THE HEALTH SERVICES BOARD AND ITS COMMITTEES (Hansard, 19 November 1976)

§ The Secretary of State for Social Services (Mr. David Ennals)
I beg to move, That this House doth disagree with the Lords in the said amendment.

§ Mr. Speaker
I call attention to the fact that privilege is involved in this amendment.

§ Mr. Ennals
This amendment from the Lords is not acceptable to the Government. There is no need for the Health Services Board to be larger than the balanced membership of chairman and four members, as was provided for in the Bill to which this House gave a Third Reading by a majority of 24. That is a satisfactory size for the job the Board has to do.
Moreover, I have to remind the House that the principle on which this House gave this Bill its Second Reading and its Third Reading was that it embodies a compromise. That compromise was reached after lengthy and difficult discussions with the representatives of the medical and dental professions. The Government undertook to embody the terms of that compromise in legislation, and that 1716 the Bill does. The terms, published on 15th December 1975, included explicit provision for the constitution of the independent Health Services Board: a chairman and two members from the medical profession and two selected after consultation with bodies representative of the interests of other NHS staff and those representing the interests of NHS patients. That was what was in the Bill as it left this House, and it should remain.

§ Mr. Patrick Jenkin (Wanstead and Woodford)
It might be helpful if at the outset I were briefly to say a few words about our approach to today's debates. We shall be dealing today, if we can, with a large number of amendments on which there were tied votes in Standing Committee. Amendments were lost only by virtue of the Chairman's casting vote. When we debated these matters last month on Report, many of these amendments—more than 30—were never reached because of the operation of the guillotine.
A great deal of time has been spent in another place in debating the Bill, and many of the amendments on which there were tied votes in Committee and which were guillotined on Report in this House come before us again today to enable this House to reach a conclusion upon them. It is the constitutional duty of hon. Members to do their utmost to ensure that each of the amendments is the subject of a conclusive decision by the House and not to send the Bill back to another place, with whatever messages we prepare, with large numbers of amendments on which we have not reached a conclusion because of the operation of the guillotine.

§ Mr. Dennis Skinner (Bolsover)
In that case, because the right hon. Gentleman feels that all the available time is needed to debate matters in the Bill which, according to him, have not been properly examined, will he use every minute available to him today, Friday, under the terms of the guillotine?

§ Mr. Jenkin
The hon. Gentleman has misconstrued what I said. I said that it 1717 is important that the House should reach a conclusion upon the amendments Many of them are hotly contested, and it would be right that we should express our views in the Division Lobbies—and there will be a number of Divisions. The time for debate must be accordingly curtailed because of the guillotine. The hon. Gentleman is inviting me to let through the amendments without Divisions. [Interruption.] The hon. Gentleman is now inviting us to finish early.

§ Mr. Skinner
No—the right hon. Gentleman is.

§ Mr. Jenkin
No, I am not.

§ Mr. Speaker
Order. The hon. Member for Bolsover (Mr. Skinner) must not interrupt from a sedentary position. If he wishes to interrupt, he knows what to do.

§ Mr. Jenkin
I gave way to the hon. Gentleman—

§ Mr. Skinner
On a point of order, Mr. Speaker. It is fair to say that an hon. Member speaking from a sedentary position should on occasion be challenged if it is being done continually. I have been a Member for some time, and in the past six years I have heard many hon. Members make remarks from sedentary positions. In the past two days, in debates in which I took no part, there were literally scores of such interruptions. I wonder whether this is a new ruling that you have decided to make—

§ Mr. Speaker
Order. The hon. Member knows that this is not the first time I have had to tell him. I have told him before, as I have told the House, that interruptions from a sedentary position, especially when they are continued, as the hon. Member did three times, spoil debates in the House.

§ Mr. Jenkin
It is our intention to do our utmost to reach a conclusion on every amendment suggested by the other place. That will require a great deal of self-discipline on the part of myself and my hon. Friends, and I hope that Government Members will help the House to reach conclusions upon amendments on which this House has not had an opportunity to reach a final decision. That means that our speeches will need to be brief.
We have made no secret of the fact that we dislike the Bill intensely. We believe 1718 that it would be improved considerably if all the amendments from another place were accepted. The truth is, and it was made clear on Report in many speeches from below the Gangway on the Government side, that the phasing out of pay beds from our hospitals owes a great deal more to Left-Wing hostility to the professions than to any desire to help NHS patients.
In fact, the Bill is nothing more than the class war carried into law. The Goodman proposals had the effect of institutionalising this class war, and by what the Secretary of State calls a balanced Board of five members, two to represent the medical profession—and two to represent other interests, he is, in effect, institutionalising the continuation of this struggle that is such a source of bitterness and anguish within the National Health Service.
In another place Lord Wells-Pestell let forth an incautious statement about the Government's view of what the Board is supposed to be. After referring to the two members of the Board to come from the medical profession he said so there will be two members over whom, if you like, the Government will have no control at all."—[Official Report, House of Lords, 4th November 1976; Vol. 376, c. 1463] The implication of that is that the other three members, the chairman and two appointed after consultation with other interests in the NHS, will be those over whom the Government have control. That is totally unacceptable to us. We believe that it is a disastrous approach, and that it will perpetuate the conflict that has disfigured the NHS on this issue.
I hope that the House will be prepared to accept the amendments that have been passed to us from another place, that the number of the Board should be increased from five to seven, that there should be three representing the medical profession, that there should be one representing, as it were, the nurses and the other supplementary professions, and appointed after consultations with the appropriate organisations, that there should be one representing all patients, and that one other member should be appointed after consultation with the other interests.
Such a Board would be far more likely to reach objective and harmonious decisions and avoid the institutionalised class 1719 war that will be involved in the Board as we have it. I therefore invite my right hon. and hon. Friends to divide the House in favour of retaining the amendment and against the Government's motion.

§ Mr. Laurie Pavitt (Brent. South)
I shall respond to the request by the right hon. Member for Wanstead and Woodford (Mr. Jenkin) to be brief, because if he proposes to take us through the Lobbies 69 times today we shall need to keep our speeches to a minimum.
Reference has again been made to the fact that there were even votes in Committee upstairs. I put it to the House that if there are equal numbers on each side of the Committee there is no alternative to arriving at similar decisions on each occasion.
I shall not use the word "tedious" when I talk of repetition, otherwise I shall be criticising the Chair, but it is my contention that on this measure containing 24 clauses there have been more Second Reading speeches on amendments and on the Lords amendment than on any other measure that has come before the House.
The Board is part of a fine balance that the Government accepted—some of us thought wrongly—after it was put forward by Lord Goodman. It seems that their Lordships and the right hon. Member for Wanstead and Woodford are anxious to destroy that balance only when it favours their side of the case, but when my hon. Friends and I would like to see the terms of some provision as part of the compromise made a little stronger, Lord Goodman is the person whom the Opposition call in aid to oppose us.
Having seven members on the Board would make a nonsense of the delicate balance that has been struck of two in favour and two against separation, with the chairman independent. All of their Lordships' proposal would not improve the legislation, but would make a dog's dinner of it. There are more idiotic amendments to be Bill from the other place than I have ever seen, and if they were passed in toto they would make a nonsense of the Bill and of the Government's policies. Therefore, I shall vote with my right hon. Friend.

§ Mr. Skinner
You will recall, Mr. Speaker, that when the right hon. Member for Wanstead and Woodford (Mr. Jenkin) commenced his remarks on the amendment he referred to the generality of the Bill and the way in which it had been handled in both Houses. I intervened to ask what I considered to be a pertinent question, namely, whether the Opposition would use the real weapon available to them to oppose a measure, and that is to debate it properly. I wanted to know whether, on this Friday, an unusual day for Government business, with a three-line Whip in operation, the Opposition would use all the time allocated to them under the guillotine motion to tell the nation what they say on public platforms about the contentious nature of the Bill and the way in which it will be carried out in practice.
I get the impression, from my intervention and the subsequent sedentary interventions, which were not occasions for shouting slogans, or "Rubbish", but merely continued the argument, that the Opposition do not intend to use the time that is available to debate the Bill but intend, instead, to run way from the issue.
I want to place it on record that the Opposition have a duty to stand by what they continually say outside the House about a measure such as this. I get the impression—I put it no higher than that—that what they are really doing is attempting to fight the issue in this House without fighting to the extent of which they are capable, as will be demonstrated today and as has been demonstrated on previous occasions, and are instead using the other place, with its massive majority of Tory peers, to fight their battles for them.
I want to get it on record that although so-called fights are put up on occasions in the House of Commons on some of these contentious measures, they really are phoney, and that what the Opposition are doing all the time is avoiding the real opportunities for debate in this House and using the House of Lords to try to obstruct measures that have been accepted by the electorate and agreed to on numerous occasions by democratic votes in this House.

§ Mr. Ennals
I refer, first, to the point made by the right hon. Member for 1721 Wanstead and Woodford (Mr. Jenkin) about the comment of my noble Friend Lord Wells-Pestell. It was a little unfortunate that the right hon. Gentleman quoted something said by my noble Friend, when three pages later my noble Friend said that he did not recall using those words and immediately made it clear that what he was reported as saying was a slip of the tongue. The arrangement is that the chairman is independent, and there are four members of the Board, two from the medical profession appointed after consultation, and two representing other interests and also appointed after consultation and the Government have no control over any of them.

§ Mr. Patrick Jenkin
Would the right hon. Gentleman not agree that inadvertent slips of the tongue are often more indicative of intention than the carefully modulated phrases which one hears and which are shown in Hansard?

§ Mr. Ennals
I have heard the right hon. Gentleman say things that he regretted later. I at least give credit to my hon. and noble Friend for, immediately after it was drawn to his attention —[Interruption.] I hope that the right hon. Gentleman will listen because, with respect, he has raised this point with me. The right hon. Gentleman ought to show me the courtesy of listening as well as showing courtesy to my hon. and noble Friend who dealt with this in the other place. My hon. and noble Friend immediately took the opportunity of correcting this on the record. Sometimes if hon. and right hon. Gentlemen opposite were as courteous in doing so we would proceed better.
I think that it would be anvantageous if we had as many votes as we could. My wish today is simply to show that the issues that we shall be debating have been thoroughly debated in Committee and on Report. In Committee the amendments were carried by a tied vote in many cases but this was because we did not have a majority. But every vote on Report was carried by a substantial majority. As we moved from Second Reading to Report the majorities increased, and this may well be so today.
The more votes we have the better, because it will then be seen that the elected Members in this House have spoken and 1722 that it ill-behoves the other place to challenge the views of the elected Members of this House. It is only on this amendment that I wish to pick up these few points. After that, I shall co-operate totally by simply proposing reasons why we should reject the Lords amendment.
This is a measure which has been carefully considered by this House in Committee and on Report. We are determined that the Bill will pass into law. [Interruption.] The right hon. Member for Wanstead and Woodford intervenes from a sedentary position. Since he has done so, I shall take no notice of what he said.
Our determinatioin is to get this measure through. The period of uncertainty about the Bill has gone on long enough. There is no benefit at all for the morale of those who work in the Health Service for the surgical operation to be postponed any longer. A lot has been said about waiting lists. The Bill has been on the waiting list since February 1974 and it is time that we got on with the job.
We wish to see this measure through Parliament. Of course, it is a compromise between two more extreme points of view. It is not satisfactory to everyone. I have heard hon. Gentlemen opposite sometimes say that it represents full-blooded Socialism. One of the criticisms of many of my hon Friends is that it is not. It is a compromise between extreme points of view. The author of the compromise, Lord Goodman, has recognised that it is in the interests of the Health Service that the Bill should now be carried through. The noble Lord said in another place, on the 21st October—

§ Mr. Patrick Jenkin
On a point of order, Mr. Speaker. I do not wish to interrupt the Secretary of State's flow of oratory but are we to understand that an exception is to be made from the normal rule that one can quote only speeches from members of the Government in another place? Is Lord Goodman now to be treated as a member of the Government?

§ Mr. Speaker
Order. It is customary to paraphrase speeches by those Members of another place who are not Ministers.

§ Mr. Ennals
I am happy to paraphrase, Mr. Speaker. What Lord Goodman said was that it was in the interests of the NHS that this compromise measure 1723 should now be completed and become law forthwith.

§ Mr. Ennals
For Heaven's sake.

§ Mr. Patrick Jenkin
Would the right hon. Gentleman agree that Lord Goodman made it abundantly clear that he was against the whole principle of the legislation?

§ Mr. Ennals
That was not the question at all. Here we are dealing with an issue which has been an open challenge within the Health Service. There are a number of people—Lord Goodman is one and my right hon. Friend the Member for Blackburn (Mrs. Castle) is another—who honestly wanted to bring a settlement to this dispute. That was the basis of the compromise put before the House in December last year. That is the basis of this legislation which has passed through this House on previous occasions. It is now in the best interests of harmonious relationships within the NHS that the Bill should become law.
I would pay tribute to Government supporters in the other place who nobly stood by the Bill presented by this elected House of Commons. I believe that any attempts to destroy the compromise by unrepresentative, unelected peers—certainly in alliance with the Conservative leadership—ought to be exposed. It should not be allowed to happen. It is playing party politics with the NHS.
We want to get the Bill through and do everything that we can to improve the morale of the NHS. The time has come to call a halt. On the following amendments I shall do no more than simply repeat the simple reasons why this House doth disagree with the Lords amendments.

§ Mr. J. W. Rooker (Birmingham, Perry Barr)
I support my right hon. Friend. If I had my way I would reduce the Health Service Board to three, but I am happy to settle for five.
It is important to get on the record that even in the short period that we have been speaking this morning you, Mr. Speaker, have already been placed in a difficult position. I wish to seek your guidance with respect to the rest 1724 of the day. It has already been conceded across the two Front Benches that the Opposition require 13 Divisions.
It is implied, in what has also been said, that they require these Divisions before five o'clock. Divisions take on average a quarter of an hour. That is over four hours for Divisions within the six hours allocated for the Bill. We shall have less than two hours to debate the issues. That can be achieved only if debate is curtailed. I am told that in fact there is an agreement that only one speaker from each side will be called on each group of amendments. I seek your reassurance, Mr. Speaker, that any hon. Member who wishes to speak on any of these amendments, and who seeks to catch your eye, will not fail to be called simply because of what the two Front Benches require.
You are the guardian of the rights of Back Benchers and you are the guardian of the rights of this House against the other place. If no more is required of you today, it is make sure that those rights are fully put into operation. We would be prepared to stay here and vote all night if necessary to make sure that this legislation reaches the statute book and not to be subservient to a squalid little deal which has obviously been done between both Front Benches.

§ Mr. Speaker
I appreciate what the hon. Gentleman said about my responsibility, and I agree with him. But the fact is that hon. Members will not be here voting all night because the guillotine will fall at five o'clock. I will ensure to the utmost of my ability that if any hon. Member seeks to speak, he will be heard.