Unionisation options for lived experience workers

For any trade union members or individuals thinking about joining a union we certainly live in interesting times. After decades of declining union membership, the last year has seen a resurgence of militancy and renewed growth in people joining unions. From the railway workers to postal workers, teachers and university workers, nurses and ambulance/paramedic staff, and across countless other disputes, unions have shown a revitalised inclination to strike for better wages and improved conditions of work. The dam has burst on decades of pay restraint, job losses and precarity in the workplace. The media profile of unions hasn’t ridden so high since the 1970s, and articulate leaders like Mick Lynch of the RMT have shown themselves to be intelligent defenders of their members’ rights to decent work and respect. The appeal of joining a union has arguably risen alongside public appreciation for the legitimacy of union demands when compared with the busted flush of a government living on borrowed time.

Across history there have been calls for alliances between critically minded service user/survivor groups and health care workers or their trade unions. Though this has resulted in some marvellous solidarity and action from time to time, arguably some golden opportunities have been missed to strengthen and deepen this solidarity in an impactful way for mental health services and wider society. For example, in the 1970s the emergent Mental Patients Union made an application to join the Trades Union Congress but was turned down on the basis that it was not a union of workers. Contemplation of the different ways in which lived experience workers might become unionised, and hopefully gain power in the workplace, can open up further critical thinking about a politics of mental health and how this might be advanced by progressive trade unions. This blog makes a start of identifying some of the issues.

Lived experience mental health workers occupy a curiously complex place in the broader workforce of the welfare state. Undoubtedly, they share the same concerns as all workers for fair pay, decent conditions of work and job security. Yet, they often find themselves in strained relationships to other workers within the mental health system because of their unique personal circumstances tied to job role. This liminal positioning can generate unwarranted mistrust and even obstruction on the part of mainstream mental health workers. Such tensions arising from job role can complicate choices regarding which trade union to consider joining and subsequent intra-union relations, especially if individuals wish to become active within the union.

Lived experience workers will usually work in or alongside teams comprised of different mental health service disciplines, who will join unions deemed to best serve their work or professional interests or perhaps align with political aspirations. Most healthcare workers, for example, face a choice between an occupation specific union or a more general union. Hence, nurses might join the Royal College of Nursing, which recruits nurses only (but latterly includes nursing health care assistants) or they might join a union like Unison, Unite or the GMB which also organise a broader range of healthcare workers and workers in other public services or industries. Though not presently active so much in the NHS, there are newly emergent alternative unions including and often modelled on the International Workers of the World (IWW). These unions are often critical of an assumed bureaucratic inertia and democratic deficit within established unions and typically organise successfully amongst low-paid precarious workers, with some recent inroads into the social care sector. Interestingly, the IWW, known as the ‘wobblies’ famously held to the ambition of ‘one big union’ – the idea that workers should always seek to organise for solidarity across differences and industrial sectors – feeling this was the only way to ever fully realise worker power and objectives. The flip side of this is the view that separate unions can be divisive of broader interests and, for example, competition between unions for members is the enemy of the cooperation and solidarity necessary to win in the long term.

It would be presumptuous to make simplistic claims for what motivates union joining choices, but one possibility is that people who join general unions see the appeal of solidarity across different groups of workers and that these larger unions effectively wield more power. Often the choice of which union to join is based upon which organisations are most well organised locally. Other considerations include differences between unions regarding to established political affiliations and claims to wield political influence, largely through the Labour Party. Discipline specific unions have historically tended to focus on professional issues and have been, until recently, more cautious about supporting industrial action. The territory is further complicated by numbers of individuals who join more than one union. In addition to all of this, some of the general unions have relatively autonomous smaller ‘unions’ located within the broader union structure. In this way, mental heath nurses can join a Mental Health Nurses Association that is organised within Unite and the British Association of Occupational Therapists is a section of Unison. Arguably, despite some special historical circumstances that have formed these particular structures, it is not beyond possibility that a small-ish union for lived experience workers could be formed within the structures of larger unions or be formed independently and then seek to become subsumed into a larger union. Being part of the larger union would bestow certain benefits of scale and solidarity, whereas a small independent union would be more vulnerable and proportionally costly to organise, not least in terms of demands upon activists’ time.

The various unions that a lived experience worker might join have developed internal structures to better support different interests within the union. Most unions are organised into local branches, which are the most likely place an ordinary member would interface with the union. Branches must hold regular meetings for members, but in all honesty, in most places, branch meetings are seldom attended by anyone other than branch activists. Unions also tend to have a variety of regional level and national level structures and committees for driving forward the business of the union. Unison, the large public service union, has been commended by external commentators for its equalities structures. Different forums within the union have been developed as protected spaces for supporting the voice of specific groups who have notably been subject to workplace and societal disadvantage. These so-called self-organised groups are linked to branch level roles (e.g. Branch Women’s Officer, Branch Disabled Members’ Officer, or Branch Black Members’ Officer) and hold their own annual delegate conferences to agree policies and take policy motions to the overarching National Delegate Conference which is the supreme decision making body of the union. Similarly, different work sectors have their own branches and national conferences e.g. health, local government, community and voluntary sector. Thus, a lived experience worker within Unison might be employed by the NHS, so they would be in a health branch, or they might be employed by a social enterprise or voluntary sector organisation, so would be part of the union’s community and voluntary sector. As an individual, this person might identify as disabled, a woman, as an ethnic minority or be a young member – so could be active within one or more of these self-organised sections. Beyond this, within the health sector, different occupational groups have their own national committees e.g. nurses and midwives or ambulance and paramedic staff; though there is not yet an occupational group committee for lived experience workers, this could be a future possibility where it to be asked for within the union’s democratic processes. As such, there are different opportunities and potential opportunities for activism associated with lived experience roles to be taken forward within the union.

It is currently Unison policy to map lived experience roles, remuneration and further explore the potential for organising these roles within the union; this being decided at the last Health Conference because of a motion moved by the National Nursing occupational group which had been prompted by discussions with lived experience workers. The work to take this forward has been slow in being organised, largely because of broader organising issues and personnel changes within the union. The Nursing Committee remain keen to take this forward and committed to consult with lived experience workers and interested groups such as NSUN. This could be a golden opportunity for developing new opportunities for union membership and organising, with the promise to improve the material conditions of lived experience workers and, ideally, the esteem within which they are held by other workers. Beyond this, there might even be the potential to reinvigorate discussion and debate within the union about bigger issues framed by a politics of mental health, with lived experience worker activists in the vanguard of taking such matters forward.