HC Deb 12 February 1979 vol 962 cc882-98

7.47 p.m.

Mr. William Hamilton (Fife, Central)

I am delighted to have this opportunity to ventilate a subject which is very dear to my heart and to that of my hon. Friend the Member for Ealing, North (Mr. Molloy). We both happen to be Members sponsored by the Confederation of Health Service Employees, which represents more than 200,000 National Health Service workers, including nurses, especially mental health nurses, and few people are more dedicated or more responsible and moderate in the claims which they make on our society.

Not for the first time in the past 20 years, our nurses are in an angry and frustrated mood. In that context, I wish to quote some comments made on this matter in The Guardian of 1 November last referring to documents presented to the Department not only about the wages of nurses but about their general conditions of work inside our hospitals and other related matters. The article said: The nurses are right to make a fuss. The National Health Service does need more resources. Some of the complaints that the nurses were making were not new. They had been made almost ever since the National Health Service was established.

The article went on to refer to wastage in the profession: Disenchantment in fact comes so early that studies in the 1960s showed that 30 per cent. of nurses hung up their uniforms before completing their training. Similarly, too many nurses have always been put on the wards too early. It went on: It says something about modern educational values that we are still prepared to spend ten times as much on the education of a university graduate as a nurse. It said in relation to the building of hospitals and the dereliction that is so evident in so many hospitals: One third of our hospitals were built before 1900; but equally, it is foolish to ignore the advances we have made. One third of our district-general hospitals are now in new or remodelled buildings. At the end of last year another 117 schemes costing over £500,000 each were under construction. We have twice as many nurses as we had at the start of the NHS. I put that on record because it is important to see the claim for increased remuneration in the context of the whole Service.

Nurses are even threatening strike action, of a sort as yet unspecified. I speak for myself when I say that I desperately hope that that situation will never arise because it would seriously damage the impeccable image of nurses in the community at large. It would be a thousand pities if the nurses took any action that destroyed or tarnished their image.

It was with amused contempt that I read early-day motion No. 164 in the names of several Tory Members. It was interesting that that motion on nurses' pay carefully did not ask specifically for more money for nurses. Why? Because the signatories were clearly embarrassed by the Conservatives' official commitment to slash public expenditure. In logic, they should not—though they do—argue for increased pay for nurses, firemen, the police and the Armed Forces and pretend that they can do all those things and, at the same time, cut public expenditure.

I want to spell out the Tory record on nurses' pay. It is a story of Scrooge writ large. I have been reading some debates of 1962—when we had no crisis of the proportion that we have now, either consequential on increased oil prices or because of a world crisis.

Mr Kenneth Robinson, who was Labour's official spokesman on health matters, said in 1962: A qualified staff nurse, after three years' training and aged at least 21, starts at about £l0 a week. That was after 11 Tory years. A qualified staff nurse after three years' training earned £10 a week. The present right hon. Member for Down, South (Mr. Powell), who was Minister of Health while the incomes policy of the time was operating, said: The incomes policy … is a policy for the nation as a whole. He presumably meant that the nurses could not be excluded from that policy.

The hon. Member for Orpington, the then Eric Lubbock, who is now Lord Avebury, said in his maiden speech that a ward orderly at that time was receiving £10 Os. 8d. for a basic 42-hour week and he went on to outline the overtime rates. The hon. Member for Maidstone (Mr. Wells) said: I have no objection to ward orderlies earning high money."—[Official Report, 27 March 1962; Vol. 656, cc. 1088–1109.] High money! The hon. Member was referring to £10 a week, with overtime paid for more than 42 hours' work in a week. That was the attitude of the Conservative Government.

In a debate in that same year, during the second phase of the Tory Government's pay policy when the nurses and others were to get 21½per cent., the Minister of Health said: a rise in incomes which outstrips production has consequences from which all are bound to suffer, not least professions like that of the nurses themselves, which will always be at the tail of the rat race".—[Official Report, 14 May 1962; Vol. 659, c. 945.] At the end of that debate there was a vote in which the right hon. Lady the present Leader of the Opposition, the then Prime Minister and most of the present members of the Tory Front Bench voted in favour of the 21½per cent. infliction on the nurses.

I put those facts on the record in order to try to convince nurses that, whatever their problem today, it will be solved only by a Labour Government.

