National Health Service (Pay Dispute)

HC Deb 20 July 1982 vol 28 cc225-69 4.13 pm

Mr. Reg Race (Wood Green)

I beg to move, That this House do now adjourn.

Leave having been given on Monday 19 July under Standing Order No. 9 to discuss: Industrial action to be undertaken by one million National Health Service staff. I believe that hon. Members in all parts of the House will wish to thank you, Mr. Speaker, for the opportunity of having a debate today on what is clearly a most important matter.

One million National Health Service workers are taking industrial action today and tomorrow, and they did so yesterday.

Before I go any further in describing the origins of the dispute, the House will want to know the action that the trade unions in the NHS have taken in response to the outrageous bomb incidents which have taken place today in central London.

The National Union of Public Employees, by which I am a sponsored Member, has instructed its members, at all the relevant hospitals in central London to which the injured are being taken to resume normal working immediately in order to support those who have been injured in the cowardly attacks by the Provisional IRA. That action shows the real merit of the National Health Service workers who are prepared to undertake a difficult and dangerous job and to support members of the public whenever they are called upon to do so.

The position is exactly the same as in 1973, when the IRA bombing attack on central London took place. Exactly the same reaction was forthcoming from the trade unions and the workers in the hospitals at that time.

Mr. Nicholas Baker (Dorset, North)

rose—

Mr. Race

I am not prepared to give way at the moment. I have not yet begun to establish my case.

The basic reason for the dispute is the appalling level of low pay in the National Health Service. Many NHS workers perform filthy jobs. They wash the filthiest sheets in Britain. They wash the sheets of the incontinent patients. They wash the blood-stained sheets of those who have had operations performed on them in NHS hospitals. They also perform dirty and often unpleasant jobs such as stoking boilers in the NHS hospitals. They are often required to work on a 24-hour rotating shift or alternating shift basis. They work unsocial hours, because the whole character of the NHS is that it is a 24-hour, seven-days-a-week, round-the-clock operation.

In return for those difficult conditions of work, the workers—whether they be nurses, ancillary staff, ambulance crews, or the administrative and clerical staff who support the nurses and medical staff on the wards—are all low paid, not only in relation to the social usefulness of the work they perform but in absolute terms. Many hospital workers today are taking home wages which are a disgrace in 1982.

My hon. Friend the Member for Oldham, West (Mr. Meacher), in our earlier debates on the matter, raised several individual constituency cases which the Secretary of State at the time was unable to refute. We could all bring wage slips to the debate this afternoon, but I want to concentrate on what the Government have been saying about the National Health Service pay statistics, because I think that they have been attempting to mislead the public about the way in which NHS pay is determined and about the level of pay in the NHS.

This is not a new problem; it has arisen over many years. As long ago as 1967, the old National Board for Prices and Incomes, in its report No. 29, described the Health Service workers as one of the lowest paid groups of workers in the country, and that is still true today.

It is also true that in the present dispute the difficulties faced by patients and the public have been greatly exacerbated by the Government's own stupid actions. It is a disgrace that the Government have sought to divide and rule the workers in the National Health Service. My hon. Friend the Member for Crewe (Mrs. Dunwoody) made that point very clearly in her contribution to our previous proceedings.

The Government were clearly hoping to be able to rely on the Royal College of Nursing's ballot result to get them out of their difficulties. They believed that, with a little intimidation from themselves through the media, they would be able to persuade nurses to vote in favour of the Government's initial pay offer. They fell flat on their faces because nurses—and, indeed, other Health Service staff—were not prepared to be intimidated by the Government's words. They wanted a decent pay settlement. Therefore, the Government's divide and rule tactics failed in that regard.

The Secretary of State had separate meetings with the Royal College of Nursing in order to try to divide the RCN from the trade unions represented on the TUC health services committee. The Government have tried also to divide and rule the 1 million Health Service workers by making different pay offers to different sorts of staff. They have sought to establish a premium between nurses and ancillary workers.

The Government in their deepest heart of hearts may wish to be the nurses' friend but they are not prepared to pay up. They are not prepared to make a decent pay offer to the 1 million Health Service workers. No amount of juggling with figures can disguise the low pay of these workers. That is especially significant in view of increased productivity and the "flat" character of the numbers who work in the Health Service. Apart from the adjustment to meet the reduction in nurses' hours from 40 a week, employment in the Health Service has been static over the past few years.

The Government pretend that the nation cannot afford a decent wage settlement for Health Service workers because they are pumping in resources for the service. That is nothing but a brutal con trick. The Government are doing nothing of the sort. They are undermining the Health Service by cutting the future level of provision by closing wards. They have done it in my constituency and I have no doubt that they have done the same in the constituencies of many of my right hon. and hon. Friends. For the Government to say that they are protecting the Health Service is nothing more than a sick joke.

Mr. Dennis Skinner (Bolsover)

Does my hon. Friend agree that it would be useful at this stage to remind the Government that they have accused NHS workers of causing pain and suffering and at the same time they have closed hospitals, or reduced the number of beds available in them? It has been revealed that the Government refuse to make good a £750,000 deficit in the London area and that as a result the Royal Marsden hospital is threatened with having to remove 33 beds that are presently used by cancer patients. So much for all the suffering that the Government accuse Health Service workers of causing. The Government are callous and brutal for the sake of a few pounds.

Mr. Race

I am grateful to my hon. Friend for that contribution, which is entirely correct. It is significant that journalists on The Sun, the Daily Express and the Daily Mail do not write stories about the closure of cancer wards when the Secretary of State is responsible. They report these matters only when they are alleged to be the result of industrial action by Health Service workers.

The dispute is linked to the different treatment that Health Service workers are experiencing when compared with other groups of workers in the public sector. When the Government say how generous they have been to Health Service workers they quote the pay increase that has been given to civil servants. They say that civil servants have been given an extra 5.9 per cent. In fact they have been given 6.5 per cent. when account is taken of their increased holiday entitlement. The Government do not mention the 7.5 per cent. increase for local authority manual workers, the 8.6 per cent. increase for miners, the 9.1,per cent. increase, plus increased holiday entitlement for water workers, the 10.1 per cent. increase for firemen, the 13–2 per cent. increase for police, the 14.3 per cent. increase for senior civil servants and the 18 per cent. increase for senior judges.

We know how the next pay round is shaping. There was a large discrepancy in the pay increases given to the police and Health Service workers last year. There is potentially a large discrepancy in the next pay round. We know that the Police Federation will soon be settling with the Government the pay round to begin in September 1982. According to the pay formula which has been established for the police, they are due to receive a pay increase of 10.2 per cent. That is what they will be offered in September if the Government keep their word. There is a discrepancy in the current pay round and there is a prospective discrepancy between the special case that the Government have established for public servants such as the police and the case for Health service workers in the next pay round. That is crucial when we consider the future of the present dispute.

The percentage pay rises that are offered to Health Service staff do not reflect the real character of the cash increases that are in prospect for them. The Government's improved pay offer provides the additional princely sum of 39p a week for an auxiliary nurse. A senior nursing officer, the most senior grade in the nurses and midwives Whitley Council agreement, will receive an increase of only 89p a week. That is the new element that the Government are offering.

Those figures must be compared with the cash increases that others receive. The full 7.5 per cent. increase for an auxiliary nurse produces an increase before stoppages of £4.92 a week. The 6 per cent. increase for a Health Service domestic yields an extra £3.54 a week. The House will be pleased to know that the 4 per cent. increase for Members of Parliament will provide an extra £10.57 a week. However, the Secretary of State in receiving his 4 per cent. increase will enjoy not £3.54, not £4.92, not £10.57 but an extra £27.98 a week.

These figures make it clear that percentages do not mean a thing. Percentage pay settlements will always produce small increases for the lowest paid workers in the country. If Health Service staff receive the same cash increase as the right hon. Gentleman, it will mean a pay increase for a laundry worker of 46 per cent. and 32 per cent. for a staff nurse.

I wish to place on record my debt to the chairman of the Conservative parliamentary trade union committee, the hon. Member for Mid-Sussex (Mr. Renton). He has expressed the issue far better than I could possibly do. In the Mid Sussex Times on 11 June 1982, having met a delegation of Health Service workers in his constituency, he stated: Their wages are really very low. They are not receiving anything like the £104 which is quoted as the average wage either before or after tax. To those people a 4 per cent. offer is not going to pay the increase in rents or bus fares. That is what the hon. Gentleman thought about the Government's initial offer. I suspect that his views have not been adjusted or mollified by the Government's latest offer.

Mr. Skinner

The hon. Member for Mid-Sussex (Mr. Renton) will still vote Tory.

Mr. Race

We must remember that we are talking about increases for Health Service staff before anything is taken from their wage packets. The money that a nurse receives in his or her wage packet is important and so are the deductions for lodging charges that are made by area health authorities. If we assume that the 6 per cent. offer is accepted, the lodging charges that will be implemented at the same time will mean that some resident nurses will be worse off than before the increase. That is an outrage and a disgrace of which the House, and especially the right hon. Gentleman, should be ashamed.

Mr. Laurie Pavitt (Brent, South)

Is my hon. Friend aware that the proposed board and lodging charges will mean that a ward sister will receive £36 a year less than her present wage even after she has received a 7.5 per cent. increase?

Mr. Race

My hon. Friend is right. That is the figure which I have in my notes. I have abbreviated my speech because I am aware that many of my hon. Friends want to catch the eye of the Chair.

There are 380,000 nurses receiving less than the maximum earnings of a State registered nurse. The Government always quote the maximum when talking about the average increase for the average nurse. The figure that they quote is always the figure at the top of the State registered nurse scale. Some 380,000 nurses are below that point, which is the vast majority of the nursing work force.

Nurses are so badly affected because not only is their pay determined by the Government's policy of cash limits, but they lack earnings opportunities. The gap between the rate of pay for a nurse and the earnings of a nurse is limited, because there is no opportunity for increased overtime and plus payments because of the character of the work that they do.

I also wish to place on record my concern that the Government are seeking grossly to mislead the House about the figures of pay for ancillary staff. They continually trot out, as they did in the last debate, a figure of £104.17 gross earnings a week for full-time male workers and £84.02 for female workers. I do not quibble with those figures. They are right, but what the Secretary of State does not tell the House is that 50.5 per cent. of ancillary staff are not full-timers. They are part-time workers, and average earnings for part-time workers—perhaps the Secretary of State will confirm this—are not £104 a week, but £42.50 a week. Thus, half of the ancillary workers in the country are receiving average earnings of £43.50 a week.

Mr. George Foulkes (South Ayrshire)

The hon. Member for Lancaster (Mrs. Kellett-Bowman) is a part-time worker.

Mr. Race

If we compare that to the position of workers in the economy as a whole, we see that even the full-time male worker in ancillary work is earning nothing like the earnings of an average full-time male worker. In April 1981, the last date for which we have figures, a full-time male worker was earning the princely sum of £140.50 a week. Even on the best construction that the Secretary of State can put on ancillary staff pay, they are still £36 behind the average earnings of male workers.

The important point that the Government always press when describing their policy in this pay round is that, although they may not be able to offer increased pay now, nevertheless there will be jam tomorrow for somebody. It is important that we discuss today precisely what that "jam tomorrow" policy amounts to. I draw the Secretary of State's attention to the speech made by his right hon. and learned Friend the Chancellor of the Exchequer recently, when he described the pay norm that he believes should operate in the next pay round. He said then that the pay norm that he wanted to see established was nil per cent.

In that context, generous treatment for the nurses or the ancillary staff may be a pay increase of 1 per cent. or 2 per cent. That is generosity in the future. Not only do we have on record the Chancellor of the Exchequer's predictions about the future course of pay, but we have the Government's document about the future character of pay negotiations for nurses and other Health Service workers. In the document submitted to the trade unions in February 1982, the Government did several things. They rejected a pay determination system based on comparability between Health Service workers and others because, they said, it ignores the need to relate the size of pay increases to what can be afforded". They also rejected indexation and a policy of a basket of analogues.

Even the Government's tentative commitment to doing something about the National Health Service pay in the future is undermined by this and other statements in this document. I wish to put on record what the document says, because it is only if one reads the Financial Times that one realises what the Government intend. The Government do not want Health Service workers to know what they have in store for them.

The Secretary of State for Social Services (Mr. Norman Fowler)

The hon. Gentleman must stop talking such complete, misleading rubbish. The document was sent to the trade unions, as he will know, so it would be peculiar if we were trying to disguise it.

Mr. Race

Yes, the document was sent to the trade unions, and that is why I know about it, but the mass of Health Service workers have to rely on proceedings in the House, and they may have been led by the Secretary of State to believe that something pleasant is in store for them in the future. If the right hon. Gentleman wishes to intervene to tell me that that is not so, I shall be glad to give way, but it seems that he does not wish to do so.

The document of February 1982 said that, in any future system of collective bargaining in the NHS, market forces must be respected. The Government talked about The extent to which the recruitment … position is more or less favourable for nurses than it is for occupations chosen as analogues". That shows me, with my suspicious mind, that it is being argued that if there are not many unemployed nurses, nurses' pay is not as bad as it might have been thought to be. On recruitment and retention, the document says that the Government must consider In absolute tents, the extent to which health authorities are finding it easy or difficult to recruit and retain nurses On affordability, a crucial point in the Government's policy, they said: The principle of 'affordability' must be reflected in any new system; and the main practical problem is how to reconcile cash limits on public expenditure with the Government's responsibilities as an employer". If that is their policy, where is the jam tomorrow, and where are the commitments that nurses and other Health Service workers can look forward to, if they accept what the Government have on offer for this pay round?

