already know but come with a huge price attached to it, this is unacceptable. All NHS organisations should be looking from within to undertake any review.

We face uncertain financial times, health workers haven’t caused this mess, and there were no million pound bonuses or hedge funds for us. Nurses are so closely regulated by our code of conduct that we have to declare a box of chocolates.

The rhetoric of the public sector having had it so good for so long, is an immoral approach to take. We care for the most vulnerable in our society, the frail and the acutely ill and dying. We look after and try to support their loved ones in both the best and worst of times. Our NHS staff our nurses, midwives, receptionists, cleaners and porters work long hours, are dedicated to their job, no one downs tools at the end of their shift. They leave when their job is done and when it is safe to do so. During the July 7th bombings in London, when everyone else was being moved away from danger our members were going into it.

We call on the Service Group Executive to:

1)Maintain the high profile campaign Our NHS Our Future to work;

2)Campaign to defend the NHS and health jobs to ensure high quality care for our patients, women and service users;

3)Use the full weight of UNISON’s influence to defend our national pay system;

4)Protect the future of our NHS pensions – with 20% of nurses due to retire in the next 10 years it essential that their pensions are protected;

5)Gather evidence of cuts and the impact they can have on levels of care;

6)Work with MPs to raise when appropriate these issues in parliament.

We call on the national nursing sector to:

a)Develop guidance on skill mix reviews to help branches understand what it is;

b)Develop guidance on how nurses, midwives and all members of the nursing family can raise their concerns about services and up hold their code of conduct.

We call on regions to:

i)Work with branches to gather evidence of job losses and frozen posts across the UK;

ii)Highlight the impact that these will have on services and patient care.