A Killing Wage?



The NHS has long maintained that a bad diet, low quality housing and poor education are the root causes of ill health and result in a massively overburdened health service. All of these factors come directly out of poverty. It is a terrible hypocrisy and a harsh irony therefore, that the NHS, the East End’s second largest employer, is allowing its workers to be paid slave wages. A health service that creates the ill health it cannot deal with? Only in Hackney.

Research commissioned by UNISON and conducted by the Family Budget Unit estimated that a lone parent with two children would need a disposable income of £272 a week to sustain a “low cost but acceptable” standard of living in East London. This would require earning £6.30 an hour yet the national minimum wage is only £4.10 an hour. Almost all those interviewed working for health institutions across the East End earned less than £5 an hour.

Since the introduction of market testing to the NHS and the implementation of Compulsory Competitive Tendering following the Local Government Act 1988, there has been increased commercial pressure applied to the provision of public services. Homerton Hospital in Hackney and other health institutions have tendered out some, or all, of their security, porting, catering and cleaning work to two dominant firms. ISS Mediclean and Medirest (Compass) have cut costs to win these contracts by slashing wages and removing basic benefits. ISS Mediclean have the contract at Homerton and give their employees no London Weighting, no pension and no compassionate leave. At Newham General on the other hand, NHS Catering still have the contract and employees, while only earning £4.50 an hour, at least have London Weighting, pension, paternity and maternity leave and sick pay. While it is easy to blame the contracting companies, it is the demand from the NHS for low cost tenders that really gives effect to these appalling employment conditions.

Large business support service companies are now responsible for considerable amounts of public service delivery. A company like ISS, the Danish-owned cleaning company has more than 10,000 staff in the UK alone with the company reporting profits of £103 million in 2000. The way the workforce is spread across a wide number of contracts means that it is very difficult to form collective solidarity, and there is no forum where these workers can come together to improve their situation.

The East London Communities Organisation (TELCO) has launched a Living Wage campaign in April this year. They are campaigning to see that public sector bodies in particular, but also a number of high profile corporations, ensure that their own contractors meet an acceptable wage standard, by writing into their contracting regulations an obligation to pay all staff a locally appropriate living wage. This involves targeting unfair employment in schools, local authorities and transport, as well as the health service. Ken Livingstone has already promised that the GLC will put a fair employment clause into its contracting demands under the new Best Value contracting and TELCO is putting pressure on the health service to do the same.

Meetings with the hospitals themselves and those in control of London health policy has revealed the real obstacle – political demands. The government cannot see beyond the short term political gains to be made by high profile media issues such as cutting waiting lists, and the hospitals are faced with a barrage of targets. Needless to say the poor of Hackney and other east London boroughs do not have such media attention and their concerns are of significantly less political weight. But it is these very employees, dragged into poverty by slave wages, who are then filling the waiting lists the government is demanding are cut.

Infant mortality in Hackney is 9.3 deaths per thousand, in Bexley it is only 3.9 per 1000. Out of 8414 electoral wards in the country, Queensbridge in Hackeny is the 46th poorest and Blackwall in Tower Hamlets has the fourth highest rate of child poverty. While contracting is witnessed throughout the public services in East London, a comparison of these two statistics shows how the health service above all must rise above political pressures and look to the direct result its employment policies are having on the very people it is trying to treat. The high profile launch of the London Health Commission has prioritised regeneration, inequality, and black and minority health. Yet the NHS is ignoring the most immediate effect it could have on these areas and is driving its employees in the East End further into the inescapable cycle of poverty and ill health.






Catherine Howarth is co-ordinating the TELCO Living Wage Campaign and she can be contacted for more information on:  catherine@telcocitizens.org.uk or 0208 9839808.