This year sees Unison reach its 20th anniversary. During those two decades, nurses and healthcare workers have seen a steady decline in their national influence and local organisation.
One of the strong arguments for Unison, which I supported, was that having a bigger union would give nurses more authority, influence and power. What we’ve seen, however, is the development of an organisation more bureaucratic even than the NHS, with no identity or profile among nurses and few local branches with a working infrastructure to represent members’ interests. It spent years fawning over a succession of New Labour health secretaries who were as busy dismantling the health service as their Tory predecessors were, and making the odd “tough” pronouncement while rolling over on basic principles, particularly regarding the Private Finance Initiative now bankrupting a number of trusts, and the establishment of Foundation Trusts.
Since the coalition’s arrival, Unison has puffed up its chest but avoided confrontation time and time again. With hundreds of thousands protesting public service cuts and attacks on its members’ pensions, Unison completely failed to build any momentum, or engage members in further meaningful activity.
Now, it has committed the cardinal sin of agreeing – without any recourse to the nurses affected – to far-reaching cuts in people’s terms and conditions, including the effective end of any system of incremental pay. Christina McAnea, Unison’s anonymous head of health, even had the gall to parrot David Cameron when she said, “This was a difficult decision taken in difficult times.” It was simply surreal when she linked it to fairness to staff and described it as benefitting patients.
The time has come for nurses to cut themselves loose from a “trade union” that completely disregards its members and is ritualistically humiliated by successive governments like this. Nor can the RCN be regarded as a viable alternative. But if 2,000 staff in a large NHS trust formed their own local union, each paying monthly subscriptions of £10, imagine the organisation, training for local reps, expertise, communication and benefits £240,000 a year could buy.
National unions decry local pay bargaining, arguing it’s the only way they can protect our pay and conditions. Which is laughable now. But representatives of a local union, locally elected and with a mandated role in negotiating on their members’ behalf, would have genuine authority and support, particularly when those negotiations impacted on peoples’ lives. Rather than pallid ballot turnouts of 20%, as we currently see with Unison (usually asking about a second ballot for some vague sort of action), people would have a vested interest in making their voice heard, in determining their local strategy, in fighting for what they believed in. Ironically, it is this kind of local autonomy, democracy and participation that the Francis Report acknowledges would genuinely benefit staff and patients. It simply didn’t follow the logic of its analysis.
Of course, the principles of local organisation and local pay bargaining are more complex than can be covered here. But the overriding question is whether or not nurses pay into national organisations that can no longer pretend to act on their behalf or finally break the mould. It’s not to suggest going back to a national heath service specific trade union like COHSE (though its achievements in its final two decades put Unison’s into the shade over a comparable period). We are witnessing new challenges, new issues that require a wholly different response. There are more than adequate individuals in nursing who could provide the type of local leadership, organisation and negotiating skills so sadly lacking in our fossilised national unions. It’s time to stop acting in Unison and start fighting for our rights together.
Chris Hart is consultant nurse in forensic and intensive care nursing, South West London & St George’s Mental Health NHS Trust and principal lecturer, Kingston & St George’s University of London.