The Socialist Equality Party calls on hospital workers to reject the attempt by the consortium of hospitals in South West England to cut wages and conditions. No faith should be placed in the unions to lead a campaign against this.

 

Earlier this year, 19 National Health Service (NHS) Trusts, covering 60,000 workers, formed a Pay, Terms and Conditions Consortium (PTC), and more trusts are joining.

 

The pay cartel wants to reduce wages and introduce a performance-based pay system, increase working hours, reduce unsocial-hours payments, remove sickness absence enhancements and cut annual leave. Anyone who resists the plans will risk having his or her existing contract terminated.

 

The attacks are a test case for the 1.5 million NHS workers across the country and are a prelude to further privatisation of health care.

 

Among the key objectives of the consortium revealed in the leaked Project Initiation Document (PID) is reducing the pay bill of the South West region NHS trusts by nearly 10 percent. It argues, “Economic challenges require health providers to continue to reduce costs over the next three to four years and probably beyond...the scale of change required is unlikely to be met (and will not be sustainable) without reducing the pay bill”.

 

The PID states that it wants to create a “flexible workforce able to respond to any qualified provider”—i.e., any private company that is looking to make profits from patient care.

 

The pay cartel intends to implement these changes in the South West NHS trusts by April next year and then extend them to Mental Health/Community and Social Enterprise Trusts across the region. Trust managements have already started to intimidate workers who voice opposition.

 

These attacks are a direct outcome of the Conservative/Liberal Democrat government’s Health and Social Care Bill and ongoing health cuts to the tune of £20 billion—almost a fifth of the NHS’s entire annual £108 billion budget.

 

NHS workers have already suffered a two-year wage freeze while inflation is at 3 to 5 percent a year. They are paying much more into the pension scheme at the same time as the retirement age has been increased. Those with families have seen child tax credits reduced and child care fees increased. Many have been forced to work extra hours in the “bank” or with agencies to keep their heads above water.

 

The same “efficiency savings” have severely affected patient care.

 

The erosion of health care and wages and conditions could not have happened without the support of the trade unions. The latter sold the Agenda for Change in 2004 by claiming that the radical reorganisation of job descriptions and work patterns would protect wages and conditions. At the core of the Agenda for Change were provisions for the end of national pay scales and an increased dependency on discretionary pay based on productivity gains. The actions now being taken by the pay cartel are a predictable outcome of the agreements previously made.

 

All the NHS trade unions have agreed to the government’s increase in the retirement age and attack on pensions, and have also indicated their willingness to take part in further discussions on the latest plans.

 

The unions kept workers in the dark on the pay cartel proposals for months. Now that workers are starting to take matters into their own hands, the unions have started fruitless petition campaigns pleading with individual trust managements to withdraw from the cartel or urging letters to be written to MPs—the very people who voted for the health care “reforms”.

 

NHS workers must reject such diversions with contempt. Action committees are required, independent of the unions, to unify all staff with patients and the wider population to prevent the dismantling of the NHS.

 

What is happening with the pay cartel is not unique. Around the world, governments have launched economic restructuring programmes, following the 2008 financial crash and bailout of the banks, aimed at eliminating basic social services and entitlements, with public health care systems a prime target. In every country, the ruling class has sought to make workers pay for this crisis.

 

Health care, education, access to culture and recreation, and secure and decent-paying jobs are social rights. Securing these rights requires a political struggle against the entire capitalist system and the big business parties that say that the selfish interests of the financial aristocracy are more important than the needs of working people.

 

A mass political movement of the working class, based on the fight for socialism, must be built so that workers can take political power and form their own government. This would reorganise the economy to meet human needs, not private profit—including the preservation and extension of decent free health care for all.