12. Using leverage: how to approach employers
NHS trusts and public sector employers
NHS trusts and public sector employers usually have formal structures for union dialogue. This creates opportunities to build relationships, influence policy, and support migrant workers visibly. The key for union reps and officials is to be present and proactive – attending inductions, building peer-led organising, and working with HR to ensure cultural and legal support for new staff. Established staff forums can also be a route to affect change, and / or create spaces for migrant workers to gather.
Local authority-commissioned providers
These vary in size and quality. Some are large and unionised; others are small and under-regulated. Where migrant workers are at risk, it’ s often safer to work indirectly through the commissioning authority. UNISON branches have used this strategy successfully – working with councils to demand better standards and enforcement.
Private care homes and agencies
These providers are often the least transparent and provide the most precarious conditions. Direct confrontation can be risky, especially where workers are tied to sponsorship or living in employer-provided accommodation. Quiet organising, evidence gathering, and escalating issues through regulators such as the Care Quality Commission( CQC) or care commissioners, if relevant, is often safer( for an example of organising a care home see Chapter 13).
“ Some providers respond to pressure. Some only respond to their commissioner.” – UNISON branch secretary
Recruitment agencies
Some overseas recruitment agencies are responsible for putting workers into a form of debt bondage by charging high illegal fees for training, travel and job placements. UNISON branches can campaign for councils and NHS employers to use only agencies on the NHS Ethical Recruiters List as a minimum – there is no mechanism currently to independently check the compliance of these listed agencies.
Naming and tracking unethical agencies can be a powerful form of pressure. If they are not upholding the basic rights of workers( see Chapter 5) they can be reported to the Employment Agency Standards Inspectorate( EAS).
Choosing your approach: direct or indirect?
There is no one-size-fits-all strategy. In some settings, it’ s safe to confront employers directly, especially where there are existing union relationships or routes
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