Supplementary evidence submitted by UNISON
(ISTC 42B)
1. INTRODUCTION
1.1 On 23 March 2006 UNISON gave evidence
to the Health Select Committee Inquiry investigating Independent
Sector Treatment Centres (ISTCs). As part of our evidence we expressed
concern on the following issues:
Lack of transparency
Value for money
Accountability
Standards of care
Democratic process
Capacity
1.2 UNISON was asked by the committee to
provide further written evidence surrounding our concerns on employment
issues, standards of care and professional development. Included
with this submission are a number of witness statements from UNISON
members, notes from UNISON members' meetings and the correspondence
from UNISON's Head of Health, Karen Jennings, to Lord Warner together
with his response.[10]
We feel this will assist the committee during its deliberations
and enable you to see this information in the context of our evidence.
We would also like to apologise to the committee for the delay
in this information being submitted for your consideration.
1.3 The staff are fearful of reprisals from
PHG; as a result we have agreed to protect their anonymity. In
addition a number of staff have indicated that they would be prepared
to meet with you privately to discuss these issues if the committee
felt it would be helpful.
1.4 We would also like to make the committee
aware that since presenting our original evidence, both written
and oral, a meeting has taken place with representatives of Partnership
Health Group (PHG) and UNISON on 13 April 2006.
2. BACKGROUND
2.1 In the autumn of 2005 we received an
email from an employee of PHG; this came in via our health web
site. The individual was raising concern on behalf of a number
of staff, none of whom were members of UNISON at that point. There
concerns surrounded patient safety and employment issues and in
light of what we heard we scheduled an open meeting for any employee
who wanted to attend and talk to us about the issues that they
had identified. This was the start of our involvement; we have
included some of the witness statements which corroborate the
staff concerns. Names of individuals have been removed to protect
their anonymity.
3. PARTNERSHIP
HEALTH GROUP
(PHG) AND UNISON
3.1 Since giving evidence to the committee
we have been able to have one meeting with two representatives
of PHG, namely the HR Director and the Nursing Specialist Manager.
They did state that they are not prepared to recognise us for
collective bargaining processes and they have indicated that they
wish to establish a staff council instead. However, our view is
that it will have no benefit for industrial relations as it is
inconsistent with the practises in the NHS. They are willing to
allow us to help with them with their training, and we have offered
to put them in touch with some organisations that will be able
to provide post basic qualifications. It is clear that up until
late last year they had no Human Resource policies and that they
have been working through a number of their clinical policies.
It also became clear that training had not been in place for mandatory
programmes. They are now intending to use a new computer system
which they say will enable them to look at training more consistently.
3.2 The governance process leading up to
the contractual procurement appears to have been robust but problems
appear to have occurred following contractual close. We believe
that the DoH need to review this again and that stronger measures
need to be put in place to monitor the implementation once the
contract is signed to ensure that the commitment to governance
and standards of care are fully implemented.
3.3 We hope to be able to develop a working
relationship with PHG, indeed this has always been our preferred
aim. However, the basis of good and effective industrial relations
is partnership and it is difficult to see how we can achieve this
if they do not recognise us as a trade union formally within their
organisation. This is a practice that works very successfully
throughout the NHS but this successful working arrangement between
employers and trade unions is something that has not extended
to the ISTCs.
3.4 We are now reviewing the outcome of
the patient fatality in the PHG Plymouth site and await the clinical
review of this. We have offered support to the staff there and
will be meeting with many of them again shortly.
3.5 PHG have acknowledged that there have
been poor management standards and ineffective levels of communication
with staff. They have now made a commitment to providing management
training to try and address these concerns. We have offered to
help to facilitate this as in our experience joint delivery is
always more beneficial in standards of practise. However, it is
clear to UNISON that there is a culture of bullying and harassment
and we are now actively encouraging staff to raise there concerns
formally. There does remain a fear of what will happen if staff
decide to take this course of action and without trade union recognition
there is no clear opportunity for us to support them through what
is always a very difficult and emotional time.
4. CONCLUSIONS
4.1 We will continue to seek an improved
working relationship with PHG and as stated earlier we believe
that this can be better achieved through recognition. PHG appear
to doubt the issues raised by their staff and their perception
appears to still be that we are causing difficulties where they
do not exist.
4.2 There were no human resource policies
in place for PHG until the early part of December 2005 despite
having been operational for over a year. This has clearly affected
the operational management of the site and it is extremely alarming
that a private provider offering services to the NHS for more
than 12 months can have been allowed to do so without reprisals.
4.3 We are concerned at the lack of transparency
surrounding governance issues as PHG do not publish statistics
on infection control rates nor on the levels of complications.
We know from staff that they have concerns at high levels of infection
control and we know also that a number of patients have suffered
with deep vein thrombosis post operatively whilst still as an
in patient. Given that in the main they are not treating complex
cases it is difficult to compare the patient experience and standards
of care across both areas. However, DVT's within 48-72 hours in
the NHS following a joint replacement are no longer a frequent
occurrence as they are treated by prevention including a sub cut
injection of Fragmin.
UNISON
May 2006
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