The NHS workers can have no confidence in the future arrangements proposed by the Government, because the Government have no intention of increasing public expenditure in the NHS an a substantial way. The Government are not prepared to increase the pay of NHS staff and they hide behind their alleged commitments to increase the level of expenditure in the NHS, a commitment that we all know to be false.

We can have no confidence in the Government's intentions on long-term pay. The principle of affordability means that the Government will veto negotiated increases when they are politically unacceptable. We have a precedent for the Government's actions because we are concerned not only with the future but also with the past. As they continually tell us, the Government implemented the Clegg report on nurses' and other Health Services staff, and did so because of an election commitment. However, they changed the Clegg commission's terms of reference in November 1980 and later abolished it. They stated a number of clear principles by which they wanted the Clegg commission to be guided.

It is important that we know that today, because I suspect that any future pay arrangements for NHS workers will reflect the position that the Government took in 1980. At that time, the Government said that there should be no historical comparisons between the pay of Health Service workers now and the pay of Health Service workers in the past. It would not be possible for trade unions or staff associations to put in pay claims with any chance of success and obtain increases that would get back to the level of pay in relation to other groups of workers that they had enjoyed in the past.

That is of some significance to the Health Service workers, because in 1974 the Halsbury committee awarded a rate of pay of £30 a week minimum for a student nurse, which at that lime was a basic rate of two thirds of national average earnings. If the trade unions put in a claim for the two thirds now, it would be greater than the level of claim established so far by the trade unions in this pay round.

When the Government tell this House and the trade union movement that the trade unions have not moved on the issue, I must disagree with them. The trade unions have moved, and did so before the pay round even began. They changed their negotiating position and did not put in a claim for getting back to the position of 1974, or anything like it.

It was not only historical comparisons that were out in 1980. The Government also maintained that job for job comparisons were the only acceptable form of comparison. The only method of comparison acceptable to the Government at the time and no doubt now would be that between a nurse in the National Health Service and a nurse outside it. There could be no comparison between a nurse in the NHS and the pay of senior civil servants, judges, the police or, indeed, the average earnings of manual and non-manual workers in society as whole.

How is it proposed, on these criteria, to close the gap between the level of pay in the economy as a whole and the level of pay of low-paid workers? These criteria established a level of pay that was immutable. In other words, the Government were saying that the National Health Service nurses could not compare themselves with the rest of the economy. They could only compare themselves with other workers doing the same kind of job outside the National Health Service.

That was not all. A principle was established in the instructions to the Clegg commission in 1980 that its report should make no reference to the going rate in that particular pay round. Under this regime, Health Service workers would not be able to argue that because the Secretary of State received a £27 a week wage increase they should have something akin to it. That kind of comparison would be completely out.

Again, no comparisons would be available between the general level of pay or earnings and the pay of Health Service staff. The Government emphasised in the document, as they have emphasised ever since, the principle of trading off job security and pension rights in the public sector against the level of wages. That has been done consistently. The Government have followed that principle over the Megaw report on the Civil Service, over index-linked pensions and in a number of disputes in the public sector. Their attitude to the Health Service workers is exactly the same. The Government stated in 1980 and still no doubt say, "We will not give you a decent rate of pay because we regard your job as safer and your pensions as better. We do not think that you deserve a proper wage increase to get you out of low pay."

The Government's so-called new proposals for dealing with long-term pay arrangements for National Health Service workers, given to the trade unions and the staff associations in February 1982, are nothing more than a rehash of their instructions to the Clegg commission in 1980. Those instructions had a disastrous effect at the time. They will not produce any new arrangements that would be of benefit to National Health Service workers.

We have an important job to do this afternoon. We on the Opposition Benches want to express our full support for the National Health Service workers who are taking industrial action. I say that without equivocation. It is important that hon. Members should support those people who are the lowest paid in society, who are being treated badly and who have been driven to taking industrial action.

The words of the Secretary of State about the attitudes of National Health Service workers in this dispute are a disgrace to the House. The right hon. Gentleman must know how National Health Service workers feel about patients and the public for whom they work. They have always felt that they are being blackmailed by any Government. They believe that a full service should be provided at all times in the interests of patients. That is why they are reluctant to take industrial action of any kind. For the Secretary of State to brand them as mindless wreckers intent only on attacking patients is a disgrace. The right hon. Gentleman should withdraw those words and give the Health Service workers a decent pay settlement.

If the Secretary of State wants to do something constructive today, he should get the trade unions and staff associations around the table and make them an improved offer that will deal with low pay. The right hon. Gentleman should also recognise that the trade unions have moved from the position that they occupied before the claims were submitted. The claims that have been submitted are for increases of 12 per cent. The Secretary of State has continually misled the House by stating that the claims were for 20 per cent. That is a fabrication. It is just not true.

The right hon. Gentleman has added on every small piece of the claim for improved and unspecified holiday entitlement and for other unspecified improvements in conditions of service. I want to know how the Secretary of State can cost these when the staff side has not told him what it wants. The figure of 20 per cent. is moonshine. The right hon. Gentleman knows it is statistical nonsense. He should recognise that the claim is for 12 per cent. and try to meet it, in the interests of patients, by making an improved offer.

Mr. Richard Needham (Chippenham)

In my constituency, large numbers of people working in the private manufacturing sector have not received increases of 6 per cent. or 12 per cent. They have had nothing for year after year. Why on earth should those in the National Health Service have more and so continue to put at risk those in my constituency who have had nothing?

Mr. Race

The hon. Gentleman is wrong. I have already quoted the figure for the police. If their pay formula is honoured, the police will receive a 10.2 per cent. increase that is related to the increase in average earnings. It may be true that some workers have not received any pay increase this year. Who is to blame? It is due to the recession that the Government have perpetrated on the workers of this country.

It ill behoves the hon. Gentleman to say that his constituents have to put up with a nil pay increase and that for that reason low paid workers should also receive nothing. My argument is that the low paid and the people who work in his constituency should begin to receive wage increases that would get us out of the recession. I know that this is what the hon. Gentleman also believes. He is one of the famous "wets" on the Government Benches.

The Government must realise that there is no obstacle to a common settlement in percentage terms for ancillary staff and nurses in 1982. Mr. Trevor Clay, the recently elected general secretary of the Royal College of Nursing, was reported in the Financial Times on 12 July as saying that many of its members felt that the varied offers to Health Service staff were divisive. According to the report, Mr. Clay said that nurses may not continue to insist on higher rises than those for other Health Service workers. That is the green light for the Government to go ahead.

This dispute shows in clear and brutal terms the Government's own political priorities. They are prepared to spend undisclosed huge sums on sending the task force to the Falklands. They are prepared to spend £10 billion on Trident nuclear missiles. But they are not prepared to pay the Health Service workers a decent wage. This dispute will not go away. It is now the focus for the whole trade union movement. It is time for the Government to act. The Secretary of State has proved by his actions over the last few weeks that he is too small for his boots. He should pay the Health Service workers or resign.

4.49 pm

The Secretary of State for Social Services (Mr. Norman Fowler)

I start by agreeing with one point that the hon. Member for Wood Green (Mr. Race) made. It is right to pay tribute to the speedy response of the London ambulance service and the hospital staff dealing with the appalling incidents that took place in London today. I shall have more to say about that in a moment. I profoundly challenge the entirety of his speech that began with the motion that he has tabled: Industrial action to be undertaken by one million National Health Service staff". Industrial action is not being taken by one million National Health Service staff. In his own district of Haringey—I believe that is his district health authority—today three people only are on strike My heroes are not the men and women who have stood on the picket lines, nor the minority who have caused operations to be cancelled and waiting lists to be lengthened. I believe that the real heroes of this dispute are the thousands of men and women throughout the National Health Service who have continued to care for their patients. The medical staff, the vast majority of nurses and the many thousands of staff spread throughout the Health Service—ambulancemen, ancillary workers, administrators, catering workers, clerks—are all staff who have put their patients first. Those I believe are the people who deserve our respect. I believe that I express not only my admiration, but the admiration of the vast majority of the public in this country, for their action in keeping hospitals going—often in almost impossible conditions.

Mrs. Elaine Kellett-Bowman (Lancaster)

Is my right hon. Friend aware that all the staff in all the hospitals in my constituency were balloted on whether to strike? They overwhelmingly voted not to strike, although they are no better pleased with the offer than anybody else.

Mr. Fowler

My hon. Friend confirms precisely the report that I have just made. This debate coincides with the second day of a three-day strike called by the Health Service unions. The latest report that I received just after midday showed that the Health Service is coping remarkably well in the face of very difficult conditions. There have, however, been incidents that I believe the whole House will deplore. In Leicester, water was put into the tanks of ambulances on emergency call. That incident is now being investigated by the police. In North Lincolnshire ambulance staff have today gone on strike leaving no emergency cover. That cover is being provided by the police and ambulance officers.

At the heart of the debate is the simple question whether the industrial action that is being taken inside the National Health Service can be justified. No one should deceive themselves that industrial action inside the Health Service can be taken without serious effects. Above all, it affects patients and puts them at risk and danger. That is the truth that those supporting the industrial action today have to face.

When I am challenged by the Opposition on that point, as I have been, let me remind them what one of their Ministers said a year or two ago. In 1979 the right hon. Member for Norwich, North (Mr. Ennals), then the Secretary of State for Social Services, made the position of the then Labour Government absolutely clear. On 1 February 1979 he said: I deplore their policy of calling any form of industrial action in the NHS. And then he added: I believe that we should condemn industrial action that does damage to the Health Service, whether it comes from doctors, nurses or anyone else who works in the Service."—[Official Report, 1 February 1979; Vol. 961, c. 1672–84.] I believe that that statement is correct, and that the House will wait, as it has been waiting for the past weeks, for the hon. Member for Crewe (Mrs. Dunwoody) who leads for the Opposition on health matters to make the Opposition's position on this matter absolutely clear.

Dr. M. S. Miller (East Kilbride)

I am grateful to the right hon. Gentleman. Does he realise that, important as the issue is, it is merely a symptom of something else in the Health Service at the moment? That is that the Government have to satisfy Health Service workers that they are not embarking on a policy that interferes with the function of the Health Service, and are not embarking on a policy of handing the Health. Service, or parts of it, over to private enterprise. They fear that that is what the Government are aiming at. What is the right hon. Gentleman doing to dispel that fear?

Mr. Fowler

I shall tell the hon. Gentleman precisely what the Government are doing. The Government are spending £14½ billion a year on the National Health Service. That is more than any Government have ever spent, either in actual or real terms in the history of the National Health Service. The hon. Member for Stirling, Falkirk and Grangemouth (Mr. Ewing) shakes his head. That represents a 5 per cent. increase in real terms on spending in the National Health Service.

Mr. Skinner

rose—

Mr. Fowler

I shall give way in a moment to the hon. Gentleman. I suggest, that we return to the question that I want to put to the House, whether the action is justified that is now being taken. We are, whether we like it or not, in the middle of a three-day strike. In the past few weeks I, the Minister for Health and other Ministers in the Department have seen for ourselves some of the direct effects of industrial action—even before the three-day strike. Ten days ago I visited St. Thomas' hospital, across the river. There, something like 2,000 operations have been cancelled since the beginning of the dispute and 1,800 outpatient appointments have been delayed. Two hundred and fifty beds have been closed as the result of the unions' behaviour. The waiting lists are getting longer. Among those needlessly kept waiting are cancer patients, heart patients and patients waiting for orthopaedic operations. What is the major cause of that suffering? [HON. MEMBERS: "You."] The action of 25 employees of the central sterile supplies department, who have simply withdrawn their labour.

Last Friday, I visited another teaching hospital, the Queen Elizabeth hospital in Birmingham.

Mr. Stuart Holland (Vauxhall)

rose—

Mr. Fowler

I shall give way in a moment.

Mr. Holland

rose—

Mr. Deputy Speaker (Mr. Bernard Weatherill)

Order. The Secretary of State is clearly not giving way.

Mr. Fowler

I shall give way to the hon. Gentleman in a moment, because I recognise that that hospital is in his constituency. Here again, there were empty wards and a major hospital had been forced to work at about one-third below its normal level of activity. On the same day my hon. and learned Friend, the Minister for Health, visited the Leeds general infirmary where ancillary workers withdrew emergency cover for eight days earlier in the dispute. My hon. Friend the Under-Secretary visited Addenbrooke's in Cambridge where elderly and incontinent patients are being forced to lie on paper sheets, with great discomfort and distress. That is the reality of industrial action in the NHS. That is what the Opposition are supporting.

Mr. Holland

The Secretary of State did not have the courtesy to let me know that he intended to visit St. Thomas' hospital. This gives me the chance to put the record straight.

The right hon. Gentleman referred to 25 workers. In fact, there are problems about 24 workers in the central sterile supplies department. However, the problem is negotiated with the management on a daily basis. For example, on 8 July after joint negotiation 60 items of health equipment were allowed through.

The right hon. Gentleman spoke of closures, but the closure of the children's ward was not challenged by the management, because the ward was due for redecoration. Will the Secretary of State admit that two-thirds of beds at St. Thomas' are being operated? I have with me a letter from the management to the unions involved thanking them for their co-operation on an emergency case where they willingly helped to resolve problems.

Mr. Fowler

The fact is that 25 employees in the central sterile supplies department have withdrawn their labour. Major and minor packs ready for operations have not been provided. Those packs are being provided by volunteers in the hospital who are working in their spare time so that operations can take place. Rather than accuse me, the hon. Gentleman should go to the hospital and see for himself what is happening there.

Mr. Holland

Will the right hon. Gentleman give way?

