Cloaked in the language of quality and care the report is little more than another vehicle for the organisations drive to introduce local pay bargaining.
The report spells out the difficulties facing Trusts from the £20BN cuts as well as an ageing population with ever more demanding and complex medical needs. It stresses the importance of high quality services. But its answer to the problems facing the NHS is to 'provide better care for less’. The report acknowledges this can only be done by reducing employee costs.
There is nothing new in the proposals and the report is designed to get Trusts to ‘optimise the efficiency of the reward strategies'. In other words cut terms and conditions.
The report spells out some options from trading benefits like increased annual leave for cuts in pay, to reconfiguring services to reduce unsocial hours payments, to recruiting new employees on local terms and conditions of employment. Other options such as more privatisation and creating new employing organisations are muted. There is the suggestion that Trusts should look at re-writing the Agenda for Change JE Scheme.
The significance of this report is that it shows there will be no honeymoon period following the national agreement on changes to Agenda for Change.
Trade Unions at all levels must start to organise their membership to meet these challenges and fight to defend NHS Terms and Conditions. If we are not prepared to stand up to the next attack the national agreement will not survive. An NHS with fragmented terms and conditions will have a dramatic impact on quality of care. This in turn will lead to more Mid-Staffordshire situations.