Unite Election Results

March 31, 2008

I attended the count today for the Unite (Amicus Section) Executive Council elections. The new Executive takes office in May. The outcome of these elections is important. Unite is the UK’s biggest union, and, as such, is enormously influential. The way the Union uses that influence obviously affects the lives of our own members – but also has a wider impact on the direction of the trade union movement, and the willingness of our trade unions to challenge a Labour Government that is pushing through some genuinely rotten policies.

I don’t have a full picture yet of the make-up of the Amicus Section Executive Council – and another 40 seats will be held by the TGWU Section.

In our Health Sector, though, the outcome was a good one. The two successful candidates were myself and Frank Wood – both serious and experienced trade unionists, both with a record as activists and campaigners in defence of the NHS.

We also have a strong commitment to defending lay control and democracy in our Union. We’ve seen a steady erosion of lay control over the last four years of Amicus.  Lay control and democracy aren’t luxury items – a union where lay activists can set the agenda is a union that is far more likely to deliver for its members.

The worrying thing is a really low turnout – much lower in Health than in the last elections four years ago, but also looking like a more general picture. I think this reflects the real disengagement that so many of our members are now feeling. If you feel a part of a union, and you believe it can defend your job or get you a decent pay rise, you’re motivated to vote. If you believe the union’s irrelevant, why bother? A fundamentally important task for myself and Frank is to make Unite relevant, and to get lay members re-engaged.

We’ll do everything we can to deliver for members in Health. We obviously welcome invitations to speak at branch meetings, workplace meetings, and wider campaign events such as Keep Our NHS Public meetings. We’ll do everything we can to be accountable to members, and to report back what happens on the Executive Council.

Many thanks to those who supported this campaign.

New Unite Rule Book

March 25, 2008

The new Rule Book for Unite was agreed by the Rules Commission on February 26th. The Rules Commission consists of members of the Amicus and TGWU Executive Councils. These draft rules now have to be approved by the Joint Executive (also comprising a selection of members of the Amicus and TGWU Executive Councils – with a significant overlap with the Rules Commission). Once the draft rules have been approved they will go to a ballot of the membership for a yes/no vote. This is all part of a process that was agreed when Amicus merged with the TGWU a year ago.

What is amazing about this process is that members have no opportunity to influence the outcome, short of voting down the rule book in the ballot. As a member of the Amicus NEC (although not on either the Rules Commission or the Joint Executive), I have not been officially provided with a copy of the draft. Members of our national industrial committees and our regional councils have also had no opportunity to see the draft rules, never mind influence the content.

Does it matter that we have not been consulted?  My view: Yes, of course it does.  The rules of a union don’t necessarily determine how effective that union is, but they do provide a framework through which members can work to make the union effective. On that basis, I’m concerned about what’s come out of the process.

Although I haven’t been officially provided with a copy of the draft, I have been sent one unofficially – Draft Rules. My comments are made on that unofficial basis.

I have significant concerns. Some are specific to the Health Sector, and some are more general.

The draft rules threaten the existence of our Health branches. The rules make provision for only three sorts of branches: workplace branches, local branches, and national industrial branches. Our health activists had hoped that a workplace branch could be one that covered a number of employers as this would cover our existing health branches – but the draft rules exclude that. A workplace branch is defined as a ‘branch at the member’s workplace’. The alternative is that members are allocated to their nearest local branch. For my branch, East London Health, that would imply members would be scattered across a wide range of branches that each included multiple industrial sectors.

I believe we risk losing what has been important about Health branches – the mutual advice and support we can give each other across different NHS employers. The problems across the NHS are similar, because they all arise from the same national agreements, and the same Government policies – but the ways in which we resist these attacks can be different. Learning from the experience of other reps has always been valuable. The other downside is that general branches will be less relevant to reps and activists in Health.  The risk is that our Health members won’t get involved in general branches, reducing lay involvement in the Union still further.

The other key challenge for the Health Sector will be our national structure. One of our strengths currently is that all of our major professional/occupational groupings are represented as of right on the national health sector committee. The issues faced by health visitors and pathologists may be different, but we have a structure where both have to be considered before we adopt a position. In the new rule book there is a provision for occupational groups within a sector, but no right for these groups to be represented on the national sector committee. The rule states that ‘each industrial sector will be led by a national industrial committee, to be elected from the appropriate regional industrial committees’. Unless the national committee were enormous, with each region being entitled to send a significant delegation, proportionality of professional groups would be almost impossible to maintain. I think we will be much weaker if a ‘winner takes all’ approach is allowed to develop.

More generally, I think the rule book represents a further erosion of democratic lay control in the union.

The Executive Council, the senior lay body, will only meet 6 times a year. Between those meetings, ‘the Executive’s powers … are delegated to the General Secretary’.  So under rule, the General Secretary has all the powers of the Executive Council for 98% of the time. He is even entitled to interpret the rules without any ability to challenge. There is not even a requirement, in rule, that he report to the EC what actions he has taken in their name. At least there are minutes of EC meetings.

Another point arises from this. There is no requirement to circulate EC minutes to the membership. If current practice is anything to go by, most members are unlikely to see them. The Joint Executive has been meeting for a year and even Amicus NEC members are unable to see the minutes of meetings. Democracy requires transparency in decision making processes. Minutes are not necessarily the best way to get information, but they’re better than nothing.

‘Follow the money’ is often a good guide to who has really got power and control in an organisation. In the new Unite rule book, if you follow the money, you won’t find much of it in lay members’ hands. Regional Councils are to get only 1% of subscription income – that’s half of the current Amicus percentage. This represents an even bigger cut for the TGWU. Currently, TGWU Regions are the main financial bodies. Their Regional Committees are responsible for all regional expenditure, including officers’ pay. In the TGWU, Head Office is granted money by the Regions. So this change represents a significant increase in centralisation from a TGWU perspective.

Things could be even worse for branches. There is no set financial percentage for branches.  The rules just say that ‘Branches will have direct access to a proportion of membership subscriptions. Such a proportion and access arrangements to be determined by the Executive Council’.  Of course, for ‘Executive Council’ you might read ‘General Secretary’. There is no guarantee here of reasonable income for the branches – another example of increased centralisation.

The document as a whole looks rushed. There are bits unfinished. There are requirements in the rules for the new Executive Council to bring in Rule Amendments to determine how their successors will be elected. It is a tragedy for democracy that the members of Britain’s largest Union will have no say in their rules until two years after they have been implemented. And what will the Rules Conference look like? Who knows? We’re told ‘The Executive Council will determine the procedure for nomination, qualification and election of delegates’. And that includes the constituencies for their election.

Unite is the UK’s biggest trade union. The way it is run – and who takes the decisions – is very, very important indeed. Democracy and lay control aren’t luxuries in a union. A union in which activists set the agenda and determine priorities is more likely to deliver for its members than a union run in a top-down way. The rule book we’re set to get may not be a surprise – but it’s a disappointment.

Agenda for Change: Agenda for pay cuts

March 25, 2008

The Unite Speech and Language Therapy Occupational Advisory Committee met just before Easter. This is the national committee representing speech and language therapists and speech and language therapy assistants in the Union. A bit of history: back in 2000, speech and language therapists won an important equal pay victory – achieving pay parity with clinical psychologists and pharmacists. This had pay implications for many other Allied Health Professionals: physiotherapists, occupational therapists, radiographers and so on. At about the same time, women health workers in Carlisle – domestics, catering staff etc – also won an important ruling that they were underpaid by comparison with male workers doing work of equal value. Estimates of the cost to the Government of implementing fair pay for women NHS workers ran into many millions of pounds.

The Government faced a choice: either pay up, or dream up a new pay system that was ‘equal pay proofed’ by the lawyers but that offered women NHS workers much less than the equal pay cases implied. They came up with ‘Agenda for Change’, a brand new pay scheme designed to reverse the speech therapy and Carlisle cases at the very same time as its ‘equal value’ credentials were proudly proclaimed.

Speech and language therapists in Amicus recognised that this was about reversing our victory, and fought hard against AFC. Many other Amicus members were set to lose out (with a majority of our members having their working hours increased, for example). We came very close to beating what was and is a major attack. Many NHS workers are still paying a high price for the acquiescence of all health unions to the Government’s plans.

The official start date of Agenda for Change was 1st October 2004. Bizarrely, in Scotland and England, AFC is still being implemented. This was a major item for discussion at our Speech and Language Therapy Committee last Thursday. We were told of very variable outcomes in Scotland, with a significant number of speech and language therapists set to lose pay. There are rumours of procedural abuses, with informal quotas being applied to posts at higher senior bands. In Northern Ireland, things are even worse. ‘Second panels’ – completely outside the scope of the national agreement – are slashing pay for speech and language therapists. ‘Pay protection’ is at 1st October 2004 levels, so staff are facing an immediate cut in pay. Worse again, speech and language therapists are being told they have to pay back the money they have been ‘overpaid’ since October 2004! This is an astonishingly brutal approach to implementing AFC, which apparently applies only in Northern Ireland.

Our meeting last week was a practical problem-solving one. Our Health Sector National Committee, also last week, has already agreed the need for more support and information for our members in Scotland and Northern Ireland. We have some genuine AFC experts on our speech and language therapy committee. We agreed that they will offer detailed support to therapists in Scotland and Northern Ireland in challenging outcomes through reviews, and through grievances where there is evidence that processes have been abused. We agreed in principle that we would run a training day in each country, with a committee member flying in to run detailed training for reps and activists.

For Northern Ireland in particular, we were clear on the need for a campaigning approach. We will do everything we can to assist speech and language therapists in lobbying and campaigning to get a reversal of their immediate pay cuts and the requirement to pay back ‘overpaid’ money. Union members will be supported in doing everything they can to raise the injustice of their situation, within the Union and more widely across Northern Ireland. As Chair of the Committee, I’ll be writing to MLAs (Members of the Legislative Assembly) calling for ‘overpayments’ to be written off. We have agreement that a speech and language therapist can be co-opted onto the Union’s Northern Ireland Health Sector Committee. 

There’s a shocking injustice going on here, and it needs to be over-turned. We talked about speech and language therapists, as these are the cases we knew about – but there will undoubtedly be other health workers in the exact same situation. Unite must support its members.

So was AFC a good idea? Almost certainly, the answer is ‘No’. There will be losers in Scotland and Northern Ireland, as AFC is rolled out. Plenty of our members lost out in England and Wales back in 2004 and 2005. Our pathologists across the UK remain at risk of losing out badly when new on-call proposals are finally implemented (on hold now until March 2009, or possibly as late as October 2009).

The priority for our Speech and Language Therapy Committee is a vigorous damage limitation exercise, trying to safeguard the position of particularly vulnerable members. There’s a wider lesson to be learned, though. People join a union because collective strength makes us stronger. Agenda for Change has always been about divide and rule tactics – allowing some members to gain (typically very small) pay increases, while other members lose out. Union organisation for all of us is weaker as a result. The old slogan is ‘an injury to one is an injury to all’. With AFC, those important concepts of solidarity and standing together got lost.

Why it’s time to challenge Labour

March 23, 2008

 Our big unions – the likes of Unite and Unison – get themselves in a mess when it comes to attitudes to a Labour government.

We’ve got a Government that drives through some desperately reactionary policies – war in Iraq and Afghanistan, the scapegoating of asylum seekers, a celebration of anti-union laws, a systematic assault on civil liberties and so on. And, of course, the steady dismantling of our NHS, together with the rest of the public sector.  In spite of this, we go on handing over the cheques – around £1/2 million a quarter from the Amicus section of Unite, from memory.

My own view is that this is nonsense. Why hand over so much members’ money when we get so little in return? I support the democratisation of the political fund – of course Unite and other unions have to be able to take part in political campaigning, but we should spend our money in the interests of our members, rather than just handing it over to Labour.

There can very direct consequences for our members in tying ourselves so closely to a Labour Government – a drift towards downgrading the interests of our members so as not to embarrass Labour. If we had a Tory government, I strongly suspect we would have had a more robust response from the union movement than we’ve actually seen.

I’m pleased that Unite’s Health Sector is acknowledging some of the contradictions, and recognising the need to fight for our members. We had an excellent discussion at the Health Sector National Committee last week on the threats to the NHS, and how we need to defend the NHS and our members more vigorously. We talked about some of the ideas that recent reps meetings in London have raised – a more strategic approach to resisting the attacks we face, organising meetings for the groups of members who are under attack to share ideas on how to resist, and higher profile campaigning against cuts, redundancies and privatisation. We talked about the scope for campaigning around the 60th anniversary of the NHS – celebrating the values of the NHS, but highlighting the speed and scale of the erosion of a public sector service with public sector values and public accountability. The Union is already working on two new publications – on Foundation Trusts, and on ‘Where the power lies’ – exploring how public control of the NHS is being handed over to big business. The meeting heard reports of industrial action taken by members to defend pay and conditions.

