LONDON AMBULANCE SERVICE (DISPUTE) (Hansard, 19 January 1979)

§ Mr. Cyril D. Townsend (Bexleyheath)
I had hoped to raise on the Adjournment a matter of considerable interest to me—United Nations peace-keeping operations—but Greater London faces on Monday a major crisis, and as a Greater London Member I wish to use my right to change my subject from United Nations peace keeping to ask the Government what they propose to do to tackle the grave emergency that I have just mentioned.
I should like first to apologise to the relevant Foreign Office Minister, who know had prepared an admirable reply, and to my hon. Friend the Member for Cambridge (Mr. Rhodes James), who had kindly come along to speak on the subject of United Nations peace keeping.
I give a big "Thank you" to the Secretary of State for Social Services, who, at incredibly short notice and in what I regard as a public-spirited manner, has come to the House to assist Greater London and my constituents. As you will know, Mr. Deputy Speaker, if you have had a chance to glance at today's evening papers, London ambulance men have decided to refuse even emergency cover during their one-day strike next Monday. Their spokesman, a Mr. Dunn, whoever he may be, has said: This time we are determined that the capital will take notice of what we are saying. and if it means lives lost, that is how it must be. It means, to the best of my knowledge. that Greater London, a city of about 7 million inhabitants, will be without emergency ambulance cover for the first time 2217 in its entire history. A spokesman has said: There will be very strong pickets at all ambulance stations to prevent voluntary workers from using them. I think that the House will agree that on Monday we shall be faced in Greater London with an unprecedented situation.
I am a strong supporter of the National Health Service. It has made a major contribution to the British people since it was inaugurated. Surely we should begin to question where the hell we are going. I happen to believe in high pay rather than low pay. There is no great advantage in having low-paid workers in our society. However, the claim of the ambulance men happens to be well outside the guidelines that the Government have put forward. Is it not time that we should stop in our tracks to ask where on earth we think we are going when we have a union leader saying that if it means lives lost, that is how it must be"? Lives lost for what? Are they to be lost for some great national issue, for some great principle about which we all feel deeply? No, they are to be lost for the size of a number of individuals' pay packets. It is intolerable that individuals should be prepared in cold blood to put at risk the lives of all those who live in Greater London so that they may advance one particular pay claim on one particular day in one particular year.
It is time that someone started speaking up for the citizens of Greater London, for the Health Service and for the British people, and to say "Enough is enough. Let us pause, and for heaven's sake think where we are going. Your task is to look after the sick and those in our society who are in real need of help, and here you are trampling on the very people you are supposed to be dedicated to succour." That can be no way forward for our community.
The Government of the day have a clear responsibility. I hope that the Secretary of State will give the House the Government's view on the forthcoming crisis and explain to us all, especially my constituents, what the Government will do on Monday to ensure that lives are not lost.

§ Mr. Michael Ward (Peterborough)
Although I am not a London Member I have lived in London for many years and have been a leading member of one of the London local authorities. I join the hon. Member for Bexleyheath (Mr. Townsend) in expressing deep concern from the Labour Benches about the professed view of one individual on the possible effects of action on Monday. I am not aware whether the ambulance men outside Greater London are proposing to take part in the demonstration. I hope that my right hon. Friend will be able to tell us from the best information that we have that they will not. I hope, too, that the individual concerned will reconsider his comment and that efforts will be made both by leading members of the service and by my right hon. Friend to try to initiate some urgent discussion. That should be done within hours to get the matter resolved in a different way.
One of the good things about the very difficult industrial disputes that we have been through in recent months has been that lives have not been put in jeopardy. This is obviously a path on which we would want to continue. I am sure that the House will be very anxious to learn from the Minister whether he has had contact with the trade union concerned or whether he is proposing to meet it in order to try to get some change in its view about the demonstration on Monday.

§ Mr. Anthony Grant (Harrow, Central)
I think that the Minister will agree that, although there have been various industrial disturbances of one kind and another in the past, the dispute that we are now discussing has a completely new dimension to it. As far as I can gather, it is the first time that a group of workers have specifically said, before taking action, that they do not care whether lives are lost. This is so disgraceful that it demands the condemnation of the Minister, on behalf of the Government and of hon. Members in all parts of this House.
My own constituents are served by the Northwick Park hospital, which is a very large and modern one and deals with some extremely serious cases. Patients from not only my own constituency but 2219 from all round London often have to be rushed to this hospital in most urgent conditions. What steps is the Minister proposing to take to ensure that this facility will still be open to people? Undoubtedly lives will be lost if people cannot use the unique services offered by this hospital.
Has the Minister any plans to allow people, voluntarily and privately, to use their own vehicles? If so, what will be the insurance consequences of that? What risk is there that pickets—who seem to be the fashion these days—will interfere with people who are voluntarily rendering these services to other people whose lives may be in danger?
I look forward to hearing what the Minister has to say in reply to these questions. One hopes that he is doing whatever he can to resolve the problems arising from this wholly despicable action.

