NHS bodies could be forced to provide paid cover for union activists under plans being considered by the government.
The proposal is contained in an imminent report from the taskforce on staff involvement, set up by former health minister Alan Milburn.
Unison head of health Bob Abberley, a member of the 13-member taskforce, disclosed the idea at the union's annual health conference in Brighton last week.
He said already hard-pressed staff currently had to work even harder to cover for lay officials when they took time off for trade union duties.
'I am encouraged because there is a recognition from the NHS Executive and the government that what time off means is putting someone on the ward to replace you,' he said.
The idea was supported by NHS Confederation chair of human resources Andrew Foster, another member of the taskforce.
He said the confederation would support the goal of 'a real partnership with staff' and that this was already happening in many trusts.
But he said there were resource issues if the idea was to work throughout the NHS.
'I think trusts should do it anyway, but it would be helpful if the government were to create a dedicated fund for it. They have still got£200m in the modernisation fund,' he said.
Health union MSF also told the taskforce that the NHS's 'expanding agenda' made it impossible for staff representatives to undertake the work needed 'to the quality required without sufficient time off, cover and support facilities'.
A survey of MSF health service representatives found 56 per cent expected their workload to increase despite the demise of local pay, and 66 per cent had difficulty meeting both their trade union and NHS duties.
MSF's national secretary for health, Roger Kline, called for a clear national statement on the role of local representatives and for trusts to be encouraged to establish human resources budgets to provide cover for appropriate jobs.
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