NHS plans: Unions move to 'outright opposition'


Howard Catton, RCN: "We cannot move ahead with new health bill"

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The unions representing nurses and midwives have joined others in stating their "outright opposition" to the government's NHS plans in England.

The Royal College of Nursing and the Royal College of Midwives had expressed concerns in the past, but said they were willing to work with ministers.

However, now they want the entire bill covering the changes to be dropped.

Health Secretary Andrew Lansley said the unions wanted to "have a go" at government about "pay and pensions".

The colleges' stance comes after a similar move by the British Medical Association last year.

It also mirrors the stance adopted by Unison, which represents a host of administration and support staff, such as porters.

But what impact this intervention has remains to be seen.

The Health and Social Care Bill is still working its way through Parliament, and the bill is in the Lords at the moment.

In many ways it is over the worst political hurdles and it seems the only way it could be stopped would be if the Lib Dems blocked it when it returns to the Commons - but that is considered unlikely.

On the ground, changes are already being made to pave the way for the new system to kick in, in 2013.

For example, while the doctors union is against it there has still been enough GPs coming forward to pilot the new plans in 97% of the country.


Under the plans, GPs are being put in charge of much of the NHS budget, while the health service is being opened up to greater competition from the private and voluntary sector.


The move by the two unions is unlikely to see the bill stopped in its tracks.

But it is clear the government's relationship with NHS staff is fracturing, possibly beyond repair.

Some inside government were saying the move by the royal colleges was being driven by their dissatisfaction over pensions.

That has undoubtedly played a role. So too has the drive to make £20bn of savings by 2015 - the equivalent of 4% of the budget a year.

This is putting more and more pressure on hospitals and waiting times in particular.

It means there is a toxic cocktail brewing inside the health service - and this spells trouble for the government.

It came to power saying - in private at least - that the NHS was its good news story, but all too often it is finding the headlines are negative.

In June the government announced a series of changes to the original proposals in the face of mounting opposition.

These included giving health professionals other than GPs more power over how NHS funds were spent, as well as watering down the role of competition.

The health unions initially gave the changes a cautious welcome, but they have been left disappointed by the finer details that have emerged during the parliamentary process.

One of the key developments was the news, which emerged just after Christmas, that NHS hospitals would be allowed to do 49% of their work in the private sector - something which could potentially mean eight in 10 increasing their private work 25-fold.

Peter Carter, general secretary of the RCN, which represents 410,000 nurses, midwives, support workers and students, said: "The RCN has been on record as saying that withdrawing the bill would create confusion and turmoil, however, on the ground, we believe that the turmoil of proceeding with these reforms is now greater than the turmoil of stopping them.

"The sheer scale of member concerns, which have been building over recent weeks, has led us to conclude that the consequences of the bill may be entirely different from the principles which were originally set out."

Cathy Warwick, of the RCM, said: "The government has failed to present sufficient evidence that its proposals are necessary. They have failed to present evidence that the upheaval will result in an improvement in services to the people of England.

"And they have failed to answer the concerns of the people who fear for the future of the NHS under these plans."

Savings plans

Andrew Lansley said legislation was "essential to give nurses and doctors clinical leadership"

Both unions also expressed concerns that the changes were compromising the ability of the NHS to make the £20bn of savings it has been asked to make by 2015.

Mr Lansley said that nurses had previously been "right at the heart" of the process of planning reforms to the NHS to deliver better care for patients.

"The only thing that has happened in the last few weeks that has led to this situation with the Royal College of Nursing, is that the two sides of the Royal College of Nursing have shifted," he told BBC Breakfast.

"They used to be a professional association that was working with us on professional issues, and will carry on doing that, but now the trade union aspect of the Royal College of Nursing has come to the fore.

"They want to have a go at the government - and I completely understand it - they want to have a go about things like pay and pensions."

Butr that last point was later rejected by the RCN.

Shadow health secretary Andy Burnham said it was time to scrap the bill.

"A reorganisation on this scale needs a professional consensus for it to succeed. A year since the bill was introduced, it is abundantly clear that the government's plans do have failed to build that."


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  • rate this

    Comment number 441.

    The writing is on the wall. Medical costs will soon become the largest part of our State economy unless we do something about it. You can either have rationing or you can have rationing and insurance paid extras. So the sooner we bring in a little private sector efficiency to stave off the day when we take this decision the better I think. It costs money to have infinitely good health care.

  • rate this

    Comment number 375.

    II work for the NHS. I look forward to the day when people in government and senior civil servants realise it should be about patient care and work towards a lean, tight, businesslike organisation that knows what it’s there to do. The new reforms will just swap one rather morale sapping Kafkaesque bureaucracy for another one, with plenty of NHS money leaking out to private industry.

  • rate this

    Comment number 284.

    Anyone who works in the NHS knows there's fat in the system & changes to be made. This needn't to be at the expense of patient care; savings should be made in non-clinical areas of the NHS - far too many managers. Instead of immediately bringing in policies which impact on patient care why doesn't the government converse with senior clinical staff about where cuts could be made - & listen to them.

  • rate this

    Comment number 276.

    One of the biggest spending atrocities in the NHS is PFI payments - tens of millions a year, dwarfing trusts' real deficits and making it look inefficient. Yet the PFI (private) companies are insisting on taking on other contracts (e.g. catering/porterage) as part of the deal, for decades and patients are suffering malnutrition. Just watch it nosedive if the Bill goes ahead!

  • rate this

    Comment number 257.

    Lots of lies about the NHS here. It is not inefficient. By international standards it is the most effective mass health service in the world. It is not over managed: managers and administrators are an essential part of the service. The problem is fragmentation and constant changes of policy. It is not unaffordable: a private insurance system would cost much more and leave many with no cover.


Comments 5 of 19


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