“THE biggest wave of insourcing.” That was the Labour Party’s pre-election commitment, as part of its wide-ranging plans to overhaul workers’ rights.

The government is starting to repair the damage done to the NHS by 14 years of Conservative rule.

But waiting lists will only come down, and patient care can only improve with properly motivated healthcare staff.

That’s why it’s so important for ministers to honour the promise made to stop outsourcing low-paid, and overwhelmingly female and black health workers to subsidiary companies.

A new workforce strategy is on the way as part of the 10-year health plan for the NHS. But NHS England (NHSE) seems to have a dogmatic attachment to using these firms. Chief executive officer Jim Mackey has even been encouraging more trusts to spin out their support services into “SubCos.”

These are companies owned by NHS trusts but set up at arms-length as non-NHS bodies. NHS trusts set up SubCos to allow them to outsource support services and their staff, like those in facilities or administration. NHSE reportedly sees them as a quick fix for trusts to slash VAT costs and make savings to reduce their deficits.

Unison has already written to all trusts highlighting the dangers of this approach and reminding senior managers of the many campaigns fought and won by unions the last time SubCos were seen as the go-to option for desperate health bodies.

Many trusts have heeded the warning, but some are ploughing ahead regardless.

Staff employed by Dorset Healthcare NHS Trust, Dorset County Hospital NHS Trust and University Hospitals Dorset NHS Trust are only too aware of the issues. They’re in the middle of a strike ballot over plans to shift hundreds of them to a SubCo.

Needless to say, it’s controversial. Staff fear they’ll receive inferior pay and conditions, and be unable to access career opportunities available to NHS employees if they’re farmed out to an external operator.

As well as being clearly at odds with the government’s promise to deliver the “biggest wave of insourcing of public services for a generation,” the use of SubCos also threatens to derail the staffing elements of the government’s 10-year health plan.

NHSE is suggesting the latest wave of subsidiaries will be less risky for staff than previous incarnations, due to a supposed “guarantee” that new SubCos won’t depart from NHS terms and conditions. But the reality is that no such commitment is possible once staff have been transferred out of the NHS.

Establishing SubCos is also a riskier manoeuvre for trusts than previously, given that the Treasury has been investigating the VAT loophole that prompted trusts and NHSE to push this model in the first place.

A potential move to a different financial model — which, in accounting terms, makes spin-off arrangements more expensive — would remove at a stroke the biggest reason for trusts to consider a SubCo.

It would also mean the only other realistic way to make savings through a SubCo would be cutting back on employment conditions for its staff, particularly new starters.

The NHS should be one team, working together to deliver crucial treatment and support for patients. Fracturing the workforce further, by creating another tier of low-paid staff, would only undermine the sort of unity that enabled the health service to weather the pandemic.

Unison is always prepared to work with trusts, NHS England and the government to improve services. After all, no health worker wants to see their livelihood at risk if their employer is in financial distress.

But the use of outsourcing — under whatever guise — will continue to be resisted.

I’ll be presenting a Unison motion on SubCos at the Trades Union Congress in Brighton tomorrow. It makes clear how plans for further outsourcing fly in the face of Labour’s pre-election pledge on the issue.

Calling for support from across the union movement, the motion warns the government will have nowhere to hide if it fails to clamp down on trusts farming out support services.

It says ministers can’t hide behind outsourcing being an NHS England policy. These decisions are being taken on Labour’s watch. And what’s more, NHS England will soon become part of the Department of Health and Social Care.

For the government to allow low-paid health workers to be parcelled off in a way that contradicts election promises will also play into the hands of right-wing populists.

Put simply, ministers need to make good on the insourcing pledges. And that means stopping any more of these irrational plans that will only make the situation worse.