MSPs NHS Reform Bill Stage 1 Debate BriefingMarch
On Wednesday 3rd
March the Scottish Parliament will undertake a Stage 1 debate on the NHS Reform
(Scotland) Bill. Although UNISON Scotland is in favour of some of the proposals,
such as the abolition of NHS Trusts, there are some issues that we would like
Community Health Partnerships
Scotland welcomes the commitment that the devolution of powers does not stop at
CHP level but should include all frontline staff. However UNISON Scotland is disappointed
that there is no reference within the Bill or the CHP consultation on the role
of trade unions as a key partner within both the NHS and the proposed CHP's.
Scotland also has a number of concerns relating to CHP's, including adequate resources
being provided for NHS Boards and local authorities in establishing and developing
CHP's and that performance measurement of CHP's is aimed singularly at health
issues and does not take into account local government performance measures.
separate consultation document also refers to 'local standards of treatment, access
and referral'. UNISON Scotland have concerns that this could lead to a variation
in care across NHS Health Board areas and Scotland resulting in a 'postcode lottery'
of care. There may be a case for NHS Health Boards retaining more powers to ensure
more consistent service levels to lessen this concern or establishing a framework
requiring local standards to make reference to an overarching health priority
(e.g. a reduction of health inequalities).
has produced a response to the separate consultation on CHP's which highlights
our concerns (http://www.unison-scotland.org.uk/response/comhealth.html).
UNISON Scotland welcomes the commitment by the
Health Minister to use a stage 2 amendment to include staff governance within
the Bill. However there are other staffing issues which concern us such as the
reference to a 'shared NHS culture' within the separate consultation paper on
CHPs. UNISON Scotland believes this would most easily be achieved by ensuring
that all relevant staff within CHPs are employed by the relevant NHS Health Board.
For instance, all GP practice staff on NHS terms and conditions would prevent
the problems associated with a two-tier workforce within CHPs.
Scotland also believes that the concept of associated NHS employees (where staff
would retain accumulated service conditions if they were to transfer within the
NHS) should also be introduced. This would aid the retention and recruitment of
experienced staff as well as providing opportunities for career development.
UNISON Scotland welcomes the Scottish
Executive's commitment to securing greater public involvement in the NHS in Scotland.
We believe that good practice in public involvement needs to be promoted to ensure
that quality improvement is driven by the needs of patients and service users.
UNISON Scotland is concerned that the move to a national body might prejudice
the grassroots structure and introduce more bureaucracy. We believe that it is
important that any new structure should be rooted in local concerns. This would
allow local offices greater autonomy to speak on, and deal with, local issues
without undue interference from the central body.
Scotland firmly believes that all public service organisations (including the
NHS in Scotland) should be open, transparent and democratically accountable and
should encourage active participation from users, the community and staff and
their trade unions and would therefore be supportive of direct elections to Health
Scotland believes that not enough emphasis has been paid to the role of maintaining
and promoting the health of individuals and communities. UNISON Scotland believes
we need to move the debate on health away from hospitals and illness and onto
prevention and healthy living. This includes the banning of smoking in public
places, a ban on the sale of junk food in NHS hospitals and other buildings as
well as the promotion of healthy eating for patients.
The Scottish Executive should look at standardising
the food purchasing policy, including the introduction of UNISON's
Food for Good Charter (http://www.unison-scotland.org.uk/nhs/chefs/
Scotland shares the concern of the Health Committee in their Stage 1 Report on
the Bill with regard to funding. We are concerned that the Bill has not been fully
costed and that its implementation may have a significant impact on the resources
of both the NHS and local authorities unless the Scottish Executive provides additional