During the last week of April I participated as a delegate of my Unison branch of a local NHS Trust in this annual meeting that brings together all Unison reps in the private and public health sector. This year, I reckon around 400 to 500 delegates met in Liverpool, average age around 55, mainly white, half of the delegates were women. What could have been a great opportunity of collective working class reflection on changes at work and experiences of struggle turned out to be a pretty tedious series of largely meaningless motions. Nearly all motions limited themselves to moaning about how bad things are, followed by general appeals, rather than concrete proposals. For example:
“Conference therefore calls on the Service Group Executive to: 1. Continue to raise concerns about the impact of pressures within services on staff mental health, calling on employers to provide adequate support.”
People, and often the same people, used these motions to make speeches about how tired everyone is and that everything is the Tories’ fault. The motion would then pass unanimously. It felt like these speeches were mainly used for individuals to be seen and heard, perhaps for future elections. There were only a few snippets of interesting information during the speeches e.g. concerning a recent strike vote at Manchester Community Health against restructuring, which got a 98% endorsement, or that the control room for ambulances in Dorset has a 40% annual staff turnover.
The only contested motion, and the only motion that would have at least a symbolic consequence, was put forward by the Northern Ireland delegation. These guys seemed pretty militant, at least they had some strike experience in the sector recently. They demanded that Unison stop giving evidence to the Pay Review Body, given that they are just a fig leaf for the government. The Pay Review Body (PRB) is meant to give impartial advice to the government about how much the pay increase for NHS workers should be. For more than a decade they’ve more or less suggested the imposition of real wage cuts.
Their motion was scheduled as number 8. Motion number 7 was put forward by the Executive Committee, which said that Unison should continue to demand a flat-rate, rather than percentage increase, which benefits BME, women, low paid workers – and that Unison should continue to work with the PRB. So if motion 7 would pass, motion 8 would be out the window. There were the usual speeches to bolster the Executive Committee’s motion number 7: we have to be inclusive, support the lowest paid workers etc., which was a cynical move to use ‘minority workers’ to defend the status quo with regards to the PRB affiliation. But at least it came to a card vote on the issue. Around 200,000 votes voted against, versus around 160,000 in favour of motion number 7, meaning that the motion passed, and the conference would have no consequence whatsoever.
On the second day, the head of the union for health workers in Ukraine spoke, representing 600,000 members. She mainly spoke in patriotic terms (“the Ukrainian people”, heroic efforts of the country etc.) and said that their union supports the armed forces financially. The Unison general secretary mentioned that 10 ambulances were sent from London to Ukraine, with medical supplies, otherwise the general discourse was not questioned: the UK has to support the Ukrainian army, they are fighting for Europe and democracy. Not a word about the larger and systemic context of the war or about the class contradiction within Ukraine. A motion from Manchester to speak on the ‘Stop the War Coalition’ march was folded – the SWP lot would probably have used the motion to speak against ‘Nato and imperialism’.
There were a few more interesting smaller fringe and focus group meetings though. I went to a fringe meeting on recent outsourcing disputes, amongst others at Barts Health Trust in London and Princess Alexandra Hospital.
The rep from Barts Health Trust claimed that the taking in-house of over 1,400 Serco staff was mainly due to ‘negotiations’, and that negotiations are better than strike – he denounced the ‘strike’ by Unite workers at the Trust as ineffective. The most interesting dispute seems to have happened at Princess Alexandra Hospital around the outsourcing of domestics: 200 members were involved, meeting in church halls, they collected 8,000 signatures in town etc. These workers seemed much more self-organised. There was not much time for questions. Only a short intervention by a member of the Homerton branch regarding the outsourcing and Living Wage campaign of 350 staff.
The other more relevant meeting was on disputes about whether healthcare assistants (HCAs), who are doing clinical tasks, should be upgraded from pay grade Band 2 to Band 3. From what the audience looked like, many might have been HCAs – they looked poor and knackered. Around 70,000 Unison members are HCAs. In Manchester they got 3 years back pay for HCAs, and nearly all of them are now Band 3. For more background on the NHS pay grades, click here.
The Trust ended up having to pay £16 million in total. The main HCA activist, an Eastern European woman, was pretty impressive, though at the end of the session there was little space to ask questions, such as: what about the pay loss due to less Sunday/Night-Shift bonus on Band 3; what about people saying that on Band 2 they can choose whether to do clinical tasks or not, according to how stressed they are on the day; what about HCAs often doing clinical tasks only occasionally in order to help out stressed nurses; what about the danger of deepening divisions between HCAs and porters, domestics, housekeepers, if a pay increase is attached to ‘specific tasks’ etc.
Of course I am not the only one who thought that there were a lot of missed chances in a meeting that brought so many delegates under one roof. But then we cannot underestimate the fact that many of these delegates are pretty happy with a ‘cushy’ conference and are perhaps not the most militant workers wherever they work. Still, there many reps are genuinely interested in building rank-and-file workers’ power. Some SWP and Socialist Alliance people (perhaps also other ‘rank-and-file’ oriented people) set up a slate for left-wing Service Group Executive Committee candidates and distributed a leaflet, inviting people to a meeting in the evening. At least the leaflet made some valid points about why the pay campaign in 2021 failed, e.g. that Unison was preoccupied with the difference in claims of other unions, rather than working together – and that they forced people through two indicative ballots.
There were only about 20 people at their meeting, mainly politicos, I think. They spoke primarily against the mean bureaucracy and then four candidates for their slate-made speeches. Unsurprisingly, their main focus is on the change of the Unison apparatus, though they all seem also pretty involved on the branch level. In a way, this small fringe meeting was another missed chance, as we didn’t really hear self-critical reflections of organising attempts, their limits, difficulties, problems and how people tried to overcome them. The problem is that in the framework and tussle over of a large institution with large funds, everyone wants to portray themselves as successful and victorious, which prevents a sharp analysis of the struggles of our class.
We handed out 60 – 70 copies of our own Health Workers’ Newsletter (I should have brought more), but people had to march through Socialist Workers and Morning Star lines, so they were perhaps less interested in yet another paper. At least one positive feedback. I think if people actually had a look at the newsletter, they would have been interested, as it provides some more interesting thoughts and info, e.g. on the weak points of the pay campaign 2021, and the recent strikes in Germany, which addressed the staffing question in an offensive manner. If you work in health and are up for supporting the self-organisation of workers’ struggle in the sector, get in touch: