Over the next few weeks and months, the resilience of the NHS will be tested like never before. As a doctor, I am witnessing the strain our healthcare system is under on a daily basis as the biggest public health crisis of a century tightens its stranglehold on our way of life. Amid all this though, the coronavirus pandemic has shed a light on the precarious nature of employment experienced by vast swathes of our population. Sadly, the NHS has not escaped this fate. The widespread practice of workforce outsourcing in our health service has led to a rise in inadequate terms and conditions that cannot be allowed to continue.
But there is some hope for the future. Early last month, and what now seems like a lifetime ago, my hospital announced that it would bring outsourced cleaners, caterers and porters back inhouse as NHS employees. This was not just a routine announcement. It was the culmination of months of industrial action and negotiations spearheaded by United Voices of the World, a grassroots trade union that represents primarily migrant workers in low-waged and precarious employment.
Earlier last year, when the strikes were in full swing, myself and 50 other medical staff wrote to the CEO of Imperial College Healthcare NHS Trust to show our support for colleagues who had suffered at the hands of French multinational outsourcing giant Sodexo. Their demands were not only reasonable but also laid the path for a common sense approach to fair employment within our health service. Working conditions were poor, their pay was below the London Living Wage and, when off sick, many were entitled only to the pittance afforded by Statutory Sick Pay (SSP)
What did all this mean in practice? An unmotivated, demoralised and fearful workforce. Many of the workers told me how they were afraid to take time off work when unwell as they would be left comparatively out of pocket on the measly £94 per week of SSP. Inevitably, this meant staff working in the clinical setting when, under any humane terms of employment, they would be recovering at home. Short-sighted policies like this are putting staff and patients at risk. It almost beggars belief that an organisation founded on the principle of protecting the health and well-being of our population could treat its own staff with such indifference.
The argument against outsourcing in the NHS rightly relies on the case for compassionate employment. But we should not shy away from talking about the economic narrative too, particularly when cost savings are often cited as the key reason by hospital trusts for pursuing an outsourcing policy. What is rarely taken into account is the impact a demoralised and unmotivated workforce has on productivity and, by extension, on value for money. Sadly, all too often the ‘softer’ attributes of morale and motivation are superseded by the incentive of a monthly balance sheet.
The tenacity of outsourced workers like those at my hospital has demonstrated that the tide is turning against outsourcing in the NHS and the public sector at large. But putting across the compassionate and economic arguments won’t be enough if these workers aren’t able to organise effectively. At a time of global instability, the case for our trade unions has never been stronger. The Left must do everything in its power to ensure the continued influence of our country’s largest unions but also to support the growth of the new breed of unions like United Voices of the World who have shown with this victory that they are a force to be reckoned with.
I hope that in the coming years, other NHS Trusts will follow the example set by my own. Our health service has never been under more strain and the repercussions of this pandemic will be felt for years to come. Ensuring our workforce feels valued and motivated will be critical in overcoming the challenges to come. It is evident that outsourcing has proven incapable of producing such an outcome, a sentiment acknowledged poignantly by my CEO who, on announcing plans to bring workers back inhouse, told them: “I want you to feel properly valued and part of our wider team so that, together, we can provide the very best care for our patients.”