The discussion was an interesting one. One long-standing Labour Party member said he had little enthusiasm for campaigning for Labour – he described the difficulty of knocking on doors to say, ‘Vote Labour – they’re the best of a bad bunch’. Another Committee member, a Labour Councillor, outlined that he will not be standing again – he hates what the Labour Government is doing to the NHS, and feels excluded from political decision making.

Labour needs to take care – as do TU General Secretaries. Our unions have sometimes been slow to challenge Government policy – but, at the end of the day, if unions won’t fight for members, they lose all credibility – and members will vote with their feet. And when loyal and long-standing Labour Party members are raising such strong disagreements, it’s an indication of just how rotten and reactionary this Government’s policies have now become. The contradictions for our unions get sharper – and aren’t going to go away.

Time to make our policies real

March 19, 2008

I attended a Unite study day for London NHS reps yesterday. This was a practical day to look at how we can build the campaign to defend the NHS – a follow-up to a previous event held last month. I posted on last month’s event here: http://gillgeorge.wordpress.com/2008/02/15/a-study-day-for-resistance/ . Yesterday’s meeting was lower key, but a useful problem solving day – and an opportunity to review what we’ve been able to achieve over the last month.

We’re moving in the right direction. The London Regional Council has agreed that health is a campaign priority, and is working with London Health Emergency to produce a broadsheet on the current attacks on the NHS and how we should respond. The intention is to send a bundle of ‘NHS Specials’ to every rep in London. The TGWU Regional Committee has agreed to support this initiative – so we can get material out to every rep in London, whatever industry they’re in, and whether they’re Amicus or T&G. This is an effective way of extending the campaign beyond the ranks of health workers, and using the wider opportunities that a large general union can offer us.

We’ve agreed and submitted a robust response on Darzi’s plans for London – written primarily by me, with input from other lay colleagues. This is a politically important response. Darzi’s proposals reflect the Government’s priorities for the NHS. The plans are about driving forward the privatisation and fragmentation of health services in London. It’s good to see the Union prepared to cut through all the rhetoric about ‘world class healthcare’ and expose the shoddy realities that underpin the hype.

We have a ‘pathology roadshow’ coming up – a day for pathology reps to get together and plan their response to the threats of privatisation and job loss facing this group of our members in London.

There are other initiatives we discussed today that need further work. We’ll be producing a practical guide for reps on how to challenge employers, how to build organisation at work, and what they need to be thinking about over campaign initiatives. We’re pushing for more hands-on support for reps on the ground, with increased officer and organiser support. We talked about specific initiatives to support reps around punitive sickness absence policies, the misuse of suspension, and about the way clinical staff are being used as scapegoats – disciplined for non-existent or trivial offences, apparently as a tool to keep the wider workforce intimidated and too scared to challenge ‘reform’.

We talked about the need to lobby MPs. Some reps were so furious about the contemptuous response we received at a meeting with MPs a year or two ago that they felt there was no point repeating the exercise. Most thought we couldn’t let them off the hook – and that we need to put real pressure on them to wake up and notice the catastrophic harm that they and their Government are inflicting on the NHS.

We’re also aiming for high-profile initiatives over the NHS 60th birthday – a good opportunity to build the campaign to defend the NHS, and to make the links between trade unionists and wider community campaigns.

Are things perfect? No, of course not. We’re facing massive threats from a Government that’s hell-bent on dismantling the NHS. Many of our reps are exhausted and ground down by what can feel like a never-ending onslaught. Our members are under attack on an unprecedented scale.

BUT – we still have an NHS, and it’s still absolutely worth defending. It’s good to see Unite, in London Region, taking real steps to turn our paper policies on the NHS into something more meaningful.

Scotland: An example of why lay control matters

March 17, 2008

On Friday, I attended the Scottish Health Sector Conference of Unite. This was an impressive event in many ways – well-attended, with 50 or 60 reps there, and a sense of those reps being incredibly well organised and well informed. One of the things that really struck me, though, was the level of anger that so many reps expressed.There were a few different issues that people focused on. One was Agenda for Change – still ongoing in Scotland, as it is in Northern Ireland. I knew before attending the Conference that outcomes have been very variable, and a lot of members are unhappy with the results they have got. Estates staff were particularly unhappy, with one rep saying they’d looked at job descriptions virtually identical to their own that had come out on higher Bands. He believed that his members’ jobs south of Carlisle would have come out a Band higher. Speech and language therapists told me over lunch of the same variability and described particular problems in Glasgow – with sharp reductions in salary for senior and specialist therapists. For a national pay system, AFC is turning out to be remarkably dodgy!