§ Mr. Kenneth Baker (St. Marylebone)
I am grateful to my hon. Friend the Member for Bexleyheath (Mr. Townsend) for raising this matter on the Adjournment. If anything, he has dealt with it in too moderate terms. He said that the action and the statement by the leader of the London ambulance men was intolerable. In my opinion, it is more than intolerable. It is wicked to say that strike action will be taken irrespective of the result, even if it leads to suffering or death. That seems to me to be a total distortion of the real values in our society today.
I hope that the Minister will join us in our condemnation of that statement. It is the Minister who has the greater responsibility. He is responsible for the Health Service. I hope that he will ensure that emergency facilities are available on Monday for our constituents and for the residents of London. I hope that, if necessary, such services as are available to the Crown will be used, such as the medical services of the Armed Forces, if necessary.
May we please have from the Dispatch Box today a clear condemnation of this type of action? For the last week we have seen a Prime Minister who cannot act because, as a Labour Prime Minister, he is a prisoner of the Labour movement. It is quite clear that in this instance the lives and well-being of many people in 2220 London are threatened, and we do not expect to see another Minister adopting that supine attitude while this action takes place.

§ Mr. Christopher Price (Lewisham. West)
It is astonishing to find the Opposition, at a time such as this, using the occasion simply to make such remarks as have just been made. I hope that during the rest of the Adjournment debate we shall not hear that sort of language used. I do not think that any hon. Member can really believe that partisan language of this sort assists in the solution of an extremely serious problem and one that hon. Members on each side of the House ought to take extremely seriously.
Having had some experience of the Health Service unions in London and having a number of constituents who work in the ambulance and ancillary health services, I know that they have real grievances and that the problem must be met. However, that problem will not be assisted by exaggerated phrases from one side or the other or by demands for panic measures of one kind and another.
Among ambulance men and Health Service workers there are many reasonable people who are utterly committed to the well being of the National Health Service. I am confident that on Monday there will be a large number whose sole intention will be to show what real grievances they have about their pay but at the same time to show that they do not wish to damage the essential fabric of the service.
I hope that in this mini-debate partisan language will not be used and that we can keep the discussion on a statesmanlike level.

Sir Bernard Braise (Essex, South-East)
I should like to make a brief but vital point. The North-East Thames health region is the only one in the whole of the United Kingdom without a burns unit. The essence of treatment for serious burns cases is to get the patient quickly to hospital. Otherwise lives, whether of children or workmen, will be put in serious danger.
To get from any part of Essex to a hospital, patients have to go to hospitals in the London area. I want to know 2221 whether constituents of mine or of any other Member living in Essex who may be subject to a burns accident on Monday will have free, swift, unhindered passage to hospital. I beg the Secretary of State to treat this as a vital matter, because if anyone has to go out of our region to a burns unit he has to pass through London. This could be a matter of life or death. I ask for action on that issue, and I want to know the answer this afternoon.

§ Mr. Arthur Latham (Paddington)
I do not know what the Opposition expect Ministers to do in these circumstances. There is no easy way of providing a service which is in danger of being withdrawn. I can understand alarm at a remark which has been reported, but which I have not seen. Earlier in the week it was being argued on behalf of some ambulance drivers that they recognised that, in taking any action, a risk was involved. At that time they were arguing about the future of the service—

§ Sir Bernard Braine
A risk of death.

§ Mr. Latham
A greater risk of death indeed—unless some remedy was found for what they saw as immediate grievances.
I can understand the concern, indignation and exasperation which has been displayed. I certainly share the fear of the danger of someone not receiving urgently required treatment on Monday.

§ Sir B. Braine
I am talking about burns cases. It is shameful.

§ Mr. Latham
When some Opposition Members get so indignant and display such wrath, one cannot but wonder why they did not show similar concern before this item came over on the tape.

§ Sir B. Braine
It has been raised repeatedly.

§ Mr. Latham
I know that the Secretary of State has been active, but he is party to an economic and incomes policy which is producing difficulties at this time.

§ Sir B. Braine
I am talking about burns cases.

