Circulated in <a href="https://www.vitalsignsmag.org/posts/vital-signs-no-6">Vital Signs no.6</a>, amongst colleagues at Southmead and the BRI&#8230;
Have you ever worked in receive and distribution (R&amp;D)? It’s quite mental, as so many deliveries arrive each day. Each packet has to be opened, the content compared with the invoice, then each individual delivery has to be entered into the computer system and an additional form has to be attached to the parcel. This is done by four, five guys standing at a large table all day. Some departments order literally five screws or similarly small amounts, meaning, the volume of deliveries is massive. They then have to be sorted according to destination within the hospital and delivered there. The work volume has intensified even more since the opening of the Bristol Surgical Centre on campus, as many items have to be shipped back and forth. It’s pretty much non-stop, so you definitely need a little breather, a little break. 
A few months ago, management decided to take away the ‘unofficial’ tea break of 15 minutes, because some people were allegedly ‘abusing’ it. Whether this is true or not has to be dealt with within the team of R&amp;D workers themselves. The main question that is relevant for most workers in the hospital is:
Can management just take away an ‘unofficial’ tea break?
Management usually says that these kinds of breaks are ‘discretionary’, meaning voluntary, and can be taken away again by management decision. Slow your horses, boss! If you have had an extra break every day for a considerable period of time, you become entitled to this break even if it is not ‘official’, meaning, if it is not part of your formal work contract. This is called ‘custom and practice’. If there is a regularity and mutual agreement, e.g. that all workers get off earlier on a Friday, or a certain bonus for Christmas, you develop a right to such things, even if they are not written down anywhere. But as usual, rules and regulations can be interpreted in all kinds of ways, so in the end it’s a question of collective pressure: do we let management take away our deserved break, or not! 
Has anything like that happened to you before?

Hands off our tea break! – News from Receive and Distribution at Southmead hospital

This article has been published and circulated amongst our fellow hospital workers in <a href="https://www.vitalsignsmag.org/posts/vital-signs-no-6">Vital Signs no.6</a> &#8211; feel free <a href="https://www.angryworkers.org/contact/">to donate</a> for printing costs.
In October 2025, top managers at Southmead hospital sent out an email to all staff saying that they had a great time during a visit of Army Reservists, which “brought great energy and enthusiasm”. The visit was about providing insights for the army about how a civilian hospital works. Management also allowed the army to put up a recruitment stall in the atrium. 
The collaboration between North Bristol NHS Trust (NBT) and the army goes further. There are regular ‘joint mentoring programs’, organised by NBT, the Ministry of Defence and DE&amp;S (Defence, Equipment and Support). Over eight months civilian and army medical staff share ‘transferable skills’, so far over 140 people took part in these programs. “The DE&amp;S and the NHS are unique organisations that exist in complex worlds,” says Tim Whittlestone, Deputy Medical Director at North Bristol NHS Trust. “Let’s share our experience to create resilient and powerful managers.”
What’s the problem with this collaboration?
These announcements speak about ‘skill sharing between communities’, which sounds all lovey-dovey, but what kind of ‘community’ is the army? We live in a social system where regular economic crises constrict markets and increase the competition between nation states. We first see ‘trade wars’, such as the putting up tariffs, often followed by real wars. In the last century this led to two global massacres, killing 70 to 80 million people. We are currently heading towards a situation of global war, again. 
Politicians find all kinds of explanations (“We want to defend democracy and western values”), but when it comes down to it, it is about sphere of influences, access to resources and future profits. At least Trump is honest when he grabbed the oil in Venezuela or wants to annex Greenland. The UK army was part of a military mission in Iraq in 1991 and 2003 that was based on the lie of “getting rid of weapons of mass destruction.” This military mission and its consequences ended up killing tens of thousands of civilians. 
We currently see a global arms race, led by the US, which will spend over a trillion US-Dollar on military defence in 2026. It is clear that they pay for this by cutting our income and welfare, such as health and education. The current war in Iran and the Middle East will hike our costs of living. The governments have nothing positive to offer us anymore, so they use external enemies to maintain their power, whether in Russia or Ukraine, whether in China or the US. They want to normalise this process of militarisation by encouraging more exchange between the army and ‘the people’.
The role of the health sector in wars
The health sector plays a particular role in modern mass wars. During the current war in Ukraine, both armies face a lack of man-power, of soldiers. They offer higher wages for poor folks to join the forces or use brute force to conscript young men. Still, all these measures would not be sufficient to staff the frontlines. They need a vast medical infrastructure to patch up injured soldiers. The priority is not to help those who have the worst injuries, but those who can possibly be returned to the front line &#8211; which they call “reverse triage”. At the same time they close thousands of hospital beds and services for civilian patients, at a time when the war creates fertile conditions for new pandemics. 
We won’t collaborate in this drive towards death and destruction, propelled by a system of power and exploitation that is in a deep crisis. When we asked our trade union branch office bearers to officially oppose management&#8217;s pro-army activities they didn&#8217;t want to do that. We call our working class brothers and sisters in the army to refuse being instrumentalised and maimed for the interests of the rich and powerful. We refuse to normalise ‘the army’ in our daily lives, be it in schools, where they pry on working class kids, or in our hospitals, where the re-armament sucks resources away from patients.
No penny, no paramedic for the bosses’ wars! No army collaboration at NBT!

