unite legal support

In terms of legal representation, DiU members receive this in the same way as all other Unite the Union members do for employment related matters (this includes members employed by GP’s practices). A DiU member should inform their Unite District or Regional Office via their workplace representative, where they have one, to follow the process of applying for legal assistance for an employment related matter.  There is a form to complete and the relevant information and evidence would need to submitted to allow us to assess what sort of legal advice is necessary. 

Legal advice does not necessary mean representation and there needs to be an assessment of this to determine if the union will provide legal representation at an employment tribunal, so the correct deadlines need to be adhered to.  In some cases there may not be a Unite representative in the workplace though, so support would be provided by the appropriate Regional Officer or Accredited Workplace companion.

Members should approach their Regional or District Officer if they have an employment or profession related issue which may require legal advice and the Regional Officer will be able to advise on the appropriate course of action. Individual circumstances will determine when legal advice is necessary, but as a trade union, our emphasis is to resolve matters in the workplace rather than through the courts, though we know sometimes this is necessary. 

There is a qualifying period for Unite members to receive legal support for employment related matters, this is usually 30 days of membership and the matter should not predate membership. In addition, we provide support to members that face industrial and occupational injury at work.  This is available to DIU and Unite the Union members from day one of membership and related to accidents at work or away from work. 

For more information contact your Regional or District office on call the legal support helpline on 0800 709 007 or check out the website. For non-employment related matters (including non-employment related issues concerned with HEE and the BMA), Unite has a 24 hour legal helpline  0800 709 007 to support member on any non-employment matter. Through our legal services package, Unite members are entitled to free initial legal advice on any matter which is non-work related from a Unite solicitor. This service entitles you to receive a 30-minute phone consultation with a solicitor, free of charge.   Do check out the for 24 hour non employment legal services website for this.  As DiU is part of Unite the Union, members are already part of a trade union.

A Letter from Gaza: “This Must End”

Dr. Yasser Abu Jamei is a psychiatrist living and working in Gaza, and is Director of the Gaza Community Mental Health Programme, a leading mental health provider in Palestine. He was the keynote speaker at our AGM on 7th February this year. He wrote this letter on 13 May 2021.

“I am writing this letter looking at my terrified 6-year old son, who keeps putting his hands over his ears trying block the sounds of Israel’s bombardment, my two daughters, aged 13 and 10, and my wife. These faces show the anxiety of not knowing where they can be safe now. My two older sons, 16 and 15, sit stunned and silent and I know they are reliving the memories of the previous three offensives on Gaza Strip and the family members we lost. These are the feelings that every family in the Gaza Strip are living through.

We Palestinians have lived decades of humiliation, injustices, and maltreatment. In 1948, we were expelled from our land; over 600 villages were fully destroyed, hundreds of thousands of us were killed or uprooted. Nearly eight hundred thousand ended up living as refugees in different places around the globe.

This happened under the eyes of the International Community, who have promised us a sovereign State over about one fifth of our original homeland. That decision was only accepted in the 1990s by Palestinians believing in a two-state solution.

Twenty-six years later, we look at the conditions in the promised State of Palestine and we see a West Bank divided and occupied by hundreds of thousands of settlers living in settlements built on the rubble of Palestinian homes, and who are making the lives of the Palestinian people living hell.

We see the Gaza Strip under blockade for more than 14 years, leaving us deprived of basic living conditions. Not only that, but having suffered three large offensives in this small area which killed, destroyed and traumatized thousands of our people.

And we see East Jerusalem, with its holiest sites for Muslims and Christians alike continuing to be under constant threat as settlers take over Palestinian homes and neighborhoods.

A week ago, Israeli settlers started to attack Sheikh Jarrah trying to seize more homes of Palestinian families. Everyone saw it. No one intervened.

In one of the holiest Ramadan evenings, Israel decided to evict tens of thousands of worshipers who were just praying at Al-Aqsa. These were mostly Palestinians who live in Palestine ‘48 – now Israel. Everyone saw the brutal use of military power by Israel. No one intervened.

The violent scenes in Sheikh Jarrah and the Al-Aqsa compound have lit a fire in Palestinian hearts not only in historic Palestine, but also everywhere in the world.

While we demonstrated in Akka, Jafa, Nazareth and the West Bank, rockets were fired from Gaza demanding an end to the atrocities in Jerusalem.

The Israeli army response was to attack Gaza with even more violence than in the terrible days of previous offensives. This time causing the deaths of more than 80 people including 17 children and 7 women. Bombardments hit tower blocks, apartments, governmental and police buildings and even whole streets. Everyone is seeing it. No one intervenes.

How long will the world just sit idly by while we here in Gaza suffer like this? The people of Gaza need more than just statements and resolutions, while Israel receives the arms which are killing and terrorizing us.

I am a father first and a psychiatrist second. My dream is for my children to live, to grow, to learn, in safety. This is the same dream as that of every one of the clients I see. There will be more of them today, and tomorrow. It is my job to give hope. I will tell them what I tell my children and my wife: “Because this injustice for Palestinians has gone on for seven decades, that does not make it normal. The world is increasingly full of people who do not accept it is normal. There will be change.”

Concrete political action is needed NOW to end not only the current deathly bombing raids, but also this illegal occupation and siege of Gaza by Israel, immediately.

Our current living conditions under the siege are an affront to human dignity. I tell my children and my clients, “We Palestinians have the right to live as any other people in the world: to live in peace, in dignity and to enjoy our rights. It will come.”

The International Community MUST NOW fulfil its promise of a sovereign Palestinian state. Respect for international law demands every civilized country must recognize the State of Palestine now.

After more than seven decades now of occupation and misery, we remain resilient and will never give up. But there is no father who can bear to see his children live like this.”

Integrated Care Systems threaten patient care, jobs, pay, working conditions and the integrity of the NHS as a public service. we oppose them.

Resolution on ICSs 9 May 2020

Doctors in Unite notes:

  • While attention is focused on Covid, the NHS in England is being rapidly reorganised into 42 regional Integrated Care Systems (ICSs). This will strengthen the role of private companies, including US health insurance corporations, in clinical services and management of the NHS. ICSs will mean more private contracts, more down-skilling and outsourcing of NHS jobs, reduced services and significant spending cuts.
  • The Government plans new legislation to turn ICSs into legal bodies. Their February 2021 White Paper “Integration and Innovation” is based on NHS England proposals, derived from a US model which aims to spend less on care.
  • ICSs will have fixed annual budgets based on area-wide targets, rather than providing the care needed by the individuals who live there.
  • NHS England has accredited 83 corporations and businesses, including 22 from the US, to help develop ICSs. The White Paper will allow private companies to sit on both tiers of the ICS Board: an NHS body including representation from a local authority and open to unspecified others, and a Health and Care Partnership including independent sector partners and social care providers.
  • ICSs will sideline local authorities, threatening the future integrity of social care and reducing local accountability to elected Councillors, let alone patients and NHS staff.
  • NHS providers will be bound to a plan written by the ICS Board and to financial controls linked to that plan.
  • Procurement will be streamlined, eliminating safeguards for compliance with environmental, social and labour laws and the ability to reject bidders with poor track records.
  • The White Paper proposes that unspecified NHS roles currently covered by professional regulation could be deregulated in future due to changing technology.
  • NHS England proposes agile and flexible working with staff deployed at different sites and organisations across and beyond the system.
  • NHS England calls for most NHS funding to be delivered through a fixed block payment, based on the costs of the ICS system plan, whose value is determined locally. Local funding levels could threaten national agreements on wages, terms and conditions. Local pay could lead staff to leave areas where funding is cut, further reducing care.

Doctors in Unite believes:

  • Integrated Care Systems threaten patient care, jobs, pay, working conditions and the integrity of the NHS as a public service. We oppose them.
  • After 30 years of marketisation, it is time to restore the NHS to a fully accountable, publicly run service, free to all at the point of use. As unanimously adopted at Labour Party Conference in 2017, full scale repeal of the 2012 Health & Social Care Act and new legislation for a universal, comprehensive and publicly provided NHS are required.
  • We need a separate, collaborative, publicly funded Social Care Service.
  • Genuine integration based on the wider determinants of health, such as housing, involves more input from local authorities not less.

