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South London’s Outsourced NHS Workers Are Fighting Back

Taj Ali

Today, caterers and cleaners in hospitals across south London are on strike against outsourcing giant ISS. They are fighting not just for pay but for dignity and respect.

ISS workers on strike on Sunday. (Credit: Helen O'Connor)

Cleaners and catering staff are the heartbeat of our hospitals but their work too often goes unrewarded. Many are outsourced within the NHS and this is the case across the South London and Maudsley NHS Trust (SLaM). Here, cleaners work for subcontracting giant ISS and poor pay and conditions are endemic, with some paid just £10.84 per hour. In response, nearly 200 workers have taken to the picket line to demand better.

Adrian-Daniel has always valued the work he does. He began working at Lambeth Hospital through an agency in 2017, first as a delivery driver for the catering team and then in food prep. ‘I joined the NHS because I wanted a job where we help others,’ he tells Tribune. Today, he works as a health and safety coordinator and though he appreciates the social value of the job he does, it doesn’t come without its challenges.

Catering staff like Adrian-Daniel find themselves spending up to five hours in cold rooms, prepping food for patients, but feel frustrated at the inadequate remuneration they receive for their efforts. ‘We provide a five-star service, but our pay is very low. Some of my colleagues have been here 15, 20 years and they’ve had no progression.’

Adrian-Daniel and his colleagues did not receive a pay rise last year. And, the year before that, received an abysmal 0.2%. With inflation still above ten percent, many in his line of work are feeling the pinch. ‘We don’t want a bonus. We’re not asking for anything special. We just want to live,’ he says. Adrian-Daniel’s rent has significantly increased and, though he struggles, this pales in comparison to the situation of colleagues with children.

Lume has worked in the NHS for over 16 years but has never felt more demoralised. ‘I feel unappreciated. I dedicate 100% to the company but they don’t give us an ounce of respect,’ she tells Tribune. She works as a cleaning supervisor and finds the job incredibly stressful. That stress has been compounded by a cost-of-living crisis that has exacerbated her financial difficulties. ‘Food prices are going up. My council tax is going up and I simply can’t afford it. No one sees how much we work and how much we struggle.’

It’s a grim situation made worse by a company that simply refuses to budge.

Not Just Pay

Helen O’Connor, a GMB organiser, met with cleaning and catering staff last summer. It quickly became apparent that staff were facing a vast array of issues. There are mixed contracts, unequal pay and frequent complaints of bullying and harassment.

A key issue is sick pay. Those on NHS contracts get full sick pay from day one, but the majority of workers are outsourced to ISS, where the terms are vastly different. ‘They run a credit system,’ explains Helen. ‘If you work a full month, you earn one full paid sick day, if you’re in two months, without getting sick, you get two full days and so forth.’

‘We are doing the same job and we are treated differently,’ says Adrian-Daniel. Many in his situation force themselves into work even when sick, far from an ideal circumstance for a hospital. To make matters worse, ISS workers allege that the system used by the company to build up paid sick days is often inaccurate.

‘They just don’t care enough to get it right,’ Helen argues. ‘There’s a lot of vulnerable people who work there and don’t have English as their first language and they get exploited the most. It’s all about increasing profit margins for the company at the expense of workers.’

‘Just last week we found that they didn’t pay us right,’ adds Lume. ‘We had to get them to correct it.’ This isn’t an isolated incident. ISS workers say they are frequently underpaid and having to spend additional time just to demand the pay they are entitled to.

A key cause of concern is the planned closure of Lambeth Hospital itself, with plans for a new property development on the site. ‘People could be made redundant,’ warns Adrian. ‘We have promises that we will be reallocated to other sites. But we don’t know what sites or positions we will get. It’s scary. Demand for mental health services is increasing but it looks like property development is more than mental health for them.’

The proposed restructuring of the trust is part of a broader pattern which sees services cut to the bone despite growing demand. ‘This strike is not just about pay,’ emphasises Helen. ‘It’s about conditions, it’s about the services provided across the trust and the standard of cleaning and catering for patients.’

Workers like Adrian-Daniel have been left in the lurch about what happens next. For many in the profession, they’ll have to travel much further for work. ‘The other site is Bethlem Royal Hospital which is way too far for most people,’ explains Adrian-Daniel. ‘Ladywell Unit in Lewisham is also too far. We don’t know how we’d be able to get to these sites.’

The Fightback

The GMB union wrote to ISS last year, raising the workers’ concerns and putting in a pay claim. Members wanted a significant pay rise alongside sick pay and other enhancements that NHS staff are entitled to. Initial meetings took place but no progress was made.

During this period, union density across hospitals in the trust increased, with members eventually voting for strike action. Despite their resounding demonstration of discontent, ISS has shown little willingness to meet demands. ‘We asked them to come around the table so that we can avert strike action,’ she says, ‘they’ve effectively ignored us.’

South London and Maudsley NHS Trust specialises in mental health, providing more than 300 clinical services across four psychiatric hospitals in the area.  Workers have chosen to strike for 48 hours from Sunday, when food preparation usually begins, with the hope of maximising pressure on ISS.

‘Many of these patients are locked up for 24 hours under Section Three of the Mental Health Act. Nutrition and sanitation is important for them,’ O’Connor explains. ‘I’m quite shocked that the trust doesn’t seem to be appreciating the seriousness of the situation and the impact it will have.’

The outsourcing of such services is an issue that goes beyond this individual dispute. ‘Private companies come in and take over ancillary services. They take on new hires for much lower pay and workers don’t get the same level of training,’ she argues. ‘They prioritise their profit margin over anything else.’

In the short-term, workers like Lume believe strike action like this week’s can push ISS in the right direction. ‘We will strike as long as we need to. We don’t have a choice. We have families to feed. We are human beings. It’s about time we were treated like it.’

In response to this article, an ISS spokesperson said: ‘We are disappointed this action went ahead, despite tabling a competitive new offer for employees at South London and Maudsley NHS Trust on more than one occasion, including this weekend with additional sick pay benefits. We value the contribution of every ISS team member, and we remain in constant dialogue with GMB to work towards a solution.’