Army recruitment stalls in Southmead hospital – Thanks, but no, thanks!

I work in surgical theatres in Bristol. The other day, a representative of a private company was hanging out in one of our theatres. That in itself is not unusual, we often have company reps explaining to nurses and even surgeons how to use their new instruments, equipment or implants. This representative came with a cooled box, delivering a particular bone donation, flown in just-in-time from the USA. His company is called RTI Surgical and is one of the world’s biggest tissue and bone donation corporations. I wasn’t aware of the fact that we receive donations from the ‘private sector’, so I spoke to a fellow nurse about it. She told me that one of the reps had mentioned that they receive a fair amount of donations from the prison system. Not wanting to rely on rumours I tried to find out more.
RTI Surgical and problematic donations from Ukraine and beyond
RTI Surgical has many local and international suppliers of tissue and bone donations. The company makes 280 million USD revenue and supplies hospitals in 30 countries. In 2008 it bought the German company Tutogen Medical, which was involved in various legal proceedings around unethical donorship in Ukraine. Families in Kiev complained to police in 2005 that a morgue supplying Tutogen was taking tissue without proper consent. Three years later Ukrainian police investigated another Tutogen supplier in central Krivoy Rog. Families claimed they were tricked, pressured or threatened into consenting. Police said in some cases signatures had been forged. Records show the company has offered Ukrainian tissue to hospitals in New York. Only in 2012 RTI Surgical decided to withdraw from the market in Ukraine. 
In 2012, further issues were raised against one of RTI Surgical’s former US-based suppliers. Michael Mastromarino, a former dental surgeon from New York now serving a prison sentence, supplied the company with tissue from more than 1,000 cadavers. In every case, the consent documents were forged. In most cases information about next-of-kin and physicians were fictitious. In some cases the bodies were infected with cancer, HIV or Hepatitis.
Not Squid Game, but the US prison-complex
After the colleague told me about the alleged use of donations from US prisoners I read up on the matter. In general the situation is not very transparent, e.g. only 40% of prison systems having accessible policies. In most US states prisoners cannot donate tissue or organs while being incarcerated, but some states have passed new laws that open the prison complex for the donor market. 
In 2023, legislators of the Democratic Party proposed: “The Bone Marrow and Organ Donation Program shall allow eligible incarcerated individuals to gain not less than 60 and not more than 365 day reduction in the length of their committed sentence in [prison], on the condition that the incarcerated individual has donated bone marrow or organ(s).” Also the state of Utah liberalised the use of prison donations in 2012. 
We know that it is fairly easy to end up in a US prison if you are poor and even easier if you are poor and black. We know that many multi-national companies already make profitable use of prison-labour, such as Boing, Walmart or McDonalds. We know that there is little freedom of choice once you are in prison and that prison sentences are often arbitrarily extended. We, as NHS workers, should know whether our trust is in any way involved in all of this.
A wall of silence
To be clear, I don’t know whether RTI Surgical receives prison or other unethical donations. As a theatre worker who has to handle donations, I asked the manager of our theatres if she knows more about the connection between our Trust and RTI Surgical. The manager said that they did not and suggested a Freedom of Information Request. I issued the first request to the Trust in July 2025, but received no response. I issued a second request a month later, but they only replied that the Trust has no relations with RTI Surgical. I sent them the exact date and patient details of the surgery where the RTI material was used, but received no reply. I wrote to RTI Surgical directly and asked whether they receive donations from the prison system, but no reply. I wrote to the head of nursing of the Trust, no response.
Our social responsibility as workers
According to the current system we have no say in how we produce things and what we produce. We are forced to sell our labour power to pay our bills and the companies that buy it can do as they please. This puts us in a difficult spot. Officially powerless, it is still us who make the whole system work, who produce all those things, whether harmless or deadly. Recently, more and more workers have become aware of this dilemma. 
In France, workers of <a href="https://www.labournet.tv/en/videos/grenoble">ST Microelectronics in Grenoble</a> went on strike against the use of their micro-chips in the Israeli war machine. They went on strike to enforce that they are informed about where and how the micro-chips they produce are used. In <a href="https://www.labournet.tv/en/videos/blocchiamo">Genoa and Marseille</a>, dock workers refused to load and unload ships that carried arms. In the USA, tech workers at Google and Amazon protested against the use of their software for military or surveillance purposes. Currently the UK government wants to outsource NHS data processing to the <a href="https://nopalantir.org.uk/">US company Palantir</a>, which also supplies the war machine that commits genocide in Gaza. 
Together, as NHS workers, we can question this! This is the power we have to influence what is happening. As you were able to gather from this article, as long as we are alone it is difficult to find out even basic information &#8211; but if we get together we can take on responsibility for the world we live in.

