NHS trusts are spending millions of pounds outsourcing staff to new arms-length private companies, research has revealed.
A Freedom of Information (FoI) request by Unison showed that trusts in England are "shelling-out" huge amounts of money on consultants.
Companies are advising trusts on the setting up of wholly-owned subsidiaries, to which staff are then outsourced, said the union.
Unison said the new companies appeal to NHS trusts because they can reduce their VAT payments, and cut the pay and pensions for any new staff.
Health workers being transferred tend to be the lowest paid, such as porters and cleaners, said Unison.
Only 21 out of 31 NHS trusts approached by Unison complied with the FoI request but the amount spent by 15 of them is already more than £3.2 million.
Topping the list of high-spenders is Clatterbridge Cancer Centre in Birkenhead, which spent more than £661,000 establishing a wholly-owned subsidiary.
The Royal Free London NHS Foundation Trust and Gloucestershire Hospitals Foundation Trust have both already spent a minimum of £400,000 setting up subsidiaries.
And Airedale NHS Trust in Yorkshire spent an estimated £343,000 outsourcing staff, said Unison.
The union's head of health Sara Gorton said: "The amount of public money being frittered away on transferring NHS staff to private companies is a disgrace, especially at a time when there's such a huge squeeze on resources.
"These wholly owned subsidiaries are creating a two-tier workforce where new staff are likely to be far worse off in terms of their pay and pensions.
"There is also no evidence that these new companies improve efficiency or productivity.
"Porters, cleaners and other staff chose to be part of the NHS team, not to be contracted out and treated like second-class employees."
The research was published at Unison's annual health conference in Brighton.
Shadow health secretary Jonathan Ashworth said: "It makes no sense whatsoever that NHS trusts are spending so much money transferring their own staff out of the public sector.
"This transfer of staff to effectively private companies amounts to a back door privitisation and creates a two tier workforce with fair pay and conditions undermined. Ministers should block this process now."
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