Since the last Council meeting, there will have been two meetings of the local Group - an update on methadone prescribing in Glasgow and on hepatitis C by Kay Roberts and Ysobel Gourlay, and the Annual General Meeting.
Organisational Changes
Angela Munday of Inverclyde Royal Hospital has been appointed as the Chief Pharmacist for Argyll & Clyde Acute Trust. In North Glasgow University Hospitals NHS Trust, the Service Manager for Pharmacy and PAMs has been appointed. She is Mary McKenzie, a former Nurse Manager for Theatres at the Western Infirmary. The CIVAS service at the Vale of Leven Hospital has closed for six weeks for remodelling. The effects of some of the services at the Vale closing are uncertain as yet.
Staffing
There are still two B grade vacancies at Stirling Royal Infirmary to be filled.
The Millennium Holiday
The interpretation of the Millennium Agreement which was finally worked out just before Christmas has reached most corners of Scotland, with the exception of some parts of Glasgow! A problem within my own Trust was sorted out after a call to the pay office involved. Staff in the South Glasgow Trust are still waiting for payment at the time of writing.
Pay
I have had several calls about the pay award over the past month or so, as more problems crawl out of the woodwork. A number of staff in one hospital at least receive an extra increment on their salary which is paid by the
University for being an accredited tutor. The value of this increment has fallen considerably since most of the pharmacists involved are at the top of their pay scales. Incorrect and delayed payment has led to pharmacists at South Glasgow Hospitals Trust being very unhappy over the past month, as they are unsure of exactly what they have been paid. Other colleagues are unhappy at the public holiday pay only increasing by 3% instead of 8%.
In addition, I have been asked what is happening with those members on senior managers pay scales. Apparently a working party is looking at these rates which were frozen last year and capped this year. A report is due soon and I will forward a copy to all reps (or those requesting a copy if it is lengthy)
I have received a reply to my letter to the Director of HR of the NHSiS pointing out the "30 days/30 hours" error in the advance letter and a corrigendum has been issued. A copy was forwarded to the chair of Pharmaceutical Whitley Council, and one is attached to this report. The same letter stated that "a partnership approach will be adopted by the Management Executive including all key stakeholders representing the pharmacy profession in discussions concerning career options. The issues concerning modernising the grading structure however, will continue to be developed within the context of the Agenda for Change discussions and there should
be no duplication of effort."
Law Hospital
In my last report, I mentioned the situation with the new pharmacy at Law, where there would be no central pharmacy department. I have spoken with Peter Jones since the last meeting to find out more details of this concept. He pointed out that there were not going to be 9 manned sub pharmacies,
but 9 "hotbed pharmacy workstations". The new hospital would have two floors, one essentially surgery, the other essentially medical, and there would be teams of pharmacists, and a major pharmacy unit on each floor. The workstations would be manned and run by technicians. The oncology unit will be live when required, not all the time. Services would be provided by pharmacists rather than the pharmacy, and therefore a more definite line would be drawn between pharmacist and technician work. Since there is to be no store, the medicine supply will be outsourced, using another hospital to do the provisioning.
The occupation date for the new hospital is 25.5.01, and some of the reengineering to be done is to begin earlier. He is also looking at the establishment and the funding required, keeping the hospital management group informed at each stage. There is also the probability of a published paper on the concept, and the problems and advantages of putting it into action. Lanarkshire is in the position of having 2 PFI projects coming on stream within a month of each other, but their Chief Executive formerly
worked on the PFI in Edinburgh.