Let us look at the position of the Conservative Party today. Its official policy document "The Right Approach" says of the NHS: When the service is short of funds … there is no case for holding down prescription and other charges. The Conservatives believe that there is no case for holding down any of the existing charges in the NHS. On 29 October 1977, the right hon. Member for Wanstead and Woodford (Mr. Jenkin), who is the Opposition's spokesman on health and social security, said: If… we are able substantially to reduce the burden of direct personal taxation, is it not reasonable to ask people to pay something towards their health costs? There it is in black and white. Direct tax reductions, mainly for the benefit of wealthy people, are to be recouped by increased health charges, mainly on the poorer sections of the community.

"The Right Approach" went on to say: We should encourage … private provision "— that is, the provision of health services via private medical insurance. It added: We see no reason for quantitative controls over the development of the private sector outside the NHS. That is the background to the present claim and complaints of the nurses.

Everyone, including the Government, accepts that nurses' pay has fallen behind in the past few years. I passionately believe that they are a uniquely special case and I shall explain why. They are unique because support for their claim, above that for any claim made by any other section of the community, would meet with unanimous public approval—more so than in the case of the police, the firemen and the Armed Forces, who have all had exceptional treatment from the Government.

The nursing profession is also unique because use of the strike weapon, I like to believe, is unthinkable. It is unique, too, because these people are serving in a universally popular and vital national service.

I should remind the House and the public of what Labour Governments in the past decade have done, and what I hope they will do in the immediate future. In 1970 there was a great advance in nurses' pay. My right hon. Friend, the Secretary of State, said of the Labour Government of that time: They picked them up virtually off the floor."—[Official Report, 30 January 1979; Vol. 961, c. 1220.] I do not think that that is an exaggeration. The Halsbury award in 1974 was very substantial. Despite those achievements, the right hon. Member for Wan-stead and Woodford was belly-aching about Government delay in settling the nurses' pay claim. He demanded an answer from the Secretary of State, who explained that the Government were considering the claim which was, in any event, not to be implemented before 1 April.

On 6 February, in answer to my question, the Secretary of State for Scotland indicated that nurses had certain claims outstanding from the previous round of negotiations. The Secretary of State also said, which I found disturbing: but these are not under active discussion at the moment."—[Official Report, 6 February 1979; Vol. 962, c. 212.] Why not?

Secondly, the Secretary of State indicated that the nurses would be considered in some future comparability study, subject to agreement with trade unions and employers. I do not know what commitments, if any, the Prime Minister gave when he met the nurses a week or two ago, but it is almost without dispute that every Member of this House and almost every member of the public would be unanimous in supporting the acceptance by the Government of the nurses' claims. That, in my view, is not enough. Although the Labour Government's record in this matter needs no great defence from me, I think that the Minister would agree that any advances made are bound to be eroded in direct proportion to our inability to control inflation.

I notice that some of my hon. Friends on the Left of my party are listening to the debate. I would tell them that the policies of free collective bargaining urged equally forcefully by the extreme Right and the extreme Left—by the 1922 Committee of the Tory Party and by the Tribunte group of the Labour Party—leave in the lurch the very people I am talking about. They are the nurses and others whose bargaining power, for one reason or another, is incomparably weaker than that of other sections of society. Even supposing that the Government accept the claims of the nurses, which I hope very much they will, there must be machinery devised for dealing with such deserving cases. That must happen very soon.

Mr. Dennis Skinner (Bolsover)

I would not want my hon. Friend, who is making out a good case for the nurses, to mislead the House by coupling the Tribune group with the 1922 Committee of the Tory Party. I believe he will agree that, although most sections of the Tory Party posture about free collective bargaining, when it comes to the practical details—for instance, over cuts in public expenditure—they tend to become confused. If they really believed in free collective bargaining, they would have supported the lorry drivers when they demanded an increase and the public sector workers who are currently in dispute. They say that they believe in free collective bargaining. but they do not want to practise it, whereas some of us on these Benches—I agree, a minority—believe in collective bargaining, because nothing is free when negotiating for wages. We are prepared to see that carried through. I think my hon. Friend would agree that there is a considerable difference in our views.

Mr. Hamilton

My hon. Friend has made the most gentle interruption that I have heard him make since he became a Member of this House. I am gratified because I sense he is on the retreat. He does not like much to be associated with members of the Conservative Party in believing that the law of the jungle will get us out of the problems we face. It will not. He and his colleagues on the old-fashioned Left of our party believe it will. But it cannot be done. One has to intervene. The Left in our party many years ago accepted that if one wants a Socialist society one has to intervene and control in some degree wages, which are, in effect, the price of labour. If one is not prepared to accept that form of intervention, one cannot build the kind of society we want.

