Privatisation, Franchising and Procurement

Back to all Motions

2014 Health Care Service Group Conference
7 December 2013
Carried as Amended

Conference notes the alarming expansion of privatisation within the English NHS. For example, the NHS Support Federation found that the private sector had won 21 of the first 25 NHS contracts awarded since April 2013, and it has been estimated that £5bn of NHS work is now up for grabs. Since the abolition of the two-tier workforce code in 2010, the threat of a two-tier system for those working on outsourced contracts has increased, with private providers now more able to cut pay, terms and conditions to win contracts.

Conference asserts that the competition provisions of the Health and Social Care Act 2012 and the subsequent Section 75 regulations are beginning to have a significant impact, with three quarters of new contracts put out to competition since April 2013. In addition, the NHS is witnessing a growing role for the Office of Fair Trading and the Competition Commission; even outgoing NHS chief executive David Nicholson has pointed to the damage being done to the NHS, with competition lawyers “all over the place.”

Further, Conference notes that the use of the Any Qualified Provider approach has already expanded to a point where GPs fear they will be unable to monitor properly services commissioned in this way. Conference asserts that the spread of the Any Qualified Provider approach, where providers have no guaranteed levels of demand, will see a rise in the number of staff forced to work on casual and zero-hours contracts in order to cope with fluctuating demand – thus causing massive insecurity for the workforce.

Conference believes that the procurement regime set up by economic regulator Monitor has robbed clinical commissioning groups of the autonomy they were supposed to enjoy, binding their hands with inflexible rules that make it very hard to avoid using competition, and making a mockery of government changes being supposedly “clinically-led.”

In addition to these threats, Conference notes that the failed experiment in “franchising” at Hinchingbrooke Hospital is likely to be replicated elsewhere, as trusts that will struggle to attain foundation trust status, such as George Eliot Hospital and Weston Area Health Trust, look to bring in external organisations.

Conference notes the impact that this uncertainty and upheaval is having on healthcare staff across the NHS, with pay, terms and conditions likely to come under renewed threat after privatisation has occurred. Conference is concerned that the rapid growth of privatisation will continue to fragment services, will have an impact on how members are represented and organised, and could undermine facility time arrangements in the health service.

Conference notes that different approaches have been taken in Scotland and Wales that have allowed the NHS to be reformed without significantly introducing markets and additional privatisation.

Conference welcomes the work of UNISON in developing the union’s campaigning and organising work against cuts and privatisation, and calls for a flexible approach that allows the union to respond to these different threats as quickly and effectively as possible when they arise.

Conference therefore calls upon the Health Service Group Executive to:

1)continue campaigning against privatisation and cuts, including responding to new threats such as the use of the franchising model;

2)build capacity amongst activists and support branches in responding to procurement processes;

3)work with regions and branches to organise, recruit and build density in organisations that are threatened with privatisation;

4)work with other parts of the union to map which companies are expanding into the health sector and to do targeted organising work around these companies;

5)continue to raise awareness of the impact of privatisation on staff terms and conditions and the forced casualisation of the workforce, and to defend Agenda for Change against these threats;

6)seek to use the UNISON influencing guide to exert a wider influence in communities against cuts and privatisation;

7)provide ongoing guidance to keep members updated on how the new NHS structures in England are working;

8)continue working with allies to monitor and oppose the expansion of privatisation; and

9)encourage a wide take-up of the new UNISON contracts alert system to help spot problems early on.