Mr. Fowler

No. That is the reality of industrial action inside the NHS. There is no balking that issue. There is no running away from it. Industrial action inside the Health Service harms patients. It strikes at the heart of the NHS because it strikes at patient care.

What is the position now? The Government have provided for pay increases ranging between, on average, 6 per cent. and 7½ per cent. for all those working in the Health Service. That compares not only with the 5.9 per cent. for the Civil Service, which the hon. Member for Wood Green mentioned, but with the 6 per cent. for teachers and the 6.1 per cent. for the Services. But more than that, it represents a substantial move by the Government in response to the Royal College of Nursing's initial ballot and to other settlements in the public sector.

The response of the health unions to those moves has been simple. They demand a pay increase of 12 per cent. and longer holidays and shorter hours. They have not moved one jot from those demands.

I must make it clear once more to the unions that the Government are not prepared to spend more money on pay. The offer that we have made is a final offer and I do not believe that the unions would find one person in a hundred among the public who would be prepared to support the claim that is being put forward.

Dr. Shirley Summerskill (Halifax)

Will the right hon. Gentleman give way?

Mr. Fowler

No, I shall not give way. Over the past three years and in spite of the worst recession since the war, the Government have not just maintained health spending, but have increased it. Total spending on the NHS in Britain in 1978–79, under a Labour Government, was £7.7 billion. This year, it is £14½ billion.

Mr. Skinner

Will the right hon. Gentleman give way? Mr. Fowler: There has been a 5 per cent.—

Mr. Skinner

Will the right hon. Gentleman give way?

Mr. Speaker

Order. The hon. Member for Bolsover (Mr. Skinner) must have heard the Secretary of State say that he was not giving way. The right hon. Gentleman has the Floor and is entitled to address the House.

Mr. Skinner

But the right hon. Gentleman promised.

Mr. Speaker

Order. The hon. Gentleman knows that there are promises and promises.

Mr. Fowler

If I made a promise to the hon. Member for Bolsover (Mr. Skinner) I would not dream of breaking it. If he will contain himself for another 30 seconds, I shall give way to him.

The point that I was making was that there has been a 5 per cent. increase in real terms since May 1979. We have taken on new staff, particularly front-line medical staff such as nurses, and we are spending more on the Health Service in both cash and real terms than have any Government in the history of the NHS.

Mr. Skinner

Perhaps the right hon. Gentleman will now tell us where much of that additional money has come from. Since the Government came to power, they have increased health charges across the board, increased dental and optical charges and put up prescription charges from 25p to £1.35. In other words, he is telling us that the total amount has gone up and the amount per head might have gone up. But the sick are subsidising the sick. That is where the additional expenditure has come from.

Mr. Fowler

The hon. Gentleman is, typically, wrong in the generality. What he says about increased charges is true, but 85 per cent. of the revenue for the NHS comes from taxation. If he is seeking a 12, 15 or 20 per cent. increase for NHS workers—

Mr. Skinner

Keep going.

Mr. Fowler

If the hon. Gentleman conceded such increases there would be even bigger increases in taxation. There is no other way of finding the money.

Dr. Summerskill

Will the right hon. Gentleman give way?

Mr. Fowler

I will not give way again.

The Government have made available extra money, above the 4 per cent. factor, for pay this year. More than 60 per cent. of that extra money has come from the Government. The rest has come from the existing budget of the NHS. In spite of the extra money that we have asked for, growth in the hospital service will still continue. The rate of growth will reduce from 1.7 per cent. to 1.3 per cent.

It should be pointed out to those who argue that we should go further on pay that the only result of that would be wards closing and redundancies—that is, unless it is believed that an extra bill of anything between £500 million and £700 million can be presented to the taxpayer.

The way forward is this. My priority is to see an end to industrial action in the NHS and I believe that that should be priority of all those who work in the service and all who have an influence on it. Certainly it is the wish of the people of this country, patients, those waiting to get into hospital and the families and friends of the sick. I hope that today we shall hear at long last from the Opposition Front Bench a condemnation of the industrial action.

People want hospitals out of the headlines. They want them to go back to their real job of caring for the sick, and union leaders, as much as anyone else, have a responsibility to heed that public demand.

Mr. David Stoddart (Swindon)

Will the right hon. Gentleman give way?

Mr. Fowler

No, I will not give way. I wish to put forward a three-point plan to get the NHS back to work.

Dr. Summerskill

Will the right hon. Gentleman give way?

Mr. Fowler

No, I will not give way. I have given way several times and the hon. Member for Wood Green hardly gave way at all.

As I said, I put forward a three-point plan to get the NHS back to work. First, on pay for this year, negotiations should resume in the Whitley councils on the basis of our improved pay offers. Those offers are final and are fair and reasonable. They compare well with settlements that have been accepted by millions in both the public and the private sectors. There is £400 million on the table. The money is there. The time has surely come for negotiation on its distribution.

Second, we should make urgent progress on finding a new permanent arrangement for determining nurses' and midwives' pay. This Government first suggested longterm arrangements back in August 1980. That is when we made our first approach. We are anxious to make progress, and I believe that there are very many in the nursing profession who see this, rightly, as a vital and long overdue step forward. I want to see a new system in place by April 1983. We have had some discussions, but if we are to achieve that target we must make progress urgently, and progress car be made only by talking.

Third—this is important, because it has not always been put inside the NHS—there are other groups inside the Health Service, apart from nurses and midwives, who would like new arrangements for their pay. It is my offer to the Health Service unions that we should get down to talks on such arrangements. I am ready to start those talks immediately, but again it is discussion which will take this forward, not industrial action. I understand the aspirations of those working in the Health Service, but I say with all the sincerity at my command that I do not believe that industrial action that can only affect patients will ever bring those aspirations into effect.

I believe that we should talk on the agenda that I have set out. Each day of industrial action is putting lives at risk and causing worry and anxiety to many thousands, of people. Providing care is a purpose that should surely unite everyone in this House. Once again, I appeal to the union leaders in the name of good sense and of common humanity to bring this pointless and damaging industrial action to an end. So let us waste no more time, no more resources on destructive industrial strife, and for goodness sake let us have constructive talks now on the basis of our improved offers and in accordance with the proposals I hat I have put before the House today.

5.11 pm

Mrs. Gwyneth Dunwoody (Crewe)

I received a message at 2 o'clock today from a number of hospitals. Without being asked, emergency services, nurses working in emergency and accident departments, and all the ancillary workers who service those departments have gone back to work to ensure that no casualty from a bomb disaster anywhere in London would have difficulty in receiving the normal high level of health care. The Secretary of State could hardly bring himself to congratulate those people. He has never withdrawn his charges that those same people are ingrates who are holding patients to ransom and who do not care about their patients in any circumstances. Unlike the right hon. Gentleman—

Mr. Fowler

rose—

Mr. Speaker

Order. It appears that the hon. Lady is not giving way.

Mrs. Dunwoody

Unlike the right hon. Gentleman,I—

Mr. Fowler

rose—

Mr. Speaker

Order. This is only a three-hour debate, and if we are to go on like this we shall have no more than an hour.

Mrs. Dunwoody

Unlike the right hon. Gentleman, I was about to give way, because I believe in courtesy, which he does not.

Mr. Fowler

The hon. Lady surely remembers that in my opening remarks I paid tribute to that action. Surely she remembers that those were the opening remarks of my speech.

Mrs. Dunwoody

The right hon. Gentleman then went on to repeat the criticisms that have been made of Health Service workers, without once withdrawing any of the charges that he has made during this industrial action.

I am quite appalled that the Secretary of State should come to the Dispatch Box today—even on this occasion—and continue to assert that industrial action is closing hospitals and preventing people from getting urgent treatment. If the right hon. Gentleman can give the House honest information, will he tell us how many of the wards in St. Thomas' hospital, which he visited, have been closed on previous occasions through lack of the resources that his Government refused to find? I noticed that he was extremely careful to quote only those instances where he thinks political capital could be made out of suggesting that Health Service workers were not interested in caring for their patients. That is completely unworthy, and also wholly untrue. It is similar to the action that he takes on the financing of the Health Service.

Dr. Summerskill

This is a different point from the one that I should have liked to make in an intervention in the Secretary of State's speech. I remind the right hon. Gentleman of the Government's proposed closure of the Elizabeth Garrett Anderson hospital unless thousands of pounds can be raised by voluntary contributions. We heard nothing about that from the Government today.

Mrs. Dunwoody

If we were to list the hospitals and hospital wards that were being closed by the Government we should have a never-ending list, and I should then be in considerable trouble with you, Mr. Speaker. That is also true, of course, of finance. The right hon. Gentleman is very good in the sums that he presents to the House, but he never deals with the real problem—the one that has afflicted the Health Service for too long. The problem of low pay in the Health Service is not new, but it has been made ten times worse by the Government's actions.

Successive Labour Ministers in the past have sought to do something about low pay by setting up a number of commissions, starting with the Halsbury commission and progressing to the setting up of sensible machinery in the Clegg commission. Unfortunately, this Government do not wish to reach an equitable pay solution through the machinery of consultation. They are interested only in confrontation.

This Conservative Government came to power absolutely determined to remove any vestige of sensible planning from the National Health Service. They immediately dismantled not only the Clegg commission but any method of comparability with outside pay rates. This dispute is one of the inevitable consequences of that intransigence.

For the first time, all the Health Service unions, working together, have submitted a claim that is sufficient to maintain their living standards—a core claim for 12 per cent. The Secretary of State responded by announcing that the allocations of moneys to the health authorities for 1982–83 included 4 per cent. for increases in earnings. When that was flatly rejected, the Secretary of State tried a new tack. He sought to divide the nursing profession from its confreres, after refusing to refer the dispute to ACAS—a request that was made by all the trade unions working in the Health Service. Although he later tried to confuse the issue by asking Mr. Pat Lowry to intervene on what he called "a personal basis", he refused to let him negotiate, or even to explore realistic grounds for a settlement. So Mr. Lowry's efforts, not surprisingly, were abortive.

The Secretary of State tried very hard to persuade the Royal College of Nursing to accept an offer without consulting the other unions. He even went as far as keeping the TUC health committee waiting while he did a deal which he hoped would undermine the entire joint efforts. The first that the TUC health committee knew of it was at a press conference, when it heard what was going on.

Throughout the dispute the Secretary of State has behaved extremely badly. From the moment that the Chancellor of the Exchequer announced his expenditure plans for 1982–83, with a 4 per cent. pay factor for the public services, far from seeking to effect an equitable settlement the Secretary of State has, by his conduct, sought to exacerbate an already delicate situation.

First, the Secretary of State failed signally to obtain his Cabinet colleagues' support for a pay award that would even keep pace with inflation. After two years in which Health Service workers have taken a direct cut in their standard of living, the Secretary of State was so out of touch with opinion in the Health Service that he did not realise how unanimous would be the condemnation and rejection of his pathetic offer.

On 8 March 1982 the Secretary of State was forced to increase his offer, but for certain groups only—most notably, the nurses. The offer that he then made was 6.4 per cent. His reasoning was probably that the general public had made it plain that there was a case to be answered. By seeking to divide the nurses from other Health Service workers, the Government hoped to isolate the ancillary grades and to make greater difficulties for them in their pay claim.

The Minister for Health showed that he was aware of the criticism of Government action when he said on 22 April 1982 that Since 1979 nurses' pay has been raised well ahead of inflation and their working week has been sharply reduced from 40 hours to 37½ hours. He could not bring himself to point out that that was no thanks to the Government but that it was forced upon them by an EEC directive. It has been used by them ever since to distort the numbers of workers whom they say are available within the Health Service. We should look at both those statements with some care because the truth is rather different.

Since the Government took office the nurses pay settlements have been constantly below the rate of inflation. In April 1980 the award was 14 per cent. compared with an inflation rate of 21.8 per cent. In April 1981 the award was 6 per cent. compared with an inflation rate of 12 per cent. Over the past three years the nurses have suffered a direct cut in their incomes.

The Minister was not content with simply reversing the figures. He went on to allege that the number of jobs in the National Health Service had increased and he implied that the workers should be grateful that they had employment.

An examination of other groups of public service workers soon exposes the hollowness of that argument. If a reasonable increase in pay means a fall in the number of workers employed, perhaps the Secretary of State and the Minister would like to explain to the House how, in a comparable period, numbers in the Armed Forces have grown by 5 per cent. while their pay has increased by 72 per cent., numbers in the police force have risen by 10.4 per cent. while their pay has increased by 73.9 per cent.

and the fire service has had a 5 per cent. increase in numbers with a 72.2 per cent. increase in pay. Those figures—

The Minister for Health (Mr. Kenneth Clarke)

rose—

Mrs. Dunwoody

I shall give way in a moment but let the hon. and learned Gentleman listen for once.

Those figures represent the position before the current round of pay settlements. From April 1982 the Armed Forces received a pay award of 6.1 per cent., the police received a pay award of 13.2 per cent. from September 1981 and the fire service has been awarded 10.1 per cent. from November 1981. If one aggregates the current settlements for those three services over the same period that is used to aggregate the figures for the nurses, the Armed Forces have received 82.5 per cent., the police services have received 96.8 per cent. and fire services 89.6 per cent.

By comparison, if the current offer to the nurses of 7.5 per cent. were applied, the comparable figure for nurses would be 71.7 per cent. If they were awarded the full 12 per cent. that figure would rise only to 78.9 per cent.

Mr. Kenneth Clarke

rose—

Mrs. Dunwoody

I shall give way to the hon. and learned Gentleman to hear what new history he has thought up now.

