HC Deb 12 March 1957 vol 566 cc979-84
The Prime Minister

With permission, Sir, I will now answer Questions Nos. 45, 47, 55 and 57, which I was asked earlier this afternoon.

The Queen has been pleased to approve the appointment as Chairman of the Commission of Sir Harry Pilkington. With permission, I will circulate the names of the other members of the Commission in the OFFICIAL REPORT.

I will, if I may, recapitulate the main events that have led up to the appointment of the Commission. Last June, a claim was submitted for an increase of not less than 24 per cent. in the remuneration of doctors in the National Health Service. Apart from the very large sum involved, the Government felt that the claim raised important questions of principle which required further investigation. They therefore concluded that the general interest, including that of the professions concerned, would be best served by calling in the advice of an independent body.

It would, perhaps, be convenient to restate the terms of reference: To consider: —

  1. (a) How the levels of professional remuneration from all sources now received by doctors and dentists taking any part in the National Health Service compare with the remuneration received by members of other professions, by other members of the medical and dental professions, and by people engaged in connected occupations;
  2. (b) What, in the light of the foregoing, should be the proper current levels of remuneration of such doctors and dentists by the National Health Service;
  3. (c) Whether, and, if so what, arrangements should be made to keep that remuneration under review:
And to make recommendations. I have asked the Chairman to regard the work of the Commission as a matter of urgency.

I have already explained that the appointment of the Commission does not preclude an interim adjustment in advance of and without prejudice to its recommendations. The Government have already decided to make such an adjustment without delay in the remuneration of junior hospital staff, both medical and dental, up to and including the grade of Senior Registrar, all of whose remuneration will be increased by 10 per cent. from 1st April next. We are also considering what should be done by way of an interim adjustment for the other doctors and dentists covered by the Commission's terms of reference. I shall make a further statement on this matter in due course.

The Government are convinced that this procedure is a fair and proper one. They are also confident that with good will on all sides it should result in the position of the medical and dental professions in the National Health Service being placed upon a mutually satisfactory and lasting basis.

Dr. Summerskill

Can the right hon. Gentleman say whether this means that the Spens recommendations are to be entirely repudiated? Secondly, would the Government consider setting up some kind of arbitration machinery pending the final recommendations of the Royal Commission?

The Prime Minister

Neither of those conclusions is correct. The Spens decision will, of course, be within the terms of the Royal Commission to consider. With regard to any interim arrangement, I have already announced what we have decided to do in the case of the junior staff and I am saying that I am considering what might be done by way of interim adjustment for the other members covered by the Commission's terms of reference.

Mr. Bevan

Is the right hon. Gentleman satisfied that the terms of reference are wide enough to cover everything that really matters? For example, there appears to be no reference whatever to the easement now given to the medical profession by way of training, scholarships at universities, and things of that sort, which are a considerable advantage over the pre-war position. Is the Prime Minister quite satisfied that there is a sufficiently precise reference to assistants so as to enable their claims also to be considered?

The Prime Minister

I think the terms are sufficiently wide. They are, of course, a matter primarily for the Commission to interpret, but I do not feel that there will be any difficulty, although I have thought about that and discussed it. If there is any difficulty, of course we shall have to deal with it, but I feel that the terms, which are fairly wide, are wide enough to deal with all the relevant matters.

Mrs. Hill

When my right hon. Friend considers any interim adjustment to the salaries of general practitioners, will he take into consideration any rise that there may have been in practice expenses?

The Prime Minister

Perhaps there is some misunderstanding. My information is that there is a regular procedure by which an adjustment for practice expenses is made annually. I am, of course, speaking of general practitioners. That is a quite separate problem from their remuneration.

Mr. Wade

Does the Prime Minister agree that there is a strong case for something more immediate than the appointment of a Royal Commission? Does he agree that there has been considerable misunderstanding over the distinction between general medical practitioners and those on hospital staffs? What is in the Prime Minister's mind when he uses the words "in due course", which he applied to the general medical practitioners? Does he mean that there may be some adjustment at an early date?

The Prime Minister

I used the words "in due course" because all the other expressions seemed to be either unduly optimistic or unduly pessimistic.

Mr. H. Morrison

Can the Prime Minister say who the members of the Royal Commission will be? Surely they are not so many that he cannot name them now. It is rather important that we should know the balance of the membership.

The Prime Minister

I will read the list and, if necessary, give a very short description. The names are as follow:

Mrs. Baxter

Secretary to the Cambridge University Women's Appointments Board.

Mr. A. D. Bonham-Carter

A Director of Unilevers. Formerly Personnel Manager.

Mr. J. H. Gunlake

Vice-Chairman. Institute of Actuaries.

Professor John Jewkes

Professor of Economic Organisation. University of Oxford.

Mr. I. D. McIntosh

Headmaster, George Watson's College, Edinburgh. Was a member of the Committee on Recruitment of Dentists.

Sir David Hughes Parry

Professor of English Law, London University. President, University College, Aberystwyth.

Sir Hugh Watson

Deputy Keeper of Her Majesty's Signet.

Mr. Samuel Watson

Secretary, Durham Miners' Association.

Dame Irene Ward

Is it my right hon. Friend's intention to amend the Industrial Disputes Order, or will that also be included in the terms of reference?

The Prime Minister

I cannot answer that question without notice.

Mr. H. Hynd

Has the Prime Minister not omitted the Keeper of the Zoological Gardens from the list?

The Prime Minister

I can think of various doctors whom I could add.

Mr. Woodburn

Do the terms of reference include the doctors who are employed by doctors? There is a great problem there of assistant doctors and the various terms under which they are employed.

The Prime Minister

That will be for the Commission to interpret, but I have no doubt that it would be within its power.

Mr. Hastings

Does the Prime Minister realise the strong feeling that exists among all members of the medical profession, particularly the general practitioners, a feeling such as has not existed since the passage of the National Health Service Act? Will the right hon. Gentleman give instructions to the Royal Commission to issue an interim report with recommendations within a given time—say, three months?

The Prime Minister

I understand the hon. Member's feelings. I had considered that, but I thought it better to deal immediately with the case which everybody seemed to think was well made out—that of those of whom I have spoken who are to get the 10 per cent, as from 1st April—and to try to the best of my ability, in a matter to which I am devoting a good deal of attention, to reach an interim payment for the remainder and then to let the Commission produce a proper report as soon as it can. It would only complicate matters if we were to have in addition an interim report from the Commission.

Mr. Lipton

Will the Prime Minister bear in mind that there will be quite a strong case for back-dating the interim adjustment of pay for general practitioners to 1st April, as in the case of the hospital doctors where that concession is to be made?

The Prime Minister

I think that the hon. Member had better wait and see from what date it starts.

Mr. Emrys Hughes

In view of his long experience of this matter, why was not the Chancellor of the Duchy of Lancaster appointed to the Commission? Does the Prime Minister not realise that we would all be quite pleased to give the right hon. Gentleman extended leave of absence?

The Prime Minister

I think that my right hon. Friend is in a very good position to take an unbiased view of all these matters.