One of the biggest problems seems to be that our activists aren’t getting the support they need with AFC.  The same is almost certainly true of Northern Ireland. When AFC was being rolled out across England, we had briefing packs for reps, training days, detailed back-up from FTOs and so on. That’s pretty much gone. If we’re going to stand a chance of over-turning poor outcomes, the Union must get detailed support in at review stage – and that means moving quickly to make sure this happens.

Another issue causing huge anger is the review of Scottish community nursing. I did a more detailed posting on this back in November: http://gillgeorge.wordpress.com/2007/11/07/disaster-for-scottish-community-nursing/

This is really serious. There are proposals to merge the separate roles of health visitor, school nurse and district nurse into a single generic ‘community nurse’ role. This will have major consequences particularly for children and their families – almost certainly there will be a loss of focus on public health and preventative work, and a loss of any focus on child and family-centred work. There’s likely to be a real dumbing down of the distinct and specialist roles of these three separate professions. There is overwhelming opposition to these proposals within community nursing – but the plans are about to be piloted. Once rolled out, this will be very difficult to reverse.

What was astonishing was the explanation given by a senior full time officer at the event. His view was that our nursing members didn’t understand the technicalities of what was going on, that we were working in partnership, we had to be working on the inside not the outside, when there was a conflict between the Health Department and our members we had to be very careful… In practice, this seemed to amount to not opposing the plans. Nurses at the meeting are furious at seeing their jobs dismantled, essential services threatened – and their Union at best equivocal in its support. One CPHVA rep has resigned from a senior Union position – I don’t believe the right thing to do, but understandable.

This was the third theme of the Conference: the loss of lay control, a theme bubbling away beneath very many contributions. Our activists in Scotland don’t believe that they run the Union – and many individuals told me of their anger at a top-down approach in which lay members have little say. The loss of lay control was clear in the discussions around both Agenda for Change and community nursing.

This has got to be a priority in the new Union, as we move forward to full merger – and a priority for the whole UK, not just Scotland. Lay control and democracy in any union aren’t just nice, fluffy things that are a bit of a luxury. They are essential. If reps and activists set the agenda and determine priorities, we’re far more likely to end up with a Union that’s responsive to members and that delivers for members. That means  a Union that can grow and organise, and a Union that has a future. We’ve tended to lose lay control in Amicus – it’s essential that we to win it back in Unite.

Patients? A great opportunity to make money!

March 13, 2008

The introduction of the market into healthcare has some pretty horrendous results. We know about the soaring rate of hospital acquired infection following privatisation of cleaning services, for example. Allyson Pollock’s recent research shows that competition in the NHS leads to worse outcomes for patients – no great surprise, if hospitals are competing with one another instead of collaborating, or kicking patients out of hospital early to save money on a bed.Some of the effects of ‘marketisation’ are more subtle – but have a huge impact on patients. There have been some fascinating press stories this month on the money made by hospitals in car parking fees – over £100 million across the NHS in England. Addenbrookes makes £2.5 million a year from car parking alone! Southampton General Hospital picks up a tidy 2.1 million.

Patients or visitors can end up paying out as much as £70 a day to park – very costly indeed for someone attending a course of radiotherapy treatment, or for relatives visiting a seriously ill or dying patient.

Patients aren’t just a money-making opportunity when it comes to parking. A company called Patientline sells its services to many hospitals now. It increased its telephone charges by 160% last year – but was forced to put them down again following an outcry.

The costs are still a disgrace. Outgoing calls – the patient phoning home, for example – cost 10p a minute. The real horror story, though, is incoming calls – the typical situation of a friend or relative phoning someone in hospital to find out how they are. This costs 39p a minute off-peak, and an astonishing 49p a minute at peak times. It’s hard to justify paying so much more to ring your Mum or Dad up the road than to call someone in Australia – but that’s life in an NHS run on money-making lines.

The TV package from Patientline costs £2.90 a day in some hospitals and £3.50 a day in others.  Again, that’s a substantial sum of money for someone on a low wage or a state pension.