Mr. Clarke

Before the hon. Lady wandered off into the mists of figures relating to other services, she quoted a statement of mine as though about to reveal that it was somehow inaccurate. I said that since the Government were in power the pay of nurses had been increased ahead of inflation and that their working week had been reduced from 40 to 37½ hours. The hon. Lady missed out the 20 per cent. Clegg award to nurses that the Government honoured and paid.

As the hon. Member for Wood Green (Mr. Race) has at long last agreed that the average figures that we have used for ancillary workers are accurate, will the hon. Lady concede that my statement about nurses' pay and hours is also accurate? If not, will she give the grounds upon which she claims that they are wrong?

Mrs. Dunwoody

No, I shall not. I have just given detailed figures that show conclusively that over the past three years pay awards for nurses have been below the rate of inflation. So much for the little games that the Minister plays all the time with figures. The police service is far more important to the Government than the Health Service workers. No amount of complacent shuffling of the statistics will disguise that.

If we are to play these games, perhaps we can carry out one more little exercise before we leave the wonderland of percentages. The current offer of basic pay plus 6 per cent., minus taxes, would be worth £1.48 to a grade one National Health Service ancillary worker, £1.62 to a grade four NHS ancillary worker and £2.13 to those ambulance men who do a dirty and dangerous job on the streets.

However, when we come to the nurses the figures are even more revealing. If one takes account of lodging and meals charges and taxes the current increase for resident nurses is worth 34p to a student nurse, minus 69p to a ward sister—I hope that that will not go to their heads—one penny to a staff nurse, minus 30p to a State enrolled nurse and minus 63p to a nursing auxiliary. The Government's generosity knows no bounds.

The Secretary of State has used another argument to deter the NHS staff from seeking proper pay increases.

Mr. Clarke

The hon. Lady has been most courteous in giving way. I concede the details of the figures on the basis that she gives them. However, as every figure that she uses has to be hedged about with evey kind of qualification, can she tell me what is wrong with using average earnings figures as the Government do? They are plainly identifiable and used in every other walk of life.

Mr. Race

They are not.

Mr. Clarke

Will the hon. Lady explain why it is not acceptable to use average earnings figures and why instead one has to have those convoluted and ridiculous mathematical mazes to go through?

Mrs. Dunwoody

I am happy to ignore such convoluted things as meal and lodging charges if the Secretary of State will undertake today not to charge the nurses for those amounts that he intends to demand before the end of the year. That is an important point. 'The Government are not prepared to compare nurses' wage rates with outside wage rates when they are seeking a pay settlement but they insist on comparing meal and nursing charges with outside costs when they want to charge the nursing profession. They only want to use whatever basis suits them.

The Secretary of State has used another argument. to deter the staff from seeking a proper pay increase. He has emphasised all along that increases in pay would be at the expense of patients and patient care. It is true that in a speech on 27 March 1982, the Minister said that: Any money for larger settlements could only come from increased taxation or from reductions in patient care —but he then said— which are both quite unacceptable However, that pretence was rapidly abandoned. From the beginning, the pay offer has been calculated on the 'Oasis of a direct cut in the resource allocation to the regional health authorities.

The original pay increase of 6.4 per cent. was to cost £81.9 million, of which two-thirds was to come from the Government and one-third from the regional health authorities. However, the Government had already assumed a wholly notional "efficiency saving" of £17 million in their original calculations. They gave no evidence for that figure, but simply plucked it from the air. In addition, the effect of the subsequent offer, made on 22 June, of 7.5 per cent. for nurses and 6 per cent. for other Health Service workers will be virtually to wipe out all new growth moneys for the regional health authorities and many of the areas most in need will be directly affected so badly that they will be unable to meet their existing commitments in the coming financial year.

The Secretary of State may shake his head, but we are working from the figures that he gave in a written answer to me and he will have time to juggle with the figures between now and the conclusion of the debate. The real figures are that the extra cost would amount to £172 million, of which £113 million, or 66 per cent., would come from the Treasury and £59 million, or 34 per cent., from the regional health authorities. At a time when democraphic changes alone cost the Health Service 1 per cent. more each year, the Secretary of State has set out to deprive some of the most needy regions of even basic resources, and intends to wreck the resource allocation working party machinery by making nonsense of any suggestion that resources should be channelled where they are most needed.

The figures speak for themselves. Since the beginning of the dispute the Government have sought to push the Health Service workers not in the direction of the conference table, but out of the door on to the picket line. The Secretary of State has not only used provocative language, but has encouraged others to regard Health Service workers as selfish, "hard-Left" unionists and greedy ingrates taking vicious strike action against patients. Instead of recognising the workers' genuine grievance he has used the dispute as a palpable excuse to cut the resources available to the NHS. He has announced that he intends to freeze existing vacancies and has already made it clear that he will reverse the trend of real growth.

Even the pretence of growth has been abandoned. From now on there will be direct cuts in the NHS budget, irrespective of what happens to this pay round. However, one politician has played a large part in the dispute, but is never seen at the negotiating table at which no one ever negotiates. I refer to the Prime Minister. Since the beginning of this shoddy tale she has called the tune with her insensitive monetarist madness, and the Secretary of State—like some malicious and manipulated marionette—has danced excitedly on the end of her string. He has never once defended the Health Service from the depredations of the vultures in the Cabinet. He has never once fought for a fair deal for those who devote their lives to caring for the sick and the mentally ill. He has sought only to divide one health worker from another, slyly seeking to play off one group of workers against another and to cover up the true cost of his iniquity. He has insulted those with whom he sought apparent agreement and misrepresented those whom he purports to represent. Where there should be consultation there has been confrontation. Where there was need of unity he has deliberately fomented friction. He is a disgrace to his great office and he should resign.

5.34 pm

Mr. Tom Benyon (Abingdon)

I am glad to contribute to the debate. Indeed, this is the second time that I have made a speech on the subject of the nurses. The first time that I did so was some three months ago in Trafalgar Square. I took part in a debate and made a speech that was largely supportive of the nurses' cause. However, my illusion of demure sweet nurses was somewhat pricked by those who abused me and other parliamentary colleagues that afternoon. The hon. Member for Crewe (Mrs. Dunwoody) was with me on that occasion.

I was slightly daunted to see a very large lady in the front row with a large placard saying "Get your enema here" with which she subsequently tried to sweep me from the platform. Let us hope that this time I shall have better fortune at the hands of those who listen to my speech. However, I was amused by the general secretary of the Royal College of Nursing, who, at the end of my speech—which was totally drowned in catcalls and boos—wrote me a letter thanking me very much for my contribution which had made the afternoon such a great success.

However, having received several delegations in the House and in my constituency I have come to the conclusion that we speak a different language from many of those who seek more money from the public purse. I do not know whether those who seek more money understand that each week we are lobbied by more people who want more money from the same public purse. During the past few months university teachers, firemen and nurses have sought more money and there is a steady train of people demanding more and more money. I wonder whether they understand where the money would come from if we were to be forthcoming in every case. However, all hon. Members are sympathetic to the cause of the nurses and of those who work in the health sector. [Interruption.] There has already been plenty of political flatulence from the Opposition Front Bench today. However, from my experience I would say that hon. Members on both sides of the House are sympathetic to the cause.

The aims of democracy are not served by those who try to misrepresent the Government's position. I am perfectly prepared to criticise the Government. I have often done so and probably will do so in future. I am not afraid of doing so, but I will not sit mute listening to unfair and unjustified criticism and to distortions of the facts that are presented to the public for their consumption. Such criticisms are a disgrace and no one should be allowed to get away with them. All hon. Members recognise that those who work in the health sector are immensely valuable. Indeed, the value that the Government attach to them is represented by the additional 2 per cent. to 3.5 per cent. offered to them. Indeed, they have been offered more than our soldiers who fought in the Falklands.

The hon. Member for Crewe may shake her head but those soldiers fought bravely with no hint of a three-day week or stoppages and the public would regard it as a disgrace and a scandal if we were to pay more people more money in the public sector than the Armed Forces have accepted.

Mr. Terry Davis (Birmingham, Stechford)

The hon. Gentleman is making an important point, but he should not exaggerate his case. He said that the public would not understand it if the Government paid those in the Health Service more money than those who serve in the Armed Forces, but those who work in the Health Service will still be paid less—even if they receive an increase of 12 per cent.—than those in the Armed Services.

Mr. Benyon

I am fully aware of that. Indeed, the Conservative Party fought the last election on the firm promise that we would give internal and external security the highest priority. We fought the election on that platform and we rightly honoured the promise.

However, I pay tribute to the hon. Member for Wood Green (Mr. Race) who, with his characteristic charm, discretion and understatement, made the opening speech in the debate. He would make a splendid tribune for the class war and he covered every political cliche from putting babies before bombs to calling the Government callous and brutal and a party of conspiracy. Indeed, I believe that the hon. Member for Crewe called the Government's attitude malicious.

One important fact should not be forgotten. This is not a new problem. The people in the health sector have never been paid well. Dimly searching in the mists of my mind, I remember that the hon. Member for Crewe was a member of the Labour Government when the health workers were paid deplorably. When we came to power in 1979 we honoured, as we said we would, the Clegg report. It is no good the hon. Lady saying that we had to do that, because we did it. It is right for us to take credit for that and to explain to the health workers what we have paid them to date. We must say that clearly.

Therefore, low pay is not a new problem. Successive Governments have faced it. It is the problem of the lower paid. No one can say that our Government are directly responsible for it.

Mr. J. W. Rooker (Birmingham, Perry Barr)

The hon. Gentleman is right that the Government paid the Clegg award. What is dishonest about the Government's claim is that they think that the world started in May 1979. They refuse to count from 1978 when they talk about that pay increase. That is gross deception of the public. That point has riled my right hon. and hon. Friends. The Minister for Health is responsible for that deception and he will not admit it at the Dispatch Box.

Mr. Benyon

I thank the hon. Gentleman. I would not say that we thought that the world started when we came to power. We can take credit for a sense of realism. We stated unequivocally and it was the main thrust of our election campaign that we could not go on paying more and more money without showing people precisely where it came from, and without increasing taxation and borrowing further because taxation was too high and borrowing limits were squeezed too far already.

The Opposition have been grossly politically irresponsible. They have been trailing lost causes around the Chamber and telling the general public the story that everything is negotiable. It does not matter what the issue is—be it the Falklands, ASLEF or COHSE—providing that we can talk about it and negotiate it, doubtless we shall come to a fudged compromise. The Government have rightly fixed cash limits, which is the best way of reducing inflation. They are right to stick to those cash limits.

I charge the Opposition with peddling dreams to the electorate because the problems are always with us. They are peddling dreams by saying that we can continue to pay more to the public sector without paying any attention to where it comes from.

Mr. Stoddart

Will the hon. Gentleman give way?

Mr. Benyon

I have given way twice. I am anxious to make a brief speech, because I know that many hon. Members wish to speak.

We cannot continue to pay more in the public sector by printing more money. The Labour Party has been putting its party interests before the national interest. It has attempted to enhance its flagging political fortunes by making grossly irresponsible speeches and saying that it could do things that it knows it could not do if the country were unfortunate enough to have that party in office.

I shall draw up a balance sheet with regard to the health workers. It depends on which side one puts all the different items as to whether one is an optimist or a pessimist. I shall start with the pessimistic list. We recognise that health workers are subject to low pay. Many of them do dirty jobs and many feel that they have been ignored by Government for too long. On the optimistic side, it is important that those people are in work when more than 3 million are unemployed. Further, 47,300 more are working now than in May 1979. The job is expanding because we are spending 2 per cent. more each year on the National Health Service just to stand still. They enjoy pension rights that are fair and reasonably generous for the work that they do. Many of them achieve considerable job satisfaction. I received a letter fron one of my constituents, Miss Karen Christie of 4 Park Crescent, Abingdon, who said: However—it is a really worthwhile job and I really enjoy it, but it is wrong that the elderly and handicapped are suffering delays as they have been a particularly brave generation—several having fought in two world wars. Many people are suffering terribly because of this irresponsible and damaging strike. It is wrong of the Opposition to give succour to the people who are on strike.

New initiatives for pay for the health workers are under way and on offer. Many of the figures that are quoted are specious. For every low figure that can be quoted—some figures are distressingly low—there are others that are substantial and reasonably fair. We must remember that many health workers are unskilled. There must be differentials between the skilled and unskilled. The real problem is that we are a low productivity economy. Until that problem is solved no more money will be available for increases in the public sector. Unless there is an expanding private productive sector and the wealth-creating sector of the economy no further money will be available for additional pay. That message should come through.

In a recession refuse to sit in the House hearing the myth that we are in the midst of a conspiracy by the Conservative Party to dismantle the National Health Service. That is rubbish. One of the successes in the Government's period of office and one of our considerable achievements has been in that area. We have instituted a hospital building programme for the first time for many years. Under the Labour Government between 1974 and 1979 the capital programmes fell by one third. We are spending £1 billion this year. The waiting lists have fallen by 130,000. People can make constructive criticism, but they should not fabricate it, which is irresponsible.

The strike is intensely damaging. I hope that the workers understand that the offers on the table should be looked at again. They should come back to work immediately and negotiate. They should not try to negotiate from a posture of strike.

One of the most constructive ways forward is for the Government to look at synchro-pay. There should be a new deal for the health workers. They deserve it. They also deserve recognition. We must work out a new system of paying people in the public health sector so that we do not have continuing arguments year after year. We should have cash limits and explain round the table what the situation is. We should have public debate so that people know what is fair and unfair. That is a more satisfactory way of achieving a calmer reign on pay in the public sector.

