HC Deb 20 February 1957 vol 565 cc431-4
The Prime Minister (Mr. Harold Macmillan)

With your permission, Mr. Speaker, I wish to make a statement on the remuneration of doctors and dentists in the National Health Service and in the employment of local authorities.

The House will know that a claim has been submitted for an increase of 24 per cent, in the remuneration of all doctors in the National Health Service. The extra cost to the country would be about £20 million a year. In present circumstances, the Government do not feel able to admit this claim, and representatives of the profession have been so informed.

This does not mean that the Governmnet have reached any conclusion as to the merits of the claim. Indeed, they have decided that the time is opportune for a full review of medical remuneration through an independent inquiry which would take into account the position of the medical profession in relation to other professional classes in the community, and would suggest how the matter could be kept under review.

I have accordingly recommended to the Queen, and Her Majesty has been graciously pleased to approve, that a Royal Commission should be appointed for this purpose.

Within the last few days a claim, similar to that of the doctors, has been received on behalf of the dental profession, and the dental profession will be included in the review to be conducted by the Royal Commission. The question whether the remuneration of doctors and dentists employed by local authorities should be included in the terms of reference is under consideration.

I will announce at a later date the names of the chairman and members of the Royal Commission, together with the terms of reference.

Mr. Gaitskell

Would the Prime Minister clarify the position? How long does he expect it will be before the Royal Commission reports? Is it to be in the nature of an arbitration tribunal which is to pronounce upon the claim? If so, are we to understand that the Government bind themselves in advance to accept whatever recommendations are made by the Royal Commission? Will the terms of reference include specialists as well as general practitioners? Finally, will it be within the terms of reference of the Commission and within its powers to recommend back-dating the award, if there is an award?

The Prime Minister

It will, of course, be in the power of the Royal Commission to recommend that any award or any proposal should be made retrospective, but we must await the recommendations of the Royal Commission on that point. The terms of reference will include the specialists.

I believe that the character of the Royal Commission will be best set out in detail when I am able to present both the names of the members and the precise terms of reference, but I think it is generally agreed that it would be a good thing if the relation of this profession with other professions could be established and if a satisfactory system could be laid down by which future reviews could be carried out from time to time. I think it would be to everybody's benefit if that resulted from the Royal Commission?

Sir I. Fraser

While welcoming this proposal, may I ask whether the remuneration of medical auxiliaries, such as physiotherapists, radiographers and others who work so closely with the medical and dental profession, could be included in the Commission's considerations?

The Prime Minister

I should prefer not to answer that today, but to take it into account when the terms of reference are settled.

Sir I. Fraser

Thank you.

Mr. H. Morrison

Does not the Prime Minister think that this is a very doubtful way of seeking to settle wages, salaries and remuneration? Does it not take negotiation, from the taxpayer's point of view, out of the hands of Ministers who are responsible to the House and put it in the hands of an outside body? Is it not unlikely to lead to co-ordinated responsible decisions? Does the Prime Minister recall—I admit that this happened under the Labour Government—that the Spens Committee, dealing with somewhat similar circumstances, landed the country into an expenditure and into repercussions which were very embarrassing?

The Prime Minister

This is a very difficult problem, but I feel that the work of the Royal Commission on the Civil Service, which is not quite similar but is somewhat parallel, has been an advantage. Again, it was a question in which Ministers were finally responsible, as they will be in this matter, but I think that it has been an advantage in the general life of the Civil Service. If some equally good results followed from this Royal Commission, I think it would be generally acceptable.

Mr. Nabarro

While wishing warmly to congratulate my right hon. Friend, may I ask him to make it perfectly clear, in framing the terms of reference for the Royal Commission, that a primary purpose should be to endeavour to eliminate all the legal and other uncertainties which have arisen during the last few years from the Spens Report and the Danckwerts Award made under it, all of which are responsible for the present difficult position with the doctors?

The Prime Minister

One of the purposes of the Royal Commission will be to clear up this situation and to lay down a system which, through the years, will be more workable and more acceptable.

Dr. Summerskill

As this is virtually a repudiation of the recommendations of the Spens Report, could the Prime Minister say what was the reaction of the professional organisations towards this new suggestion?

The Prime Minister

No, Sir. The discussions between the representatives of the profession and the Minister of Health are another matter. Today, I have simply preferred to confine myself to stating that I have recommended the appointment of the Commission, that Her Majesty has been pleased to accept the recommendation and that the terms of reference and the membership will be announced. I think that all the detailed questions had better be put to the Minister responsible.