Outsourcing causes differentials in wages and conditions
There are concerns in health unions and amongst staff regarding the lower wages and poorer conditions offered to outsourced workers by their private employers which is creating a two-tier NHS work force.
Where Trusts have created these outsourced groups of workers are the Trusts managing and preventing this aspect of their contracts with the private companies causing serious differentials in pay and conditions?
One local example of the negative impact of outsourcing on wages and conditions for NHS workers came to a head in Lewisham University Hospital in November 2025. Staff were outsourced to the private company ISS UK, a global facilities management company. The out-sourced staff have for several years been paid lower rates of pay and conditions than their directly NHS employed colleagues. In 2024-25 as negotiations over pay and conditions stayed unresolved, the company would not commit to written offers to the workers and GMB their union. It needed the threat of strike action. ISS UK only came to the table after strike action was taken in late November 2025 when eventually a reasonable settlement was agreed.
Ladywell Unit Lewisham
South London and Maudesley NHS Trusts had outsourced cleaning and catering across their three hospital sites to OCS a private company. Over 200 GMB members working for OCS took strike action in May 2026 which included the Ladywell Unit in Lewisham.
OCS, having won the outsourced contract was proposing 2000 hours of cuts, which represents a drop in service provision of 20%. The union reported “these cuts will leave wards and hospital facilities in disarray and allow bad food to be served under OCS governance” In addition the GMB noted “unfair dismissals and if OCS cannot afford to provide services needed for patients, the contract must be taken back in-house.”
When facilities privateers win NHS contracts (and usually the lowest tender wins) a well established pattern asserts itself ending in serious disputes with their outsourced workers.
The companies want to make higher profits and the only way to do this is by cutting employment costs, so reducing working hours, dismissing workers who challenge their management, paying the minimum wage possible, dragging out the resolution of pay negotiations and reducing the pensions terms and conditions for the out-sourced NHS workers.