Doctors in Unite resolves:

  • To immediately report these threats to the NHS and social care, to appropriate Union structures and to find out what action the Union is taking.
  • To press the Union to take urgent action, including using its influence with other unions, the Government and opposition parties, based on the following demands:
  1. An immediate halt to the rollout of ICSs,
  2. An extended and meaningful consultation with the public and Parliament to decide how health and social care services are provided in England.
  3. The introduction of legislation to bring about a universal, comprehensive and publicly provided NHS, free at the point of use and fit for the 21st century.
  4. New technology must be used to improve patient care, not to deskill or replace or performance manage staff, or to deprive patients of face-to-face interaction with clinicians and other care staff that they may want or need.

.

DEFEND THE RIGHT TO PROTEST: DEFEAT THE POLICE, CRIME, SENTENCING AND COURTS BILL

Doctors in Unite have grave concerns about the Police, Crime, Sentencing and Courts Bill 2021.

We believe that the measures proposed in the bill will erode civil liberties and severely undermine the right to protest, a cornerstone of UK democracy.

The Bill will give the Home Secretary:

“the power, through secondary legislation, to define and give examples of “serious disruption to the life of the community” and “serious disruption to the activities of an organisation which are carried out in the vicinity of the procession/assembly/one-person protest”

“Serious disruption” is highly subjective and in our view is no basis on which to enforce the law.

Even now, before the proposed measures become law, there are regular examples of heavy-handed policing which very rarely result in prosecution or conviction of the officers involved. The disgraceful behaviour of the police during the vigil for Sarah Everard on Clapham Common on March 13th 2021 and the ten thousand pound fine handed to an NHS nurse for organising a perfectly safe socially distanced protest against the Governments 1% pay award to health workers both serve as a warning of things to come should this Bill pass successfully through Parliament. 

The protest tactics of Extinction Rebellion and Black Lives Matter have been cited as examples of serious disruption, despite the fact that these protests have been entirely peaceful.

Protest is often the only way that citizens are able to express themselves when those in power fail to listen. People are outraged at the government’s catastrophic failure over the pandemic, its slap-in-the-face 1% pay offer for nurses, its failure to address structural racism and its continued support for the fossil fuel industry. We could be forgiven for thinking that the government are seeking to restrict the right to protest to prevent an outpouring of anger onto the streets as the country begins to emerge from lockdown.

The disruption to people’s lives caused by the government’s failure to listen is much greater than the temporary disruption caused by a demonstration.

Restriction of the right to protest historically arises from increasingly authoritarian governments to quell public unrest, it has no place in a democratic society.

The outrageous jail sentences proposed, of up to ten years for toppling a statue, will disproportionately affect the rights of marginalised communities such as migrants to protest as they can be deported if given custodial sentences of more than one year. This Bill will effectively silence them.

This Bill must be defeated and the right to protest and freedom of speech preserved for today and for future generations.

The data is clear: front-line essential workers should be vaccinated now

“These are the sickest, the ones where over 40% will die……It’s the Uber driver, bus drivers, restaurant workers, delivery people, security guards.  People think its old people dying.  Everyone I’m looking after (in ICU) is in their 50’s and 60’s.”

These are the words of Dr Helen Simpson, Consultant Endocrinologist, who is volunteering in UCH Hospital Intensive Care Unit, quoted in the Guardian on 12 February 2021.  Her words reflect what we have now long known about the pandemic: front-line essential workers, those who have kept the country going throughout, are much more exposed to Covid-19 and are dying at disproportionate rates than other workers. 

The ONS recently released its updated report on Covid-19 related deaths by occupation (up to 28 December 2020).  It paints a stark picture of high death rates for essential workers, who have had to go to work, many times higher than others who are able to work from home, such as senior managers, directors and professionals. 

