Health Workers Take Up the Fight Against the Capital Centred Direction of the Hospital Trust Subsidiary Companies
NHS workers across Yorkshire & Humberside and Lancashire and in a number of places across England have had recent union consultative ballots and voted for strike action against being transferred to wholly owned subsidiary companies by their NHS employers which will lead to NHS staff, some already the lowest paid, having worse pay, pensions and terms and conditions. These subsidiary companies, known also as subcos, are increasingly being set up by Hospital Trusts in England into which they transfer almost all non-medical staff and even health sector buildings and estate with leaseback arrangements. Health workers are increasingly taking up the fight against this capital-centred direction of these hospital Trust subsidiary companies.
According to Unison reports early in February, Unison members working at three hospitals in Lancashire – at the Wrightington, Wigan and Leigh NHS Foundation Trusts – voted to reject the plans and ask the union for a strike ballot by 93% in a 79% turn-out. Nearly 900 NHS staff who work in estates and facilities across the trust’s three hospitals are threatened by the plan to outsource them to the wholly owned-subsidiary company, WWL Solutions.
Unison North West regional organiser Sean Gibson said the consultative ballot had shown staff members’ deep concern. He said: “Good quality catering, cleaning and portering services are all crucial to the efficient operation of the hospitals and to the experience of patients. The staff performing these roles form a key part of the NHS team and they should remain in the direct employment of the Trust – not pushed away into an outsourced separate company.” Sean Gibson said that the union will initiate steps toward an full industrial action ballot, while continuing negotiations with the trust and pressing it to change its plans.
The Harrogate District Foundation Trust had also announced plans to set up a wholly-owned subsidiary to manage its estates and facilities in November last year, and transfer more than 300 NHS staff to it. Unison held a consultative ballot early in February over the plans, which saw a 97% rejection on an 89% turn-out, with members saying they would vote for industrial action in any formal ballot. Unions Unite and GMB have also joined in with this fight. However, the Trust has so far ignored the ballot and according to reports the first transfer of staff was to go ahead on March 1st.
The Health Service Journal has estimated that about 3,000 NHS non-medical staff at eight trusts, mainly those working in estates and facilities, have already been transferred to subsidiaries. A further 8,000 more could follow, if further planned subsidiaries go ahead at dozens of Trusts. Among reports of the transfers already made, or expected, Yeovil district hospital has transferred 350 workers out to “Simply Serve”. Gloucestershire Hospitals Trust had a closed board meeting in November 2017 where they agreed to consult on plans to transfer 750 estates and facilities staff out of the NHS, and Royal United Hospital in Bath has said it plans to set up a subco for 500 workers.
As with the consultative ballots and some halting of these plans across Yorkshire, Humber and Lancashire, there is growing opposition from health workers across the whole of England. At the beginning of February, opposition by the staff and trade unions stopped the North Bristol NHS Trust plan to set up a subsidiary. But what is emerging is that the government and NHS England, especially its NHS Improvement team are going all out to get the NHS public sector Trusts to more and more operate in this capital-centred direction. Dangling the carrot of subsidiary companies having exemption from VAT payments, which of course at a later date can be withdrawn, they are driving NHS hospitals in the same outsourcing direction that recently led to the collapse of Carillion. This revealed the criminality of the wholesale outsourcing of hospital-building, maintenance and hospital support services. Speaking about the hospital subsidiary companies, Unite warned that these companies “could create a Pandora’s box of dozens of Carillion-type meltdowns among NHS trusts in England”.
In the case of of the Northumbria Tyne & Wear Mental Health Trust (NTW) how far this outsourcing is already going can be seen in the business case  of its subsidiary company NTW Solutions in that not only does it transfer staff but: “Setting up the company would involve the transfer of some assets to the company, including 25 year leaseholds on some properties, funded through a combination of loan and equity funding.” In the case of QE Facilities, the first subsidiary companies set up in the northern region, in answer to a Freedom of Information Request in 2015  it was revealed that not only had the Queen Elizabeth Hospital Gateshead transferred some 50 estates staff and were to transfer 400 portering, catering, domestic, facilities and operations staff but the estimation of the value of the equipment, property and facilities which the Trust has transferred to, or entered into lease or other commercial agreements with QE Facilities, was a staggering £26,737,623. QE Facilities has not only profited from moving to worse terms and conditions for staff, replacing the defined NHS pension scheme with a non-defined pension scheme for new starters, but also its profits come by bidding for other hospital services and setting itself up as an expert in advising other trusts how to set up subsidiary companies.
The setting up of these private companies alongside NHS Trusts has to be seen in the context of the Health and Social Care Act 2012 which enabled the Trusts to devote up to 50% of their bed capacity to private health care whilst also giving them freedom to enter into commercial deals with their own and other private companies as well as to directly borrow from predatory finance capital. This latest move in the setting up of private companies in partnership with NHS trusts is painted, depending on the Chief Executive, as a way to “make profit” for the NHS services, or “a lesser evil than full privatisation” of non-clinical services, whilst they all insist that they have the well-being of the staff and the patients alike. But the reality is that it is a capital-centred direction of new public/private partnerships, but this time within Hospital Trusts. It is a direction that is taking over what is left of public authority in the NHS state-run services, which are increasingly run like private corporations. The aim of such a move is for the complete domination by “private” and “public” corporations over the vital health and well-being of society. Such a move is in keeping with the whole direction of chaos and corruption of the entire economy dominated by finance capital and its predatory pro-war interests to exploit the peoples at home and abroad. Health workers are right to fight these plans in order to defend their own interests and to safeguard their rights, terms and conditions, and pensions. This must also be seen as a fight in the interests of all for the right to health care within a pro-social economy and an anti-war direction for society.