Private sector care providers and the grey zone

It is clear that we cannot allow Richard Branson, Victoria Beckham or any other multi-millionaire to enjoy the benefits of taxpayer-funded bail outs during the pandemic. It is also clear that we cannot allow business to use this crisis to exert another disastrous wave of austerity on us after the pandemic has receded. But we know we are always fighting that very battle – it’s another facet of the global class war, ebbing and flowing across the world.

The government’s actions to keep businesses going, with the type of spending and State interventions that only months ago we were told were impossible and insane, has unintentionally revealed the market and profit insanity at all levels of business.
British Airways and others have provided the headlines exposing high-profile explosions of greed and incompetence. But around the edges of the NHS, there are plenty of small-scale examples of market insanity, further undermining the mad notion that the market does what is best.

Quite aside from the huge national scandal that is private care homes, there is another area of privatisation that has escaped the headlines but is just as discomforting.

These are services ‘commissioned’ by the NHS but not on the frontline in the pandemic. They do not qualify for ‘furloughs’ but instead continue to be funded entirely to their contract. Prominent amongst these are dental surgeries, GPs, some lab services and a whole range of small to medium sized businesses that are reliant on NHS funding.

According to the rules, their staff can be considered ‘key workers’ who can be redeployed back into the NHS and trained to assist those services fighting the pandemic. Putting aside the question of whether there would be any equipment for them to use (obviously not) they are a useful back up for the hospital trusts around them, as sickness further hits the workforce and admission rates continue to increase. In return, the contractor receives its full NHS funding and the staff remain on full wages awaiting redeployment.

It is not surprising, however, that this appears not to be the priority of these business owners.

Still taking full payment from the NHS, they are using the staff for other purposes. Around 13 dental nurses (a prime group for retraining and redeployment) employed by one surgery have been ordered into work to carry out cleaning duties, filing, cleaning fridges, sweeping up and even painting and decorating. There is no question that the work they are performing is ‘non-essential’ and that the social distancing rules of two metres are not being enforced. Nurses who cannot get childcare (schools are closed, remember, and most child-carers are looking after their own children) are told that if they cannot report for such ‘duties’ then they have to use their annual leave to miss work.

We’re all in it together?

More broadly, workers are being told that they cannot cancel their leave. If they have a two-week holiday booked in July, which they may have lost as flights are cancelled, they are told they must take it anyway.

Nurseries, not covered by NHS funds, are seeking to furlough staff and then also demand that they attend work for painting and decorating and other ancillary work if they want their 80% pay. When the staff say no, they are ‘laid off’ with no pay.

There are hundreds of thousands of workers in these employment circumstances. Mostly not protected by a union, mostly BAME, mostly women and mostly desperate for the work and the money, who are being exploited under the very terms of both the government schemes and the NHS commissioning structures.

The market doesn’t work on a macroeconomic scale, but here we see how it fails workers and our services at this micro level.

Many of these firms have fewer than 21 workers so trade union recognition rules don’t apply. The NHS Commissioning Services are concerned mostly with clinical and medical standards rather than employment. Most employment offered is of the precarious world of zero-hour contracts. So these workers, many of whom are more than able and willing to help out in hospitals, are left unused in the national effort against the pandemic. Worse, they are put at risk by being instructed to do non-essential work in small workplaces.

Only a nationally planned, wholly regulated approach in partnership with trade unions can make the best and most efficient use of labour. This is the example in other parts of the world. We must press for the end of commissioning of services through private sector contracts and end the precarious employment that leaves workers in small businesses vulnerable to this exploitation.

What did you do in the great effort against the pandemic? I got my workers to come into my surgery and clean the fridge and paint the walls.