The ONS report is timely: it was published 2 days before the Joint Committee for Vaccination and Immunisation (JCVI) published its strategy for vaccinating the country against Covid-19, which has been endorsed by the government.  Because of the initial shortage of vaccines, and the logistical challenges of vaccinating the entire adult population, the strategy is quite rightly based on prioritising those at greatest risk of dying.  Age by far the greatest risk factor: people over 70 are at very high risk while those over 80 are at extremely high risk.  Care home residents are a very high priority, as they are at very high risk.  Health and social care workers have also been allocated high priority – they are at high risk of exposure to infection and of spreading the infection to those they care for.  Next in line are those who are “clinically extremely vulnerable” (CEV), people with serious medical conditions such as cancer, immune disorders, organ transplants and severe disease of vital organs.  The rationale for this is that CEV people have about the same risk of dying from Covid-19 as do people aged 70-79, from data from the first wave last year, according to the JCVI.

At the time of writing the vaccination programme has been very successful to date; it has vaccinated the great majority of people in the above categories, so called groups 1-4 of the JCVI priority list.  However, it is very concerning that the rate of vaccination of BAME people within groups 1-4, is much less than the rate for whites, i.e. about half in some ethnic groups.  BAME people are at considerably higher risk of dying of Covid-19 so this is especially worrying. 

We are at the point now of beginning to vaccinate the next two priority groups in the JCVI’s list: group 5, who are people over 65 years of age, based on their “absolute increased risk” which is considered to be higher than the risk for those who have underlying health conditions, who constitute group 6.  Groups 7, 8 and 9 are people aged 60-64, 55-59 and 50-55 years respectively.  The rest of the population will be vaccinated after this.

The table below shows the priority groups, and the number of people in each group:

The problem is that when it comes to essential workers, the JCVI abandons the methodology of determining priority according to absolute increased risk of death.  According to the death rates in the ONS report, many groups of essential workers have much higher absolute death rates than both people aged 65-69, and those aged 16-64 with underlying health conditions.  This is especially true of male workers, while women working in essential jobs have risks roughly equal to those in priority groups 5 and 6.  Some women workers however, ie, machinists in garment factories, have four times the average death rate.  The graphs below illustrate the various deaths rates. 

Please note health and social care workers, who are at high risk, are not included as they are already in the first four priority groups of people being vaccinated.

Death rates for essential workers (men) *

(average rate is in purple on right)

Death rates for essential workers (women) *

(please note the different Y-axis values, i.e. half of that in the graph for men)

*ONS occupational categories are broad, for a detailed breakdown see here

JVCI has the following to say about occupational vaccination:

The committee considered evidence on the risk of exposure and risk of mortality by occupation. Under the priority groups advised below, those over 50 years of age, and all those 16 years of age and over in a risk group, would be eligible for vaccination within the first phase (i.e. all 9 priority groups) of the programme. This prioritisation captures almost all preventable deaths from COVID-19, including those associated with occupational exposure to infection. As such, JCVI does not advise further prioritisation by occupation during the first phase of the programme.

Occupational prioritisation could form part of a second phase of the programme, which would include healthy individuals from 16 years of age up to 50 years of age, subject to consideration of the latest data on vaccine safety and effectiveness.

This is moving the goalposts.  JCVI cannot on the one hand argue that absolute risk of dying should determine priority when this is due to age and underlying medical condition, and then on the other hand say that risk of dying does not apply when it is due to occupational risk.  The reasons behind the high death rates are surely irrelevant in terms of determining who gets priority for vaccination.  If we are vaccinating people according to risk of dying, that is what we should be doing, across the board.  The “first phase” referred to in the above quote, includes all 9 priority groups, and yes it will ultimately cover almost all preventable deaths (because it covers the great majority of the at-risk adult population i.e. over 38m people), but this will take many more weeks.  One could apply the same logic to those with underlying medical conditions and advanced age, and say, “Don’t worry once we have vaccinated everyone over 50, you will also be covered, we don’t need to prioritise you”.  That would clearly be nonsensical.

Many essential workers have death rates more than double those of people with underlying medical conditions and well in excess of people aged 65-69.  It also cannot be right that a worker in a processing plant, and a senior manager or professional of the same age, have the same priority for vaccination, when the worker has over six times the risk of dying from Covid-19.  Many essential workers are poor and many are black or Asian and it is striking that this double standard is being applied to them.  One cannot imagine company directors and stockbrokers not getting vaccine priority if these death rates were reversed and they were the ones dying disproportionally from Covid-19.

