Scottish Parliament
Scottish Health and Community Care Committee

UNISON Scotland Submission
October 2001

 

I. INTRODUCTION

• UNISON welcomes the opportunity to address the Health and Community Care Committee
• We congratulate the Scottish Executive and MSPs for the introduction of free personal care.
• Strategies contained within the bill are a radical change from present practices and could impact on up to 100,000 staff and various health and local government services.
• Clear managerial structures need to be established.
• A protocol between the Executive, trade unions, health and local authorities need to be agreed.

II. UNISON'S POSITIVELY PUBLIC CAMPAIGN

UNISON supports the modernisation and change needed to provide better, more responsive public services. This process must be based on the following five principles:

Effective delivery

High quality public services are best delivered by well trained, directly employed staff who put the needs of service users and the community first.

Adequate funding

Modern and high quality services need long term investment. This means investment in infrastructure, in information and communications technology, and in the training and development of the workforce.

Equality of access

Public services should be responsive to the needs of all members of the community. There should be no discrimination in service provision, but equality of access for all people, based on their needs. High quality, accessible services are the best guarantee against social exclusion and against more affluent members of the community weakening public services by making their own arrangements.

Fairness at work

High quality services and good employment practices go hand in hand. Staff are the public services' greatest asset and they must be treated fairly.

Partnership at work

Genuine partnership between government, service users, the community, employers and trade unions is central to ensuring a process of continual improvement of public services.

III. JOINT RESOURCING - (PAPER DATED 5 SEPTEMBER 2001)

Elements of joint resourcing will include:

• Staff
• Money
• Equipment
• Property

From:

• Local Authorities e.g., Social Work, Housing
• LHCC's
• Primary Care Trusts
• Acute Trusts
• Scottish Homes

IV. BENEFITS TO USERS/PATIENTS

• Remove barriers within care journey, e.g., reduce delayed discharges
• More consistent, more integrated services at locality level
• More single points of access to community care services
• Better use of resources e.g., reduce cost-shunting
• More holistic planning and delivery of services

V. 6 ACTION STEPS BY PARTNERS BY 1 APRIL 2002

• Agreement on joint resources (staff, money, equipment, property
• Agreement on joint management arrangement
• Agreement on governance and accountability framework
• Agreement on priorities and targets
• Agreement on performance and measures
• Local Partnership Agreement document

VI. WILL INCLUDE SERVICE SUCH AS:

• older people's nursing homes and residential care beds
• domiciliary services - personal care, domestic tasks, laundry, shopping, equipment services.
• day centres and day hospitals
• continuing care NHS beds and assessment beds
• housing for older people
• primary care resources - community nurses
• occupational therapy services for older people
• equipment and adaptation budgets and services
• elements of NHS acute services
• others as locally agreed.

VII. JOINT BUDGETS

Aligned Budgets

• money brought together, ‘aligned' by agencies
• use of money agreed by all agencies
• responsibility for money remains with each individual agency

Pooled Budgets

• money put into single pot
• for agreed shared aims and services
• loses its identity
• one agency plays host to pooled fund

VIII. JOINT MANAGEMENT

Elements can include:

• joint high level board or committee
• senior management group
• new partnership body
• single manager at high level and/or locality level

IX. JOINT MANAGEMENT ARRANGEMENTS

Three models in Scotland:

1. Joint Management Structure

2. Partnership Body, Type A (aligned budgets)

3. Partnership Body, Type B (pooled budget)

Joint Management Structure

e.g. Dumfries and Galloway, Glasgow LD

• Aligned budgets
• Not an independent legal entity
• Staff employed by own agencies but both agencies share joint management arrangements, e.g., committee/board, management group, single manager

Partnership Body Type A

e.g., "Care Together" in Perth and Kinross

• Aligned budgets - not pooled budgets
• Not an independent legal entity
• Has a distinct "badge" or identity
• Cannot employ staff in its own right

Partnership Body Type P

e.g., Manchester Mental Health Partnership

• Pooled Budgets
• Has a distinct badge or identity with more decision making powers
• Not an independent legal entity
• Cannot employ own staff in its own right.

Staff must be employed by one or other statutory agency, usually the host partner.

X. HR ISSUES

• Management structures based on secondment - not sustainable in short or long term.
• Rapid Response Team - staff doing the same job on different terms and conditions.
• Proposed management structure - unclear, not focused.
• Professional accountability - potentially lacking.

XI. OPTIONS

The Scottish Executive, Health Department, local government and appropriate trade unions need to plan and agree the HR Strategy to property manage and co-ordinate these new services. The following are options to consider:

a) New Employer

• Scottish Structure.
• Scottish Parliament can set minimum standards.
• It would standardise terms and conditions.
• It would reassure transferring staff.
• Model employment practices.
• May lead to the standardisation of terms and conditions in health and local government in the long term.

b) Staff Employed by the NHS

• Minister responsible for Health and Community Care
• New Boards from 1 October have significant local government input.
• Maintain professional and managerial accountability.
• It would standardise terms and conditions.
• Model employment practices.

c) Staff Employed by Local Government

• Democratic accountability.
• In line with current statutory responsibilities.
• Power of well being.
• It would standardise terms and conditions.
• Model employment practices.

XII. SUMMARY

The proposals contained within this bill have major implications for health and local government. There needs to be a wider debate and agreement on the HR Strategy that is going to be adopted by the Scottish Executive in the medium to long term.

For further information please contact:

Matt Smith, Scottish Secretary
UNISON Scotland
UNISON House
14, West Campbell Street,
Glasgow G2 6RX
Tel 0141-332 0006 Fax 0141 342 2835
e-mail matt.smith@unison.co.uk

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