I should like the Minister to take this matter back to the Cabinet. Nothing will serve our purpose better, than to go to the country saying that we believe in social justice and in giving to the people who do the most important jobs the best rewards and that this will be achieved by deliberate Government intervention. Nothing will serve that purpose better than if the Minister tonight says "We will put this case to the Cabinet with the support of the whole of the Parliamentary Labour Party. There is not one hon. Member on the Opposition Benches. I hope that the Minister's resolve will be strengthened by this worthy case.

8.8 p.m.

Mr. William Molloy (Ealing, North)

Like my hon. Friend the Member for Fife, Central (Mr. Hamilton), I have a tremendous interest in the National Health Service. Both our families, our wives and daughters have been involved in the practical side of the National Health Service as nurses and State certified midwives. My hon. Friend, like myself, has probably been at the receiving end of some sharp and severe criticisms over the way in which this House has behaved in trying to make the National Health Service an even better service.

The truth about the NHS was outlined and adumbrated by Aneurin Bevan. Everyone of any note in the medical profession, the economists in the City, the bankers and regrettably some members of the Labour Party in prominent positions remarked that it was a wild ideal. It could not be done, they said: it would take 10 or 15 years to achieve a full NHS covering everyone from the cradle to the grave. Thank goodness the Minister took little notice of well-educated people in Cambridge and Oxford.

That service was introduced within a couple of years of the most horrendous war in history. Today's problems are tiny compared with those faced by that Labour Government in introducing a great principle. Many men and women who had fought in the war were still overseas. There were massive housing problems. Europe was devastated and poverty-stricken. In passing, I would say that some members of the EEC should reflect that this country's generosity was enormous. Yet at that time we laid the foundations of the National Health Service. It is saddening that its progress in the subsequent 30 years has been so abysmal.

Central to this problem has been the treatment of the nurses. How can we tell young women "Don't be a mug. Don't become a nurse in the NHS. Take your clothes off instead and be pictured in some glossy magazine. You will earn more in a week than a nurse earns in five years."?

Perhaps the Archbishop of Canterbury would apply his mind to this problem now and again. What does he think of young women stripping off to be photographed in newspapers, exhibiting their breasts in fancy glossy magazines? Does his Lordship agree—if not, how strongly does he disagree—that a young woman engaged in that activity should receive a thousand times as much pay as a young girl working at night, emptying bed pans, dealing with someone in pain or in a geriatric ward, or, unpaid, comforting families who are visiting the sick? That is the sort of problem that Governments and clergymen should consider.

There is a lopsided situation in the NHS. One sees a disgraceful situation when one compares the fees of part-time consultants, important though they are, with the pay of nurses.

Mental nurses—in perhaps the most poignant profession, dealing with someone's loved one who has not a proper mind and might be dangerous—are not only ill paid but sometimes run legal risks which this House permits and of which we should be ashamed.

The Minister has received representations on behalf of all nurses, including mental nurses, from the Confederation of Health Service Employees, with which I am connected, as is my hon. Friend the Member for Fife, Central. If Ministers want to make this wonderful ideal a reality, they can do no better than act on the weekly advice that they get from that body.

I have raised many times in this House another matter that irritates and annoys our nurses. It has been a waste of time mentioning it to the Front Bench and certainly to the Opposition parties. With our Socialist ideals we do not believe that the only way that people receive medical treatment is if they have sufficient money to pay. This principle applies also to high-class schooling. It is never asked how this money to pay for privileges is obtained. It could be from running a brothel.

One assumes that private patients pay for their beds, but they do not. They cheat. There is a good hospital with a fancy name within a few miles of this House. It has a large number of pay beds where nurses, consultants and other doctors have to work outside the National Health Service. There are other hospitals like this. At the monthly meeting of the board of governors one of the main problems is who has done a bunk. Patients have had a month's treatment and vanished without paying the bill or cheques have bounced.

I had a devastating reply to a question that I asked in the House. It was said that the cheating was known and that the high-flown people who receive the treatment, preference and privilege vanish and do not pay. But little could be done. In the first place, the Government could move over and let my hon. Friend the Member for Fife, Central and myself take over for six months to set a level. I do not accept that in Great Britain private patients can keep another patient who cannot pay out of a hospital bed, that they can jump the queue with a promise to pay and then double-cross the system and not pay a halfpenny. It has been said that there is no way of checking. But a short circular could be sent to governing boards asking how many thieves have stolen national resources by promising to pay for a bed in a National Health Service hospital.