5.48 pm

Mr. Laurie Pavitt (Brent, South)

I confirm the experience of the hon. Member for Abingdon (Mr. Benyon) in Trafalgar Square because I was sitting next to him. He need not be too worried. I assure him that the audience that he was addressing know all about the National Health Service and the Government's record. Because he was a Tory Member of Parliament he had to stand up to the knowledge and experience of people of what has happened under this Government. He had to carry the can and record of his right hon. and hon. Friends.

I invite the hon. Gentleman to read the speech made by my hon. Friend the Member for Wood Green (Mr. Race), which was well researched. As someone who knows a little about the National Health Service, I assure the hon. Gentleman that his comments did less than justice to my hon. Friend's first-class contribution to this important debate.

As my hon. Friend the Member for Crewe (Mrs. Dunwoody) said, the Government are trigger-happy. I accuse the Secretary of State and the Minister for Health of desiring confrontation and of playing political games with a great and internationally famous system of health, medication and care. They are far more concerned to make political points and to achieve strategic and tactical advantages than to negotiate genuinely about a justified claim by the lowest-paid workers in the public sector.

The nurses and professions supplementary to medicine—physiotherapists and radiographers, for example—are among the most devoted workers in the public sector. They have spent a lifetime giving service. I accuse the Government of being directly responsible for three days of industrial action and picket lines rather than resolving a justified campaign. After a long time of trying, the nurses and Health Service workers can see that the Government will not respond to justice and fair arguments unless this type of activity takes place.

I accuse the media and the Secretary of State of maximising the problems and minimising the way in which, even though industrial action is taking place, emergencies are dealt with apart, that is, from today's case. When I was on the picket line at the Central Middlesex hospital yesterday, I witnessed an emergency. The nurses on the picket lines were the first to get the person into the hospital for help. The difficulties are always being maximised. The news publicised is always the bad news. There is no word about the hundreds of thousands of people who make their protest in as civilised a way as is possible. They are leaning over backwards to do as little harm as possible to the patients in their care.

I accuse the Minister of Health of unforgivable blackmail in a speech that he made a few weeks ago. When referring to the need for an increased offer, he said that if the nurses and ancillary workers persisted in their claim they should realise that the claim represented the loss of so many kidney machines, so much of one type of equipment and so much of another type and a reduction in hospital building. In other words, he shifted to the nurses the responsibility for providing resources that rests firmly with the Government. He suggested that they should find the money to buy kidney machines by taking a reduction in their standard of living. It was a deplorable speech. I know the hon. and learned Gentleman quite well. It is not within his competence to tell the country such things and to try to shift his own responsibility to the backs of the health workers. That responsibility lies fairly and squarely on his shoulders.

My hon. Friend the Member for Wood Green made a point that cannot be repeated too often. He pointed out that a percentage of nothing is nothing. Three per cent. on tens of thousands of pounds is quite different from the same percentage increase on an ancillary worker's probable earnings of £50 a week. In that case, one is talking about practically nothing.

It is all very well for the Secretary of State to ask why, when we compare wages, we include board and lodging and stoppages, and why we do not simply deal with overall pay. The reason is simple. Board and lodging and stoppages are part and parcel of what nurses must pay. If stoppages for nurses' residences increase at the same rate as inflation and they are given a pay rise that is only half the rate of inflation, they will inevitably take a cut in the standard of living to which they are entitled.

I declare a personal interest. My daughter is a nurse. I have watched the way in which she has had to struggle compared with her friends who received the same education and had fewer qualifications. Only once since 1950 have nurses been given a square deal. That was the Halsbury award which was implemented by Barbara Castle in 1975. That was the only time when nurses got a foot on the ladder and had fair comparability. Perhaps the Minister will confirm that, even with the 7.5 per cent. award, nurses will be 18 per cent. less well off in real terms than they were in 1975.

The notion that the Government are benevolent and that they are giving nurses justice is perhaps the biggest misstatement of the year. Because nurses are vulnerable, conscientious and try to do a job of work for the community, they are held to ransom by the Government in their pursuit of their policies.

Mention of the changing number of nurses has not revealed that there are 7,411 nurses on the dole queue. Yet we are trying to increase the level of service. When I have asked about the number of nurses, I have been given no breakdown of the numbers, into those who are auxiliary, enrolled and State registered. No mention is made of the discrepancy on numbers between some areas. Government policy has caused bottlenecks of trained and qualified theatre sisters and other specialties such as renal dialysis.

The Government seem to be obsessed with surgery and operations. The Secretary of State never makes a speech without mentioning surgery and operations. Anyone who knows anything about the Health Service knows that those duties are just the top of a range of health care where other responsibilities are more numerous. But we are always given the drama of a patient being wheeled into an operating theatre. The absence of qualified people in areas where there are bottlenecks is a sign of the failure of the Government's policies.

I shall take the example of renal dialysis. The limited number of nurses who are expert in renal dialysis means that some of them must work a 60 or 70-hour week. The Minister may tell me that they then receive overtime payment. They do not. The hospital is subject to a cash limit. Therefore, the allocation for nurses' pay may not be exceeded. If a nurse works a 60, 70 or 80-hour week, he or she will receive no more pay but will have time off in lieu at some stage. The Government's cash limits hold the ring.

The North-West Thames regional health authority is the largest in the country. The Secretary of State boasts about resources. At the moment, the growth rate for 1982 in that authority is 0.03 per cent. for the year. That calculation was made before the £59 million that may be taken, if the nurses or any other NHS workers settle for the present offer. That means that I shall be faced with all types of closure and cutback in my district and all finance Officers of district health authorities will be faced with an impossible job.

I notice that the Secretary of State never compares the figures with the gross national product. He describes only the figure in terms of global funds. The Health Service now absorbs about 5.9 per cent. of the GNP. In spite of the fact that the Secretary of State claims that resources have been increased, if one takes into account the way in which joint funding has been handled for social services departments in local authorities, his figures are more suspect than ever.

The Government's tactics and strategy have been deplorable. Even today, the Secretary of State suggested that if interested parties would come to the conference table, he would trade off a little more here for a little less there—in other words, that he is not prepared to reconsider his strategy. I warn the Government that if they continue to pursue that strategy, not only will we have the unrest of today and tomorrow, they will destroy the morale and the co-operation that exists throughout the Health Service where so many varied workers form a team. Morale will be destroyed not just for this year but for the next 10 years.

Several Hon. Members

rose—

Mr. Speaker

Order. Before I call the next hon. Member, I remind the House that the debate will finish at 7.12 pm. At least seven hon. Members hope to catch my eye, in addition to the Front Bench spokesmen. If speeches are brief, far more hon. Members—especially those who have been present throughout the debate—can be called.

6 pm

Mr. John Cartwright (Woolwich, East)

I should say, first, how much I appreciate the initiative of the hon. Member for Wood Green (Mr. Race) in obtaining this debate. He made an extremely powerful case on behalf of the Health Service workers. He will not be surprised to hear that I did not agree with everything that he said, but it was a powerful case and it was inadequately answered by the Government.

The saddest aspect of the Government's handling of the dispute is the cynicism that it shows. Very few hon. Members would disagree that if the Health Service workers had the industrial muscle of the miners, the water workers or the gas workers they would have been offered a more generous settlement. The Government's attitude to pay policy is developing clearly. Most will go to those who fight most toughly and threaten the greatest damage. The Government should not be surprised if the Health Service unions learn that lesson. It is doubly hard on the Health Service workers to receive a low pay offer on the basis of an existing pay level that everyone recognises is extremely low.

There have been arguments about average pay, and many hon. Members will have seen pay slips during the dispute. I have seen many, but I quote just one that is typical. A porter at the Brook general hospital in Woolwich who works 40 hours per week on a rotary shift basis receives the princely sum of £64.20 in basic pay. London weighting adds £11.28 and his rotary shift allowance adds a further £6.40. His total gross pay is therefore £81.88. Deductions for income tax, superannuation, national insurance and so on remove £21.61, leaving him with the magnificent sum of £60.27 for a 40-hour week on which to keep a family in the circumstances of 1982.

It is easy to understand the anger of people who receive such a poor reward for the vital work that they do. An increase of 6 per cent. on the gross pay to which I referred would add less than £5 per week gross. By the time that normal deductions have eaten it away, it would be about half that figure. That is before one considers the problems of rent and rate rises, fuel costs and all the other inflationary circumstances of 1982.

It is a tragedy that Health Service workers have been forced to take industrial action. I recognise that in most cases the unions are seeking to minimise the impact on patients, but they recognise that any industrial action must harm the quality of the service to patients. At Greenwich district hospital, for example, white collar workers in NALGO took action last week. As a result, ambulances bringing elderly patients to a geriatric clinic were turned away, appointments were disrupted and waiting lists were extended. That shows not the mindless militancy of the people involved, but their sense of grievance, frustration and bitterness at the treatment that they have received.

A NALGO official was quoted in my local newspaper as saying: It is unfortunate that patients will be hit. But there is no other way to put our pay claim across. It is an appalling indictment of the way in which industrial relations are conducted in this country that people feel that they have to take that kind of action.

Mr. Kenneth Clarke

Will the hon. Gentleman make it clear whether the Social Democratic Party condemns industrial action in the Health Service? The Labour Government condemned it unreservedly. Has even the moderate breakaway now changed its mind?

Mr. Cartwright

If the hon. and learned Gentleman will be patient, I am about to deal with that point.

I understand the bitterness and frustration that lead people to take industrial action of this kind. Nevertheless, comments such as those that I have quoted from a NALGO official, understandable though they may be, simply play into the Government's hands. I much prefer the comment of Mr. Ian Maccaul, a COHSE branch secretary in my constituency, who was reported in the local newspaper as saying: We will take no part in any action that will hit the patients. Although we support the fight for more pay, patients must come first. I very much endorse that approach. It is typical of the majority of Health Service workers and it will enable them to retain the public support that they have so rightly built up. I believe that that public support is their most powerful asset and should not be put at risk. Despite all the anger and frustration that the workers feel, I believe that the public support that they have achieved is far more likely than industrial action to obtain results because I believe that the overwhelming majority of people in this country recognise that the cause of the Health Service workers is a just cause.

6.5 pm

Mrs. Jill Knight (Birmingham, Edgbaston)

I begin by paying sincere tribute to the many people in the Health Service who are working normally. A large majority of the nurses and some other workers have not been coerced or frightened into joining the strike. They deserve our tribute today.

Only last week someone in my constituency who has worked in the Health Service for about 22 years said to me "I never thought that I would be ashamed of my profession, but I am today". She felt that there was no possible excuse for what the militants in the Health Service are doing. It has been made clear time and again that the Government have done their utmost to make every last penny available. Many Health Service workers, including nurses, physiotherapists and others, have been offered 7.5 per cent., ambulancemen have been offered 6.5 per cent., and other ancillary workers have been offered 6 per cent. Those are not bad figures at a time when other workers are accepting 4 per cent.

It is important to note what others are saying about this. The Guardian, which is not universally known for its support of the Government, said on 23 June: The unyielding demand of the unions for a 12 per cent. pay increase (or 20 per cent. if the demands on holidays and hours are included) suggests that they are not seriously seeking a settlement. They must know that no responsible Government could possibly meet this claim. Their determination to widen the conflict is reflected by a COHSE spokesman threatening to call a general strike in order to succeed in its aims". It is important also to notice the kind of people who are pushing the strike. The intervention of the miners' union and others clearly shows that some militants are seizing on the situation with great joy as a stick with which to beat the Government. As The Guardian said, there is no case whatever for a 12 per cent. pay increase. It is well above the inflation rate, well above what others are accepting and far more than the country can afford.

I was surprised when the hon. Member for Wood Green (Mr. Race) claimed that the Government were not prepared to pay up. It would not be a bad idea if some Opposition Members recognised that every penny spent by the Government in this way is not the Government's money but the people's money. There is no magic tap at the Treasury that can be turned on and guaranteed to produce all the money that is required. If the Government agreed to the 12 per cent. demand, the worst of our economic troubles would begin all over again. Others would want 12 per cent., 15 per cent. or 20 per cent., as the hon. Member for Wood Green himself made clear.

Mr. Geoffrey Lofthouse (Pontefract and Castleford)

Will the hon. Lady give way?

Mrs. Knight

No, I am sorry, but I cannot give way. I wish to show courtesy to you, Mr. Speaker, and to meet your request for short speeches.

The trouble is that whenever a 12, 14 or 15 per cent. claim is settled everyone else immediately wants the same figure. It starts the spiral again and in that case there would be no hope of beating inflation.

I remind the Opposition of what a Labour Prime Minister said in 1978–79. At that time the Labour Government were attempting to hold pay awards in the NHS to 5 per cent. because they knew that a pay explosion would aggravate inflation and increase unemployment. It is a pity that the Opposition have forgotten what that Prime Minister said.

Mrs. Dunwoody

Will the hon. Lady give way?

Mrs. Knight

I shall finish what I am saying. The hon. Lady had a jolly good bash and I intend to have a bit of a bash, too.

The hon. Lady served under that Socialist Prime Minister. He said To those who want to improve the Health Service, as I do, and those who want to improve education, as I do, I say that the first test is to keep inflation down. Inflation cuts away at jobs. It reduces the attraction of our goods to other countries and lessens the opportunities for export."—[Official Report, 1 November 1978; Vol. 957, c. 50.] If that was right then—Conservative hon. Members recognised how right and fair it was—and considered to be words of wisdom when a Labour Government were in power, why does it become wrong as soon as the Conservatives take office?

Have the Opposition calculated the cost of a 12 per cent. increase? A claim of 12 per cent. would cost £850 million. Honestly, where do hon. Gentlemen think the money will come from? That is not the full amount. If the longer holidays and other demands in the package are met the cost would be £1,000 million.

