CPHVA: Defending services, defending the NHS

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.

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