Health and Social Care Bill

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2012 Health Care Service Group Conference
1 January 2012

Conference reaffirms its complete opposition to the Government’s Health and Social Care Bill.

Conference believes that the Bill is the biggest threat to the English NHS in its 64 year history. Despite minor changes made by the so-called “listening exercise”, the fundamental dangers of privatisation, fragmentation, instability and inequity remain. The Bill will turn the NHS into nothing but a source of profit for the big health monopolies.

Conference notes the following major threats in the Bill:

a) the abolition of the private patient income cap, meaning NHS patients are likely to have to wait longer for treatment, endangering the principle that access is based on need rather than ability to pay;

b) the use of wholesale competition in the NHS with the regulator able to enforce competition law in the style of the utilities regulators;

c) a much greater role for private companies in both the provision and commissioning of care;

d) the Secretary of State will be able to abrogate responsibility for the NHS, with implications for the maintenance of comprehensive, free and consistent NHS services;

e) attempts to address transparency, democracy and involvement are far too weak.

For NHS staff, Conference notes that the Bill represents a major threat to job security and also to terms and conditions. The Government predicts 13,000 redundancies and has completely failed to acknowledge the need to retain national workforce structures for terms and conditions, pay and bargaining, with encouragement for employers to break away from Agenda for Change.

In addition, Conference notes the threat posed by the accompanying move to using the Any Qualified Provider (AQP) policy. Conference believes this will lead to a greater role for private companies in delivering health services and threatens the jobs and terms and conditions of UNISON members, as a more unstable market environment is created and government claims that TUPE is unlikely to apply under AQP. Further, Conference notes the need for UNISON to be able to respond with local campaigns to the threat posed by AQP.

Although the Bill and the “Liberating the NHS” white paper relate to the NHS in England, the impact they could have on undermining pay and bargaining structures could affect UNISON members across the UK. There is also the potential for parties within the devolved nations looking to emulate some of the damaging changes in the Bill, in the way that ideas such as PFI (private finance initiatives), Payment by Results and Independent Sector Treatment Centres have been exported in the past.

Conference resolves to fight the Bill every step of the way in Parliament by continuing to campaign for the Bill to be scrapped and by seeking amendments to rid the Bill of its worst excesses.

Conference notes the successes of UNISON’s Our NHS Our Future campaign in bringing the dangers of the Bill to a much wider audience and in galvanising opposition to the Government’s plans.

If the Bill becomes law, Conference notes the importance of mounting local challenges against the implementation of Government plans where possible and monitoring the impact of changes in terms of the expanding role of the private sector and the impact on NHS patients and staff.

Conference also notes that some foundation trusts are already beginning to threaten to break away from Agenda for Change and to increase the money they make from private patients. Conference believes that this justifies UNISON’s ongoing concerns about forcing hospitals to move to foundation status. Conference also believes, however, that with virtually all hospitals due to become foundation trusts within the next two years, now is the time for UNISON to increase its influence within these bodies as a means of blocking moves that could threaten NHS patients and staff terms and conditions.

Conference therefore calls on the SGE to:

1. thoroughly condemn the Bill and its effects;

2. continue and intensify the Our NHS Our Future campaign against the Health and Social Care Bill;

3. work with other organisations to continue to have days of action, locally, regionally and nationally.

4. take these issues to our members and to the public and explain there is an alternative.

5. oppose the Government’s move to using AQP to deliver services;

6. develop an organising strategy to meet the new challenges for the union presented by AQP, particularly in the science, therapies and technical sector where services and staff are already being affected;

7. monitor and challenge the local implementation of government plans; and

8. encourage UNISON members to become active in the staff membership constituencies of foundation trusts, as a means of influencing plans that could harm staff and patients.