An increasing use of ‘zero-hours’ contracts by NHS Trusts trying to make the coalition government’s reforms workable amounts to an “untested experiment” that is putting patient safety at risk, critics have warned.
According to the Independent, a number of Trusts including Oxford Radcliffe Hospitals, South Gloucester and University Hospitals Bristol are currently turning to the arrangements, which require personnel to be available on an on-call basis, but do not guarantee them specific numbers of working hours, income or employment rights.
A consortium of 20 health trusts in South West England, which is threatening to abandon the NHS’s nationally negotiated pay and conditions framework and introduce its own local structure, has also discussed extending the use of zero-hours contracts to help cut its wage bill.
Although such contracts have been employed in the service sector and in the low-paid fringes of the health services in the past, the fact that they are starting to be applied in core areas such as psychiatric therapy, cardiac and respiratory diagnostics signals a key change in the way that staff are employed.
Unison said that it had already received “worrying feedback” about the contracts as the government’s controversial push to a more market-driven NHS model had begun to see Trusts and private companies bidding to provide patient services.
The union’s senior national officer, Sara Gorton, said that neither the Trusts nor the private firms knew how much work they would be given on winning a contract because it was supposed to be up to patients to decide which provider they chose.
Potential risk
“Yet in order to be approved as a provider, they must demonstrate they can operate with spare capacity so they can meet increasing patient demand should that happen,” Gorton explained. “But rather than simply hire staff that might be needed, which is expensive, many providers are turning to zero-hours contracts. The whole thing is an unnecessary, untested experiment – a nightmare.”
Shadow health secretary Andy Burnham said that he was so worried about the “potential risk to continuity of care and patient safety” that he was calling on the government to “halt the spread of zero-hours contracts in the NHS pending an urgent review”.
Staff hired by service providers simply to prove that there was spare capacity in the system was “a dangerous model to provide healthcare” and amounted to the “casualization of our health service, turning parts of the NHS into a ‘temping’ workforce”, Burnham pointed out.
The danger was hospitals could “face a ‘G4S situation”, with the taxpayer picking up the bill again, or worse, patients being left untreated”, he warned.
But the Department of Health said that providers “do not require available extra capacity to meet unexpected demand”. A spokesman added: “The NHS has always had to be flexible to meet variations in demand and it is up to providers to organise themselves to make sure this happens.”
The rules for qualified providers only applied to the introduction of community and mental health services, he said.
