How should health workers respond to the unprecedented wave of attacks on their jobs, pay and conditions? And what can be done about health unions that are retreating in the face of a vicious bosses’ offensive?
These are real questions after unions last week agreed to worsen the Agenda for Change conditions of almost one million NHS staff in England.
From April, sick pay will be paid at the basic salary level with no added shift allowances.
Thousands of workers doing unsocial hours, including health care assistants, nurses and paramedics, will lose around a third of their pay if they are ill.
Performance related pay will replace incremental pay increases that reflect the growing experience of staff. Only those who have pleased their management, and been able to jump through their hoops, will have a chance of getting a raise.
Bosses now have a free hand to “re-profile” job specifications. Jobs can be down-banded and pay slashed.
Union leaders plead that they had to agree worsening conditions to stop NHS bosses abandoning Agenda for Change altogether and implementing local pay. They include leaders of Unison and the RCN.
But the ink on the union’s agreement wasn’t even dry before the heads of NHS foundation trusts were insisting that workers had not sacrificed enough.
They said that in the future they would still scrap national terms and conditions.
The Foundation Trust Network wants the government to be bold and allow it to slash holiday entitlements and implement local pay.
The attack—combined with overwork, job cuts, the coming pension contributions rise and the end of mileage allowance for community staff—makes many despair.
But all is not lost.
There is growing anger among workers in every part of the NHS.
The strength of feeling can be seen in the response to A&E closure plans, privatisation threats, and various reorganisations.
The hundreds of medical secretaries and admin staff on the picket lines at Mid Yorkshire NHS showed the willingness to fight earlier this year.
And still more workers at that trust have said they are prepared to join the battle.
Readiness to stand up to the bosses could also be seen in the south west of England. Rank and file health workers there have led a superb campaign to resist a local pay cartel.
The union leadership is not tapping into this feeling, but activists on the ground can.
We should look for opportunities for local disputes.
Start by circulating petitions, doing reps’ walkabouts and organising ward and departmental meetings.
Use the filled-in petitions to help pressure local, regional and national union leaders to call action.
Many union branches are battling the union bureaucracy for the right to ballot for industrial action.
We should all pile in behind this strategy—the more the pressure on the leadership the better.
Another key task is to link workers’ anger and frustration to the growing number of very confident community campaigns.
The marches and meetings going on all over Britain help health workers to see that they are not alone.
If we fight, we will have allies.
These are undoubtedly tough times in the health service. But we can be sure that any struggle to defend ourselves, and the services we provide, will be hugely popular.
Some 450 Unite union members employed by Yorkshire Ambulance Trust are being balloted for strikes against job cuts and derecognition of the union.
The trust management wants to replace fully qualified paramedics with lower paid emergency care assistants with only six weeks training.
The ballot closes on 18 March.
Some 50 doctors met in London under the banner of the Medical Practitioners’ Union (MPU) section of the Unite union last Saturday.
Ron Singer who chairs MPU said, “We need to show the government that the Lewisham campaign will happen up and down the country.”
A number of London NHS campaigns and Keep Our NHS Public have called a London-wide march on 18 May
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