The NHS white paper, which heralds the rapid privatisation of the health service, has no democratic mandate from the public, Unite said on Monday.
Unite was responding to the consultation on the proposals outlined in ‘Equity and Excellence: Liberating the NHS’ as the union launched a campaign to oppose the white paper and the cuts being inflicted on the health service among its 100,000 health sector members.
Unite national officer for health, Karen Reay, said: ‘If you join up the dots in the white paper, the menu on offer is unpalatable – rapid privatisation, lack of proper public consultation, a reduction in services as the contract culture starts to bite, and poorer employment conditions for hard-working NHS staff.’
In its submission, Unite said that the proposals represent ‘a shift in gear to the privatisation so far seen in the NHS.’
‘The impact of these proposals will be far reaching – they are being introduced and implemented without any democratic mandate from a public that has not been properly and genuinely consulted with.’
Unite pinpoints the emphasis on gearing future services to financial and business contractual relationships and results, rather than meeting health needs.
This will lead to increasing health inequalities and opens the door to priority being given to those willing to pay a fee or charge.
The creation of the ‘NHS Commissioning Board’ is also a ‘contracting out’ of the responsibility of the NHS by the government.
It is an attempt by ministers to be at ‘arms length’ when the quality and range of health services decreases because of the implementation of the government’s proposals.
The white paper contains the proposal to make £20 billion ‘efficiency savings’ by 2014, but Unite argues that these ‘efficiency savings’ are just cutbacks in services.
The announcement of the government’s implementation of a pay cut for NHS and other public sector workers rode roughshod over the collective bargaining arrangements in the NHS and other parts of the public sector.
This will lead to high staff turnover, and recruitment and retention problems as in the early 1990s, and higher stress and workloads for remaining staff.
These factors will lead to lower quality of services, and through lower staff numbers, fewer health services in total.
Unite believes the proposals outlined in the white paper will undermine the concept of a universal service, free at the point of delivery to all those in need.
And all that will be left will be a marketing logo, as services will be provided by a myriad of competing businesses trying to maximise their profits.
This will be brought about in three main ways:
• Implementation of GP commissioning: Consortiums will put all local health services out to tender, and will then be able to award the contract to ‘any willing provider’. This means any private company can apply to provide services.
• Bringing about the disintegration of the remaining public sector, NHS organisations: The extension of the ‘right to request’ to opt out of the NHS proper will mean a deepening drive to break apart NHS organisations and transfer them section by section to the private sector. This is not altered by the softer sounding moniker, ‘social enterprise’.
• Carrying out the role of ‘commissioner’: The bringing together of ‘consortiums’ of many and varied GP practices; the time pressures on individual GPs; and the complexity of the health business market being set up means that the practical solution for many of these consortiums will lie in contracting out the commissioning function itself to private, management consultancy.
The Unite 4 our NHS campaign to fight the white paper and cuts kicked off with an email calling for health sector members to put their names on a map highlighting support for the NHS and to provide the union with information on the real impact of the £20 million ‘efficiency savings’.
Meanwhile, the biggest healthworkers’ union, Unison, warned that the NHS White Paper is an £80 billion gamble that will wreak havoc to patient care, while wasting public money. In its evidence to be submitted today, the union has raised concerns that a top-down shake-up, profit-hungry and competitive system would leave the NHS a shadow of its former self.
Unison General Secretary, Dave Prentis, said: ‘Taking an £80 billion gamble on patients’ lives, with their own money, is a shocking move by the coalition Government and we will fight it all the way.
‘Andrew Lansley must put people before profit and rethink his proposals, alongside the crude cuts agenda, which will devastate a service that has huge support from employees, patients and members of the public.
‘There is no evidence that this gamble will succeed – the changes proposed by the White Paper are not borne of necessity, they are driven by ideology.
‘If these plans are put into place, the NHS would become a shadow of its former self and would be seen as little more than the NHS brand name attached to a business, which is made up of a variety of competing providers.
‘There is a risk that small and specialised services will be lost and that the quality of care we receive will depend on a post-code lottery.
‘British people have great pride for the NHS and they have the right to know that their lives and money are safe in the Government’s hands.’
A new campaign backed by ten major unions has been launched against the coalition’s health white paper.
Unions representing around four million workers have teamed up with grassroots health campaigners and patient groups for what they describe as the ‘first big coordinated move against the new reforms’.
The campaign, organised by the NHS Support Federation and backed by Unison, Unite and the GMB, is warning that proposals outlined in the Government’s white paper ‘will break up NHS services’.
The group said it was aiming to mobilise NHS staff and patients against the white paper to ‘exert maximum pressure on MPs’ before the health bill is put to Parliament.
Paul Evans, director of the NHS Support Federation, said: ‘The white paper is the most extreme reorganisation of the health service since it was founded in 1948, but was not mentioned in either the Conservative or Lib Dem manifestos.
‘The public are not being given the chance to say no and don’t realise how far the reforms will go.’
The joint statement says that the NHS is already making £20bn of ‘tough savings’, and pours scorn on the use of the NHS market.
It added: ‘In the face of the threat of the white paper proposals, we are asking all NHS supporters to come together to protect the NHS and safeguard its future.’
