HC Deb 16 July 1982 vol 27 cc1281-7
The Secretary of State for Social Services (Mr. Norman Fowler)

With permission, Mr. Speaker, I should like to make a statement on next week's threatened industrial action in the National Health Service.

The Health Service unions affiliated to the TUC have called for a three-day national strike throughout the Health Service starting on Monday. This action is in support of their claim for pay increases of 12 per cent. Each health authority will do everything that it can to maintain services and to minimise the effect of action on patients in accordance with the guidance that we issued in 1979.

The Government have made contingency arrangements to maintain emergency services where these are withdrawn, but I must warn the House that if industrial action is taken for three days patients will suffer. In the previous 24-hour stoppages the response was patchy, but seriously disrupted services in some places. If the strike goes ahead out-patient appointments and non-emergency admissions will be cancelled and waiting lists for operations will grow longer. Experience suggests that not even emergency services can be guaranteed in all areas.

I believe that, in the light of this, the health unions should now urgently reconsider their decision to take industrial action. Their claim for a 12 per cent. increase in pay and improvements in holidays and hours of work, making a claim of 20 per cent. in all, is quite unjustified. Over £400 million has been provided for increases in pay this year. That is our final offer and there is no more money.

The offers made by the Whitley councils are for average increases ranging from 6 per cent. to 7½ per cent. This compares with settlements of around 6 per cent. for civil servants, teachers and the Armed Forces. The money on the table, backdated to 1 April, is substantial. We estimate that average earnings would increase by £6 a week for a male full-time ancillary worker, £7.50 a week for a staff nurse, over £9 a week for a nursing sister and £11 a week for a leading ambulance man.

In addition, the Government have already started talks on permanent new arrangements for determining nurses' and midwives' pay which we want in operation by next April. I have also offered to have talks with the health unions about improved arrangements for pay in the future.

On pay for this year, the right action for the unions would be to return to the Whitley councils and begin discussions. On future arrangements for pay, talks between myself and the unions could start at once. I therefore urge all those working in the Health Service not to take industrial action. Such action will only damage the Health Service and put patients at risk.

Mrs. Gwyneth Dunwoody (Crewe)

Is it not now clear that after trying to blackmail the health unions, trying to divide the Royal College of Nursing from the health unions and threatening the regional health authorities, the Minister has had to admit that what he is suggesting is no new money in terms of pay and a direct cut in patient care? Since this is a clear attempt to influence the RCN ballot of nurses, will the Minister make it clear that his offer is worth 69p to student nurses and £1.31 to nursing officers? Will he make it clear that he and not the health unions has been fiddling the figures?

Will the Minister make it plain that he has intended all along to cut the resources available to the National Health Service and that if at the same time he can clobber the health unions that is to him a positive political advantage?

What is the cost to the regional health authorities of the extraordinary letter that he insists they print at short notice and circulate to all staff? Who will pay for that? Will the Minister admit the real cost of the poor deal that he is offering—a deal which will be rejected by the health unions because of its unacceptable terms and because it is a direct attack on the fabric of patient care?

Mr. Fowler

I reject everything that the hon. Lady has said. It was totally absurd from beginning to end. She knows that her claim that the Government have cut spending on the Health Service is totally untrue. The Government are spending more money, in actual and real terms, on the Health Service than any other Government in the history of the Health Service.

Even with the adjustments which I announced yesterday, there will be a growth of 1.3 per cent. in Health Service spending for this year. That is the fact, and I ask the hon. Lady to check it and accept it.

The hon. Lady obliquely recognises that the Royal College of Nursing is balloting on the offer. I hope that she welcomes that development. The hon. Lady asked about circulating in wage packets the details of the offers by the management side of the Whitley councils. Surely the hon. Lady supports that. Is it not a good idea that the members concerned should know the facts of the offers instead of listening to the rubbish which the hon. Lady insists on putting before the House?

Mrs. Dunwoody

rose—

Mr. Fowler

It looks as though the hon. Lady intends to intervene again, so perhaps she will make the Oppositions's position clear. Her right hon. Friend the Member for Norwich, North (Mr. Ennals), when Secretary of State, said: I believe that we should condemn industrial action that does damage to the Health Service, whether it comes from doctors, nurses or any one else who works in the service."—[Official Report, 1 February 1979; Vol. 961, c. 1684.] Do the Opposition stand by that statement? Are the Opposition prepared to condemn industrial action? If they are not, they have no credibility.

