The effect of compulsory competitive tendering in three Scottish hospitals domestic services on patients and staff.

Cumming, Morag

Abstract

The main rationale behind this research is the circular 1983 (GEN) 13 - 'Use of contractors in the NHS' - in which the government set out their policy on the use of the private sector for the provision of domestic, catering and laundry services. The stated main objective of this exercise was to obtain better value for money from available resources by being more cost effective and efficient. The arguments for the introduction of competitive tendering in Scotland were substantiated by figures showing significant savings being made in England and Wales; moreover, money was, according to government claims, being ploughed back into medical services. The net effect of competitive tendering on patients and staff is more difficult to assess. Work by Kelliher (1987) and Edwards (1990) indirectly but strongly suggests that there is an effect (mostly detrimental) on staff and patients when a domestic services contract goes out to tender. Changes in working practices and conditions of employment occur whether the contract is won out-house or stays in-house. Neither author, however, explores the overall effect of competitive tendering on patients and staff. In particular, there are implications for patients in long-stay hospitals, where a great deal of their time may be spent on the ward, following a set routine in familiar surroundings. Studies in the past have been undertaken to determine patient views (see for example Harrison 1986) and certainly the Griffiths report on NHS management gave force to the belief that the views of patients should be actively solicited. Further studies (see for example Green 1988) suggest that the role of the ward domestic is much more important than just carrying out a cleaning function and that to change or minimalise the job would have a detrimental effect on the welfare of patients. This raises a number of questions which form the basis of the research: 1) What effect has tendering had on staff and can this be measured through levels of absenteeism?; 2) What have been the changes in remuneration and working conditions as a result of competitive tendering?; 3) What has been the effect on the quality of the service provided?; 4) What has been the effect of these changes on patients? Three hospitals agreed to collaborate in the study. The three hospitals were selected for the study based on their location, specialisms and demographics. The thesis is structured topically, in a way that helps to answer the research questions. The topics are: finance, user attitudes, changes in remuneration and working conditions, and quality control.

Citation

CUMMING, M. 1994. The effect of compulsory competitive tendering in three Scottish hospitals domestic services on patients and staff. Robert Gordon University, MPhil thesis. Hosted on OpenAIR [online]. Available from: https://doi.org/10.48526/rgu-wt-2807343

• Thesis Type: Thesis
• Deposit Date: Aug 6, 2025
• Publicly Available Date: Aug 6, 2025
• DOI: https://doi.org/10.48526/rgu-wt-2807343
• Public URL: https://rgu-repository.worktribe.com/output/2807343
• Award Date: Dec 31, 1994