C16 Defending the NHS

Composite of motion 52 and amendment, and motions 53 and 54

Congress recognises the significant strides in healthcare that have been achieved in recent years, and supports the Government’s drive to improve the quality of health delivery for UK citizens. But this progress is clearly vulnerable to the impact of the economic downturn and consequent squeeze on public expenditure.

Congress calls on governments and health employers across the UK to learn the lessons from the damaging approach taken in 2006 to address financial deficits in the NHS. Indiscriminate expenditure cuts, targeting jobs and training, and a misconceived reliance on competition to solve problems are bad for NHS users and bad for staff.

Congress notes with concern the Transforming Community Services programme. The NHS may have to stop providing services directly to communities as a larger role emerges for social enterprises and companies – with staff jobs, pensions, terms and conditions coming under threat.

Congress is alarmed by the establishment of the Co-operation and Competition Panel, which will help companies break into the NHS. Panel guidance suggests that mergers resulting in a market share of 25 per cent will be investigated – effectively ruling out mergers between in-house PCT provider arms.

Congress deplores the publication of the new operating model, Necessity Not Nicety, which lays out a vision for a commercially driven NHS and sets up regional Commercial Support Units. It is explicit in its desire to ‘maximise the contribution of third and private sector organisations’ and provides clear encouragement for PCTs to go down the commissioning and procurement route. Congress acknowledges, however, health minister Ann Keen’s letter reasserting the Government’s preference for NHS provision.

Congress believes efficiency can be improved without resorting to privatisation, but the current agenda is opening the way for future governments to dismantle the NHS, and see soaring USA-style transaction costs where private healthcare is most developed with over 16 per cent GDP expenditure on health, yet more than 45 million Americans lacking health insurance. Congress notes that Britain spends half that, yet the NHS covers everybody.

Patients, NHS staff and their trade union representatives must be put at the heart of decision-making on the future shape and delivery of local health services. Knee-jerk decisions aimed at producing short-term savings must not be allowed to threaten long improvements, nor roll back the transition of the NHS into a service that actively promotes good health, rather than being mainly a service for the sick.

As a key provider of diagnostic and cancer treatment services the Society of Radiographers strives to ensure that at all times the patient’s needs come first, that only relevant examinations and treatments are undertaken, and that users fully understand the reasons for their attendance.

The Society has evidence that, in a drive to increase patient throughput, women using the NHS Breast Screening Programme are facing a full-screen examination in appointments as short as three minutes. The Society takes the view that this is a short-sighted and flawed policy and to conduct a serious examination on a vulnerable and anxious woman in such a short space of time will compromise the quality of care, do nothing to improve the communication between the woman and the health professional, exacerbate existing concerns about operator welfare and safety, impact negatively on morale and reduce confidence in the service.

Congress calls on the General Council to reactivate the NHS Together campaign, as a platform for all affiliated unions to work together to contribute to the debate on the future direction and funding of the NHS. Congress calls on the General Council to work with NHS Together unions and patient groups to campaign for:

i)        services to remain within the NHS, delivered by NHS staff

ii)      better standards of care for all, while retaining the quality and effectiveness of healthcare

iii)    a moratorium on any further use of private companies in healthcare delivery

iv)    the Co-operation and Competition Panel to be scrapped

v)      making the case to the Government for proper and full resourcing for any initiative to improve and develop service delivery

vi)    staff and unions to be properly consulted and involved in decisions to alter service delivery

vii)  evaluation of costs of privatisation, including related ‘quangos.’

Mover:  UNISON
Seconder:  Chartered Society of Physiotherapy

Supporters:  Society of Radiographers, Unite