A strike ballot at Dorset’s three National Health Service (NHS) Trusts opposing the transfer of 1,700 NHS staff into a subsidiary company (Subco) produced a 94 percent vote for industrial action by staff. The results were announced last Wednesday.

Launched on August 27, the ballot involved Unison members at Dorset County Hospital, Dorset Healthcare, and University Hospitals Dorset. Porters, housekeepers, catering, maintenance, and some administrative staff were involved. The 74 percent turnout reflects mass opposition to the subco, a fire-and-rehire scheme by NHS England aimed at gutting pay, terms, conditions and pensions.

On Thursday, one day after the ballot result, Unison claimed it would “meet to discuss and plan upcoming strike action.” But the next day, Unison issued an “urgent message for members” claiming sudden victory in the fight against the mass transfer of staff into a private company.

Unison claimed to have secured win for all NHS staff in defeating the subcos agenda. It claimed, “This is incredible change—not only have you led the fight for you and 1,700 of your colleagues to remain in the NHS, you have won the fight to protect thousands of NHS staff just like yourselves, across England.”

No such victory has been secured.

NHS England has not scrapped the subco plan, it has merely announced a “pause.” Furthermore, subcos can proceed locally if supported by the unions. NHS England’s statement left no doubt: “Proposals involving the transfer of NHS staff currently under review will be paused with immediate effect while we undertake this consultation, unless they are supported by local unions.”

Workers have heard this before. In 2018, NHS Improvement (NHSI), then the regulator of NHS trusts, announced a supposed pause on the creation of subcos. Jonathan Ashworth, Labour’s Shadow Health Secretary, had declared this a “victory”—claims echoed at the time by Unite and Unison officials.

But the pause was nothing more than a tactical retreat by NHS England and the health unions to defuse staff anger and buy time for “consultation” that was used to push through the very measures opposed by workers. By March 2018, 42 NHS Foundation Trusts had established or were preparing subcos. Within a year, that number had climbed above 65. Far from being defeated, the policy was accelerated behind workers’ backs.

The current pause is aimed at derailing resistance while management and the unions prepare to impose the same agenda by other means.

“We have listened carefully”

Unison’s General Secretary Christina McAnea called NHS England’s announcement “a positive step in the right direction and shows ministers are listening to the union’s warnings.” Unison stated its officials had been in talks with the government all week.

Glen Burley, Financial Reset and Accountability Director for NHS England, confirmed the change in policy followed Unison’s warnings that subcos were creating “unnecessary anxiety for staff.” He concluded, “We have listened carefully to those concerns and the Secretary of State has been clear that we must take action.”

In other words, Unison, NHS England and Health Secretary Wes Streeting feared a rebellion by NHS staff in Dorset could ignite wider resistance to Labour’s programme of privatisation by stealth that is opposed by millions.

After the subco plans were unveiled in Dorset, staff fought back. They denounced the bogus NHS “consultation” meetings and organised protests. Their stand drew support from nurses, doctors and other NHS colleagues, threatening to break the political straitjacket being imposed by the health unions.

On May 19, NHS FightBack convened a well-attended online meeting in Dorset advancing a strategy to oppose the subcos. A nurse from NHS Fightback told colleagues: “The defence of the NHS cannot be left in the hands of the trade unions. Their strategy of ‘common ground’ with the employers and government is a path to defeat. If there is going to be a fightback, we must organise it ourselves. That means preparing the necessary leadership by building a network of rank-and-file workplace committees across every hospital and care setting, led by the most trusted workers.”

While Unison is trying to dress up NHS England’s subco “pause”, Burley’s statement makes clear the change is geared to providing “clarity and consistency for trusts as they navigate challenging financial and operational pressures” i.e., is a more effective way to impose cuts. Burley instructed that NHS England will be working with trusts and unions “to agree the proposed changes and the detail of how this will work in practice.”

Labour’s 10 Year Plan: a blueprint for war

NHS England’s agreement with Unison confirms the preferred strategy of the Starmer government: inflict attacks on NHS workers via collaboration with the health unions.

Labour’s 10 Year Health Plan for England states the government will “continue to work with trade unions and employers to maintain, update and reform employment contracts and start a big conversation on significant contractual changes that provide modern incentives and rewards for high quality and productive care.”

Streeting has announced a “relentless focus on productivity”, declaring, “The NHS will no longer receive emergency top-ups to plug deficits”. Hospital services will be slashed in favour of “community care”. Local GP clinics will be established via Private Finance Initiatives, imposing crippling debt repayments aimed at further crashing the NHS.

The fight at Dorset is against a decades-long assault on public health. Systematic underfunding and privatisation began under Blair, was accelerated through the Tories’ Health and Social Care Act, carried out with union complicity. Across the country, dozens of subcos have already been imposed, devastating the pay, terms, and conditions of the lowest-paid workers.

These attacks have triggered repeated struggles. The most recent involves workers at AGH Solutions, a subsidiary of Airedale NHS Foundation Trust. They are denied standard NHS protections including the pension scheme, sick pay, annual leave entitlements and enhanced Sunday pay. This is the future facing all NHS workers if the carve-up is allowed to continue.

The way forward

Unison’s declaration of “victory” is a smokescreen. The Starmer government has signalled its intention to wage all-out war on the NHS and its workforce. But the health unions are working to divide and suppress the opposition of health workers and prevent a political confrontation with the Labour government’s pro-market agenda.

Unison, Unite, GMB and the British Medical Association are organising separate strike ballots or consultative ballots for pay among NHS nurses, midwives, resident doctors and paramedics. The strategy is divide and rule, aimed at blocking any challenge to the agenda of cost-cutting and privatisation.

To overcome the divisions being imposed by the bureaucracy and their collusion with NHS England, workers must organise independently. Rank-and-file committees must be built in every hospital, trust, and care setting, uniting doctors, nurses, paramedics, and support staff in a common fight to defend the NHS as a public service, free from privatisation and corporate control.

The way forward requires a fighting programme:

* Scrap the subsidiary companies and transfer all workers back onto NHS contracts with full compensation for pay and benefits lost!

* Defend NHS pensions, pay, and conditions—stop the jobs cull!

* Billions for health and patient care, not for rearmament and war!

* Scrap Labour’s 10 Year Plan, designed to accelerate privatisation and corporate control of the NHS!

* Organise a unified, independent struggle to defend the NHS and its workforce!

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