It is argued that the National Health Service and the nursing profession could not exist without people who jump the queue and pay large sums to get into hospital. That is disgraceful and phoney. It has had a deleterious effect on the National Health Service, and especially on the nurses. The senior nurses and experienced staff in the Confederation of Health Service Employees particularly have seen over the past 30 years an insufficient contribution to maintain the National Health Service to the spirit and ideal orginally conceived. During the years when "we never had it so good" the National Health Service was quietly allowed to run down and nurses' pay to slip behind.

As my hon. Friend the Member for Fife, Central has so often said, during those years not only was the Health Service quietly allowed to run down but the nurses actually had a pay cut. There was no great outcry because Governments took cruel advantage of the idealism of both mental health and ordinary nurses. All that has happened in this long period is that the very essence of the National Health Service has been sucked away by disguised vampire Governments who are not interested in the principle of the creation of an even better Health Service.

My hon. Friend the Member for Fife, Central mentioned the Halsbury report. I agree that it was a good report, but the brutal truth is that nurses have still missed out. They did not get anything like the police or the Armed Forces. What a contrast. Are not nurses just as important as Service men? Is it not vital that the British nation should be adequately defended against disease as much as against anything else? Yet we have failed to do that.

I sincerely believe that any form of preventable pain is a blot on any society. There are smudges still left on the National Health Service, and these smudges did not exist when it was created. We have allowed this tiny little cancer in the Service to grow—surreptitiously, but nevertheless to grow.

I wonder whether the Minister really understands the strain on nurses or the feeling of great achievement of young trainees. Does he understand the devotion and the agony of waiting for examination results? I have been through all that. I remember the day when I received a message on the House of Commons notice board from my daughter. I felt quite choked. It simply said "Dad, I have passed State." There was more pride in that than if she had said "Dad, I have landed a Hollywood contract." Somebody has to do this work, so why should we penalise men and women in the nursing profession when they have such pride and fine idealism in their work?

I hope that the Minister will look at some of the petty restrictions with which our nurses have to contend in some of our hospitals. I readily admit that nowadays there are very many enlightened matrons who are a great credit to the NHS. But here and there are the remains of old Victorian attitudes which do not match the requirements of professional nursing in a modern society. Along with that aspect is the aspect of frustration felt by many of our mental and psychiatric nurses. Unless something is done about these irritating features, and unless these nurses are properly remunerated for their important job, our Health Service will suffer even more.

The creation of the NHS was a great endeavour, and those of us who sit on the Labour Benches are proud to be connected with the party which created it. But we shall no longer be proud if the Labour Government try to cash in on the job satisfaction of the nurses and deliberately exploit their idealism. That would be a heinous crime, and I hope that we are not even approaching the possibility of committing such a crime.

We must match the pride of the nurses' contribution to society, reflecting the nation's appreciation by ensuring a proper remuneration for all our nurses. I am sure that the people of our country would endorse it. We very rarely arrive at the frontiers of understanding of the problems of the National Health Service until our own souls are smitten with grief. Then we realise what a great service it is, and right at the heart of that service is the nursing profession.

Let us have much closer liaison with the great trade unions within the National Health Service, particularly with the Confederation of Health Service Employees. Its devoted officers understand these problems and they want to improve the National Health Service. I have been present at meetings of COHSE at which we have talked for hours not about increases in pay and scales of remuneration but about the problems in our hospitals which have to be resolved. The officers of COHSE feel that their members can make a contribution here. But while they take a great deal of interest in the NHS outside their normal scope of their duty, it must be acknowledged that they are not given the sort of treatment to which they are entitled. If their members are treated shabbily, and if the nurses are treated shabbily, we shall have a shabby National Health Service.

I hope that the Government will not allow frustration and desperation within the nursing profession to continue to the point at which nurses might even contemplate all-out industrial action. The continuance of this frustration and desperation can be prevented only by action on the part of the Government. I do not mean simply action taken to avert a strike. I mean the sort of action that will increase the morale of the trade unions and their members, and of the nursing profession as a whole, so that the nurses will once more be proud to be members of a great profession. They will benefit from such action, and, more important still, the British people will benefit from it immensely.

8.28 p.m.

The Under-Secretary of State for Health and Social Security (Mr. Eric Deakins)

I am well aware that the subject of pay of nurses is one on which there is widespread and genuine interest among my hon. Friends, as is evidenced by their attendance here tonight.