Remember the good old days of WRVS cafés selling cheap snacks? Not quite gone yet, but going fast. There are at least four Burger King outlets now in NHS hospitals, and a host of Costa Coffees, Café Ritazzas and the like. This is another opportunity for hospitals to make money out of patients and relatives – part and parcel of daily life in an NHS where hospitals are forced to run as small businesses

The Welsh NHS has just banned car parking charges, quite rightly. It would be nice to see the rest of the UK follow suit – and extend the philosophy to cafés, TV viewing and phone calls. The ethos of the NHS is that we care for sick people because that’s a part of the values we share and hold on to in a decent society. £3.50 a day to watch the TV or 49p a minute for a phone call isn’t compatible with putting people first.

Time to rebuild union organisation

March 6, 2008

 I was chatting to a Unison member yesterday – an NHS worker in a London primary care trust. She really needs a full time job for financial reasons, but she reluctantly accepted a 25 hour a week contract because the job was local and convenient.

Eight or nine months later, the manager decided that there had only been enough money in the budget for 22 hours a week, the 25 hour a week post had supposedly been offered by accident, and the person’s hours would be reduced. The health worker obviously said ‘No’ – so the manager told her if she didn’t agree, she would have her contract terminated. On that basis, the worker ‘agreed’. The fear of dismissal outweighed her confidence that her union could do anything about it.

There’s an obvious problem here. This is vicious and nasty bullying, and it’s outrageous that this stuff happens in the NHS. I hear far too many stories of Trusts bullying people into accepting worse pay or worse conditions, and even of trumped-up disciplinary charges being used as a cheap alternative to redundancy.

It’s inexcusable that employers behave like this – but it’s also inexcusable that we let them. There’s a real urgency now to rebuilding our union organisation. We’ve got to have the union density and the level of confidence amongst members that we can stop this nonsense. Some of this is down to individual reps – re-learning old traditions of being accountable to members, keeping people informed, organising meetings and trying to build a sense of collectivity. It’s not easy doing this – it means taking risks, sticking your neck out, and working very, very hard.

Sometimes that not enough. I read in an Officer’s report to the last Regional Council that we had no reps across three neighbouring Trusts in London. They are all places where only two or three years ago we had good, competent reps who worked hard and delivered. But, obviously, the pressures have led to a weakened organisation.

That’s where the Union comes in. We must ensure Unite gives reps all the support they need. Some of this is the obvious stuff around effective training for reps, and support from full time officers being available when you need it. It’s about strategy – of course we can’t fight on a Trust by Trust basis. The Government has a coherent strategy of dismantling the NHS. The employers work together and share information, and the ‘reforms’ of the NHS are all variations on a theme of marketisation and privatisation. We need a far more strategic response ourselves on how to resist, how to organise, how to make links between different groups of workers under threat. We need a campaigning approach too – making the links between trade unions and community campaigns, and – in a general union like Unite – making sure that defending the NHS is an issue for ALL our members.

These are the sorts of things that we’re now working hard to put in place in Unite in London Region. We’ve got some good campaigning work just beginning to get off the ground; a special issue newspaper on defending the NHS going in bundles to every T&G and every Amicus rep, across all our industrial sectors, for distribution to members; plans for much better dedicated support from officers for NHS reps; London-wide reps study days to build those vital links between reps from different employers, and to involve lay members in agreeing the best response to the attacks we face. We’ve made real progress over the last month in moving this agenda forward.

The final area that needs tackling, of course, is politics. The attacks from employers don’t come about because Chief Executives are individually nasty. This is about a political agenda from the Government – but we continue to hand over the cheques and give political support. Unite (Amicus Section) has a national position of ‘Two years peace for Gordon Brown’. This isn’t good enough. Our members in Health can’t afford two years peace for Gordon Brown. Going forward, there are serious questions to be asked about unconditional support for Labour, and about how we use our political fund.

CPHVA: Defending services, defending the NHS

March 4, 2008

Yesterday evening I had the pleasure of speaking at a CPHVA Centre meeting in South East London. The turnout was good, with a spread of health visitors, school nurses, specialist nurses, a community nursery nurse, and a staff nurse. The impressive turnout is probably no accident – this is a well-organised group, with four reps.There was a good discussion about some of the local problems. The Trust is moving  its clinical services to an Autonomous Provider Organisation, talking already about staff being ‘TUPE’d’ out of NHS employment, and about staff moving to insecure 3 year contracts. People were very clear about their opposition to this – but also felt they needed more support from the Union to feel confident about taking on big fights like this. There was discussion on the need for information and for detailed support from full time officers.

