- 2017 Health Care Service Group Conference
- 15 December 2016
Conference notes that across the UK there are a number of current initiatives seeking to bring about service transformation. These include, but are not limited to, Sustainability and Transformation Plans (STPs) in England, the ten year vision for health and social care based on the Bengoa report in Northern Ireland, and further moves towards more integrated health and social care in Scotland and Wales.
Conference remains deeply concerned that, as a direct result of the actions of the UK Conservative government, service transformation across the UK is taking place at a time of prolonged austerity with the NHS experiencing the poorest funding settlement for a generation. Taking this into account and despite the positive spin being put on the STP plans by NHS England the evidence suggest that in most cases they are nothing more than a smoke screen for making the planned NHS savings promised by 2020 and not plans for the improvement of the NHS.
Conference notes that these STP bodies set up to draw up the plans for the 44 ‘footprints’ do not have any formal legal status and it therefore unclear how they can produce plans which will be accountable to both the staff and the users of the services in the particular ‘footprint’ they are transforming. Bearing in mind this lack of a legal basis, it is also unclear how these STP bodies can facilitate any consultation on the proposed transformation plans.
Conference also notes that there are many challenges for staff from such reforms, including cuts to services, the threat of privatisation, mergers and the use of shared services, issues around harmonised terms and conditions in integrated workplaces, and attempts to deskill or downband staff.
Conference reiterates UNISON policy in favour of the principle of greater health and social care integration, but with a number of important caveats around the need for integration not to be used as a cover for cuts, the need for separate investment in social care not money transferred from the already stretched NHS budgets, the need for full patient and staff engagement, and crucially the need for integration not be used to level down pay, terms and conditions in a race to the bottom.
Similarly, Conference notes that UNISON members have always been open to discussing new ways of working and to consider change if this is demonstrably in the interests of patients. However, where change is just a smokescreen for cuts, privatisation or attacks on our members’ pay, terms and conditions, Conference is adamant that UNISON must continue to act decisively and firmly to defend jobs, terms and conditions and the services that our members provide.
Conference asserts that the most effective and enduring innovations in our health services have come when workers and trade unions are properly involved and engaged, as well as the public. Conference therefore expresses its anger that too often this has not been the case, with the secrecy and lack of transparency around the development of STPs in England being a particularly worrying recent example.
Conference notes the contrast between this approach in England and the attempts in Northern Ireland to root plans for change more clearly in partnership working and the fact that the Bengoa report seeks to use set criteria to evaluate changes in the light of clinical evidence and workforce considerations.
Similarly with shared services, Conference notes the differences between England, where this is too often based around private companies or joint ventures, and the devolved nations, where there has been more of an emphasis on public sector shared services.
Conference notes that while many transformation initiatives may have new names or be promoted as using revolutionary approaches to achieve change, in many cases they simply represent cuts, privatisation or threats to terms and conditions so the way in which UNISON responds will need to be rooted in traditional campaigning against these threats.
However, given the lack of money in the NHS and given the wide geographical spread of such plans, Conference is clear that UNISON branches across the UK must be fully equipped to respond to these challenges.
Conference therefore calls upon the Health Service Group Executive to:
1)condemn in the strongest possible terms any attempts to use service transformation as a smokescreen for cuts, privatisation or attacks on pay, terms and conditions;
2)use every means at the union’s disposal to challenge damaging plans – whether in the media, in councils, in Parliament, or through protests and demonstrations;
3)challenge plans where there is a lack of evidence for change and consider the use of set criteria to evaluate the feasibility and desirability of plans;
4)where shared services are used, campaign for these to be within the public sector and established in such a way that guards against future outsourcing;
5)ensure that work takes place with local government colleagues in UNISON to provide a joined-up response where necessary;
6)spread best practice from across the UK, both in terms of approaches to service transformation and tactics for challenging damaging plans;
7)demand that the workforce is involved from the start in the development and implementation of service transformation plans;
8)as appropriate, work with the TUC, other trade unions, patient groups and campaigning organisations to build alliances against damaging changes; and
9)continue to produce guidance and provide campaigning support where branches are fighting damaging changes.