It must be recognised that that money is not available. I suppose it is true that there are none so blind as those who will not see. The hon. Member for Woolwich, East (Mr. Cartwright) referred to a statement made by a COHSE official. It was a good statement and I imagine that in that area the strike was not harming the patients. However, In many places the strike is causing endless grief and worry to innocent, sick people. How can that be right?

Two days ago a newspaper reported that doctors were unable to help a pregnant woman who was in agony and well past her time because surgical induction demanded medical supplies that the strikers were holding up. How can the Opposition support that? How can the Opposition support the reports of pickets interrogating people? Newspaper reports mention one woman with severe abdominal pains. How can it be right that that woman should have to describe her medical condition and how she feels to trade union pickets who have no medical knowledge?

It is reported that normally St. Thomas' hospital deals with 120 emergency operations each day. That is now down to 30. Surely if an emergency operation means anything it is an operation that is desperately needed by the person who is undergoing it. Can the Opposition understand what is happening in the minds of those people whose operations are postponed?

Only this morning I received a heartrending letter from a constituent who tells me that she found a lump in her breast and because she was unable to make a normal appointment under the National Health Service she arranged a private consultation. The surgeon was reassuring, but told her that she needed an operation quickly. An appointment was made for the operation to be carried out last Sunday. Four days before it was due she was told the operation was cancelled. She was given another appointment and that was cancelled. The next appointment was also cancelled. Can anyone imagine what is going through the mind of my constituent? She is worried to death about whether she has cancer.

It is no use some Opposition Members saying that it is the Government's fault. It is the fault of the people who are denying that woman treatment. There is no doubt about that. Such people cannot be allowed to win. Bullies are always thoroughly nasty, but the bully who attacks the sick, the old and the helpless is, in my book, unspeakable.

What would have happened to Florence Nightingale's image if she had put down the lamp and left dying patients in order to get more money? It is deplorable that such things are happening today.

The Minister has made it clear and the Government's case is cast-iron. They have offered all they can, yet these actions continue. Who is in the right?

6.18 pm

Mr. Stan Thorne (Preston, South)

There is much in what the hon. Member for Birmingham, Edgbaston (Mrs. Knight) said that needs a reply, but I have my own points to make and I shall not follow her argument.

The Minister referred to what was done in the Health Service by the Labour Government. Some of his criticisms must be accepted. A number of us objected at the time to the Front Bench decisions that were taken on Health Service workers' pay. We cannot escape the fact that we, too, have some responsibility for the existing situation. However, that in no way excuses the Government.

Several of my hon. Friends and I took the opportunity this morning to meet a delegation from London's Royal Free hospital. That delegation was widely representative of laboratory technicians, biologists, porters, cleaners, domestics, clerks, members of NUPE, COHSE, NALGO and ASTMS. They put a very clear exposition of their problems. We examined pay slips, which covered several months. One of the men, married with children, takes home about £58 a week. That man is capable of controlling the water and power supplied to a hospital. He could act in the irresponsible way that the Minister suggests workers are doing, but he is unwilling to do so because he recognises—obviously, far more than Government spokesmen recognise—the need to look after the patients in spite of, not because of, the Government's activities.

References have been made to NHS expenditure. In spite of what the Minister says, it is clear that there will be a 2 per cent. cut in real terms in the next two years. What effect will that have on Health Service provisions? If the present pay offers are implemented, the health authorities will need to find £67 million, possibly by cutting jobs by about 12,000. They will certainly need to reduce their ability to provide adequate patient care. How many people have needlessly died in recent years owing to the absence of kidney machines and other important life support measures?

The Government appear to have no real understanding of what can be done. It is all a question of priorities. A few days ago we debated defence expenditure. It is clear that the Government prefer to find money for death and to cut the Health Service. Yet again they have illustrated that they are an anti-life Government, and the sooner they go the better for all concerned.

6.20 pm

Mrs. Sheila Faith (Belper)

I listened with some sympathy to the hon. Member for Wood Green (Mr. Race), although I did not agree with everything that he said. I also listened with sympathy to some of my constituents, who are members of COHSE, who came down from Derbyshire yesterday to see me. Some of them recounted stories of great hardship. I sympathise with them, although I recognise that the average wage of ancillary workers is more than £100 a week.

The ancillary workers must recognise that the NHS is spending more than £12 billion a year, the majority of which goes on wages. It is therefore difficult to give the Health Service workers all the financial help that they require, because it would cost an extra £1 billion, which would affect our economy and the future development of the NHS both capital projects and possible staff increases.

I believe that in their heart of hearts the majority of the COHSE representatives whom I met knew that they were being used by militant Left-wing elements in a campaign against cash limits and picketing laws. Indeed, Mr. Arthur Scargill, the president of the NUM, has said: The best way to oppose the Tebbit Bill is to support the nurses and health workers". When I pointed out that NHS expenditure had increased from £6… billion in 1979 to more than £12 billion today, they knew that that was true, just as they did when I pointed out that nurses' pay had more than kept pace with inflation. I also pointed out that nurses' hours had been reduced, that waiting lists had been shortened and that many more people—doctors, nurses and ancillary workers—now worked in the NHS.

Those constituents did not say that they would vote for me at the next general election, nor did they say that they would vote Labour. They said that they would not vote at all. They have good memories and are aware that as recently as 1979 they were in confrontation with a Labour Government. They recall that the then Prime Minister, the right hon. Member for Cardiff, South-East (Mr. Callaghan), said: To those who want to improve the Health Service, as I do, and those who want to improve education, as I do, I say that the first test is to keep inflation down. Inflation cuts away at jobs. It reduces the attraction of our goods to other countries and lessens the opportunities for exports."—[Official Report, 1 November 1978; Vol. 957, c. 50.]

Mr. Lofthouse

Is the hon. Lady aware that when the Labour Government were attempting to keep inflation down the Conservative Party supported a 22 per cent. wage incease for the Ford motor workers, which was outside the 5 per cent. norm?

Mrs. Faith

I do not think that is particularly relevant to the present situation.

I pointed out to the Health Service workers who saw me yesterday that if they were given extra money it would come from the taxes paid by private industry thereby causing more bankruptcies and unemployment. They understood the point that I was making.

They were also aware that in 1979 the former Secretary of State for Social Services said: I believe that we should condemn industrial action that does damage to the Health Service, whether it comes from doctors, nurses or anyone else".—[Official Report, 1 February 1979; Vol. 961, c. 1684.] The Secretary of State talked about real danger to life as a result of this dispute, as did my hon. Friend the Member for Birmingham, Edgbaston (Mrs. Knight). Only this morning, I received a letter from a dentist who works in a psychiatric hospital in Kent. He said that since early May the operating theatre had been closed due to the COHSE dispute, and I understand that yesterday the trade union district committee refused to reopen that theatre. Those are the only facilities available to him and there are now 49 patients on his waiting list. The allocation of three beds each week means that the waiting time has become 16 weeks rather than the normal one to four weeks.

Several patients have been prescribed antibiotics for their abscesses, and many are taking analgesics. As a dentist, I know of the acute pain and discomfort that can be caused by dental distress and I also know of the real danger to health that can be caused by an infection in the mouth. I am referring here to mentally handicapped patients. I implore NHS workers and the NHS unions to accept the Secretary of State's recommendation and to remember that a new review body may be proposed for them if they agree to speak to the Minister. I therefore hope that they will stop their industrial action.

6.26 pm

Mr. Doug Hoyle (Warrington)

It is an understatement to say that I have been disappointed with many of the speeches by Conservative Members. The hon. Member for Belper (Mrs. Faith) showed more sympathy for the Health Service workers than the hon. Member for Birmingham, Edgbaston (Mrs. Knight). I hope that the hon. Member for Edgbaston has now put away her economic primary text book, because, although Conservative Members believe in free market economics, the Health Service workers are not applying them. If they did so, they would indeed put patients' lives at risk. However, because of their loyalty and devotion to patients, they are not prepared to do so. Indeed, the attitude of the Health Service workers has been one of restraint.

The Secretary of State and Conservative Members cannot have it both ways. I am glad that the right hon. Gentleman has now returned to the Chamber, because his performance today was petty, small-minded, uncaring and unfeeling. It was one of the most miserable performances that there has been from the Government Front Bench. I wish that the right hon. Gentleman would behave more like a Secretary of State who has feeling and responsibility for his office and less like a leader writer for The Times, although his performance today was more suited to a mass circulation tabloid.

The responsibility for what is happening in the Health Service rests with the Government. This dispute could be stopped at any time if there were meaningful negotiations. It is no good the Government saying that there has been no movement on the trade union side. Of course there has. I am vice-president of ASTMS, and I know that the Health Service unions and the TUC are always ready to talk to the Secretary of State if there is something meaningful that they can discuss.

Mr. Tom Benyon

Will the hon. Gentleman give way?

Mr. Hoyle

No. The hon. Gentleman's contribution was an absolute disgrace. He now has the cheek to try to intervene when he revealed his lack of knowledge of the Health Service. Either that, or he deliberately misrepresented the Health Service workers' case.

Mr. Tom Benyon

rose—

Mr. Hoyle

I have no intention of giving way to the hon. Gentleman. We have heard enough from him.

I want to talk about the facts of the Health Service workers' case, and the fact is that they are among the lowest paid workers in the country. As for paying people for professional qualifications, I should like to say a few words about my members who have professional qualifications. There are medical laboratory scientific officers who earn about £100 a week. If they were working in industry, they would be earning £188 a week. Indeed, for many of them the average pay is less than £100 a week. A third of them are women. They are doing a very important job in testing blood, urine and other samples, and they are getting £80 a week. A quarter of them are juniors on £52 a week. What kind of reward is that for study and professional qualifications?

For a very long time Health Service workers have been prepared to put the interests of the patients first and to say "We are not prepared to have a dispute. We do not want a dispute. We know that our salaries are inadequate but we hope that, without resorting to any industrial action, our needs will be recognised." Their needs are not being recognised. When the Secretary of State speaks of cost of between £500 million and £700 million to settle the 12 per cent. claim they know that that represents only a quarter of the cost of the operation in the Falklands, but there was no question about the cost of that operation. The contingency reserves were there and the operation was funded. Why cannot the Heath Service workers be funded as well?

The Health Service is important to every man, woman and child in this country. Unless we are very fortunate, we shall all spend some time in hospital. When people come out of hospital, the one thing that they talk about is the dedication of the Health Service workers. The Secretary of State tried to divide them. He tried to get the nurses to call off the strike. He tried in every way possible to get them to accept his offer, but it was impossible, because they realise that unity is strength and that Health Service workers must stand together if they are ever to get a decent deal.

It surprises me that the debate is necessary when the one thing that is apparent is that we spend less of our gross domestic product on the Health Service—just under 6 per cent.—than is spent by most other countries of Western Europe. Most of them spend about 10 per cent. on their health services. We know, too, that other changes are coming in the Health Service.

Only about 6 per cent. of the expenditure on the NHS goes on administration, yet in Australia and various other countries it accounts for 20 per cent., because of the private health insurance schemes in operation there. The Secretary of State will not reveal the contents of the report that he has been sitting on since about January, but it is believed that private health insurance schemes are to be introduced. That is what we gather from leaks in the press, but we have not yet had a statement in the House about the matter.

Dr. M. S. Miller

My hon. Friend is right when he says that we spend less on our National Health Service than other countries spend on theirs, but will he agree that, for the lower proportion of our gross domestic product that we pay, we get a better deal?

Mr. Speaker

Order. The hon. Gentleman must remember that he is not having a private conversation with his hon. Friend the Member for Warrington (Mr. Hoyle). He must address the whole House.

Dr. Miller

I apologise, Mr. Speaker. Although we spend less on our Health Service than other countries spend on theirs, our Health Service is a better service than that of many other countries. That shows clearly that the British people are getting their Health Service on the cheap.

Mr. Hoyle

I could not agree more with my hon. Friend. It is time that we stopped having it on the cheap, because that is achieved through the low salaries of the Health Service workers, and part of the other saving is due to the rundown in the medical services.

The Secretary of State is always talking about getting out into the country. I should like him to see what is happening in my constituency. One hospital, Winwick, is 117 nurses short. Does he imagine that the way he is treating the Health Service workers will overcome those practical difficulties? Of course it will not. We ought to be spending more on our Health Service, and our expenditure falls well below that in France, West Germany or even the United States of America. This state of affairs cannot be tolerated, and it is not good enough for Ministers to say that the dispute must be called off. They must get back to the negotiating table.

The Health Service administrators have said that the Government's policy is not defensible, and I think they speak for most people in Britain when they say that. It has been clearly shown that the public have an understanding of what is occurring in the Health Service and are backing the Health Service workers.

I remind the Secretary of State that 5,000 members of the Medical Practitioners Union sent him a telegram on 12 July pledging their support to the Health Service workers and pointing out that any risk to patient care would rest with the Secretary of State and his unsympathetic policy. It is clear that it must rest upon him.

After the Secretary of State's display today, I must join the other voices raised on the Opposition Benches and say to him "For God's sake go, and make way for somebody who might be more sympathetic to the needs of the Health Service."

Mr. Fowler

You silly man.

Mr. Hoyle

You are the silly man.

Mr. Speaker

Order. The hon. Gentleman knows that that does not apply—well, it might apply but he is not allowed to say it.

6.37 pm

Mr. Clement Freud (Isle of Ely)

I rise, after that brief private conversation, to say that I recognise the intrinsic decency of the Health Service workers. I join the Minister and the hon. Member for Crewe (Mrs. Dunwoody) in paying tribute to the instant cessation of industrial activity as a result of today's bomb attacks.

