Health members in Brighton today voiced their anger at the increasing practice of NHS trusts in England to set up wholly owned subsidiary companies to provide support services, and voted to fight their spread.
The practice is widely regarded as backdoor privatisation of health services – putting at risk the pay and conditions of thousands of NHS staff, particularly low-paid women, Black and disabled workers.
The importance of the issue was reflected in the fact that nine bodies contributed to the the composite motion being debated.
One delegate argued that wholly owned subsidiary companies represented “the biggest threat of privatisation seen in a generation.”
Trusts are exploiting a loophole in UK tax law to establish the new companies, arguing that the move will allow them to save money on VAT. While these companies are owned by the trusts, they are no longer part of the NHS and NHS staff are seeing their jobs outsourced to limited companies.
UNISON is particularly concerned that most NHS trusts that have set up these companies have introduced non-Agenda for Change contracts for new starters, while denying them access to the NHS pension scheme.
Adrian O’Malley of the service group executive told delegates: “This is yet another attack on lowest-paid staff. Another way of privatising services. Another way to bring in a two-tier workforce.
“We have to send a message to any managers considering setting up these companies that we are 100% part of the NHS and will fight to remain so,” he said. “We have got to stop this blatant attack on our terms and conditions.”
Mr O’Malley added that in his region of Yorkshire and Humberside wholly owned subsidiaries was “taking off with a vengeance”, with seven or eight trusts, including his own, considering setting them up.
But the union is combating these moves with the threat of taking industrial action, he added.
“While they are considering business cases, we are preparing our members for strike ballots. We have a right to strike to keep our NHS status.”
Jean Boswell, of Sheffield community health branch, told delegates: “We’re concerned about how fast this is moving.
“This is a direct attack on lowest-paid members of staff, moving them away from Agenda for Change and introducing a two-tier system.
“We do believe that this use of wholly owned subsidiaries is entirely cosmetic and won’t improve efficiency or productivity. But it will exploit future staff. And low-paid workers are first on the front line with diminishing terms and conditions.
“We know we have a fight on our hands, but working together we can resist.”
Delegates agreed to:
- continue to support regions and branches in campaigning against the establishment of wholly owned subsidiaries – and to prioritise this work in the coming year;
- encourage branches and regions to work together to resist the spread of these schemes;
- safeguard the interests of the union’s members threatened by the creation and existence of such companies;
- work with the Labour Party to reform the tax loophole;
- campaign for all members who work for such subsidiaries to be employed on NHS terms and conditions, including access to the pension scheme;
- continue to be vigilant against employers in Wales, Scotland and Northern Ireland exploiting the same loophole.
While UNISON will deal with the new companies if necessary, the conference said that “everyone working for the NHS should be employed by the NHS” and that the union would campaign for their return to direct NHS employment at the earliest opportunity.