Union stands its ground

Prime Minister, Tony Blair is about to take on one of the country's biggest unions, in one of the country's last nationalised services, in what is surely his last term as Labour leader. He has backed plans to increase private sector involvement in the National Health Service (NHS), but Downing Street aides have admitted that the NHS staff union, UNISON, will make it difficult in a conference vote this Wednesday.

The NHS is set to spend £4.5bn annually - nearly 6 per cent of its budget - on privately provided clinical care and facilities management. This could increase with further expansion to private provision after the government's White Paper on 'care outside hospital' is published next year.

Three years ago the Department of Health (DoH) announced that it would expand NHS capacity and cut waiting lists by financing operations performed in privately run centres. The government is now inviting bids for a second phase of treatment centres, and it is thought that new bidders will even be allowed to take over NHS facilities and buildings.

Health Secretary, Patricia Hewitt, said: ìThis is all about giving patients speedier access, more choice and improved services. It builds on earlier success.î

However, Hewitt's faith has been called into question by the fact that the first wave of privatisation accounted for only 70,000 of 5.5 million annual NHS operations, despite extensive funding. The British Medical Association (BMA) and UNISON voiced concern over Hewitt's plans. Dr Paul Millar, chairman of the BMA's consultants committee, told the Financial Times that it looks, ìas if we are at the start of a massive privatisation of healthcare in the NHSî.

Ms Hewitt has dismissed BMA comments as ìnonsenseî claiming: ìThere is no question of the NHS being privatised.î She said that by 2009, the independent sector would account for only 1 per cent of the NHS budget and 10 per cent of waiting list operations.

Chris Ham, professor of health services management at Birmingham University, explained in more detail what the proposals implied: ìThis clearly is privatisation, although it is a limited privatisation of the supply of healthcare. It is not privatisation of demand as patients won't pay.î

Unconvinced by Hewitt's plans, UNISON, have tabled a motion on `The Future of the NHS' calling for an end to, ìexpansion of the role of the private sector into the NHS.î

There is a huge question of trust for New Labour - will privatisation remain partial? Karen Jennings, UNISON's head of health, thinks not: ìIt is hard to believe that the government doesn't have a hidden agenda and more privatisation is round the corner.î

Passions could be inflamed further. A Labour spokesman told the Daily Telegraph that even if defeated, Blair would press ahead with NHS reforms. Gordon Brown and Tony Blair have ruled out any leftward move for Labour; they have scuppered plans to bolster union rights, and with renewed spending on private services coupled with an opening up of a nationalised industry, many on the Left are calling this a Thatcher-like attack on the last of the public service unions - some are even beginning to question how much more the unions will take should their wishes be ignored.