Thousands of doctors and nurses will be sacked unless they agree to drastic changes to their pay and conditions as hospitals tackle an escalating funding crisis, it has been claimed.
A leaked document obtained by the Sunday Times outlines measures from 19 NHS bosses to maintain patient services in the face of multimillion-pound budget cuts.
Among proposals are the termination of all staff contracts and a reissue on different terms that could include pay cuts of up to 5%, an end to overtime for nights, weekends and bank holidays and reduced holiday leave, the paper said. Staff may also be forced to work longer shifts and sick pay rates could be cut, it added.
The NHS is being forced to make £20 billion savings, with average hospitals needing to save at least £45m over the next five years to avoid financial disaster.
It is reported 19 chief executives of hospitals in the south-west of England have set up their own organisation outside NHS structures to drive through the changes. The measures could affect more than 60,000 NHS staff, with about half of them medics, the Sunday Times said.
The nine-page document from the chief executives states that by co-operating they will be able to overcome an "extremely hostile" reaction to the steps they believe must be taken, especially if they take the "last resort" of sacking all staff and re-engaging them on less favourable terms, the Sunday Times reports.
Three London hospitals have just gone into administration. To avoid a similar financial catastrophe, hospitals in the South West are considering pay reductions on all staff earning more than £21,000 a year, "perhaps on a sliding scale with a 5% cut above a certain level of pay, for example £55k".
At least two other hospitals, in Surrey and Manchester, have floated plans to renegotiate staff contracts, the Sunday Times said. However, the chief executives in the South West believe that if hospitals "act in isolation" they will be "singled out" and unable to take on the trade unions.
A Department Of Health spokesman said: "NHS providers have long had the power to employ staff on such terms that they consider appropriate, including under the foundation trust laws passed under the previous government. This means employers are free to negotiate any changes to national agreements directly with staff locally or their representatives. We would expect NHS employers and trade unions to work together to ensure the national Agenda for Change pay scheme remains fit for purpose."
Shadow health secretary Andy Burnham said the cuts were a direct result of David Cameron's failure to honour his general election promise to protect spending on the NHS.