Scottish NHS Advisory Committee 8.3.2000
The meeting was addressed on the subject of the merger with the AEEU by NS Paul Talbot. He explained that the current situation stemmed from a conference motion last year that MSF should have a merger strategy. What does the future hold for MSF? None of the sectors it represents are staying still, every one of them is subject to continual changes. The hierarchy of the union wish to increase it's effectiveness, and to do this, new members must be attracted, and existing members must be retained. Resources are required if MSF is to move forward. However, MSF has never had major resources in the bank. Their income has always been used for members services and this is why subscriptions need to be increased each year. Most of the manufacturing members want the merger, as they can see that consolidation will improve their representation in their areas. The structure proposed for the new union would mean that there would be a designated NHS sector and a greater profile. The sector would have direct representation to the policy conferences backed up by appropriate resources. There would be a seat on the Joint Executive and the NEC for the NHS sector. The memorandum which he had written to the CPHVA recognised the concerns of groups within the NHS and should allay them. If the resources were available, they could be redirected as necessary e.g. to provide cover for sickness, which currently is not available in a lot of areas. He insisted that the protections will be there and rather than a diminution of the sector, the opposite would be the case. MSF want to have an NHS section that other professional groups want to join. The new union would have an asset base of around £60m and be the second largest union in the UK, Scotland, Ireland and Wales. The proposal needs to get through conference, but after that the members will be the ones to decide. In answer to allegations that the only arguments put forward to the members had been positive ones, Mr. Talbot said that the next edition of MSFworks would have the arguments against. However, the NEC are in favour of the merger and are promoting it as much as possible. Concerns were raised about the continuation of democracy, noting how the AEEU block voted for Frank Dobson in the London Mayor vote without consulting its members. It was pointed out that they are only half of the new union. There was disquiet about the apparent change in the rules governing rule changes. Previously a 50% vote was required, but now it was 60-75%. Mr. Talbot said that this was down to the circulation of an incomplete document in January. The first rules conference will take place in 2003, and members will be asked to accept or reject the rules. They will have had 2½ years to get them right for the conference. At all subsequent rules conferences, changes will be agreed by a simple majority. When the two unions come together, all the resources will be combined, and then there will be joint say in how they are utilised. MSF would like to hear any alternatives that anyone has. Standing still is not an option.
At the suggestion that other unions might be better to merge with, MR Talbot asked which unions? After last years conference, MSF had spoken to all other unions, and only the AEEU were interested enough to enter negotiations. It was pointed out that the option appraisal that was compiled by the NEC had not been shared with members, and this might have alleviated a lot of the doubt and answered a lot of the questions. The reason everything has gone so quickly is that there has been considerable agreement on the way forward and few major disagreements. There are still areas where no agreement has been reached, but both sides have seen the advantages of the merger. What do the AEEU get out of the merger? Mainly bigger clout on the workplace. MSF in Scotland already has a much greater input than would be expected for it's size. Changes in the Scottish Executive and the NHSiS will require
much greater resources. The Scottish Executive seems to want one Health service union.
National Report from Mick Fuller: There is a push to get MTOs state registered. However there hasn't been much information from MTOs themselves about whether they want to be state registered. Comments to Roddy Kelly are required as soon as possible. Please contact me with any comments and I will pass them on. Two reference groups have been set up at London level to look at the proposed legislation. All unions have been invited, and Mick Fuller has been invited as Joint Chair of the Scottish Partnership Forum. There is no information as to what the Scottish perspective would be, since state registration is a reserved power. However, it is increasingly clear that state registration is going to be a determining factor in PRB inclusion and PFI exclusion.
Learning together will demand that each member of staff has a personal development plan by the end of the year. The cost of all the training will have to be considered. At present 80% of training budgets are spent on medical staff. In the future, before attendance at a course is approved, the benefits of the course to the trust - not the individual - need to be evaluated, and this will probably be done at the partnership forum. The training strategy for the trust needs to be signed off by the staff side of the partnership forum.
When the Pay Review Body reports were published, the Health Minister, Susan Deacon, called in the BMA, BDA, RCN, RCM, Unison and MSF and accepted them in full - making the point that anything produced by London has to be agreed for Scotland.
Internal MSF matters: Mike Fuller has been invited on to the task force being sent in to sort out the problems at Tayside. This is the first time a staff side nomination has been taken for such a group, and the inclusion was ensured by the Minister ad the Director of HR - despite the civil servants! Mike Fuller will be there on a partnership basis to ensure no detriment to staff. Initially, the acute trust had announced 2-300 redundancies as a measure to cope, but Geoff Scaife, the Chief Executive of the NHS told them to take them off the table. The basic message is that there will be no more compulsory redundancies in the NHS again, instead reskilling, retraining and redeployment. What comes out will have lessons for all other trusts. Tayside has a deficit of £12m this year and a projected deficit of £20m for next year. Apparently, a lot of services have been built up without thought on future funding. Tayside has the best cancer services, with three professors, but no thought was given to the support services required and their cost. The Health Improvement Plan has been scrapped as it was all good intentions.
There has been a change in the attitude of the Government towards modernisation of the NHS - they are tired of strategies and advice where nothing happens due to local incompetence or fighting civil servants. They want to change the situation where you live longer in Perth than in Dundee, and want to force the service to deliver. This is the motivation behind the Modernisation Project. Tayside has a large teaching hospital with insufficient population. There are large amounts of university money invested in it, and the main driver has been clinical judgement. There have been several meetings in Ninewells already, and by the end of March the task force should have identified what is wrong. There appears to be little communication or resource sharing between the Trusts involved. e.g. the acute trust is overstaffed and overspent, but the primary care trust is short of nurses and there are no transfer plans.