The news that people with learning disabilities have now been prioritised for vaccination by the Joint Committee on Vaccination and Immunisation (JCVI) is to be warmly welcomed (Guardian 25 February 2021).  The JCVI has done so “to ensure those most at risk of death or hospitalisation are prioritised” according to its statement, and a government source is quoted as saying “this is ultimately about who most likely to get seriously ill and die from this disease”.  Why then have the JCVI and the government at the same time once again ruled out prioritising essential workers for vaccination, when their risk is also very high and certainly much higher than many people in groups 5 and 6 of the JCVI priority list who are now being vaccinated? 

An equitable prioritisation programme of vaccinations demands essential workers should be immunised as the next priority group.

There are in addition several other important reasons for prioritising essential workers: 

  • While clear evidence of reduced transmission following vaccination is not yet available, early indications are that the vaccines do reduce transmission which is very much the hope of all of us, including the JCVI.  If this does prove to be the case, immunising essential workers will have a greater impact on reducing transmission, because they are much more likely to live in overcrowded housing, and deprived communities where social distancing and other mitigation measures are more difficult.  In addition, the more essential workers are protected the less transmission there will be in their workplaces which may be high risk, such as meat packing plants and garment factories.
  • Although the great majority of deaths have been in people aged over 50, there have still been several hundred deaths of those under 50, and many thousands of Covid-19 infections in this age group, 5-10% of whom will have progressed to suffering debilitating Long Covid. 
  • There also appears to be a clear impression amongst front-line clinicians like Dr Helen Simpson that younger patients are getting sicker in the second wave, perhaps linked to the greater transmissibility and virulence of the new mutations.  There is no data yet on this, but there have been a number of similar reports of patients in their 40s and 50s in intensive care recently.
  • It will take many more weeks to vaccinate another 25m people, by which time many thousands of new infections will have occurred among essential workers because of their greater exposure, both to the public as part of their jobs, and/or to their fellow workers because of the nature of their work, and it must be said, poor compliance with health and safety requirements in the workplace by employers.  Every week the PHE weekly surveillance report notes scores of outbreaks in the workplace; in the first week of February 2021 there were 112 workplace outbreaks reported to PHE.
  • As noted above many essential workers are black or Asian and priority for vaccination would go a long way to protecting their families, especially those in overcrowded multi-generational households and the local community from the virus.  This would be a very concrete way of addressing some of the large disparities in deaths suffered by black and Asian people, and send a clear signal that their lives matter to all of us.
  • A nationally recognised campaign to immunise all essential workers would also make it plain to everyone, our collective appreciation of the role they have played throughout the pandemic on the front line, in ensuring that there is food, transport and essential services for all of us.  Many essential workers are poorly paid and many are in precarious employment; offering them early protection against the virus would ensure they could continue working safely without putting the families and colleagues at work at risk.
  • The recent report by the Joint Biosecurity Centre (JBC) states there is a “perfect storm” of factors, resulting in stubbornly high infection rates, which applies in deprived areas of the country: low wages, cramped multigenerational housing, failures in the test and trace service, lack of support for isolation, and public facing jobs.   These factors are not going to be corrected any time soon, and vaccination would offer protection to these vulnerable workers and their communities. 
  • Without prioritisation, and a publicity campaign, many essential workers will end up not being vaccinated for all the usual reasons: poverty, reduced access to health care, language difficulties for many, etc.  For once we could ensure that the “inverse care law” (those most in need get the least care) does not apply.

26 February 2021

References

Occupational risk

Age

Learning disability risk

Different figures have been published for death rates, but a government review of Covid-19 deaths of people with learning disabilities published in November 2020, stated an age and sex standardised death rate of 6.3 times the general population during the first wave of the pandemic.  Black and Asian people with learning disabilities appear to have twice the death rate of white learning disabled people.  The ONS recently reported the risk of death involving COVID-19 was 3.7 times greater for both men and women compared with people who did not have a learning disability, for the period January to November 2020.  An average figure of five times the average risk has therefore been used for men and for women.

Risks for diabetes, COPD, hypertension and obesity have been calculated from the following sources and multiplying by average risk.

Diabetes risk

Hypertension risk

COPD risk

Obesity risk