I think that it must be recognised that, whoever is the hero of the strike, it is not the Government. The Secretary of State said at one point in his speech "I appeal to the Health Service unions." That is where he is so wrong; he does not appeal to the Health Service unions. The sooner he recognises that, the easier it will be to come to a satisfactory conclusion of the dispute.

The longer the strike continues and the worse the situation becomes, the clearer it is that Health Service workers are as invaluable as nurses, and the Government policy—if it is a policy—of dividing in order to rule does little credit to the Front Bench. The dispute began with the nurses and we watched in some dismay as the Minister appealed to the Royal College of Nursing and tried to divide that profession. He went on to suggest variable rates of pay, failing to recognise that ancillary workers feel that they are just as important as nurses. It has been a ham-fisted way of dealing with an industrial dispute—and it is an industrial dispute which the people of this country support.

There was widespread and general condemnation of the rail strike, but I believe that the average man in the street has very considerable sympathy with the nurses and ancillary workers who are on strike. I understand that the Government's coffers are not bottomless, but if the workers cannot have the money, let us at least have straight, plain dealing and honesty.

After the Minister of State announced that a 12 per cent. pay rise would cost £1,000 million, we heard the Secretary of State say today that it would cost between £500 million and £700 million to meet the claim. In conciliatory mood, the hon. Member for Birmingham, Edgbaston (Mrs. Knight) made the figure £850 million. One would have thought that three people sitting in such close proximity could have got together and agreed upon a figure, however wrong, that would have given the nurses and the country some idea of the cost of the claim.

The Secretary of State will not be surprised when I say that I and my hon. and hon. Friends have always supported a pay policy. We now have a pay policy for the police that works well, but unless we have a genuine pay policy for the country we shall have the same misery year after year.

Mr. Fowler

For my own information, what precisely was this pay policy?

Mr. Freud

I am delighted to be given this opportunity to explain and I am sorry that I have so little time in which to do it. A pay policy is the determination by the party in power to have a system of linked pay awards whereby the different sectors know what they will be receiving. Does that surprise the Secretary of State?

Mr. Fowler

II has given the policy a little more flesh.

Mr. Freud

That is the big difference between the Secretary of State and me. Briefly, and simply, I ask that the intrinsic decency of the Health Service workers be recognised. The general condemnation that most strikes receive does not apply to this one. My hon. Friends—[HON. MEMBERS: "Where are they?"] I already represent over 8 per cent. of my party. Nothing like 8 per cent. of either the Government or the Opposition are present. We are well represented in this debate.

If the Secretary of State will not pay the nurses and the ancillary workers what they need, the least that he can do is level with them so that they might have some faith in his dealings.

6.43 pm

Mr. Stuart Holland (Vauxhall)

rose—

Mr. Speaker

I am sorry to tell the hon. Member for Vauxhall (Mr. Holland) that it is hoped that the Front Bench replies will begin at 6.45 pm. I know what difficulty that must place on him.

Mr. Holland

I am grateful to you, Mr. Speaker, for recognising my special problem. None the less, I should like to devote some time to the dispute at St. Thomas' hospital to which the Secretary of State referred and which was the subject of a disgraceful article in the Sunday Express last Sunday. That paper claimed that 25 strikers are sabotaging one of Britain's top hospitals. The dispute at the hospital does not simply concern 25 workers. It is supported by all the major unions in the hospital including ASTMS, AUEW, COHSE, NUPE, NALGO, TGWU, UCATT, EETPU and others. In the central sterile supplies department the staff have been on strike for over three weeks but a permanent staff of two people is maintained dealing with 20 sterile packs per day. A regular meeting takes place between the unions and the health authority chairman before any industrial action because the unions wish to resolve any industrial problems in advance. There is a regular daily meeting with management on both drug supply and emergency cases. Post has been let into the hospital and management is able to open it. In the case of the children's wards, the management did not oppose the closure because the wards were scheduled for redecoration.

I have two brief and key points, which are relevant to the dispute. The Minister is basically passing the buck. He is saying, in terms of the relevant circulars to which he referred the district health authorities, that they have to decide how to handle the industrial action. On the other hand, he is saying quite simply that the money is not available.

What I would like him to say to the House is whether he has or has not sent what amount to sealed instructions on the dispute to the chairpersons of health authorities which are marked "confidential" and are not for discussion by the health authorities themselves.

Secondly, what circulars concerning the hiving-off of catering, cleaning, laundry and medical preparation are now in the pipeline, having been prepared by Government Departments, and to be released after this dispute as if the dispute itself had caused them?

The Government, with their policy of manic monetarism and almost lunatic laissez-faire neglect the fact that public spending in the Health Service, especially on the wages side, sustains rather than drains the private sector. Also, there is not a hospital built in this country, not a drug supplied and no equipment used which is not provided by the private enterprise sector. It is in this light that we see the claim that there is no cash to raise the wages of the low paid in the health sector, whereas there has been no trouble about undertaking the Falklands dispute and paying the cost later. There is cash for killing but not for curing. There is cash for the death industry but not for the life industry of the Health Service. It is a disgrace that reflects upon this Government and it is a disgrace that will reflect upon the House if it does not oppose the Government later tonight.

6.47 pm

Mr. Terry Davis (Birmingham, Stechford)

The Secretary of State began his remarks by saying that the heart of the debate would be whether the action that is being taken by Health Service workers could be justified. The real heart of the debate is whether the right hon. Gentleman's attitude can be justified. It is his attitude which is responsible for the action that is being taken by Health Service workers. It is his attitude which is responsible for the distress and suffering of patients.

The right hon. Gentleman has offered those who work in the Health Service some pay increases which, on average, are 6 per cent. and 7.5 per cent. depending on the group to which they belong. However, the Government have agreed increases for other groups of workers that are much higher than 6 per cent. and 7.5 per cent. They have agreed increases of 10 per cent. for firemen, 13 per cent. for the police, 14 per cent. for senior civil servants and 18 per cent. for judges. How does the right hon. Gentleman justify the difference in the increases?

Are those in the other groups paid lower wages than those paid to Health Service workers? Obviously not. Is it because firemen, police, senior civil servants and judges work in conditions which are more unpleasant than those of Health Service workers? Obviously not. The police and the firemen may encounter unpleasant conditions but I doubt whether they would argue that their conditions are more unpleasant than those experienced by Health Service workers in our hospitals, especially in the kitchens and laundry rooms of those hospitals. The difference in treatment is not justified on those grounds.

Have firemen, the police, senior civil servants and judges seen a reduction in their numbers? Obviously not. There have been increases in the numbers in all those groups. Is there a difference because those people are in work and others are unemployed? That is obviously not so because that factor applies to all groups. Is it because the other groups do not enjoy the same pension rights as those who work in the Health Service? Obviously not. The fact is that the Government have no justification for their miserable offer to those who work in the Health Service and who are paid measurably low wages.

The Government want to take into account in determining the wages of those who work in the Health Service something that they call "market forces"—in other words, supply and demand. Apparently, it would mean that because there are far too many people—more than 3 million—registered as unemployed, those who work in the Health Service should accept lower wage increases. Does that not apply to firemen, policemen, senior civil servants, judges and the rest? Of course it does.

If the Secretary of State wishes to announce to the House that he is prepared to discuss an increase in the figures of 6 per cent. and 7.5 per cent. on average, let him intervene. That would be welcome news to all Labour Members.

Mr. Fowler

The point I should like to make is that the Government have increased their offer twice. We have increased it once for the nurses, and on a second occasion following discussions with the unions. However, at no stage have the union moved one jot from their position.

Mr. Davis

The Secretary of State has shown that he is either very bad or very clever with his figures, depending on how one looks at it. When he says that the Government have increased their offer twice, he means that they have increased each offer once. They have made an increase from 4 per cent. to 6 per cent. for one group, and from 6 per cent. to 7.5 per cent. for another group. They have moved once, and they refused to move again. That is the problem. The Secretary of State refuses to negotiate. He asks the unions to accept his offer, but negotiation means discussing on both sides what is on the table.

Mr. Tom Benyon

It takes two to negotiate. As I understand the position, the trade unions have refused to budge from their 12 per cent. demand. Even if the Government move up one jot further, how can we know that the unions will come down one jot?

Mr. Davis

It is impossible to know whether the unions will move from 12 per cent. unless people sit around a table and discuss the matter. Neither unions nor management negotiate by public announcement. That is the way that the Government seek to negotiate with the Health Service workers. The Secretary of State invited them to return to the table, but, he says, to discuss the distribution and allocation of the 6 per cent. and the 7.5 per cent. That is not negotiation. It is not negotiation if there are preconditions.

It is against that background that those who work in the NHS feel that they have no alternative, and no other way of making the Secretary of State return to the negotiating table with them. My information is that the trade unions would return to the negotiating table as soon as the Secretary of State opened the door to the room, but he will not do that. Instead of sitting down with representatives of the Health Service unions, the Secretary of State tried first to divide the nurses from the Health Service workers. Having failed, he is trying to separate the patients from the health workers and to set the patients against the workers.

The Secretary of State says—I agree with him on this—that people want hospitals to get back to caring for the sick. That is what the public want, and so do the people who work in those hospitals. The Secretary of State appealed to the trade unions to end their action, and proposed a three-point plan. I propose, on behalf of myself and my hon. Friends, a one-point plan. We appeal to the Secretary of State to put an end to the need for industrial action by engaging in real discussions, without any preconditions, with the representatives of the Health Service unions. It is his refusal to negotiate that is at the heart of the dispute and at the heart of the debate.

6.54 pm

The Minister for Health (Mr. Kenneth Clarke)

Having heard the latest explanation why the Labour Party is backing the Health Service strike, I begin to think that perhaps the two days that my right hon. Friend and I spent locked in negotiation with the TUC health committee were some kind of bad dream that I now recollect. We have tried to negotiate in a genuine attempt to settle the dispute, having already moved on the offer that we made to the nurses and midwives from the original 4 per cent. pay factor. In the course of those two days, the trade union side did not budge from the 12 per cent. demand, which my right hon. Friend valued at his figure, or the overall 20 per cent, which I valued at £1 billion in earlier speeches.

The form of negotiation that the hon. Member for Birmingham, Stechford (Mr. Davis) suggested, would be one in which the Government kept meeting the Health Service unions to edge nearer and nearer the 12 per cent. demand that they have backed up with strike action.

At times today, we have been far from negotiating. Labour Members have brought the rancour of the picket lines into the Chamber. Certain matters ought to unite us on a subject as sensitive as health care. We are united in agreeing on the basic humanity and dedication of the bulk of those in the Health Service at all times. The hon. Member for Crewe (Mrs. Dunwoody) made an unworthy attack on the way that the Government have responded to today's news that the strike was suspended in some London hospitals after the bombing outrages. I first heard the news of the bombings and the response in the LBC studios in London. My spontaneous and unconsidered reaction, and the reaction of every hon. Member, was to congratulate the picket lines and the trade unions on their gesture following the bomb outrage.

There are no points between us on that and there ought to be no points between us about the inhumanity of the strike action continuing in other parts of the country, and, in some places, putting accident victims, who are not victims of the IRA, at risk. As my right hon. Friend revealed, emergency cover has been withdrawn by the ambulance service in Lincolnshire, and he gave other examples which showed the extent to which the TUC is unable to guarantee emergency cover. People go too far in place after place and there is no condemnation of that action by the Labour Party.

We have also, sadly, been divided on the facts underlying the dispute. I made a statement a week or two ago about people fiddling the figures to belittle the Government's offer. The speech of the hon. Member for Wood Green (Mr. Race) in particular, supported by that of the hon. Member for Crewe, relied heavily on so-called research that was based on these fiddled figures.

I hope that no one will swap the more obscure figures that have been bandied about with endless discussions and curious comparisons of basic rates at minimums of scale, leaving out bonuses and the rest. The essential figures shine through.

Mr. Lofthouse

rose—

Mr. Peter Hardy (Rother Valley)

rose—

Mr. Clarke

I am sorry, I do not have time to give way.

Essential figures shine through the published documents, the computer payroll figures and so on.

It has been suggested that the Government's figures are not based on a commitment to the National Health Service. We have demonstrated that commitment by increasing expenditure in real terms on the NHS throughout our period of office. If those plans are regarded as inadequate, I should point out that we have maintained the planned growth that the previous Government published in their White Paper. There will be a real growth of 6 per cent. by this time next year, and the idea that that is some plot on the part of the Government to undermine the NHS seems to me to be difficult to sustain.

The hon. Member for Crewe said that the improved offer, with its effect on the cash limits of the NHS, undermines that to some extent. We announced increased cash limits for the NHS to accommodate our final offer, although the increased cash limits did not accommodate the entire offer. We had to dig into some of the growth money for the NHS in our plans for next year. It has not extinguished that growth money, but merely delayed the developments of the service that the Government were planning and which we hope will come to fruition as soon as the economy will allow.

That is the basic position on the NHS. There ought to be factual agreement about the movements of pay, the extent of the offer and what it is worth to individual members. I find it unforgiveable that those who are encouraging Health Service workers to take strike action against patients are so anxious that the health workers should not know the precise and accurate details of the money that is on offer and that the trade union leaders are insisting on refusing.

At one point, the hon. Member for Crewe sounded as though she were trying to challenge a basic factual point, that under this Government the pay of nurses and midwives has increased ahead of inflation. Between 1978 and 1979 and between 1981 and 1982 the pay of all nurses and midwives increased by 60 per cent., that of ward sisters by 63 per cent., and that of staff nurses by 60 per cent., while the retail price index increased by 53 per cent. We have increased the pay of nurses and midwives ahead of inflation. At the same time, their working week has been reduced from 40 hours to 37½hours. That is the only fair basis on which to judge the special case that the Government are now making for nurses.