Mrs. Dunwoody

Will the Minister now answer the questions that I asked him? How much will the offer mean in real terms for the health authorities? He knows that, far from a growth of 1 per cent., there will be a direct cut in patient care. How much will it cost the regional health authorities to circulate copies of the 12-page letter which represents a straight attempt to influence the RCN ballot?

If the Minister wants condemnation from the Opposition, let me make our position clear. We condemn those who seek to push Health Service workers, who are committed to caring for patients, into industrial action to which they are totally opposed and which he is forcing upon them.

Mr. Fowler

The House will recognise the hon. Lady's remarks as weasel words. Is she or is she not condemning industrial action in the Health Service? She is not, and once again the Opposition are showing no leadership.

The growth in the Health Service for this year will go down from 1.7 per cent. to 1.3 per cent. That is the fact. That is the price of the wages offer. It is extraordinary for the hon. Lady to criticise attempts by the Government and the regions to get over the true facts of the offer. Such attempts are right and are entirely justified. What is totally unjustified is the hon. Lady's inability to condemn industrial action in the Health Service.

Mrs. Sheila Faith (Belper)

Does my right hon. Friend agree that the action of the Health Service unions is prejudicing the whole development of the Health Service as well as patient care? Will he reassure the House that volunteers have been brought in to help wherever possible to alleviate the situation?

Mr. Fowler

The House should recognise that there is absolutely no question but that industrial action within the Health Service is damaging and harming patients. Last Friday I went to see the position at St. Thomas' hospital. As a direct result of industrial action, more than 1,000 operations have been cancelled and cancer patients, among others, are now waiting for treatment. That is the effect of industrial action in the Health Service.

As for the use of volunteers, there were contingency plans and guidance issued in 1979. It is a matter for the district health authorities, but volunteers are included in that.

Mr. William Hamilton (Fife, Central)

Does the Minister accept that, as a result of the Government's pay policy over the past two years, almost every Health Service worker has suffered a reduction in his or her standard of living? He talks about there being no more money available but does he agree that, as the Government have suddenly been able to find about £1,000 million for the Falkland Islands exercise, as well as enough to give enormous pay increases to judges, top civil servants and the rest, it is clear that in this case it is the political will that is lacking? Is he aware that I shall be in Fife next week supporting the trade union action to protect patients and the Health Service from the depredations of a Tory Government who never liked the Health Service anyway?

Mr. Fowler

I deeply regret the hon. Gentleman's last comment, although I am not sure that his presence on any picket line would be likely to gain more general support for the action. He talks as though we were not already making substantial sums of money available to the Health Service. We are making £14½ billion available. That is 5 per cent. more in real terms than the Labour Government provided.

As for the discussions, I invite the hon. Gentleman to talk to the Health Service unions and let us get round a table and talk about new arrangements for determining pay if that is what they want.

Mr. John Watson (Skipton)

Has the total number of nurses increased or decreased in the last three years? Has the average number of hours that they work increased or decreased? And has the number of nurses earning far more than the basic rate increased or decreased in that period?

Mr. Fowler

In the two years to September 1981, there was a general increase in staff of about 47,000 in whole time equivalent terms. Of that number, 34,000 were nurses and midwives. In addition, there were 2,000 extra doctors and dentists. That gives the lie to the Opposition's allegations. Hours have decreased to 37½.

Mr. Mike Thomas (Newcastle upon Tyne, East)

Is it not hard to condemn industrial action on the part of the Health Service workers when they are being so grossly unfairly treated by the Government? Is it not true, however, that the workers must be very careful that in taking such action they do not lose the public sympathy that is their greatest asset? Is it not a scandal that trade union leaders and the Labour Party have joined in a conspiracy with the Government to deny the one thing that could ensure fair pay in the future—a proper incomes policy?

Mr. Fowler

We have had this discussion before and I have invited the hon. Gentleman to define exactly what he means by "a proper incomes policy". Several months later, the House is still awaiting a reply. I hope, however, that he will welcome my offer to have talks with the Health Service unions about new arrangements for pay determination, if that is what they want. We are already doing that for the nurses. We want new arrangements there. I believe that that is the way forward.

Mr. Laurie Pavitt (Brent, South)

When I petitioned you, Mr. Speaker, one and a half hours ago about the urgency of this matter, I did not expect the Secretary of State to respond so quickly. Why does he not compare these offers with the pay increase awarded to policemen? Why has he not consulted the Prime Minister on the figures given by the Royal College of Nursing showing that a ward sister will be £36 worse off at the end of the year if the offer is accepted? Is he aware that I am perhaps the least militant person in the House but that, because this industrial action has been forced on the lowest paid workers in the country by the Secretary of State, I shall be proud to be on the picket line next week?