I talked about a particular bug-bear of mine – this is happening in a lot of PCTs across London, and also nationally. It’s essential that the Union develops a much more strategic response to this, and to similar threats, instead of just leaving reps to fight Trust by Trust. Of course there will be differences between Trusts – but there will be similarities as well. We need a united and coherent response – trying to influence the agenda on this regionally and nationally, and also giving much better support to reps in terms of information, guidance on what the threats are, what we should be challenging, and so on. How can we fight a Government that has a coherent strategy, and employers who work together to implement this nonsense, when we’re so fragmented ourselves? We have to shift this.

The Trust I visited suffers from the same old picture of not enough staff and way too much work to do, with the situation steadily getting worse. It’s amazing how this has become commonplace in the NHS. Two school nurses reported on the service they provide. There used to be 16 qualified school nurses – now there are only 5. They are supported by 3 Band 5 nurses, but one of those posts will be lost in April. The school nurses reported their belief that they can no longer provide a safe service. We talked about how to make this a campaign issue.

They’re absolutely right to challenge on the question of workloads – all staff in clinical jobs should be much more alert to this. The Full Time Officer at the meeting suggested that they write to managers stating that they can’t practice safely, making it clear that this is the manager’s responsibility, that the manager is in breach of the NMC Code, and asking the manager to do something about it. The message needs to be, ‘A kid’s going to die and it’s your fault’. This is a useful one – easy to do, and it gives some protection against scapegoating if a lack of resources leads to an exhausted and over-stretched member of staff making a mistake.

We also discussed the need for wider campaigning – lobbying the Board, contacting MPs and the Health Scrutiny Committee, informing the press, alerting the public about what’s happening to local services. Community nurses in this Trust have done this before – and are up for doing it again.

This was a good meeting – realistic about the scale of the problems, but optimistic about fighting back. Professional and trade union issues were seen as the two sides of the same coin. The strength of the CPHVA remains its ability to combine the roles of professional body and trade union. It’s a combination that works well.

Speech and Language Therapy – A profession in deep trouble

March 2, 2008

 Some recent comments from speech and language therapists:

  • I have become disillusioned by higher management who tell us how to streamline our department for more efficient output. We are made to sound like a factory, but a good therapist takes time to learn about individual families and to support their individual needs… in the long run this proves to be more beneficial in terms of time and therapy outcomes.
  • Decisions are being taken by people who understand nothing about clinical services and care even less.
  • In 30 years of NHS practice, I have never known a time when staff are so demoralised, frustrated, depressed and generally stressed out by the constant demands, not just to do with our caseload, but the systems which leave us feeling watched, monitored and totally unsupported at every turn.
  • Would I recommend speech and language therapy as a profession? Yes, but only if someone is not particularly ambitious.

I’m a speech and language therapist by profession. It’s a job I love.  Like a lot of speech and language therapists, I believe communication is a central part of what it means to be a human being. I work with children with disabilities, and it’s incredibly rewarding to help a child get their message across, and to support a parent or teacher in understanding what the child wants to communicate. For therapists working with adults, there is equal job satisfaction in giving support to someone who may have impaired communication following a stroke or head injury, for example.

Tragically, this is a profession that is now sliding into crisis. The ‘Agenda for Change’ pay package introduced in 2004/05 was very damaging for us, effectively reversing an important equal pay victory back in 2000. Since then, we’ve been badly hit by the cuts and redundancies sweeping across the NHS.

If Trusts axe doctors and nurses, the public is more likely to notice. If it’s speech and language therapists, they reckon on not many people noticing. Tragically, employers don’t seem too fussed by namby-pamby stuff about communication being a human right.

The document ‘Unite response’ is the Union’s response to the ‘Bercow Review’, written by me on behalf of our Speech and Language Therapy Occupational Advisory Committee. John Bercow is a (Tory) MP asked by the Government to review speech and language therapy provision.

This is a genuinely frightening document, and worth a read. Speech and language therapists report job loss and worse pay and conditions for staff – and a steady dumbing down of the services we provide. The agenda is one of worse clinical care for very vulnerable people.

It’s more clear than ever that we need a Union that’s prepared to stand up to employers who shove through cuts – and willing to challenge the Government that wants to carve up the NHS and hand out the more profitable pieces to big business. The people we work with deserve much better than that.


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