Foundation Trusts - a real threat the the very existence of the NHS

NHS Foundation Trust Consultation: GMB Union Wiltshire and Swindon Branch Response

A Fundamental flaw in the consultation document

Wiltshire and Swindon Branch of the GMB represent staff working within the Swindon and Marlborough NHS Trust and also patients and potential patients of the trust. Wiltshire & Swindon GMB considers that the ‘consultation’ process is fundamentally flawed because it denies local people and staff the opportunity to discuss whether Foundation Status is desirable, sustainable or necessary, nor does it allow a full discussion of the implications of Foundation Status both for the local and national NHS.

Considering the large focus throughout the consultation document on the importance of the views of patient’s, local people and staff, it is ironic that all of these groups have been denied the right to have any say on whether or not they would like their local trust to convert to a Foundation Trust with all that entails.

Therefore although we are not specifically asked for views regarding the fundamental decision about Foundation Trust status, in line with GMB national policy and the feelings of local members to express our opposition to the prospect of the trust requesting Foundation status.

We believe that the consultation document is heavily biased, outlining the positives of a proposed change but no comment on any possible negative outcomes. Although the principle of Foundation Trust is not out for consultation, we should be give the full facts regarding what negatives there are.

The GMB Position regarding the principle of Foundation Trusts

GMB oppose the creation of Foundation Trusts. We consider this form of organisation as posing a real threat to the very existence of the National Health Service.

Many health experts agree that Foundation Trust status will introduce profit and competition into the NHS and mean that financially better off hospitals will be able to poach staff from less well off trusts.

With competition firmly rooted, NHS Trusts will compete with one another and will spell the end of the sharing of good practice that exists today. Instead Trusts will compete with one another and waist money on advertising etc.

The increasing marketisation of the NHS will inevitably threaten the national dimension of the NHS and in the long term threaten the universal principles which underpin Britain’s health service.

We are opposed to Foundation Status in principle because it is central to the government’s strategy of a competitive market in which Trusts compete with each other and with private companies for patients.

The more the Trust operates like a business the more patients and potential patients are subordinated to profit making.

Subjective/Misleading statements in the consultation document

“Main advantage of Foundation status is that it will bring us even closer to the people who work for us and the people we care for.”

In this section there is no mention of trade unions being an active part in this relationship. There is already an existing negotiating structure within the trust where trade unions and the employers communicate. It is not by any means clear how or what Foundation status will bring the trust closer to the needs of the local community, there is a huge variety of numbers engaging with existing trusts as members and the impact that they have in terms of strategic policy making and to services on the ground is not proven.

We also believe that the consultation is further flawed by the failure to include the governance arrangements in the consultation. The relationship between members, governors and the Board of Directors is critical because it will determine who has the power of decision. For instance, if there is a proposal to stop doing work currently done, owing to financial or other reasons., will the members have the power to vote down such a proposal?

“Healthcare is our Business”

The statements contained in this paragraph are subjective opinions promoted as facts. There is no evidence that Foundation status in itself will lead to the trust “focus(ing) on the needs of patients and our local population”. As far as the view of GMB is concerned Foundation status will mean that the priority of the trust will be financial rather than service based.

The consultation document certainly outlines the perceived benefits of this financial independence, however nothing is mentioned of some of the downsides to this. The Healthcare Commission found that being financially independent also carried risks for trusts, particularly with regards to introducing other policies and initiatives for example Payment by results caused Foundation Trusts serious organisational and financial difficulties.

There is continuing concern that by gaining financial freedom from National government the trust also looses the financial security which comes with that structure. The issue of what would happen where a Foundation Trust to become bankrupt has never been resolved and the potential impact on the national NHS is an unknown quantity.

“Foundation status will also give us more business and commercial opportunities to offer services in new and innovative ways.”

However the Guardian Dec 2004 survey of Chief Executives of Foundation Trusts found that the Chief Execs found themselves “tied up in red tape and denied the commercial flexibility they needed to prosper.”

Will there be better healthcare as a consequence of becoming a Foundation Trust?

The answer in the consultation document to this is evasive. However the Healthcare commission report Dec 2005 stated one of its findings “We did not find significant differences so far on readily available indicators of quality of and access to care between NHS foundation trusts as a whole group and other acute NHS Trusts.”

From national surveys of patients and staff, the Healthcare Commission found that “no significant differences were found between NHS Foundation Trusts and NHS Trusts in relation to experiences of patients, the attitude of staff and provision of care.”

Comments on the Consultation issues:

Although the GMB continue to be opposed to any NHS Trust becoming a Foundation trust we feel it is necessary to comment on the consultation as it is likely to be our only opportunity to do so.