Mr. Fowler

The hon. Gentleman should not be proud to be on the picket line; he should be ashamed. I believe that the public will regard our offers as fair and reasonable. They range between 6 per cent. and 7½ per cent. I do not believe for a moment that the public will regard them as unreasonable.

Viscount Cranborne (Dorset, South)

Are not the Government to be congratulated on cutting the queues of Health Service patients in the past three years? Does my right hon. Friend not think it remarkable that the Opposition and the unions that they support are doing their best to lengthen those queues despite their well-known and well-expressed support for patient care?

Mr. Fowler

That is absolutely the effect of what is taking place. Until the beginning of the industrial action, waiting lists were falling. They had been reduced from the 750,000 that we inherited after the winter of discontent to 620,000. I believe that everyone would regard that as a substantial improvement. I must warn the House that industrial action is now putting that achievement at risk and that waiting lists are rising again.

Mr. Peter Hardy (Rother Valley)

Is the Minister aware that his statement to the House will be regarded as highly inflammatory? Will he admit that the examples of pay increases that he gave were extremely selective as he picked out the groups with the highest awards and completely ignored those who will receive niggardly increases, although their qualifications may be more substantial than many people imagine and their devotion to the Health Service is a great deal more substantial than that displayed by the Minister? Does he realise that he appears to National Health Service workers to be more concerned to win the headlines than to secure a solution in this tragic situation?

Mr. Fowler

I cannot see how an appeal to end industrial action and for the strike not to go ahead could be considered inflammatory. That is an absurd claim. The offers—I emphasise that they are final—range between 6 per cent. and 7½ per cent. I believe that they are fair, and they compare favourably with other offers—for example, the 6.1 per cent. awarded to the Armed Services.

Sir Victor Goodhew (St. Albans)

In view of the comparison between the increase offered to the Health Service workers and that awarded to the Armed Forces, is it not disgraceful that Health Service workers should be prepared to put other people's lives at risk so soon after the Armed Forces have demonstrated their willingness to put their own lives at risk and to sacrifice them in the interests of the democracy in which the Opposition pretend to believe?

Mr. Fowler

Many people will take that view, particularly when there is more than £400 million on the table and the option is open to the Health Service unions to go to the Whitley councils and talk about its distribution. In addition, there is my offer to have talks not only with the nurses but with everyone in the Health Service about new pay arrangements.

Mr. Ioan Evans (Aberdare)

Where is the morality in the stand taken by the Government when a judge on £40,000 a year gets a 16 per cent. increase while nurses and Health Service workers, many of whom are on less than £4,000 a year, get an increase which is less than the increase in the cost of living and which means a further cut in their living standards? Does the Minister accept that the industrial action which is to take place next week is the only reason why he has come to the Dispatch Box to make a statement? Does he accept that the workers are taking action to protect not only their living standards, but the National Health Service, which he is seeking to undermine?

Mr. Fowler

They are certainly not taking action to protect the National Health Service. That is absolutely certain, because the direct effect of industrial action on the service will be to harm it deeply and, above all, to harm the patients. I wish that Opposition Members would start talking about the patients and the effect that industrial action is having on patient care.

Mr. Neil Thorne (Ilford, South)

Will my right hon. Friend confirm his commitment to a differential for those in the National Health Service who forsake the right to strike? In other words, will he make sure that nurses, if they are committed not to strike, will receive a higher settlement than any other workers, in the same way as the police and the Armed Forces can expect such treatment?

Mr. Fowler

There is a differential of 1.5 per cent. between our offer to nurses, midwives and professions supplementary to medicine of 7.5 per cent. and our offer of an average 6 per cent. to other workers. We have told nurses and midwives that we want to get into place by April 1983 a new permanent arrangement which will determine pay in future. I believe that many in the nursing profession regard that as equally important, and I regard it as a major goal.

Several Hon. Members

rose—

Mr. Speaker

Order. I propose to call the hon. Members who have been standing, of whom I think there are seven altogether. Then we shall move on.

