(May 2011) In the 1980s, the Thatcher government in the UK introduced compulsory tendering of all cleaning and catering work in hospitals throughout the UK. This was bitterly fought at the time, with a series of lengthy strikes, public campaigns and court cases. For the next 20 years the unions continued to organise cleaners, negotiate to improve their pay and conditions , and campaign to bring work back in-house. Now, three of the four countries in the UK have decided that there will be no more contracting-out of these services, and all cleaning in NHS hospitals will remain in-house.
The decisions have been taken by the elected assemblies in Scotland, Wales and Northern Ireland. These elected bodies have devolved powers in their countries, similar to regional governments elsewhere in Europe.
In Scotland, the decision was taken in 2008, against the background of major problems in British hospitals with infections resistant to treatment. The Scottish ministry of health banned any further contracting-out of these services, so that when existing contracts expire all work returns and remains in-house. It also financed the employment of 600 extra cleaners to raise standards of cleanliness.
In Wales, the last private contract expired in 2008, and the Welsh assembly has decided not to offer any more contracts to the private sector. All hospital cleaning in Wales is now carried out by directly employed staff. The Welsh government also set up a working party, including union representatives, as a result of which the government also increased resources for cleaning in hospitals.
In Northern Ireland, the last private cleaning contract expired in 2010, and the staff were re-employed directly by the hospital. During the course of the contracts, the union had successfully sued the health authority for failure to apply TUPE transfer rights, denial of pension rights, and failure to provide equal pay for the women..
Contracting-out remains in the fourth and largest country in the UK, England, but the unions continue to campaign to reverse this. Even in England, the unions have negotiated ‘retention of employment’agreements for PPP/PFI contracts, so that cleaning and other ancillary staff remain directly employed.
• Campaigns can be won at regional level, even if the problem was created at national level
• Arguments about public health concerns are very powerful
• Persistent pressure can succeed even after many years