South West NHS: Testing the waters for further pay cuts

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In the Summer 68,000 health workers (including junior doctors) in the South West of England learnt that their employers were considering cutting their pay by up to 15%, through possible reductions in basic pay of 1%;  a 10% reduction in unsocial hours  pay (many hospital nurses earn up to 30% extra due to working nights, weekends, and evenings); an increase of the working week by 1 hour without extra pay; cutting 2 days of annual leave; reducing sick pay to new staff – which will start at only 50% of pay;  a 10% cut in annual pay increments,  whilst at the same time increasing the power of managers by introducing performance-related pay. Naturally this has caused anger not only amongst those workers affected but amongst other health workers in Britain, who correctly see this as the thin end of the wedge. 

The unions reacted with great ‘anger’ and ‘surprise’ at this news. Unison and the Royal College of Nurses, the main NHS unions, both issued press statements denouncing this plan, called various demonstrations and protests and said they will no longer cooperate with the South West Consortium or NHS Trusts. Such a response by the unions has come as a surprise to many of those workers effected given their almost total absence on the shop floor, but perhaps it’s a case of better late than never? Well, if we look behind all the radical hot air by the unions we will see that they are fully involved in laying the groundwork for this attack.

The Consortium says that their proposal for the introduction of local pay agreements is within the framework of the legal and pay structures already in place. They point to the 2006 Health Act and the Agenda for Change pay structure introduced in the early 2000s, both of which contain provision for local pay agreements. The Health Act was introduced by the Labour Party whilst the unions worked closely with the management to introduce the Agenda for Change, which also contains provision for the performance-related pay that the Consortium want to introduce. The unions have also worked closely with government and management to introduce the £35bn of efficiency and productivity savings put in place by the Labour government in the 2007 Comprehensive Spending Review, and they have carried on participating in the same process with the new government. In their statement denouncing the proposed attacks, Unison made clear that it is willing to work with the same 20 Trusts involved in the South West Consortium: “UNISON is willing to work in partnership with these Trusts to help them deal with their financial pressures in a way that doesn’t threaten quality of care. But we will not stand by and let this cartel rip up our nationally negotiated terms and conditions” ( So as long as it is done nationally Unison is willing to participate in the proposed attacks. 

As for the protection of quality of care, this will make any health worker laugh given the way the unions have worked with management to impose 3 years of wage freezes, a reduction in the number of health workers - through lay-offs, reorganisations or not replacing those who leave or retire - the increased use of temporary contracts and agency workers, reductions in bed numbers, closure of wards.  Thoroughout the NHS health workers are faced with the daily distress of trying to care for people despite all of the pressures being imposed by the management , with the collaboration of the unions.

The proposed attack is a qualitative development because rather than the hidden cuts of pay freezes, the Consortium is proposing  to directly cut pay, increase hours etc. For example if they impose the 1hr a week increase in work this will give them 3,536,000 extra hours a year for nothing! Combine this with the loss of 2 days annual leave, and the bosses will get 13,736,000 hours of labour extra a year for no more money. Each worker will have to work an extra 67 hours a year!

The unions have known about these plans for months; they have been collaborating with the Consortium up until their recent announcement that they will no longer recognise it. But now they are trying to look like they are defending the workers. What are they doing in reality? They are doing all they can to keep the 68,000 health workers in the region isolated from each other and the rest of the class. They have called protests outside of hospitals (insisting that this is not strike action) and public meetings in this or that city in order to appear to be doing something, but in reality keeping workers confined to their workplace and separate from other health workers who do not work in that  hospital or Trust. For example, in Exeter there was a demonstration of local mental health workers outside of a meeting of a board of their Trust, but the union did not tell the workers in the neighbouring general hospital about this demonstration.  At the moment beyond some public meetings the unions are doing all they can to not provide any potential meeting places between health workers (such as demonstrations) let alone with the rest of the working class. They are aware of the deep respect and solidarity for health workers amongst the working class, and have organised petitions in local towns and cities to reduce this solidarity to the passive signing of useless pieces of paper but not demonstrations where workers could come to show their solidarity.

In fact the only action recommended on the Unison website (under “How can I get involved?”) is to sign the petition, write to your MP or a local paper, comment on Twitter or Facebook, and join the union. Of course they are also calling for support for the TUC demonstration on 20 October for ‘a future that works’ (there’s no such thing in capitalism) which is also a way of appearing to mobilise for the working class while actually just spreading illusions in capitalism and its state.

Unison has publicised a leaked document about the proposed regional pay agreement when actually the Consortium has not announced the precise nature of the attacks it wants to make. This looks like a manoeuvre in which the management and union can test the water to see how ready the workers are to resist, and how well the union can control any response, before making a definitive announcement. It no accident that this attack is being proposed in the South West as it has little history of militancy. However, if the bosses and unions can impose this attack here it will be rolled out gradually over the whole of the NHS, in such a way that any region which resists it will be left isolated and thus crushed.

Faced with this it is important that health and other workers seek to try and contact each other, not to allow management and unions to keep us apart just because we work in different departments or hospitals or belong to different unions. Demand that meetings are open to all, regardless of what job they do, whether they belong to any union or none – all workers are under attack and all need to fight back together. Above all an effective struggle means getting together outside the framework of the union to discuss the attack and how to resist it.

Phil  7/9/12

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