More than 150 support staff at Airedale General Hospital near Keighley, West Yorkshire staged a three-day strike from October 1-3 demanding pay and conditions parity with their National Health Service (NHS) colleagues.

The strikers—porters, cleaners, catering workers, sterile services staff, security and other non-clinical workers—perform vital functions that keep the hospital running. They are denied NHS terms and conditions because they are not employed directly by the Airedale NHS Foundation Trust, but through its wholly owned subsidiary company (SubCo) AGH Solutions (AGHS), established in 2018.

This has created a two-tier workforce. Workers transferred into the SubCo from the Trust have retained “Agenda for Change” pay and conditions, while new starters employed by the subsidiary are on vastly inferior contracts. They receive fewer paid holidays, worse sick pay and maternity entitlements, lower enhancements for weekend and night shifts, and drastically worse pensions.

Hospital porter Bradley Moorcroft told the BBC, “There’s a huge difference in pension contributions, sick pay and holiday entitlement. Over a whole year it would account to thousands of pounds we should rightfully have for doing the same work as our NHS colleagues. All we want is equality.”

This most basic right runs contrary to what AGHS was established to carry out. What has been gouged out from the lowest-paid hospital workers has shown up in its coffers, with after tax profits of over £1.4 million in the year to March 2024.

The determined opposition of support staff is clear. Members of the GMB union returned a 90 percent vote for strike action in August, with the first round of three-day stoppages taking place in mid-September.

The Trust has not made any concessions on the core demands. After the earlier action, GMB national organiser Joe Wheatley stated, “Despite three strike days and significant disruption to the hospital, the trust’s management still refuse to have a grown-up discussion around our members’ issues.”

Unite and Unison are not taking part in the strike action at AGHS despite representing workers among its 300+ workforce. The fight by non-clinical staff for equality has been ringfenced by the GMB and the other health unions from a broader mobilisation of Airedale hospital staff against the backdoor privatisation of vital hospital functions and the two-tier workforce entrenched over the past seven years.

The defence of the NHS and its workforce cannot be entrusted to any section of the leaderships of the health unions who are sitting on mass opposition. They have been enablers in the imposition of a 3.6 percent below-inflation pay award by the Starmer government for this year—against nurses, paramedics and other NHS staff in England under the Agenda for Change.

The GMB, Unison, Unite and the Royal College of Nursing only organised consultation ballots in which the insulting offer was rejected overwhelmingly. But these were non-binding ballots which did not commit the union bureaucracy to organising any industrial action. Labour’s health secretary Wes Streeting used this suppression of workers’ wishes to viciously attack the resident doctors’ strike in July for pay restoration, claiming they were being “reckless” compared to other NHS staff who were supposedly content with their wage settlement.

The fight at Airedale hospital cannot be won through action against a single Trust. It requires a far wider mobilisation against the SubCos throughout the NHS—a struggle which all the unions have divided and demobilised.

AGHS was established as one of 42 SubCos being prepared or implemented around the country in 2018, after an initial “pause” was officially announced by NHS Improvement—then regulator of the Trusts. Labour’s shadow health secretary Jonathan Ainsworth declared this pause a “victory”, a claim echoed by the health unions which used seized the chance to divert opposition down the dead end of consultation exercises.

Support staff at Airedale and around the country cannot allow history to be repeated. The GMB and Unison are attempting to claim the announcement by NHS England on September 26 of a “pause” on a further roll out of SubCos represents a U-turn by the Starmer government. But NHS England was clear that no such reversal was involved.

In a press release on September 26, GMB national secretary Rachel Harrison declared, “Today’s announcement shows the Health Secretary is listening to GMB members… AGH must now give Airedale workers the NHS terms and conditions they deserve.”

There is nothing within the announcement which offers anything to workers at Airedale trapped in the SubCo, or at any other Trust. GMB officials know full well Streeting’s announcement does not signal to the Trust they have to harmonise terms with NHS staff. He has not scrapped the SubCos but left the cost cutting and for-profit entities intact.

At other NHS Trusts such as in Dorset where Unison members voted for strike action against the implementation of a SubCo, the “pause” announcement has been used by union officials to stand down opposition, with Unison’s general secretary Christina McAnea claiming calling it “a positive step in the right direction” which “shows ministers are listening to the union’s warnings”.

The “warnings” being made by the union bureaucracy are over the opposition among their members which they are trying to stifle while facilitating Labour’s 10-year plan for the NHS. This right-wing agenda is based on widespread privatisation and saddling the 1.4 million strong NHS workforce with even more punishing work targets.

This is aimed at the same ends as outsourcing via different means: overhauling the contracts of NHS staff in collaboration with the unions with “modern incentives” tied to productivity strings. Overall funding will be squeezed, with increasingly necessary emergency funding top-ups ruled out. A new “care model” will shift patient treatment from hospitals to neighbourhood health centres developed through Private Finance Initiatives: notorious for leeching billions out of the NHS in private profits.

A World Socialist Web Site reporting team visited the picket line at Airedale on October 3 to interview strikers about their struggle, distribute the leaflet, “Unison claims victory over NHS England “pause” on private subsidiaries: Beware the fine print”, and discuss a unified fightback by NHS workers.

GMB officials intervened to shut down discussion, telling strikers not to take the leaflet or give any comments, with one official abusing the WSWS reporting team as “arseholes”. Peter Davies, the GMB’s Regional Senior Officer, threatened to call the police, claiming reporters were “harassing” the pickets.

In truth it is the actions of the GMB officials which constitute harassment, aimed at preventing free discussion among workers. At Airedale or any other struggle, every worker has an interest in opposing such bureaucratic methods.

The GMB’s actions underscore the need for precisely the type of democratic organisations of struggle described in the WSWS article:

Rank-and-file committees must be built in every hospital, trust and care setting, uniting doctors, nurses, paramedics, and support staff in a common fight to defend the NHS as a public service, free from privatisation and corporate control. The programme for action is clear:

• Scrap the subsidiary companies and restore all workers to NHS contracts with full compensation for lost pay and benefits.
• Defend NHS pensions, pay, and conditions—stop the jobs cull.
• Fund health and patient care, not rearmament and war.
• Reject Labour’s 10 Year Plan, designed to accelerate privatisation and corporate control.
• Build a unified, independent struggle to defend the NHS and its workforce.