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Staff consultation is vital before service redesign

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Dave Prentis on how UNISON will support nurses during the recession

It’s at a time like this that we really understand what Nye Bevan meant when he said the NHS promised ‘freedom from fear’.

Around the world, as the recession takes hold, incomes are being squeezed, and millions are losing their jobs. In many places one of the biggest worries on people’s minds is what would happen if they, or a member of their family, get sick.

In the US, for example, the price of health insurance is out of reach for many people, and anyone thrown out of work also loses their entitlement to health care.

Times are tough in the UK too - we all know someone who has lost their job, or their home, or is struggling to pay their bills. But one thing we can be proud of is that whatever your income, even if you’re out of work, if you’re ill or injured, the dedicated staff of the NHS will be there to provide the best care they can.

It’s that extra peace of mind it offers that is priceless. So at a time when everyone is tightening their belts, we need to make sure everyone understands that the money we put into the NHS is money well spent.
Of course we know it’s not perfect. In fact, it’s our members who work in the NHS who know more than anyone else where the problems are. But it’s important that we don’t forget the amazing results that NHS staff are delivering for patients and the public.

‘The figures show that trusts achieve the best results with limited resources when they make sure to engage and involve all their employees in improving services’

Long waits for surgery or outpatient appointments are becoming the exception rather than the rule. More and more people are surviving cancer and heart disease. And new figures from the Office for National Statistics show that the volume and quality of treatment delivered for every pound of money spent is improving every year.
That’s why we all have to be concerned by the numbers set out in chancellor Alistair Darling’s budget. Here, for the first time, we began to see the full extent of the damage done to our economy and our public finances by the irresponsibility of the City speculators. For too long the government let them call the shots, and they drove the economy over a cliff.

It’s the public sector that has had to try to break the fall, and begin to put the pieces back together again. And this has put huge strain on public finances and public sector budgets.

Rightly, the government is reassessing priorities and asking those who did best out of the boom years to pay a little more in tax. UNISON thinks that is a step in the right direction, but far more needs to be done to reallocate resources and make our taxation system fair and effective. Otherwise the costs of this crisis will ultimately be met through cuts to public spending that will hurt public service workers and the services they deliver.

Already the government has said it will take £2.3bn out of the Department of Health’s central budget next year - which could hit training, research and regulation. For the period 2011 to 2014 the chancellor pencilled
in spending plans that could amount to real-term cuts in services and capital investment every single year.
If these plans are followed through we can expect a serious squeeze on the income received by acute trusts through the tariff, increasing temptations for PCTs to cut costs by outsourcing to cheaper providers, and pressure for low pay offers from the Treasury.

And you’d better not believe that a Tory government would make life any easier, despite their cynical spin. They’ve already promised to make even bigger cuts to public services so they can offer tax breaks to millionaires. And we know they’re looking to break the agreements that UNISON negotiated on pay and pensions for NHS employees.

So these could be turbulent times for NHS staff, as for all public service workers. But UNISON will be there to make sure they have a strong voice, and a comprehensive system of support, to make sure they aren’t seen as easy targets.

Where savings do need to be delivered, and services need to be reconfigured, we want to make sure all staff have a say, as well as the security they need in a time of change. The figures show that trusts achieve the best results with limited resources when they engage and involve all their employees in improving services. And UNISON has shown it can best support that process by negotiating to ensure employee interests are protected - minimising the need for redundancies, and maximising the positive opportunities for training and development.

But as well as supporting individual members and negotiating with their employers, UNISON will be conducting a wider campaign, across our workplaces and throughout our communities, for a fairer society that puts people, jobs and public services first. Whichever party is in power, we will be resisting the imposition of spending cuts that risk sacrificing the public good to preserve the luxurious lifestyles enjoyed by a privileged few.

This crisis has shown us what can happen when inequality and private greed get out of control. We’ve seen it with the bankers, and now, sad to say, we are seeing it with many of our elected representatives.

Now is the time to stand up for a society based upon values of compassion, cooperation, equal treatment and public accountability - values that NHS workers put into practice every day.

Dave Prentis is UNISON General Secretary

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