Select Committee on Health Written Evidence


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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