Our NHS Our Future

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2011 National Delegate Conference
13 June 2011
Carried as Amended

Conference condemns the government’s white paper for the NHS in England, “Equity and Excellence – Liberating the NHS”, which amounts to the largest upheaval in the 62-year history of the NHS, and the funding cuts to the NHS that are affecting services across the UK.

Conference asserts that the government has no mandate for such massive top-down structural change that did not feature in either the Conservative or Liberal Democrat manifesto.

Conference believes that the key features of this new system, as legislated for in the Health and Social Care Bill, will render the NHS unrecognisable: responsibility for 80% of the NHS budget will transfer to GP commissioners overseen by an NHS Commissioning Board; strategic health authorities and primary care trusts will be abolished; all hospitals will be foundation trusts and broken away from the NHS; hospitals will be able to raise unlimited income from private patients; there will be an increased dependence on competition law; and a much larger role will be created for the private sector, both as providers of care and as commissioning support organisations.

Conference notes that in addition to massive structural upheaval, the Bill brings an entirely new role for competition into the NHS with repeated references to the Competition Commission and the Office for Fair Trading. The Bill will open the NHS up to the vagaries of EU competition law, meaning that once services have left the public domain it will be impossible to get them back.

Conference rejects entirely the Bill’s proposal to abolish the private patient income cap for foundation trusts that will mean NHS patients can now be pushed to the back of the queue by those that have the means to pay for their care. Conference believes this is a fundamental assault on the founding principles of the NHS and must be resisted with all our union’s might.

Conference notes that the Tory plans are opposed by the vast majority of staff in the NHS including unions and professional organisations. Reasons for this include:

1)the lack of integration with social care;

2)lack of any genuine democratic influence or control over key decisions about allocation of scarce resources;

3)increased management costs caused by outsourcing of procurement and administration;

4)devolution of £80 billion of public spending to GP consortia which lack the expertise in commissioning and which has not been trialled or tested.

Conference notes the findings of recent reports and surveys from the international Commonwealth Fund and the British Social Attitudes survey that demonstrate an NHS renowned for the equity of its provision and more popular with the public than it has ever been. Conference believes that the NHS must always strive to improve, but also that it has improved immeasurably over the past decade and is continuing to do so.

Conference asserts that government claims to have protected NHS funding are simply not true. Jobs and essential services are already being lost across the country.

Conference notes that government claims to have protected NHS funding are similarly misleading. Whether disguised as “efficiency savings” or not, jobs and essential services are already being cut right across the UK. Although they are not yet directly affected by the latest English reforms, the devolved nations are not shielded from the massive squeeze on spending that the NHS is now being subjected to. Cuts in services and jobs will also be major issues in Scotland, Wales and Northern Ireland – with the latter already particularly badly affected by financial problems.

Conference notes that as the financial squeeze continues to bite, so some primary care trusts are beginning to cut back on the comprehensive service that the NHS is supposed to provide. In the North West areas such as Bury, Oldham and Rochdale are cutting back on more than 50 types of surgery – even operations with a success rate as high as 80% are deemed “of no clinical value”. Vital life-enhancing operations on cataracts, knees and hips are increasingly being seen as non-essential.

Conference believes that, as well as being entirely against the comprehensive nature of the NHS, such cutbacks are a false economy. The Royal College of Surgeons have pointed out that where preventive operations are not carried out to deal with problems such as hernias, patients often need more expensive emergency treatment instead.

Further, Conference continues to stress the importance of UNISON having an alternative vision to challenge the prevailing orthodoxy that promotes competition and markets. After all, Conference notes that the market approach has not been adopted in all parts of the UK.

Conference is alarmed at the government’s aim in England to move NHS organisations away from the public ownership ethos and believes that the public needs to be made fully aware of the possibility that the English NHS as we currently know it may not exist in a few years time. Conference is determined that Scotland, Wales and Northern Ireland must do everything possible to stop this destructive process spreading across the UK.

Conference therefore welcomes UNISON’s “Our NHS Our Future” campaign, as part of the overarching Million Voices programme, which aims to make the case for properly-funded, publicly-provided local services and to resist the ravages of privatisation and cuts across all countries of the UK.

Conference notes that before the Bill came to Parliament, UNISON had already won concessions from the government, such as protecting the right of local authority overview and scrutiny committees to monitor changes in the health service. Conference believes that the campaign must be intensified to block the government’s plans in Parliament and their implementation across England.

Conference believes that an essential part of our ability to influence the governments’ agendas – both in political terms and the implementation of policy locally – is by building strong alliances with other unions, campaigning organisations, community groups and charities.

Conference therefore calls upon the National Executive Council to:

1)continue to make the case for a universal, comprehensive and equitable NHS that focuses on patients not profit and campaign for an integrated health and social care system funded out of general taxation;

2)continue campaigning in the strongest possible terms against government proposals that will lead to the break-up of the NHS as we know it, and to involve UNISON’s retired members as ‘real people’ affected by the cuts, many of whom worked in the NHS and many of whom now rely on the services provided by the NHS, in such campaigning;

3)work to expose the lie that NHS expenditure has been protected and highlight the impact of cuts on health staff and patient services across t