As we face a pandemic it is clear that 30 years of National Health Service (NHS) privatisation has created a crisis within a crisis. Vital workers like cleaners, porters, catering staff and even those delivering care have been sold off to the cheapest bidder, as real terms funding for the NHS has decreased. 

Outsourcing has led to multiple employers operating within the NHS causing a dangerous fragmentation in delivery of services to patients. Outsourced workers are often cut off from the key communications and resources they need to do their jobs effectively, as well as the personal protective equipment (PPE) that would ensure safety at work.

In addition, many contractors do not recognise trade unions and privatisation has led to an erosion of collective bargaining power and trade union recognition. This demonisation of trade unions in our hospitals has led to the creation of a workforce on inferior terms and conditions.

The imposition of the internal market in the NHS has led to an influx of companies out to make a quick buck at the detriment of planning and solidarity. The end result was growing numbers of hospital workers driven into poverty, demoralisation of staff and many leaving the service. This is the unwritten story behind many of the 20,000 NHS staff the prime minister says are returning to assist with this crisis.

As a former nurse with twenty-eight years of frontline experience, I personally witnessed the deterioration of standards as a result of the market ideology imposed on our NHS. I saw the hardnosed corporate management techniques employed by NHS ‘leaders,’ most of whom had little or no clinical expertise, but saw fit to put targets and income generation before staff and patients.

The real priorities of delivering safe and effective healthcare were pushed to the back of their agenda. I also witnessed the bullying culture that became commonplace in our NHS. Clinical staff are aggressively managed to prioritise demonstrating NHS ‘activity’ and ‘throughput’ over patient care. By driving down our wages and conditions year on year, the government also failed us – the message was ‘we don’t value you, the work you do, or the services you provide.’

An anti-union culture has been built in the NHS which aims to stop unions organising in hospitals. As an NHS union organiser, I have personally experienced attempts at bullying and intimidation, and found myself stonewalled by outsourced employers as well as some NHS trust managers. Our workplace representatives have been targeted for disciplinary action when attempting to organise GMB members – and have been characterised as ‘anti-management militants.’

Many patients aren’t aware that the outsourced hospital cleaner cleaning their ward is living hand-to-mouth due to low pay. They would be shocked to know that the hostess serving their meals is forced to come into work when they are unwell. We even have documented examples of workers with vomiting bugs serving meals due to the lack of occupational sick pay.

Hospital porters once had key roles which included evacuating patients out of hospital wards in the event of fire. Today, they are no longer trained for tasks like this by the multinational companies operating in the NHS. Hospital staff who genuinely care about patients are finding their jobs diminished and their voices silenced.

In spite of these obstacles, the GMB union continues to organise in the NHS. Our aim is to expose the hidden and dangerous practices inherent in the marketisation of public health services. There is no doubt that private companies like Sodexo, Mitie, ISS, Interserve and others are failing in their basic duty of care to their employees, patients and the public.

The GMB has brought its concerns to NHS trust managers and to the government itself. We are encouraging outsourced hospital workers to organise and fight for terms, conditions and sick pay that they can actually live on. We have launched a national PPE campaign for our healthcare keyworkers, many of whom are dealing with unacceptable health and safety practices. We have argued from day one that testing all NHS staff must be a key priority.

The exploitation of outsourced NHS workers across the UK is not just about workers’ rights. It is a real and pressing public health issue that must be urgently addressed. Outsourcing leads to deteriorating standards as it drives down staffing levels and expertise, demoralises and disincentivises workers, and creates a bullying culture that runs counter to accountability.

If a public health emergency isn’t the time to address this issue, when is? We are calling for insourcing across the NHS, and for outsourced workers to be brought onto the same pay and conditions as those contracted to the NHS. Now is the time to demand that resources go into improving our hospitals and into the pay, terms and conditions of all health service key workers. Our lives quite literally depend on it.