My hon. Friend the Member for Fife, Central (Mr. Hamilton) and my hon. Friend the Member for Ealing, North (Mr. Molloy) have made their case very strongly. I welcome this opportunity to tell the House something about the background and to explain the present position. But before doing so I should like to respond to the last point made by my hon. Friend the Member for Ealing, North concerning the relationships with the Health Service trade unions. I can assure him and my other hon. Friends that our relationships with the National Health Service trade unions are extremely good. We meet them regularly in a series of meetings at which each side can put on the agenda whatever items it chooses. Indeed, in recent weeks we have been meeting extremely regularly. The weekend before last I spent 24 out of 48 hours with one of the Health Service unions over a hospital dispute. I can assure my hon. Friends that we take very seriously the task of maintaining good relationships with the unions which represent a great proportion of the workers in the Health Service.

I echo my hon. Friends' tributes to the nurses and express my own appreciation, and that of my right hon. and hon. Friends, of the valuable and dedicated work which they do in all parts of the National Health Service. Wherever there are sick or injured or seriously ill people, whether in hospitals of various kinds or in their own homes, skilled nursing care is a key element in their treatment.

The nurses and midwives who work in our mental and acute hospitals and in the community have established standards and traditions which are not bettered anywhere. I therefore gladly join my hon. Friends in paying tribute to the devotion and hard work of all our nurses. I wish to make clear at the outset that any disagreements or difficulties about the size of the increases in their pay which we can contemplate do not detract in any way from our appreciation of the valuable contribution which nurses make to the National Health Service.

I hope that my hon. Friends will forgive me if I do not follow them in their comments on comparisons of the pay of nurses with that of other perhaps less honourable but more glamorous professions. Many years ago I wrote that nurses were an invaluable part of our society, and while one can imagine a society without quite a number of the professions one could not possibly conceive of a society without nurses.

At the beginning of the present decade, in 1970, there was widespread concern about the level of nurses' pay, and the Secretary of State at the time—who was Richard Crossman—instituted an internal review which led ultimately to substantial increases of some 20 per cent. in nurses' pay levels. By 1974, there was again concern on this subject, and my right hon. Friend the Member for Blackburn (Mrs. Castle) appointed a committee of inquiry under the chairmanship of Lord Halsbury to look into this question. The Halsbury committee produced its report in September 1974 and it was accepted by the Government. The committee said it had been concerned not merely to update the pay levels established in 1970 but to provide the right sort of pay levels for nurses, taking account of increased responsibilities which they were undertaking and of the need to continue to recruit good quality entrants to the profession, which is a matter which must concern us all. The Halsbury award was a substantial one by any standards. Nurses received increases of 30 per cent. in their pay with effect from May 1974 in addition to the increases of some 7 per cent.—with associated improvements in conditions of service—which had been paid from April of the same year.

During 1974–75, nurses—like other groups of workers—received threshold increases, and their next main settlement was in April 1975, when they received increases of some 11 per cent., which resulted in pay levels of nearly 17 per cent. above the May 1974 position. Since then—in April 1976, 1977 and 1978—nurses and midwives received the amounts authorised under incomes policy. When they tabled their pay claim in March 1978, the staff side of the Nurses and Midwives Whitley Council claimed that nurses should be entitled to more than the 10 per cent. allowed under incomes policy because, they claimed, their pay had fallen behind since the Halsbury award of 1974 and they felt at a disadvantage in that they were not able to take advantage of self-financing productivity deals which were available to other groups of workers. They therefore argued that they should receive some form of "compensatory" payment in addition to the 10 per cent. pay increases.

In discussions with the staff side, my right hon. Friend the Secretary of State made it clear that there was no scope under the Government's incomes policy for a compensatory claim of the kind suggested. He told the staff side members that, if they felt they had a claim on more general grounds to be treated more favourably than was allowed for under incomes policy, it was for them to develop their case, which the Government would examine carefully. Such examination would be undertaken, however, in the light of all the relevant circumstances at the time.

My right hon. Friend wrote on 9 May 1978 to the chairmen of both sides of the Whitley Council to put on record the position which he took on this question. That letter was of some significance for a reason which I should explain. Pay agreements by the Whitley Council require the formal endorsement of my right hon. Friend—under the terms of the NHS Remuneration and Conditions of Service Regulations—before health authorities may introduce the higher levels of pay. The purpose of the letter of 9 May 1978 was to make quite clear what position the Secretary of State took on the claim for additional payments when he authorised the 10 per cent. settlement which had been negotiated within the current incomes policy.

