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Could this birthday mark the end of NHS as we know it? On 5 July this year the National Health Service will reach the grand old age of 64. But will you be raising a toast to its future?

Edmund Burke, the 18th-century political philosopher and Whig parliamentarian said, 'All that is needed for evil to triumph is for good men to do nothing'.

This year, 5 July will mark the 64th birthday of the NHS--and it will be its last unless we act. Services are on the cusp of being sold off to the private sector right across England, and from 1 April 2013, the vast majority of the NHS budget will be handed, not to GPs, but to clinical commissioning groups, which by 2016 will be run by the private sector--making all clinical and spending decisions and buying all that Virgin Care, Serco, BUPA and others have to offer.

At the same time, we are seeing 20billion[pounds sterling] stripped from the NHS budget and when this has been complete, the next 20billion[pounds sterling] worth of cuts has already been announced, with funding for the NHS being cut by 35%.

In addition, public health services are being moved into local authorities who are struggling with losing over 25% of their budget, and will be eager to see where savings can be made from their new partners. And who will lose out? Patients and staff.

The banking collapse provided the perfect excuse for the Tories to complete their market revolution and to crush the terms and conditions of the workers. We know that public services are the most efficient, cost effective and have the best outcomes; however, while the country is being frightened off with 'austerity', the government is pressing ahead with the deconstruction of the welfare state.

The impact is this: Pensions, despite receiving 2billion[pounds sterling] more than paying out, are being seriously cut through you having to pay more and work into old age--not just 68, but now they are looking at 69, 70 or 71--all to get less in retirement.

We are in year two of a pay freeze which, against inflation, has already been a 3.4% real terms pay cut, and a further two-year pay freeze is being discussed, apart from in London, Birmingham and Manchester, and along the M4 corridor to Bristol where a 1% uplift has been mooted.

Staff are being downbanded and downgraded, where jobs are not being cut. Staff are being told to work under ridiculous pressure, which is compromising them and their practice.

Agenda for Change

Now Agenda for Change is under serious threat of being torn up. Employers are planning to move all NHS staff onto performance-related pay (which in the private sector, usually means a pay freeze), except to the favoured sons and daughters, where they get recognition for their work. At each incremental point, under the proposals, staff will be expected to exceed a set of stringent criteria. Inequality in pay is bound to emerge. Cuts to unsocial hours pay, cuts to annual leave and cuts to sickness entitlements are also part of the employers agenda.

Through modelling that Unite has done, we know that some of our members will lose 30% of their pay over the course of this government in real terms. Why? This is not just about making services cheaper, but making you all far more marketable and attractive to the private sector to buy. Services to patients will then be fragmented, bringing significant risk to patients and your practice. There is a time to speak up, and if we do not resist these changes, then it is making it easier to privatise the NHS.

NHS employers have said that they will try and negotiate with the unions, but when we refuse to assist with their privatisation and cuts scheme, they will consult with individuals to tempt them to support their programme, but pleading that the savings will help patients and save the service. Failing this, they will sack all their staff and then re-engage them on very poor terms and conditions.

What must you do?

* Read--Make sure you read Community Practitioner, emails and all communications from Unite for updates information is power

* Say NO--Never agree to contractual changes--we cannot afford for a few to break away as this will weaken Unite's defence for everyone. They don't have to do this, there is an alternative

* Act--Take action--when we stand up and fight, we have a strong chance of winning. Our weakness is when we leave it to others to fight for us. It is now time that we all have to be involved and act collectively

* Lead--We need a lot more people to volunteer to be a rep. We know everyone is under considerable pressure, but if you volunteer to be a rep or even job share this, it will make considerable difference (please contact your local Unite Branch or Unite Office and say that you are interested in being a rep). If you don't--who will?

Rachael Maskell

Head of Health, Unite
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Title Annotation:EMPLOYMENT
Author:Maskell, Rachael
Publication:Community Practitioner
Date:Jul 1, 2012
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