My mission statement

The times we are working in now need a great deal of accelerated change and there must be no negotiating that down. So my mission statement for this part of my consultancy career is to be clear that there needs to be and will be a lot of change from the work that I do with individuals and organisations and if organisations don’t want that, then it is probably best to go somewhere else.

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Will the next Labour leader be chosen by the Health Service Unions?

Filed Under (Health Service Unions, Reform of the NHS, Trades Unions) by Paul on 10-12-2009

One of the interesting issues about leadership is the way in which leaders can become known not only for their own reasons for doing things, but also the reasons their allies and supporters give for their actions. This is usually under the heading of the phrase ‘by their friends shall ye know them’.

At the moment it is interesting to note who the Secretary of State has as his friends in trying to impose his own personal preference for the NHS as preferred provider on all those who commission health care for NHS patients.

There are those who say that the only reason the Secretary of State announced his new personal preference on September 17th was that it coincided with the TUC conference. Apparently, they argue, the trades unions have a large number of votes in the next election for the leader of the Labour Party and, they continue,  if the Labour party were to lose the next election there would be such an election in the next 9 months or so.

Apparently, they go on, if the Secretary of State were to stand for election as leader of the Labour Party, the health service unions – that have members who could vote for him for that post – would do so because they would be grateful to him.

Apparently they claim as evidence for this the fact that the Secretary of State announced the second tranche of this policy not to an NHS audience, but in a letter to the General Secretary of the TUC in which the Secretary of State thanked the TUC for the work his staff had put in to developing the policy.

I find all this a bit far-fetched myself. I can’t imagine that a politician would see their own future as more important than the right of NHS patients to have as wide a choice as possible of different providers of health care.

But I am always interested in tracking down an argument so I thought it would be interesting to find out what the health service unions have been saying about the Secretary of State’s personal preference.

One of the main changes that has taken place in trades unions over the last 20 years has been the drop in the number of members in the private sector. Old industries have died and new ones have grown up. The trades union membership of the old industries has gone – along with the jobs. And the new industries have not developed anywhere near the same level of membership.

I think this is a pity because trades unions are an important part of the structure of the way in which bargains are constructed between private sector owners of services and the labour they need to provide that service. Sitting round a table and arguing how the workforce can play a role in helping an industry thrive in an international market place is an important part of the balance of our society.

But as private sector trades unions have declined in both number and penetration of new industries, in the public sector they have thrived. This has radically changed the balance of what matters to the trade union movement. The TUC I grew up with was dominated by a trade union leadership that had to win its battles in the day by day negotiation with employers for pay and conditions. It was a bargain between those who owned the industry and those who provided labour for it.

Most of that has gone now. Public service trades unions don’t only negotiate with their employers in schools, hospitals and local authorities. They also negotiate with the Government to try and change the balance of power in those negotiations.

If this is how they see negotiation then it is clearly in their interests to have providers of public services that are in some way ’owned’ by the Government.  If all of your members work in an industry that is owned by the government then you look after their interests by negotiating with that Government and not with the employers.

Those trade union leaders who believe in this way of working would be against the idea of their being a plurality of different employers. If public services are provided by some public employers (owned by the state); some private employers (owned by shareholders); and some third sector employers (owned by a variety of organisational structures) it means that simply negotiating with the state doesn’t cover all of your members. You have to negotiate with different sorts of employers.

Therefore it follows that such trades union leaders would be against a plurality of public service suppliers and in favour of there only being one form of provider – the state.

Such a stance would not only mean that these trades union leaders would be against the private sector being involved in public service provision, but they would also be against the involvement of the  third sector. Irrespective of the fact that the motives behind the third sector and the private sector are very different, they would dislike both of them because they were not owned by the state.

That would mean then that the trades union movement would – like the Secretary of State for health have a preference for the NHS as the provider of health care services and it is probably this that is behind the argument that the TU movement would strongly support such changes.

Not surprisingly this has been the stance of the health service trades unions in the debate about the Secretary of State’s personal preference for the NHS as preferred provider. 

Tony Woodely the Joint General Secretary of Unite make this clear in a letter to third sector organisations

Unite agrees that the Government should be congratulated for improving the NHS and in particular, for the massive increase it has made to the funding of our health service.  But we also believe Government should be congratulated for the decision to ensure that the NHS is given ‘preferred provider’ status, as it shows the Secretary of State has listened to our arguments that the NHS, not the private or not-for-profit sector, is best placed to provide health services.

Charities have a place in providing health services such as palliative care however as we have seen in the provision of services for children, as they compete with each other over contracts, collaborative working such as sharing good practice can be compromised.

There is also no guarantee that, where not-for-profit organisations win contracts at the beginning of this outsourcing process, that they will hang on to those contracts next time round.  We are then left with the very real danger of global multinationals honing into our health service to extract maximum profits. 

This makes his position against third sector organisations clear.

But over the last few years the Labour party and the labour movement have been supportive of the growth of the third sector. They have recognised that such organisations can, on many occasions, develop an important and innovative approach to mainstream service delivery. They can also develop imaginative forms of organisation.

New Labour, both as a political party and as a Government, have put a lot of effort and, in many departments of state, a lot of resource into building up the third sector. This means that the Government has a policy of developing that third sector and providing it with a level playing field in bidding for services from commissioners.

The Secretary of State’s personal preference for the NHS as provider undermines this. With the support of the health service trades unions he is apparently against the plurality of providers that has been the hallmark of the government for the last few years.

How the politics of the third sector develops in the next few months may be an important part of the coming election.

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