Charities have slowly increased their share of health contracts.
Charities and other “social enterprises” say they are different to private companies. But when they take on contracts to run public services, they increasingly behave in the same way, squeezing workers and cutting costs.
This is something workers at Addaction in Wigan and Leigh in the north west know all too well.
The workers were outsourced from the NHS to Addaction, which now runs the service on a contract to the Labour-run council.
Paul is a Unison union rep at the alcohol and drug rehabilitation charity, where workers took their fourth round of strikes for equal pay last week.
He explained how bosses are refusing to give them NHS Agenda for Change pay and terms and conditions.
“This dispute started just over a year ago when management said they wouldn’t pay Agenda for Change and they haven’t budged in any meaningful way,” he told Socialist Worker.
“They’ve stated they can’t afford to pay us—and even if they could pay us, they wouldn’t anyway because of concerns about pay unfairness.
“We know that they exist because a staff survey cited that people are working next to others doing the same job and being paid significantly less.
“But the unfairness didn’t come about because we were transferred over on NHS rates—it’s because they choose to pay their staff lower rates.”
Paul added that the workers’ alternative was “levelling up everyone”.
“Despite them seeming to share the concern about their staff—they have quoted that survey—they haven’t taken any action to reduce the unfairness,” he said.
“We would support any action to reduce the unfairness by levelling people up, but they don’t want to do that.”
It’s no wonder that Addaction charity bosses act like any other capitalists when you look at their board.
Mike Dixon, Addaction’s CEO, has recently left to take up another post as chief executive of the Liberal Democrats.
He leaves behind Addaction chair Baron Carlile, who was a Lib Dem peer between 1999 and 2017.
His other interests have included the security services.
In the 2000s Carlile served as the government’s “independent” reviewer of terror legislation and supported greater powers for the spooks. He went on to set up a consultancy firm with a former head of MI6, pocketing £400,000 in dividends over three years.
Their own wealth hasn’t stopped bosses treating workers with contempt.
Paul said, “They said if you sign a document saying we wouldn’t strike any more about this dispute they would pay us the wages we lost on strike.
“I thought that sounds like the icing on the cake—if you’ve resolved dispute, they say we’ll make up the loss up as a gesture of good will.
“But, unfortunately, it was the icing without the cake.”
Addaction is benefiting from legislation pushed through by the Tory-Liberal coalition that made the NHS put services out to tender.
To sugarcoat the move, the coalition said it was trying to get the “third sector” to alleviate the pressure on the NHS.
In reality, it was about prising open the health service for business.
Labour has talked about renationalising the NHS, but its plans have only talked about making the NHS the “preferred bidder” in contracts.
All NHS and public services should be taken back into full public ownership and properly funded.
And that’s why everyone should back the Addaction workers—a win for them will be a blow to all the outsourcers.