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 270.

    No - its all about privatisation by the back door. The pensions part is just a footnote.

  • rate this

    Comment number 269.

    258. Missd_1984
    @ 230.forgottenukcitizen that £50 was on top of the £130 i already pay each month - my partner pays about the same. I have friends in america who pay less than that each month for their Health insurance and receive a better service if they are ill - go figure!
    How are the 13 million unemployed doing regarding their health care?

  • rate this

    Comment number 268.

    Frankly it's not possible to have a sensible discussion about the inefficiency of the NHS on these boards because the opposition simply deny that the NHS has ever wasted any money ever on anything at all in any universe. You're wrong. It wastes money every day.

    Ps the NHS should be strictly confined to English born nationals and taxpayers of at least 5 years. That accounts for a LOT of waste.

  • rate this

    Comment number 267.

    The timing of this is very interesting, following the powerful and highly paid Union Leaders attack on the Labour Party. Apparently, all discussions were going well, changes and concessions gradually being made by the Government. Now, more flexing of Union muscles! Let's face it is all about pensions and wages! if one accepts wage cuts then more people get jobs. Talk about selfishness!

  • rate this

    Comment number 266.

    @244.Dancin Pagan The Mad Kiltie
    So why then is the government insisting that GPs look after the NHS budgets.
    A good question, and one that needs answered. what qualifies a gp to be put in charge of millions of pounds?

    I know business but you would not give me a scalpel and point me to the operating room? This is no different.
    This mess needs looked at by business professionals, not doctors.

  • rate this

    Comment number 265.

    I hope all those in favour of this decimation of the NHS don't ever have to reflect on their comments as a chronically or acutely ill person. If you really study what's been happening you can see this is purely a politically ideological move to move the NHS into private hands.

  • rate this

    Comment number 264.

    Working in the NHS over the last 15years with different Governments in power I've not really seen any improvements, just costly changes. It's true there is a huge problem with waste and poor management. We could get rid of a quarter of our total staff and not really notice (because some do very little and some are off sick alot). Also stop those not entitled to free treatment and charge them.

  • rate this

    Comment number 263.

    The NHS is a great lumbering dinosaur which delivers some of the worst health care in the developed world, yet people support it with something akin to religious fervour. Wake up everyone..

  • rate this

    Comment number 262.

    @182. farkyss

    So are you saying we will pay for more things directly under the reforms?

    Fine, we pay for prescriptions, dentists etc but I think to say that the NHS is essentially free at the point is not unfair nor do the reforms do anything to change this.

  • rate this

    Comment number 261.

    The plural of GP is GPs not GP's. They used to teach this kind of thing at school in my day.

  • rate this

    Comment number 260.

    @BMT - This isn't about simply left or right - it's about losing a vital service. No one really is against efficiency, but not about vicious cuts that hurt the sick and needy who can't necessarily speak for themselves. Have a heart and try not to be so dogmatic.

  • rate this

    Comment number 259.

    A lot of people commenting don't seem to have a grasp of how the NHS works and what effects the reforms could have. Separate Commisioners (PCTs in future GPs) and Providers (hospitals, community clinics) etc for a start as there isn't one big NHS family.

  • rate this

    Comment number 258.

    @ 230.forgottenukcitizen that £50 was on top of the £130 i already pay each month - my partner pays about the same. I have friends in america who pay less than that each month for their Health insurance and receive a better service if they are ill - go figure! Private will also encourage companies to look after the health of its employees more too!!

  • 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.

  • rate this

    Comment number 256.

    There are two many Chiefs and not enough Indians in the NHS. Too much waste. Too many patients and too many people attending Surgeries when they have just a sniffle.

    People abuse the NHS. They don't use it correctly.
    Only go when its something you cant sort out yourself is my motto.

  • rate this

    Comment number 255.

    Govt out of touch because they have to rely on Director level Docs and Nurses who are too interested in their own careers & wages who no longer have either clinical input to keep them informed of whats really going on at grass roots & would Lansley et al even recognise a bedban if someone hit them round the head with one.I doubt it. How many of these actually have proper management experience?

  • rate this

    Comment number 254.

    Is the NHS perfect? No.....Is it nonehteless very good? Yes.......Should we make improvements where possible? Yes........Does it waste vast sums of cash? No.....

    Lest we forget, last year the WTO (a bastion of right wing economic think) declared the NHS the MOST efficient health service in the western world.......get real all you moaners......

  • rate this

    Comment number 253.

    @ 237

    That is a joke. When I worked in a hospital, meals were delivered to every bed regardless of whether they were occupied, or nil by mouth. The Trust started a monthly competition for the best suggestions for cost savings. A porter came up with the idea of only delivering meals that would be eaten. £30,000 saved a month. It's not rocket science. The amount of waste is criminal.

  • rate this

    Comment number 252.

    @243, CTDavies: Calling the NHS "inefficient" when it's rated 2nd in the world according to the USA for efficiency is amusing. Note, that's not saying you're wrong.

    There are inefficiencies, but these plans will only create more.

    Bring in a SINGLE private firm to sort the whole IT system, reduce the admin teams to per hospital, and reintroduce matrons. Put the PRIDE back into the NHS.

  • rate this

    Comment number 251.

    160: Do you work for the 4th largest organisation on earth? Does your organisation provide a life saving service? Seems unlikely! Moreover the NHS provides comparable services for much less cost than private systems around the world. The micro-level wastage you describe should be looked at in this context. Comparisons with profit driven and competative business make no sense.


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