Blog 53: We own it!

Blog 53 is here, and I write this with England on the precipice of football Nirvana . Leeds’ own Kalvin Phillips seems to have become the genius hybrid of David Batty, Gary Mcallister , and Pele, and for those 90 minute windows our NHS Covid woes have been forgotten. It shows what a desperate 16 months it’s been when the  England football team has become our salvation!

You will often hear us Trade Unionists, or Labour politicians (the good un’s) bang on about NHS privatisation, and yet it doesn’t ever happen, does it? I mean the NHS brand is still plastered everywhere, isn’t it? You haven’t paid for that hip replacement, have you, Mabel?  You may guess dear reader that I’m being slightly sarcastic, impish even.

NHS privatisation is happening here in Leeds and up and down the country constantly. Without perpetually fighting against it we will eventually lose that battle. That would be a tragedy. Piece by piece, service by service it is eroding like Flamborough’s crumbling cliffs.

You will remember a few years ago our very own Trust attempted to jettison our Estates and Facilities staff. We warned then if the staff did go, they would see their terms and conditions eroded and a two-tier workforce would emerge. We got accused of scare mongering, however if you look at Airedale hospital, where this was allowed to happen, that very same thing is occurring.

Employees at AGH Solutions Ltd, a private wholly-owned subsidiary of Airedale NHS Trust responsible for facilities management, estates and procurement services are currently on unequal pay rates despite doing the same job.

To outline the pay difference. A Domestic employed on the NHS contract receives a basic rate of £9.89 per hour. If they work between 8pm – 6am or on a Saturday they get paid £14.14 per hour, and if they work on a Sunday they get paid £18.29 per hour. In contrast, a Domestic employed on the AGHS contract only gets paid £9.00 per hour no matter when they work.

Currently in Leeds the fertility service at Seacroft is out to Tender, minor injuries at Wharfedale isn’t run by the Trust, catering facilities are outsourced, as are sterile services, and even within The operating suites  we are seeing teams from a national agency take over our theatres working without LTHT staff.

Outside of our area the same local things are happening coupled with American insurance firms sniffing around NHS data (your health records) and dozens of GP practices.

So why is this a bad thing? The below is copy and pasted from the fab website “We Own It” and it puts it far better than I could…

1. Your services get worse

Public services involve caring for people. But private companies make a profit from public services by cutting corners or underinvesting.

There is a conflict between making a profit and taking the time to care. For example, private care workers often can’t stop for a cup of tea with an older, vulnerable person they are caring for – because they’re only allowed 15 minutes for their visits.

  1. Privatisation costs you more

You pay more, both as a taxpayer and directly when they privatise public services.

Have you noticed how your water bills, energy bills, train and bus fares keep on rising in real terms? And did you know that the US privatised health system costs double what we pay for ours?

In a privatised service, profits must be paid to shareholders, not reinvested in better services. Interest rates are higher for private companies than they are for government. Plus, there are the extra costs of creating and regulating an artificial market.

  1. You can’t hold private companies accountable

If a private company runs a service, they are not democratically accountable to you. You don’t have a voice.

Contracts to deliver public services are agreed between private companies and government behind closed doors. There is very little transparency, public accountability or scrutiny. The companies are not subject to Freedom of Information requests because of ‘commercial confidentiality’.

When private companies fail to deliver, the public has no powers to intervene and government (local and national) doesn’t always have the time or expertise to force them to keep their promises.

  1. You don’t get a democratic voice

When we go to the shops, we all make our own individual decisions about what we want. Public services are different – they give us a chance to come together to decide what kind of society we want to live in.

For example, we might want clean, green energy for our future – but the private companies control the energy ‘market’ and often invest in dirty energy, without giving us a say.

  1. Privatisation creates a divided society

Public services are important to meet everyone’s basic needs, so we can all be part of the community.

Schools and hospitals are not optional extras. We all need and rely on public services – they are universal. That means they need to be accessible and high quality for everyone.

Privatisation often goes hand in hand with encouraging richer people to pay more and opt out of the services we all use. This leads to division, making it harder to provide excellent public services for everyone.

  1. Public services are natural monopolies

Privatisation was introduced because of a belief in free markets and consumer choice. But public services are often what economists call ‘natural monopolies’.
For example, when you take the train, you don’t really have a choice about which one to use. There’s no real competition. Facebook is another, relatively new ‘natural monopoly’. If all your friends are using it, it’s difficult for you not to.
Private monopolies often become the worst of all worlds. You don’t have consumer power because you can’t go elsewhere. But you don’t have power as a citizen to make the service better through democratic accountability.

  1. Privatisation means fragmentation

When lots of private companies are involved in delivering a public service, this can create a complicated, fragmented system where it’s not always clear who’s doing what. For example, our railway.

Private companies don’t necessarily have much incentive to work together and share information. This makes it difficult to provide an integrated service.

Privatisation is fragmenting our NHS and the cost of the internal market is at least £4.5 billion a year.

  1. Private companies cherry pick services

Private companies cherry pick the profitable bits of a service so they can make as much money as possible.

For example, bus companies will only run services in busy areas, so rural communities lose out unless government steps in with a subsidy. It’s more efficient to run public services in public ownership so that profits can be reinvested across the whole network as needed.

In probation services, private companies are paid to manage medium to low risk offenders, while the state continues to take responsibility for high risk offenders.

  1. Privatisation means less flexibility

Councils and government departments are responsible for meeting the needs of the public – but privatisation means less flexibility for changing circumstances.

If an outsourcing contract with a private company needs changing, government must pay more to make changes or improvements, add in extras or to opt out.

And selling off public assets (like student loans) or public land (like school playing fields) means we the public have fewer options and resources for delivering the services we’ll need in the future.

  1. Privatisation is risky

Look what happened when Carillion failed. If private companies are running our public services and are too big to fail, the public has to pick up the pieces when things go wrong.

You may not think our Trust gets everything right. That is inevitably true. However I can assure you, as someone who deals with these imbedded companies, you are very much better off being an employee of LTHT than any of the private companies who work alongside us. In terms of personal treatment, terms & conditions, and stability, being an NHS employee trumps the precarious opposite.

Every single year since the NHS was established it’s faced threats from vultures who wish to make money from folks ill health and misery – let’s not be the generation that condemns our kids to choosing between health care and bankruptcy. Let’s keep fighting.

As Joni Mitchell said

“ No woman, no cry “

Err , I mean

“ you don’t know what you’ve got till it’s gone”

….. speak soon xxx

John Ingleson – UNISON Branch Chair