Dicey donations for surgical theatres?

If the idea of robots taking our jobs wasn’t bad enough, now they want us to keep the robots running for nothing! 
The NHS maintains a service of volunteers, particularly in hospitals. These tend to be retired individuals with some sort of affinity toward the NHS, and often fill purely non-clinical roles such as meeting and greeting, signposting or ferrying patients down the cavernous halls of a hospital in an airport transport buggy. At UHBW management is currently piloting a new End of Life Care Volunteer Service. While we can all agree that palliative and EOL patients don’t get enough care in the current staffing situation, we don’t think that this is a job for volunteers. It’s a job that requires proper training and proper payment.
Sometimes, however, managers request volunteers for other purposes. Against the background of increasingly squeezed budgets, with Trusts cutting jobs, withholding pay rises and constantly seeking efficiencies, management realises that they might be able to fill gaps in staffing with volunteers. At NBT, there was a recent attempt to do just this. A job description was sent out to the Joint Consultative Negotiating Committee – a forum where the Trust consults with Trade Unions – for a volunteer position inputting stock and medicines into the pharmacy robot.
In pharmacy, thousands of pounds worth of medicines are received each day and a huge amount of this stock is fed into a robot which stores the stock and then releases it when required by a pharmacy worker. Filling this robot is a massively time consuming, repetitive, manual job. The stock must be individually scanned into it using unique QR codes so that the robot can register each input and storage location for timely release on request.  
Up until this point, the job of filling the robot has always been a part of a paid role. Due to a disconnect between management’s idea of adequate staffing levels and the reality of the volume of work, the department have been struggling to transfer stock into the robot after receipt quickly enough. The solution, according to the management of the area, is to get someone to do it for free! 
The job role was challenged at the JCNC and has been withdraw, but it raises a wider question. What other roles could management try to get volunteers to do? 
The UK has recently agreed to pay more for pharmaceuticals, bowing to pressure from big pharma companies and the US. The Trusts in Bristol already spend around 1/5 of their budgets on drugs. Instead of challenging big multinationals, the government seems more interested in directing anger towards migrant brothers and sisters who come to the UK to work and live and promising billions in funds for re-armament. This extra money is going to be squeezed from us workers if we don&#8217;t push back. For a longer conversation of pharmacy workers, click <a href="https://www.vitalsignsmag.org/posts/chemical-brothers-conversation-of-three-pharmaceutical-workers">here</a>.
Robots, automation, artificial intelligence, bring it on! But only if it reduces the working hours for everyone and increases our living standards! This will only happen if<a href="https://www.vitalsignsmag.org/posts/thoughts-for-a-working-class-revolution"> we defeat the capitalist class</a>!
&nbsp;

Hands off our tea break! – News from Receive and Distribution at Southmead hospital

Share this article:

Read Next:

Army recruitment stalls in Southmead hospital – Thanks, but no, thanks!

Dicey donations for surgical theatres?

The pharma robot and the volunteer