§ Mr. Latham
It is no good the hon. Member for Essex, South-East (Sir B. 2222 Braine) shouting and believing that that is a substitute for action.
I shall not detain the House any longer because I want to provide an opportunity to the Opposition Front Bench spokesman and the Minister to make their contributions. But I do not believe that the majority of ambulance men—[Interruption.] The hon. Member for Essex, South-East is extremely indignant. He is almost overdoing it. In fact, one begins to wonder whether his indignation is synthetic or real.
I do not believe that on Monday the majority of ambulance men will be prepared to stand by when people are fatally ill. I think that their sense of responsibility and dedication is one of the dilemmas of those working in the Health Service.

§ Sir B. Braine
What about the minority?

§ Mr. Latham
They feel that they are neutered when it comes to taking industrial action. I hope that my right hon. Friend will comment on this. I think that there are lessons to be learnt when such a dedicated group of people feel such a sense of grievance that it is necessary for them to act and to state their case in such strong terms. I decry and deplore the blanket condemnation of all ambulance men implicit in some of the remarks from Opposition Members.

Mr. Deputy Speaker (Mr. Bryant Godman Irvine)
Dr. Vaughan.

§ Mr. Hugh Dykes (Harrow, East)
On a point of order, Mr. Deputy Speaker. Are you aware that a number of hon. Members, including me, wanted to speak on this life or death matter but that we are prevented from doing so by the brief time allowed for this debate?

§ Mr. Deputy Speaker
That is no point of order.

§ Dr. Gerard Vaughan (Reading, South)
The whole House is immensely grateful to the Secretary of State for coming here at such short notice. I know how little notice we gave him of this debate, and we appreciate his presence here.
2223 First, will the right hon. Gentleman condemn this strike, yet another strike in the National Health Service? Secondly, will he condemn the refusal to cover even emergency cases? Thirdly, will he condemn the appalling attitude which is demonstrated in the words of the spokesman for the ambulance drivers: If it means lives lost, that is how it must be"? This House cannot tolerate a situation where words of that kind are used.
Is the Secretary of State aware that the instruction being issued by NUPE is that the strike on Monday should cause the maximum possible disruption to services? That is an appalling instruction to go out to union members.
Would not it be better, rather than wait until patients lose their lives and until crises arise on Monday, to set in motion today steps to prevent the tragedies upon which we fear we are embarking? Secondly, what instructions will the right hon. Gentleman give to the pickets on duty on Monday? What advice will he give them about how they should carry out their picketing? Thirdly, will the right hon. Gentleman now call for help from the Red Cross, from the St. John Ambulance and from the voluntary services? I am sure that it will be available from them as well as from the troops.

§ The Secretary of State for Social Services (Mr. David Ennals)
I was glad that the hon. Member for Bexleyheath (Mr. Townsend) decided to change the subject of his Adjournment debate, and I came to the House immediately I heard about it, because I share the concern which has been expressed by hon. Members on both sides of the House, though not perhaps in the language and with the provocation which some of them used.
The House must have learnt with great sadness that such a decision had been taken this morning. I deplore the action. I am appalled by the apparent lack of concern for human life. But at the same time, as I did yesterday, I pay tribute to the men of the London ambulance service. They have provided a magnificent service to the people of London over the years, in war time and in peace, and the people of London will always remember it. Many of those ambulance men who have that respect will deplore, as I do and 2224 as others have done, the statement by one of their spokesmen that if it means lives lost, that is how it must be.
I said yesterday in the House: I have spoken personally to the general secretaries of the unions concerned and have been assured that the unions have advised their members to maintain emergency services."—[Official Report, 18th January 1978: Vol. 960, c. 1952.] I confirm that. Leaders of all the unions involved in the public sector industrial action on Monday—NUPE, the Transport and General Workers' Union, the General and Municipal Workers' Union and COHSE—have stressed that their members should provide emergency services so that lives are not put at risk. I therefore once again make an appeal to the men concerned to think again. We are talking about men and women who may have accidents, of old ladies who may have a broken bone and of accidents to children. They are situations that one cannot anticipate. Every loss of life is an equal loss to those concerned.
Many of these men are family men who must know the risk to which they are putting others. I must give an assurance. I have been anticipating the need for contingency plans should this sad situation arise. I say "should it arise" for I hope that even now the men will change their minds.
I am only too ready to meet anybody if it would prove effective. The South-West Thames regional health authority, which runs London's ambulance service, has announced that, in the circumstances, emergency cover will be provided by other means. The Government are prepared to authorise the use of troops, if necessary. By troops I mean Army ambulances with troops to drive and supervise them. Those plans have already been made. Authority has been given.
A great deal of planning work has been done by the health authority with the great co-operation of the police, together with offers of help from the voluntary organisations. I can give an assurance that an emergency service will be provided. If, tragically, the men decide that their vehicles should be locked up and they will not use their telephones or take other measures, people of London should still do what they always do. They should dial 999 and emergency services will be provided. In saying that, I hope that 2225 people will not ring for an ambulance unless it is a real emergency. The pressures are great. Some of those who may be driving vehicles are not as accustomed as the ambulance drivers are to getting from one place to another. I also appeal to people not to rush to hospital if they have no appointment and if a visit can wait. There will be great pressure on the hospitals, not only because of this action.
Having given an assurance about contingency plans, I want to say two other things. I understand that the men are dissatisfied and that they have made a pay claim which has not been accepted. That claim would have added about 80 per cent. to the total wage cost. The Prime Minister in the House on Tuesday indicated one or two ways in which the Government are showing their flexibility in trying to come to reasonable terms. We have to consider the essential need of the Government to maintain control over pay and sustain incomes policy and at the same time recognise the needs of particular groups in society. As a result of the Prime Minister's announcement. certain work has been done and discussions have taken place informally. I hope that we shall find a way towards a settlement.
Whatever the state of wage negotiations, and however much there is a feeling of frustration among those who want to see their wage packets larger, wage packets being larger do not mean more money and more to spend if inflation goes galloping ahead. The Government have a responsibility in this respect. Whatever may happen, nothing could justify putting at risk the lives of elderly people.