Changes to the Committee: It has been decided that the name should be changed to the Scottish NHS Committee and that it should become a working committee rather than a means of information exchange. There is to be a speaker at every meeting, and the goal of the committee should be to develop a Scottish MSF policy. The full committee should be representative of MSF in Scotland, and therefore the composition is to be scrutinised. Reports in writing from short life working groups will be submitted for decision. In this way, the committee will become a major contributor to the NHSiS, with inputs into the Regional Council, Scottish Parliament and senior reps meetings.
Scottish Partnership Forum: Several key points were re-emphasised. There are to be no temporary contracts or acting up allowances for greater than 12 months duration. Although partnership is inclusive of all involved parties in the NHS, the trade unions and management are the major stakeholders. There must be union representatives on the Trust Management Group, Hospital Management Team, Directorate Management team and Departmental Management teams. There must not be partnership fora on the same level but separate. It does affect a clinicians right of clinical judgement and it does affect a managers right to manage. The Organisational Change Policy will apply to all change before the end of March 2001. The Private Public Partnership Staffing Framework will allow staff to transfer on all current terms and conditions, and new employees will be taken on with the same terms and conditions. the SPF is currently looking at legislation changes which would be necessary to open up the NHS pension scheme to staff so transferred. The plan is to get Staff Governance on to the same level of importance as clinical and financial governance.
Modernisation Project: The project is to ensure delivery of the Programme for Government, the publication of the Labour/Liberal Democrat Alliance of the Scottish Parliament, and to breathe life into Designed to Care, the Scottish White Paper. It is basically modernising policy, service delivery and governance. The NHSiS has not improved the overall health of the people of Scotland in the 50 years of its existence. It is necessary to get more out of it. The Health Department is organised into separate directorates. The HR directorate is on board for partnership, but the others aren't. There is a need to reform the Health Department to take out some of the civil servants. The key is in telling all the Health Boards and Trusts two things 1. The distinction between Boards and trusts will gradually disappear, to be replaced by a corporate responsibility for delivery 2. The strategies are already out, the Government want to be told the outcomes, and explain how many people will benefit from the changes about to be made. A copy of a series of overheads used to explain the Modernisation Project are attached.
Advice
I have given advice mainly on pay matters, although there were also a couple of other discussions on gradings and job evaluation schemes.
Meeting with Roger Lyons
I attended a meeting with General Secretary Roger Lyons speaking on the merger with the AEEU in Glasgow on 12.2.00. The meeting generated a large amount of discussion from the various sectors within MSF but many attendees were left unconvinced by the arguments put forward.
'ghp'
All of the feedback I have had on the new journal has been favourable, although a member and the local MSF Regional Officer have been in touch to say they have not received it. This should have been resolved by the time of the Council meeting.
Partnership Course 21/22.3.00
I attended an excellent course on partnership in Glasgow, run by MSF to mirror the successful course run last December for Senior Reps. This course is one of several two-day courses intended for Senior Reps unable to attend the December course at Whitehall College.
GHP Stand
After the last Council meeting, I requested that the stand be delivered to my base for use at a meeting extolling the benefits of hospital pharmacy to 3rd year pharmacy students at Strathclyde University on Monday March 6th. This was agreed and I was informed that the stand would be available. I contacted the office on the Friday beforehand to check when I could expect delivery. I was told that it was in Wales, but would be getting picked up at 3pm on the Friday and with me before 12noon on the Monday. The stand had not arrived by Monday afternoon and I was left to send frantic e-mails to the office asking its whereabouts. I was finally told by Carol English that the forwarding address documents for the stand had been lost in Wales and the stand returned to London by the carriers. By this time there was no possibility of the stand being available for my meeting. I was extremely annoyed by this whole debacle. I had promised the organisers that I would bring the stand and been assured that there was plenty of space. In the event, both myself and the Guild lost credibility with the organisers.
Some new system to ensure this never happens again must be introduced. It is not good enough to be told "You won't be getting the stand because someone has lost the labels. Sorry but there is nothing we can do!" If the stand is to be forwarded to another group instead of returned to the office, it must not be possible to lose the necessary paperwork.
Group News
Welcome to Kate Wood, who has taken over from Stephen Peddie as the contact for Falkirk and District Royal Infirmary.
Colin Rodden
22 March 2000