Mr. Hal Miller (Bromsgrove and Redditch)

Will my right hon. Friend say what guidance he has given, if any, to health authorities about the treatment of those who intend next week to damage the future of the Health Service and the interests of patients by absenting themselves from work, let alone by taking more physical action perhaps by picketing? Does he accept that many people in the private sector will be interested to see how the NHS workers are dealt with, because they do not have the same job security and, in many cases, they have received a much lower increase, if any, than the one that is now being offered to Health Service workers?

Mr. Fowler

My hon. Friend the Member for Bromsgrove and Redditch (Mr. Miller) and I both come from the West Midlands, and I know of the private sector awards that he has in mind which, in some cases, are half or even less than these offers.

In answer to what my hon. Friend said about guidance, we issued guidance to authorities in 1979, and the district authorities have that guidance. The people who take industrial action and absent themselves from work will certainly not be paid for any part of that.

Dr. M. S. Miller (East Kilbride)

Instead of fiddling the figures, would not the right hon. Gentleman do better to consider the fact that, because there is still a large gap between what is on offer to hospital workers and the rate of inflation, he is asking people in the National Health Service to take a cut in their standard of living which is already not very high? In view of the element of sympathy that is involved, is he not blackmailing the workers? Is that not a deplorable state of affairs?

Mr. Fowler

Money for any increases comes from the taxpayers. This year, many millions of people have had to accept offers below the rate of inflation. That is one of the prices that has had to be paid for bringing down inflation.

What the hon. Gentleman says about fiddling the figures is totally untrue. I hope that he will therefore support my action in making available to the people working in the Health Service the details of the Whitley council offers so that everyone knows precisely where they are.

Mr. K. Harvey Proctor (Basildon)

Will my right hon. Friend ignore the stikers' mates on the Labour Benches and tell the House when he expects the health unions to make moves, as the Government have made moves, to settle this totally unnecessary dispute?

Mr. Fowler

My hon. Friend makes a good point. The fact is that the Government have moved not once but twice on Health Service pay. There is now more than £400 million on the table and for negotiation at the Whitley councils. In all the discussions that have taken place, the Health Service unions have not moved a jot. I leave the public to draw their conclusions from that.

Mr. Leslie Spriggs (St. Helens)

Is the right hon. Gentleman aware that his appeal to the Health Service unions not to strike next week would be successful if he were to make available new money on the table to meet the claims of the Health Service unions?

Mr. Fowler

I repeat to the hon. Gentleman that we have made new money available. If he is saying that he wants even more money to be made available, the answer is "No".

Rev. Ian Paisley (Antrim, North)

Does the Secretary of State agree that he should pay tribute to the dedication of Health Service workers over the years? To put the matter in the context of Northern Ireland, where we have a higher cost of living and higher transport and energy charges, does he realise that these workers need additional money? Would it not be better for him to put more money on the table today and enter into meaningful negotiations because, as I have said to him before, it is wrong to trade on their morality and dedication? I hope that the Secretary of State will not continue to do that.

Mr. Fowler

No one is trading on their dedication. The offers that have been made are between 6 per cent. and 7.5 per cent. and they are entirely in line with the offers made to the Civil Service, teachers and the Armed Services. No one can deny that. I of course, pay tribute to the dedication of those working in the Health Service at all levels, and I pay particular tribute to those people who have continued to work throughout this industrial action and who have kept the hospital services going.

Mr. Alfred Dubs (Battersea, South)

Is not the problem simply that the Secretary of State is demanding that some of the lowest-paid workers should accept a further drop in their living standards?

Mr. Fowler

No, that is not the proposition. The proposition is that we have made a reasonable offer to the Health Service unions. We have also offered them the opportunity to come to me and talk about new arrangements for determining pay.

Mr. John McWilliam (Blaydon)

Does the Secretary of State accept the the points put by my hon. Friend the Member for Crewe (Mrs. Dunwoody) are accurate? If he wishes to refute them, will he tell the House what assumptions for inflation he is making to suggest that there will be a growth in Health Service expenditure? Will he say how Health Service employees in Gateshead will do their bit to implement their part of the Black report to try to get rid of inequalities in health when he is already deliberately cutting their already low standard of living? Does the right hon. Gentleman understand the full import of the Government amendments to the Finance Bill which were passed in this Chamber the other day? Does he realise that a great deal of money is available—much more than the Government seem to need during the course of the year—so that an increase in taxation is unnecessary?

Mr. Fowler

The hon. Gentleman should recognise that we are seeking to continue the RAWP policy, but choices have to be made. In the budget, we have to choose between the money that is available for the development of the service and that which is available for paying existing staff. A balance has to be held, and I believe that the Government have got the balance right.