Council of Governors

We believe that the proposal for only 3 staff governors on the Council of Governors is inadequate. The average quoted in the Healthcare Commission report in 2005 was of 5 staff governors. The current proposals are the legal minimum of staff reps allowed on the Council of Governors. The GMB believes that there should be maximum representation of staff on the Council of Governors (some trusts have up to 7). There is evidence to suggest that staff governors are invaluable to the Council of Governors in other trusts. Surrounded by evidence that often newly appointed governors find the role challenging, it is difficult to have influence and have poor training and support the Healthcare Commission found that “(staff governors) seemed to have an advantage over other governors due to a better understanding of the organisation and as members of staff working in the trust they have existing channels of communication to build on.”

It would also be preferable for there to be both representations of clinical and non clinical staff as staff governors to ensure it is not certain members of staff from certain backgrounds and experiences that are represented. There is no mention of this in the consultation document.

Staff involvement/impact on staff

So far as the staff are concerned your failure to commit to maintain NHS wages and conditions of service is an obvious worry. Since you will be able to hold onto ‘surpluses’ then inevitably you will be seeking to cut costs in order to maximise surpluses, and this will impact on staff as well as the work you do. The threat to hard won national terms and conditions for our members working at the trust is a big concern. The fact that national terms and conditions existing and future are not safeguarded for staff , the only comment made is that there are ‘no plans to change them yet’, does not reassure employees.

There is very little detail on how staff will be involved in the Foundation Trust in comparison to the other groups which are being engaged (local people and partners). Although the document states that staff governors will be included in the decisions regarding the strategic direction of the trust, the document fails to cover staff in anymore detail.

It is a requirement prior to recommendation from the Minister for the trust to develop an HR strategy to take them into and beyond transition to Foundation trust. This should be done in partnership with the staff/recognised trade unions. To date this has not happened within Swindon and Marlborough Trust. As a vitally important document for such a wide ranging change this document and preparation along with consultation with the unions regarding this issue should have begun some time ago. GMB has serious concerns that without this preparation the transition to Foundation Trust would be hugely problematic.

Board of Directors

There appears to be no representation of non clinical staff in the proposed make up of the Board of Directors. This would be vital to get a fair representation of the employees involved in service provision within the trust, especially as the majority of staff working within the hospital are non clinical staff.

Consultation on the change of the Trusts name

Ironically this appears to be the only thing that we are actually being fully consulted on.

The GMB consider this decision to be insignificant in comparison with the other issues relating to the possible move to Foundation status. The very requirement to change the name of the trust seems to demonstrate unnecessary bureaucracy and cost which would be better spent elsewhere.

General Points

The timescales are a concern, bearing in mind a decision could be made very quickly following the end of this consultation and we do not believe that the staff, patients or local people have had the opportunity to decide about whether Foundation status is the right decision for their local trust, let alone the detail of how a foundation trust should be run.

Finally, the Trust says that it is making the application because it has been instructed to do so by the government. Whilst it is certainly the aspiration of the government for all Trusts to become Foundation Trusts we can find nothing to show that all trusts are ‘instructed’ to make applications. The government has spoken of giving them all ‘the opportunity’ to do so. There are in fact only 73 Trusts so far that have become Foundations.

We can only conclude therefore that the Trust is making the application because it wants to gain the ‘freedoms’ this gives them. It is therefore supporting the government’s dismantling of the NHS rather than merely following instructions.

For all these reasons we are opposed to the application which is neither in the interests of staff nor service users.

Yours sincerely,

Michelle Gordon

Secretary, Wiltshire & Swindon GMB

GMB Calls on Labour Government to Honour Election Pledge to Hold referendum to ratify EU Reform Treat on the Constitution

GMB European Committee endorse ETUC position “No Charter of Fundamental Rights – no EU Treaty” 

There was a meeting today of the GMB European Committee which discussed the agreement reached by the EU Council of Ministers over the weekend 22/23 June 2007 in Brussels on a new draft of the EU Reform Treaty on the Constitution.  Following the meeting Paul Kenny, GMB General Secretary said,  

“It is now clear that the legal work to give effect to the agreement reached at the end of June 2007 on the EU Reform Treaty on the Constitution will begin right away with the target of getting the new draft agreed by the Council of Ministers in December 2007. The plan is for each nation state to ratify the agreement during 2008 and for the new Reform Treaty on the Constitution to come into effect on 1^st January 2009. There will be a referendum in Ireland. Bertie Ahern, the Irish Taoiseach, has conceded that 90% of the content of the previous Constitution is included in the new Reform Treaty on the Constitution.

The Labour Party General Election manifesto pledged that the UK electorate would be given the final say, in a referendum, on the ratification of the Constitution. The Labour Party should honour its pledge and hold a referendum in 2008 on the ratification of this new Reform Treaty on the Constitution. The pledge was right at the time of the election and it is right now.

Europe can only be developed with the whole hearted support of its citizens. GMB is a strong and a firm advocate of the benefits that a Social Europe brings to the people of the UK, while guarding against proposals that would undermine the hard won rights of UK workers. A Reform Treaty on the Constitution without the Charter of Fundamental Rights is for a business Europe and GMB did not sign up for this. This position was reaffirmed today by the GMB European Committee.”

