NHS activists at Unison’s conference successfully pushed for a more militant union over a range of issues from austerity, industrial policy to Palestine, reports Elly Badcock

Last week saw Unison’s annual Health Service Group Conference take place in Liverpool, with hundreds of delegates from NHS services across the country. Unison is a major donor to the Labour Party and Health Secretary Wes Streeting is one of 74 MPs that are Unison members. Unison has a long-standing unofficial policy of not ‘rocking the boat’ whilst Labour is in government, but Wes Streeting sailed into choppy waters when he took to the platform.

The anger that met Streeting was due, in part, to the election of Time For Real Change activists to union positions. A fighting union is beginning to emerge.

Unwelcome guest

The decision to invite Wes Streeting to speak on the last day of conference provoked a great deal of anger. Despite extended pressure from delegates throughout the conference to rescind the invitation, the union bureaucracy stated they wanted to ‘hold him to account’. 

Although most of the pre-vetted questions did little to challenge Streeting, activists from a number of groups including Keep Our NHS Public and Time for Real Change ensured he did not attend unopposed. Local campaigners from Save Liverpool Hospitals greeted him outside, alongside chants of ‘Save Our NHS’ and ‘Don’t spend money on war and death, spend it on the NHS’. When he took to the conference floor, delegates held up signs saying ‘Our NHS Not for Sale’, ‘Vote Labour to SELL the NHS’ and a large number of trans flags in reference to his views on puberty blockers.

In contrast to the rapturous applause he was clearly expecting, Streeting received a lukewarm smattering of applause and notably no handshake from the union’s top table on his way out. The largest cheers were reserved for a delegate from the LGBT+ caucus who grilled Streeting about meeting with anti-trans lobby groups and banning puberty blockers for children.

Streeting’s speech was full of sound bites about his love for the NHS but his pledges were vague. He even resorted to telling conference ‘Don’t worry. The cavalry is coming’. But delegates were obviously worried and angry about job cuts, pay restraint and privatisation. All of which Streeting skirted round, merely promising ‘change’. It is precisely the changes Streeting intends to inflict on the NHS that delegates were angry about.

Pay and industrial action

The pay strategy proposed by Unison’s Health Service Executive group was not enough to make up for years of real-terms pay cuts and freezes; it limply committed the union to fighting for an ‘above-inflation’ pay rise, with no mention of how much. However, further motions and amendments from fighting branches such as Greater Manchester Mental Health Branch and others committed the union to a policy of pay restoration. 

Similarly, Unison’s industrial strategy seems to lack strength for the fight ahead; despite robust argument from the left of the union, conference agreed on a strategy of focusing industrial-action ballots on a small number of winnable workplaces. These isolated strikes will have a limited impact on delivering NHS services, and as a result will not force the government to the negotiating table in the same way our comrades in the Royal College of Nursing have managed in the past. In order to achieve a proper pay rise, including pay restoration and a minimum wage of £15 per hour, the UK’s largest union should be focusing all possible resources on building an enormous, co-ordinated strike across the NHS that would leave the government no choice but to pay us what we deserve.

Austerity must be reversed

During conference, we learned that 100,000 job cuts are looming with the axing of NHS England, an arms-length body that commissions and directs NHS services. Delegates shared stories of local commissioning bodies needing to make cuts of up to 50%, including to frontline staff, and of NHS trusts committing to recruitment freezes and redundancies to ‘tighten their belts’ ahead of anticipated further cuts.

The anti-austerity movement was born during a Conservative government, but Labour have picked up the mantle and, alongside the cuts to welfare benefits, they are launching ‘Austerity 2.0’. Numerous motions spoke out strongly against this, but the union stopped short of pointing out that Starmer’s government have increased defence spending whilst slashing the NHS and welfare benefits. Saving the NHS can only happen if we deny Starmer the warfare state he is hell-bent on.

Palestine

Ahead of International Worker’s Memorial Day (28 April), the conference held a minute’s silence for the Palestinian Red Crescent medics murdered in Gaza by the Israeli Defence Force. This was introduced by Unison general secretary Christina McAnea, affirming that the murder of humanitarian workers is an indefensible war crime.

It was a welcome surprise to see a Unison leader so strongly condemn the barbaric atrocities being committed in Gaza, especially whilst standing in front of Wes Streeting, a cabinet minister who vowed in December to strike off medics who take ‘extremist’ views over Gaza. The impact of the anti-war movement has been key in forcing union leaders to stand up and be counted over Gaza, in particular Stop the War’s Workplace Days of Action which has brought rank-and-file activists out in force in workplaces across the UK. 

What’s next?

Following conference, there are three key priorities for Unison members in the NHS:

1. The imminent consultative ballot on the 2024/25 pay offer, with the Pay Review Body currently recommending a derisory 2.8%. Although it is not the industrial ballot the left of the union argued for, it will be vital to get as many workplaces as possible to the 50% threshold, and prove to the union leadership that there is strong appetite for industrial action for fair pay in the NHS. 
2. Continuing to speak out about the atrocities in Gaza, particularly linking with our healthcare comrades who are being targeted by Israeli forces. This must include continued work with Stop the War in the workplace days of action.
3. A renewed commitment to anti-austerity work, in the face of massive job cuts looming over all areas of the health sector (whilst spending on war and death marches ever upwards). The 7 June ‘No more austerity 2.0’ demonstration will be central to this, and Unison branches should pass the model motion in support of the demonstration and organise coaches of activists to attend and tell the government in no uncertain terms that we want welfare, not warfare.