§ Mr. Ward
Would the Secretary of State comment on the statement made by the hon. Member for Essex, South-East (Sir B. Braine) that because there is no burns unit in his locality people's lives are at risk? Is it not a fact that the first treatment in burns deals with shock and that survival depends on treatment, usually in a casualty department, within the first part of the post-accident period?

§ Mr. Ennals
That is right. We have felt it essential that there should be an emergency service in London. London and other parts of the country should never face a situation in which there is 2226 no efficient means of dealing with emergency demands whether for burns cases, accidents, serious illnesses or anything else.

§ Sir Bernard Braine
The right hon. Gentleman knows, as his hon. Friend does not, that the hon. Member for Basildon (Mr. Moonman) and I have had exchanges with the Secretary of State over the lack of a burns unit in our region for a long time and about what this can mean in dealing with a serious emergency. All that I wanted from him was an assurance that burns cases from the North-East Thames region will not be held up by any picket action in moving through London.

§ Mr. Ennals
That is another question, but I do not believe for a moment that that will happen. I have made note, as my colleagues will have done, of the hon. Gentleman's point.
Monday will be a very difficult day for the National Health Service, with the day of action. This affects not just the ambulance service and not just London. Industrial action will be taken in one way or another throughout the country. It is essential that the wishes of the unions that emergency action should be preserved are carried out everywhere—not just in London—and that the public should show some restraint and not make demands on the services even of their general practitioners, who will themselves be under pressure because of pressure on the hospitals.
The Government are anxious to seek an agreement. That applies to the nurses as well. Of course important talks are taking place and will take place in future. But on this issue I have made clear on behalf of the Government my feelings of deep regret and shock that this decision should have been taken and about the words which were used in announcing it.

§ Dr. Vaughan
Can the Minister answer my question? Will he call on the Red Cross and St. John Ambulance and voluntary helpers to come in on Monday if necessary?

§ Mr. Ennals
The decision about how to produce the necessary number of ambulances has been taken by the health authority, which has worked out exactly what its needs are. They are for 100 2227 ambulances to be available from one source or another. Of course, if it can be done entirely by the police that will be good. If not, the Armed Forces are standing by with instructions and are trained and ready to act. As I have said, it is for the health authority to decide to what extent it may want to make use of the voluntary services. Certainly, it will be important for people to find their own way of getting to hospital and not call directly on the emergency services.

§ Mr. Anthony Grant
What about the insurance aspect of that?

§ Dr. Vaughan
Is the Secretary of State asking for people to volunteer to help or is he asking them to wait? If they wish to volunteer, whom should they contact?

§ Mr. Ennals
I am not trying to usurp the responsibilities of the South-West 2228 Thames regional health authority. It has responsibility for the London ambulance service. I and my officials have had discussions with its representatives and they are now satisfied that, with our backing and the availability of the Armed Forces, they will be able to provide that service. It is not for me to breathe down their necks and tell them exactly how to do it. They will do it.

§ Mr. Toby Jessel (Twickenham)
Is the Secretary of State satisfied that 100 ambulances will be enough—