UNISON highlights the dangers of NHS outsourcing, urging protection for low-paid staff and stronger measures to safeguard working conditions and patient care
UNISON, which represents the NHS staff members, has raised serious concerns over NHS trusts outsourcing support staff to subsidiary companies, warning that such practices could significantly reduce pay and working conditions for the lowest-paid workers. The Union emphasises that these measures not only threaten staff welfare but also put patient care at risk, undermining morale and the quality of services.
UNISON General Secretary Christina McAnea is calling for urgent action from policymakers and NHS leaders to protect employees, ensure fair pay, and maintain high standards across the UK’s healthcare system.
Unison vows to take on SubCos to protect staff from NHS outsourcing
At the opening session of the Trades Union Congress (TUC), which takes place from 7-10 September 2025, Christina McAnea says she will warn Government ministers that “there will be nowhere to hide” if they don’t clamp down on NHS trusts trying to parcel off health workers to subsidiary companies, known as SubCos.
Christina told the audience in Brighton that proposals for more NHS outsourcing are a direct contradiction of Labour’s pre-election pledge to bring privatised public services back in-house.
Additionally, the general secretary promises a robust response from Unison, outlining that health trusts have used subsidiary companies in the past to save money by exploiting VAT tax loopholes and cutting NHS staff pay and conditions.
UNISON General Secretary Christina McAnea said: “It’s been less than 500 days since the general election. We knew there would be a huge mess to clean up after 14 years of Tory failure, and change wasn’t going to happen overnight.
“In some areas, real progress has been made. The Employment Rights Bill is a prime example – a once-in-a-generation game-changer that represents a massive step forward for workers who have long been on the receiving end of unfair treatment.
“But we must speak up when progress is too slow. We have seen far too little action on Labour’s promise to deliver the ‘biggest wave of insourcing in a generation.’ Decades of outsourcing and privatisation have caused serious damage, and urgent action is needed.
“Subsidiary companies in the NHS have been tried before. Trusts have sought to save money by exploiting VAT loopholes and cutting staff pay, terms, and conditions. This trend was widespread towards the end of the last decade, until union campaigning forced NHS England to rethink.
“Unfortunately, it seems SubCos – like zombies – aren’t easy to kill off. NHS England appears keen to revive a policy that should have been laid to rest. Staff outsourced to subsidiary companies are almost exclusively low-paid, the vast majority are women, and many are Black workers.
“Just as we did last time SubCos were on the agenda, UNISON and other unions will not stand by. The NHS needs to be rebuilt, not dismantled and parcelled off. Ministers cannot hide behind this being an NHS England policy – these developments are happening on their watch. They are in charge and have the power to end this immediately.
“If they fail to act, they should expect a wave of opposition and industrial action. We will fight SubCos wherever they appear – because, like zombies, they need to be properly eradicated.”
