DRASTIC cuts to the NHS are being planned to meet a budget cut of £15-20 billion, with even bigger spending cuts expected in the future, says a leaked document obtained by Unison.
Mike Jackson, senior national officer for Unison – the largest health service trade union – warned that the document by the Foundation Trust Network (FTN) contained a ‘lengthy shopping list’ of damaging cuts and ‘reforms’.
The document said ‘the economic realities facing the NHS over the next several years’ will mean that:
• ‘Cash will reduce in service (£15-20 billion) with no third year commitment from treasury to even flat cash – so the situation could get worse than currently predicted.
• ‘Non-pay costs are rising faster than general inflation and NI contributions at around £500m.
• ‘The commissioning aim will be to take 30-40% activity out of secondary sector:
• ‘There is no allowance in tariff for pay – so real reduction in funding pay bill that will not be made up by using natural wastage.
• ‘Even using full natural wastage only produces 2.9% but will not give the shape of workforce and skill mix required to sustain patient services in new configurations.
• ‘Redundancies are likely to be needed with the best case option being local voluntary agreements.’
Dealing with ‘Changes Foundation Trust Employers Wish the Department of Health to Pursue’, the document says ‘workforce conditions’ will have to change.
The FTN document demands:
• ‘Reform to the need to seek Treasury approval for voluntary redundancy schemes
• ‘Negotiate redundancy payments in 12ths to ensure that the duty to mitigate losses can be implemented if employment achieved quickly in another NHS body. This would create an incentive to move quickly.
• ‘Reduce the number of pay points on A4C Bands (Red Line)
• ‘Change Schedule k so that staff members are not able to opt back in to Agenda for Change having accepted local arrangements
• ‘Freeze increments on incremental pay progression for 2/3 years. Then change increments to two points – one for learners one for experienced staff (Red line)
• ‘Agency staff – refresh the guidance and PASA agreements to drive down unreasonable costs of agency staff. . .
• ‘Sick pay – six months full/six months half pay unlikely to be able to negotiate change. So, local robust sick management needed. However, change sick pay so that plain rates are paid for sick pay (Red Line)
• ‘Either abolish or extend the time (7am to 10pm) for plain rate payment on basis that many staff choose to work nights (Red line)
• ‘End permanent injury allowance and potentially temporary injury allowance
• ‘Make clear NHS will not be able to offer employment to every trainee – national review of commissions.
• ‘Tackle regulatory demands for continual expansion of statutory training. . .
• ‘Stop clinical excellence awards (Red line)
• ‘New consultants – reduce SPAs for newly appointed consultants to enable them to develop clinical skills – suggested 9/1 (Red Line)
• ‘Existing Consultants – reduce SPAs from 2.5 to 1.5 or 1 (if possible)
• ‘Pensionable items – review all including London rating and CEAs
• ‘Stop recruitment & retention premium for all staff
• ‘Cap pensions for higher earners (over £100k: easier to do as part of a whole public sector review of pensions) and look at removal of other pensionable items such as London weighting and CEAs.’
The document continued: ‘In our working group there was some discussion of how FTN should respond on behalf of the foundation trust community to any request for guarantees on jobs.
‘The Group believed that the flexibilities outlined above were now a requirement for managing the fiscal realities but that even with these it would not be possible to give job guarantees.’
A statement was approved, which said: ‘Foundation Trusts do not believe that, in the economic climate and given the system and reconfiguration challenges they are facing, it will be possible to offer any guarantees that compulsory redundancies will not be required.’