The road to privatization is rarely straight. While we often think about the public employer/private employer dichotomy as “public good, private bad,” when it comes to unions, the reality is much more complicated.

While public-sector workers typically have an easier time organizing than those in the private sector, employers in both sectors have no incentive to improve pay or working conditions without pressure from workers. Even in the United Kingdom, where public employment contracts are often negotiated nationally and unionized private companies often use national framework agreements, without workplace power, employers are left to reduce pay and conditions as they wish.

As support services in health care have been privatized in Britain, support workers in public hospitals have become increasingly likely to work for private employers. Yet despite this process, some workers have built workplace power and revitalized their union locals, forcing private employers to raise working standards.