GMB calls 5 day strike at ASDA distribution depots

You can read below the GMB press release of the decision to organise strike action against ASDA/Walmart. The nearest depot to Swindon is at Didcot. The GMB will be calling on trades unionists to demonstrate their support for the strikers at Didcot. More detail will follow.

GMB MEMBERS IN ASDA WAL-MART TO STRIKE FOR 5 DAYS FROM JUNE 30TH TO 4TH JULY (INDEPENDENCE DAY)

GMB Shop Stewards National Council agree programme of industrial action including an initial period of 5 consecutive days strike to be followed by comprehensive further industrial action
22 Jun 2006 GMB Shop Stewards National Council meeting in Manchester today agreed a comprehensive programme of industrial action in Asda Wal-Mart’s 20 distribution depots to secure their objectives. From 00.01 Friday 30th June until 23.59 Tuesday 4th July (Independence Day) there will be a complete withdrawal of labour by all GMB members in all Asda Wal-Mart depots. This will be followed by a further comprehensive programme of industrial action.

GMB members working in Asda Wal-Mart’s 20 distribution depots across the country voted by 3 to 1 (74.1% in favour) to take strike action in support of their outstanding claims with the company. They also voted by an even bigger margin of more than 4 to 1 for industrial action short of a strike to secure their objectives.

GMB members who will take part in the industrial action work as HGV drivers and warehouse picker and loaders at Asda Wal-Mart 20 distribution depots including Bedford, Chepstow, Dartford, Didcot, Erith, Falkirk, Grangemouth, Ince George in Wigan, Lymedale Staffordshire, Lutterworth in Leicestershire, Portbury in Bristol, Skelmersdale, Teesport, ADC Wigan, Wakefield and Washington. They move 30,000 tonnes per day of ambient, fresh, chilled and frozen produce from 20 distribution depots to 300 Asda Wal-Mart Stores around the country.

GMB members in Asda Wal-Mart’s distribution depots want to see the establishment of proper national bargaining structures between the company and GMB covering pay, conditions and union facilities in all 20 distribution depots.

Once established the first thing GMB members employed in the depots want is an agreement, via the new national negotiating structures, that Asda Wal-Mart pay the unpaid 2005 bonus of £300 per worker. The second issue GMB members in the depots want dealt with via the new national negotiating structures is an end to the unilateral introduction of new technology leading to higher work rates in the depots which health and safety experts say will seriously injury GMB members over a long period of time. (See Note 5). GMB members want an agreement that safe work rates are established by a panel of independent experts.

Phil Davies, GMB National Secretary said, “GMB members know full well that Asda Wal-Mart are gearing up to try to break this strike. This decision today to set a comprehensive programme of industrial action starting with the 5 days stoppage shows that GMB members are determined to win national collective bargaining rights which are common across British industry.

There appears to be a clear clash of cultures between the way workers do business in Britain and the way Wal-Mart does business. It is significant that the strike dates set by the Shop Stewards covers Independence Day. GMB members in Asda Wal-Mart want independence from the anti-trade union tactics of Wal-Mart worldwide.

GMB members spoke decisively yesterday. The Shop Stewards decision today shows they are prepared to follow it up with decisive action.

GMB will also step up the campaign against the agencies that we know are collaborating with Asda Wal-Mart to break this strike and GMB will use the full force of the law against them.”

Ends

Contact: GMB Press Office: Steve Pryle on 07921 289880 or Rose Conroy on 07974 251823.

GMB slates job losses at Great Western Hospital

GMB, Britain’s General Union, attacked plans by the management of the Great Western Hospital in Swindon to axe up to 200 jobs, 99 of which were likely to involve redundancy.

4 May 2006
Trade unions at the Great Western Hospital were told today (4 May) that the Trust needed to make £2.2m in savings per annum as a result of a financial deficit. The Trust is required to achieve a balanced budget this year and faces a potential deficit of £5m.

Kevin Brandstatter, GMB Organiser for Swindon said: “The Swindon and Marlborough NHS Trust are the latest Trust to suffer financial problems as a result of Government policy. Patricia Hewitt was quite rightly booed off the stage at the union conferences last week. The continued bungling ineptitude of the Government is now putting the health and wellbeing of people from Swindon and North Wiltshire at risk. The decision to replace the Princess Margaret Hospital with a new hospital based on the much criticised PFI process is also partly responsible for the financial mess surrounding the Great Western Hospital. The Trust has contractual obligation to Carillion, the owners and builders of the Hospital to pay them irrespective of the financial state of the Trust or the need to provide services to patients. The essence of the PFI project is now abundantly clear - private profit first, patient care second. If the Trust did not have to pay such massive sums to a private company it would not have to make so many job cuts.

It is clear that patient care will be compromised by the cuts in staff at the hospital – there is no way that a hospital can lose so many jobs without disruption to patient care. The Trust will try obviously try to avoid compulsory redundancies by not filling these posts and by natural wastage, but when a nurse or health care assistant leaves and is not replaced there is one less person to look after patients.

GMB will defend members’ interests vigorously and intends to campaign against these unnecessary job losses”.