A group of colleagues who work at the two main hospitals in Bristol met at our regular meeting to discuss updates on current struggles, plans for the future and the next issue of Vital Signs. Our next meeting will be on 17th December. Drop us a line if you want to come along, bring a friend! In the meantime send us any updates from your wards and departments at vitalsignsmag@proton.me.

Outsourcing in theatres

We discussed the current issue of theatres being outsourced at weekends to a private company who bring in their own staff and equipment. Workers in that area aren’t happy, with overtime being cut and then not being consulted on having first say over these shifts. If the operation theatres have the capacity to be running elective surgeries to cut down on the waiting list, why is it not being organised in-house before turning outside? To us, it seems important for us to understand the finances behind this. The unions seem pretty happy with the arrangement and it was apparently all discussed with the Joint Union Council – but never with the theatre workers. At the same time, workers have signed a letter demanding to know who is using the theatres and that they have a say in how that capacity is used. So far, the Trust has been pretty opaque about it. We think this opens up a wider discussion of how this out-sourcing is used to undermine the position of workers in the NHS more generally. It also raises the question of how this could possibly be benefiting the Trust financially? If the private companies have to pay to use the theatres, pay the wages and for the equipment and still turn a profit then surely it would be cheaper for management to offer the shifts to the workers who are already there? We will update soon on the outcome of the petition that is circulating when we hear more. In the meantime, we believe that there is work to be done in understanding these financial arrangements. Who is benefiting? We can see from our conversations with colleagues in Germany that private capacity was sold in the name of efficiency but quickly became a nightmare for patients and workers alike.

Overtime vs Bank

There is also an ongoing issue in the NHS, that seems to be across the board, where management are using bank shifts to stop workers being paid overtime. In Part 2, Section 3 of the NHS Employers Terms and Conditions handbook, it clearly states that any hours worked over 37.5 hours a week should be paid at 1.5x and 2x on public holidays. What’s happening at the moment is that gaps in staffing are being filled with bank shifts, meaning that workers are working their usual jobs in their usual areas for less money than they are entitled to. Management know what they are doing here, they’re trying to cut costs at the workers’ expense. They often even try to sell it as if we’re better off on the bank shifts, when anyone who’s done a shift or two on the bank knows that this isn’t the case. We plan to write an article that analyses the way in which Bank is maintained as a sort of “reserve army of labour”, which management can sell with all their glitzy promises of “flexibility” and “independence” one minute and then turn around and tell us we aren’t entitled to shifts because we are on zero-hour contracts the next. We even see semi-permanent positions being advertised now. 6 month jobs on Bank? No sick pay or holiday? We think it would be useful to look into what Bank should be used or, and who made these mad agreements that let these things happen.

Nurses…overstaffed?

There is currently an issue at the BRI where management are claiming that the hospital is overstaffed in nursing in Medicine, but understaffed in other areas This has led to them trying to enforce people moving last minute into areas they aren’t familiar with with no warning and no incentives. It used to be the case that if you were moved last minute, a Band 5 nurse would get £45/h if they agreed to go work in Thornbury for the day, now they give you a call at 10am asking you to come in for the night shift for your usual rate. It seems that management haven’t considered offering the job internally instead of trying to force people into these situations. At the same time, there is also an issue where if you talk to any colleagues on these wards that are apparently so overstaffed, they’ll ask you whether you’re talking about the same hospital. It seems to us that these figures are only achieved by setting nurse and HCA to patient ratios at so high a level (sometimes 1:10-12). It is likely that this is what is leading to stress and burnout, understaffed wards etc at the same time as newly qualified nurses can’t get jobs because hospitals have apparently “over-hired”. We would be interested in hearing from other colleagues in different areas. What is the staffing ratio on your ward? Has it changed since the Trusts announced their “deficits”?

Outsourced Pharmacy Collapse

We haven’t heard any more updates on the out patients pharmacy at BRI. It seems that talks are still happening behind closed doors. Workers there are anxious over what will happen, and have been told to keep their mouths shut. We ask whether it would be worth raising the question of bringing the OPD back into the NHS. There’s already cooperation between the two pharmacies, but it is strained by the bureaucratic layers between the two entities. There is a case to be made that bringing them both in house, like is the case at Southmead would be better for both workers and patients. It is also important to stress that we are opposed to the creeping influence of private companies in the health service. Again, it would be important to look at the finances of this. Is it really more efficient, or is it about making a few quid and then dropping it? We need to be working towards more unity and solidarity between workers in the hospitals, not more barriers to cooperation.

National Rebel Health Workers’ Meeting

We agreed on dates for the national meeting that we mentioned in the previous report. We agreed early next year and will be publishing the invitation soon as well as a draft agenda. This meeting can provide a basis for closer cooperation amongst workers fighting for a new society in the health industry – whether in hospitals, primary care, domiciliary care, pharmaceutical or even medical device companies.

Issue 3 of Vital Signs

We are writing for the next issue of the magazine, covering topics such as: overtime, militarisation of the health sector at home and abroad, assisted dying, physician associates and healthcare in warzones such as Gaza and interviews with medical students and nurses from the US. If you have any ideas or want to write something for the website, get in touch.

We will meet again on Tuesday 17th December, 7pm, at ‘The Base’, 14 Robertson Road, Bristol, BS5 6JY