10 October 2003
Trade unions got their wish and delivered a bloody nose to ministers at the Labour Party Conference in Bournemouth last week on the issue of foundation hospitals.
By flexing their collective muscle in a co-ordinated way, which they have not managed in recent years, Unison, the GMB, the T&G and Amicus managed to dominate the conference agenda and force four votes on issues close to their members' hearts.
Of these, the composite resolution criticising the government's policy of introducing NHS foundation trusts, which would be freed from Whitehall control, was the one that they badly wanted to win.
The leaders, among them outgoing T&G general secretary Sir Bill Morris, were delighted when they did. 'It lacks legitimacy. It wasn't in the manifesto, it wasn't in a green paper, it wasn't in a white paper,' Morris declared after the vote. 'It was drawn up without any discussion or involvement.'
But the reality is that, on its own, the unions' victory on the conference floor makes no difference. The issue is whether they can convert their moral victory into something more concrete.
Labour chief whip Hilary Armstrong, speaking immediately after the vote, declared that the result would have 'no effect' on ministers' intentions to push ahead with this and a range of other controversial public service reforms. But if foundation trusts are railroaded through, this raises questions about the likely effect on the already strained relationship between government and unions.
It also throws doubt on how meaningful the Public Services Forum, announced on the eve of the TUC conference last month, will prove to be.
The PSF, which has not yet set a date for its first meeting, will bring together union leaders and government ministers. It is intended to 'promote dialogue' and thrash out differences between the two on public service reforms.
Foundation hospitals would be an obvious first topic for discussion, but there is little chance of that happening unless the government is defeated in Parliament.
A spokeswoman for Unison, which proposed the foundation hospitals resolution and has been leading the campaign against them, said unions would be meeting to agree the next phase of their campaign this week, but indicated that it would focus on individual legislators.
The Health and Social Care Bill, which provides for foundation trusts, began its committee stage in the House of Lords on October 7. The unions want peers to honour the conference vote and amend the Bill to stop the reforms.
If that fails, their last hope is to persuade MPs who reluctantly backed the Bill last time round to oppose it if, as expected, they have another vote to approve Lords' amendments next month.
Unison's spokeswoman said the leadership was sanguine on this point. 'On the last vote the government just scraped through and there were a lot of Labour MPs against. There may be more next time: they'll have been given a bit of backbone by the conference vote.'
It is certain, however, that if the government can command a majority in Parliament, the reforms will be implemented in spite of the opposition. This suggests that ministers' view of the PSF is rather different to that of the public service unions.
Their expectations are unashamedly high. 'If we'd had it now, and it works in the right way and is taken seriously, we wouldn't expect to have these problems over foundation hospitals,' Unison says.
Contrast this with Tony Blair's declaration during his Bournemouth speech: 'I can only go one way. I've not got a reverse gear.' It was a clear warning that there would be no U-turns on controversial policies such as foundation trusts or top-up fees for universities.
Blair's uncompromising message is a strong hint that, for the government at least, taking part in the PSF does not imply making concessions on policy.
The acid test of the forum will be its success in bridging the expectation gap that exists between its members.
PFoct2003