After a number of exchanges on the Whitley Council during the summer last year, a detailed case, prepared by the staff side and arguing for specially favourable treatment for nurses, was submitted to my right hon. Friend on 6 October 1978. The case submitted by the staff side was supported in principle by the management side of the Whitley Council, but the management side was not committed to any precise quantification claimed by the staff side and it accepted that no additional money could be paid during the then current pay round. In short, the position of the management side was that it hoped that an advance commitment might be given to favourable treatment for nurses, but it accepted that no additional money could be available earlier than the 1979–80 pay round. The staff side, on the other hand, was press- ing for additional payments beyond the phase 3 10 per cent. during 1978.

On 16 October last, my right hon. Friend received a deputation from the Whitley Council when the two sides developed their arguments in support of their claim for specially favourable treatment for nurses. The staff side emphasised strongly its contention that nurses' pay had been eroded seriously since the Halsbury award. It maintained that an increase of some 18½ per cent. would be needed at April 1978 to restore nurses to the position established by Halsbury. My right hon. Friend reminded the deputation of his letter on 9 May, and in particular of the statement in that letter that any general case which might be presented would be considered in the light of all the relevant circumstances at the time.

The most relevant current circumstance was that the Government had issued their new White Paper "Winning the Battle Against Inflation", which set out the approach the Government were adopting to incomes policy. My right hon. Friend emphasised that the overriding concern must be to contain inflation, which was a major threat to the well-being of nurses as to the rest of the community. The White Paper had made clear that any claims to special treatment would have to be examined very critically as it would be self-defeating if more than a very few groups were accorded special treatment. The Government would consider the case which the nurses has developed—and I note my hon. Friends' contention that the nurses are a unique case—but my right hon. Friend told the deputation frankly that he could see no prospect of any additional payments for nurses in the current pay round.

It is important to emphasise at this point, because there has been a certain amount of misunderstanding, that the nurses received a pay settlement in April 1978 and their next settlement is due in April 1979. The arguments that have been taking place in recent months therefore have been not about a particular pay claim but about a case, submitted between annual settlements, which argues that nurses should be entitled to some additional awards over and above their annual settlements. In considering representations of this kind, the Government cannot take a simple isolated view relating to one particular group and ignore the wider implications of settlements for individual groups.

My hon. Friends will not need to be reminded that towards the end of 1978 there were several groups in the public service who were pressing their claims. All of them believed that theirs was a particularly good case. No doubt from their own standpoint they all are good cases, but the Government have made quite clear their determination to fight inflation—a fight in which they have met with much success in the last two to three years. That success has been hard earned, and we must not lightly surrender the successes we have achieved in the battle against inflation.

When hon. Members press the claims for high pay increases for any particular groups of public service employees, they must consider the implications of what they are proposing. Excessive pay settlements in the public services could mean ultimately that poorer services are provided. There is no bottomless purse available for funding excessive settlements. Recently the Government have announced their public expenditure plans for the next few years. These include a significant increase in resources available for the development of the National Health Service. But, as my right hon. Friend the Secretary of State has already warned the House, excessive demands will put the Government's plans for expanding the resources available to the NHS seriously at risk. We cannot ignore these issues when debating pay questions.

When the House debated the industrial situation on 16 January, my right hon. Friend the Prime Minister announced improvements in the underpinning arrangements in incomes policy for the low paid. He also indicated that the Government were willing to accept a greater role for comparability in determining pay for particular groups employed in non-trading parts of the public sector. He said that discussions were taking place on the scope for comparability investigations for local government manual workers, National Health Service ancillary employees and some others. The Prime Minister also said that the Government would be prepared to give sympathetic consideration to an approach for the comparability principle to be applied to nurses. He reminded the staff side of this when he received a deputation from it on 24 January.

My right hon. Friend the Secretary of State has urged the two sides of the Whitley Council to accept that the offer of a comparability study provides a constructive and positive way forward on nurses' pay. He has indicated that he is willing to enter into discussions at an early date about the way this could be done for nurses and midwives. The Whitley Council will be meeting again tomorrow, when I hope very much that it will consider seriously my right hon. Friend's proposals.

Discussion on the question of nurses' pay is now clearly at a very delicate stage. The negotiators have an important and responsible task. I am not in a position to make any dramatic announcement this evening on the eve of further negotiations, and I would not pretend to do so. However, I can assure my hon. Friends that in regard to nurses' pay the present is a time for constructive discussion, and I know that my hon. Friends and the profession outside will appreciate that fact.