Even more rancour usually enters into arguments about the present pay of ancillary workers and the offer made to them. No one denies that there are some low paid health workers. There are also low paid workers in outside industry that has to pay the taxation and finance to support the Health Service. It does no service to anyone in the Health Service to exaggerate grotesquely the extent to which they are low paid and the value of the offer now made to them.

Before the hon. Member for Wood Green calls me a "creep" and provokes me into the slightly higher level of wit that I might be able to achieve in response, I shall clutch on to the one point in his speech where agreement glimmered through for a moment. The hon. Gentleman agreed and conceded that the average figures we have been giving on earnings for ancillaries are correct. Full-time male ancillaries are paid £104 a week and full-time women ancillaries £84 a week. The hon. Gentleman wants to bring in part-timers. He then compares the pay of part-timers with full-time pay in outside industries.

The Government's figures are accurate. The hon. Gentleman concedes the truth of average earnings. What he does not reveal is that the offer that we are making that has been rejected by his union would increase the figure of £104 to £110, an increase of £6 a week, and the £84 to £89, an increase of £5 a week.

Mr. Race

The Minister likes to present himself as the acceptable face of Thatcherite extremism. What he says about Health Service pay is not right. I remarked in my speech that part-time workers were receiving on average £42 a week. It was a deception for the Government to use only figures for full-time manual workers and full-time female manual workers in the ancillary staff field. Most ancillary staff are much lower paid. They would receive a tiny increase on the basis of the Government's offer.

Mr. Clarke

Half the staff are part-time. However, the average is meaningless in relation to part-time workers. Everything depends upon how many hours the individual works. In making comparisons with the outside world in respect of hourly rates, one has to compare the earnings for full-time male or female ancillaries. I shall give some indication of the earnings of other groups and what the offer represents.

I should like to make clear the basis of the figures that I use. I reject the use of convoluted and tortuous figures taking basic rates, minimum scales, making deductions for accommodation and for food and taking off the national insurance contribution without taking into account tax allowances, talking only of the final additional offer and implying that it represents the whole offer. The only basis on which one can deal factually with a situation that can be made into a minefield of figures by those intent on doing so is to talk in terms of average earnings. Deductions represent variations according to individual circum-stances. Average earnings give rise to a totally different figure.

A staff nurse at the minimum of the scale earns £99 a week and would be taken to £107 a week, an increase of about £7.50. Those on the maximum of £120 would be taken to £130, an increase of about £9. A qualified ambulanceman earns at the moment about £142 a week and would be taken to about £151, an increase of £9. I can give other examples, leaving out the London weighting allowance, available to people in the constituency of Wood Green, which adds anything up to 13 per cent. The tables can appear in Hansard if anyone wishes to see them.

I am not saying that these average earnings mean that people are grossly overpaid. I am not saying that they represent wages that are comfortable to live on. There are many people, as my hon. Friend the Member for Chippenham (Mr. Needham) has remarked, who find that in the middle of a recession it is not easy to live on the wages they receive. Many of those employed in the Health Service receive above the average pay for industrial workers. There are some low paid, but the proportion is no higher than in the generality of industry.

A special claim is put by the section of the Labour Party that, by and large, has taken part in the debate, who say that drastic industrial action will be taken against patients unless this group of workers is shoved up at the expense of other workers who have not received more than 6 per cent. and who do not have the same security of employment.

Mr. Hardy

rose—

Mr. Clarke

I am sorry. I have already given way once.

I have talked of the astonishing reverse of the Labour Party, which now supports industrial action after unreservedly condemning it as recently as 1979. Their record in Government speaks even more of a complete volteface. They presided over a dramatic decrease in the real earnings of those employed in the Health Service between 1975 and 1979. In the past four years of the Labour Government's period of office, the pay of a staff nurse increased by 31 per cent. while the retail price index rose by 63 per cent.

In those four years, living standards for those employed in the Health Service declined to such an extent that the Government wound up with the winter of discontent. For the first time violent industrial action broke out in the Health Service. The Labour Government condemned that strike action. The Conservative Party, as a responsible Opposition, also condemned the strike action. That contrasts with the behaviour of the Labour Opposition today.

The Labour Government crowned their performance by giving in to the industrial action. This put into the driving seat in the Health Service the militant leadership of NUPE, COHSE and others who believe that they can win, as they did by industrial action against a weak and supine Labour Government, increases for their workers. With that record, the Opposition have no basis for lecturing the Government.

The Government are determined to withstand the industrial action that we all face. We believe that the public would think it wrong for extra pay to be given to people prepared to take such inhumane action against patients. However, we would like to move away from this spotted history of the Labour Party and achieve better long-term arrangements for pay in the Health Service. Since 1980, the Government have been trying to get negotiations going covering new permanent arrangements for nurses and midwives. A reply was received from the staff side after a year. Matters have improved. We are now involved in negotiations with the staff side, although I regret to say that some difficulty seems to arise for some unions in finding time in their diaries for the meetings that the Government and the Royal College of Nursing wish to see proceed.

My right hon. Friend the Secretary of State has reaffirmed that the Government are anxious to discuss future arrangements for the ancillaries if they want to come to our open door. However, until they respond and show some interest in better long-term arrangements, I shall not be rid of the suspicion that there are some people, although by no means all—I exempt the Royal College of Nursing, the Royal College of Midwives and parts of COHSE—in this strange coalition of unions running the present industrial action who do not want better long term arrangements for their members. [HON. MEMBERS: "Nonsense."] They resent the possible restriction of activity for trade union negotiations. They like the possibility of annual confrontation for the self-same political reasons as several hon. Members who have spoken in this debate, not least the hon. Member for Wood Green.

The hon. Member for Wood Green began his speech by referring to low pay in the Health Service but soon trailed off into the Falklands, Polaris and other familiar themes. The hon. Gentleman aligned himself with people such as Arthur Scargill, who was quoted by my hon. Friend the Member for Belper (Mrs. Faith) as saying that the way to beat the Tebbit law was to ally oneself with the nurses' picket lines. This represents a transformation for the Labour Party. It is not a transformation of the position of the hon. Member for Wood Green, or of the hon. Member for Preston, South (Mr. Thorne) who deplored the record of his own Government. It is, however, a disgraceful transformation in the position of the Labour Front Bench, which has allowed itself to be towed into a situation in which it will not attack this political action.

The hon. Member for Woolwich, East (Mr. Cartwright) appeared to condemn some industrial action, but supported the statement of a COHSE spokesman. It sounds as though the Social Democrats are in favour of industrial action that does not damage patients. It is our belief that one cannot take industrial action in the Health Service that does not damage patients. The 8 per cent. of the Liberal Party who were present did not condemn industrial action. Everyone knows—if they do not believe us, they should read what is being said by the medical staff—the grave and serious risks being caused by industrial action in the Health Service.

As no one will condemn that action, it is being widened by a few groups into so-called sympathetic action, as the hard Left of the Labour Party see the unhappy dispute as an opportunity to take on the Government. Fortunately, apart from a few miners posing for photographs on picket lines, that sympathetic action seems largely to be incommoding one boat off Felixstowe. The extent to which sympathetic action is being organised by trade unionists, as opposed to some of the wilder of their trade union leaders, is fortunately restrained. Those who are tempted to go that way should realise how silly it can all become. One hears that a number of passengers were stuck on a boat trying to get into Felixstowe. What on earth has that to do with the Health Service dispute? Are my right hon. Friend and myself supposed to see a shaft of light and recognise the sudden virtues of the nurses' or the Health Service claim because the whole labour and trade union movement has finally brought a boat to a halt in support of the Health Service? That is the pathetic and silly side of this political action. It has a darker side as well. It will injure, and run the risk of killing innocent people.

Mr. Race

You are responsible. You are the killer.

Mr. Clarke

That should be condemned by the Opposition, and they should stop it now.

Question put, That this House do now adjourn:—

The House divided: Ayes 250, Noes 303.

Division No. 284]	[7.11 pm
AYES
Abse, Leo	Davis, Clinton (Hackney C)
Adams, Allen	Davis, Terry (B'ham, Stechf'd)
Alton, David	Deakins, Eric
Anderson, Donald	Dean, Joseph (Leeds West)
Archer, Rt Hon Peter	Dewar, Donald
Ashley, Rt Hon Jack	Dixon, Donald
Ashton, Joe	Dobson, Frank
Atkinson, N. (H'gey,)	Dormand, Jack
Bagier, Gordon A. T.	Dubs, Alfred
Barnett, Guy (Greenwich)	Duffy, A. E. P.
Barnett, Rt Hon Joel (H'wd)	Dunnett, Jack
Beith, A. J.	Dunwoody, Hon Mrs G.
Benn, Rt Hon Tony	Eadie, Alex
Bennett, Andrew (St'Kp't N)	Eastham, Ken
Bidwell, Sydney	Edwards, R. (W'hampt'n S E)
Booth, Rt Hon Albert	Ellis, R. (NE D'bysh're)
Boothroyd, Miss Betty	English, Michael
Bottomley, Rt Hon A. (M'b'ro)	Evans, Ioan (Aberdare)
Bradley, Tom	Evans, John (Newton)
Bray, Dr Jeremy	Ewing, Harry
Brown, Hugh D. (Provan)	Faulds, Andrew
Brown, R. C. (N'castle W)	Field, Frank
Brown, Ronald W. (H'ckn'y S)	Fitch, Alan
Brown, Ron (E'burgh, Leith)	Flannery, Martin
Buchan, Norman	Fletcher, L. R. (Ilkeston)
Callaghan, Rt Hon J.	Foot, Rt Hon Michael
Callaghan, Jim (Midd't'n & P)	Forrester, John
Campbell, Ian	Foster, Derek
Campbell-Savours, Dale	Foulkes, George
Canavan, Dennis	Fraser, J. (Lamb'th, N'w'd)
Cant, R. B.	Freud, Clement
Carmichael, Neil	Garrett, John (Norwich S)
Carter-Jones, Lewis	Garrett, W. E. (Wallsend)
Cartwright, John	George, Bruce
Clark, Dr David (S Shields)	Gilbert, Rt Hon Dr John
Clarke, Thomas C'b'dge, A'rie	Ginsburg, David
Cocks, Rt Hon M. (B'stol S)	Golding, John
Cohen, Stanley	Gourlay, Harry
Coleman, Donald	Graham, Ted
Concannon, Rt Hon J. D.	Grant, John (Islington C)
Conlan, Bernard	Grimond, Rt Hon J.
Cook, Robin F.	Hamilton, James (Bothwell)
Cowans, Harry	Hamilton, W. W. (C'tral Fife)
Cox, T. (W'dsw'th, Toot'g)	Hardy, Peter
Craigen, J. M. (G'gow, M'hill)	Harrison, Rt Hon Walter
Crawshaw, Richard	Hattersley, Rt Hon Roy
Crowther, Stan	Haynes, Frank
Cryer, Bob	Heffer, Eric S.
Cunliffe, Lawrence	Hogg, N. (E Dunb't'nshire)
Cunningham, G. (Islington S)	Holland, S. (L'b'th, Vauxh'll)
Cunningham, Dr J. (W'h'n)	Home Robertson, John
Dalyell, Tam	Homewood, William
Davidson, Arthur	Hooley, Frank
Davies, Rt Hon Denzil (L'lli)	Howell, Rt Hon D. (G'ldf'd)

Hoyle, Douglas	Race, Reg
Huckfield, Les	Radice, Giles
Hughes, Mark (Durham)	Rees, Rt Hon M (Leeds S)
Hughes, Robert (Aberdeen N)	Richardson, Jo
Hughes, Roy (Newport)	Roberts, Albert (Normanton)
Janner, Hon Greville	Roberts, Allan (Bootle)
Jay, Rt Hon Douglas	Roberts, Ernest (Hackney N)
Jenkins, Rt Hon Roy (Hillh'd)	Roberts, Gwilym (Cannock)
John, Brynmor	Robertson, George
Johnson, James (Hull West)	Rodgers, Rt Hon William
Johnson, Walter (Derby S)	Rooker, J. W.
Jones, Rt Hon Alec (Rh'dda)	Roper, John
Jones, Barry (East Flint)	Ross, Ernest (Dundee West)
Kerr, Russell	Ross, Stephen (Isle of Wight)
Kilfedder, James A.	Rowlands, Ted
Kilroy-Silk, Robert	Ryman, John
Lambie, David	Sandelson, Neville
Lamond, James	Sever, John
Leadbitter, Ted	Sheerman, Barry
Lewis, Arthur (N'ham NW)	Sheldon, Rt Hon R.
Lewis, Ron (Carlisle)	Shore, Rt Hon Peter
Litherland, Robert	Short, Mrs Renée
Lofthouse, Geoffrey	Silkin, Rt Hon J. (Deptford)
Lyon, Alexander (York)	Silkin, Rt Hon S. C. (Dulwich)
Lyons, Edward (Bradf'd W)	Silverman, Julius
Mabon, Rt Hon Dr J. Dickson	Skinner, Dennis
McCartney, Hugh	Smith, Cyril (Rochdale)
McDonald, Dr Oonagh	Smith, Rt Hon J. (N Lanark)
McElhone, Frank	Snape, Peter
McKay, Allen (Penistone)	Soley, Clive
McKelvey, William	Spearing, Nigel
MacKenzie, Rt Hon Gregor	Spriggs, Leslie
Maclennan, Robert	Stallard, A. W.
McMahon, Andrew	Steel, Rt Hon David
McNally, Thomas	Stewart, Rt Hon D. (W Isles)
McNamara, Kevin	Stoddart, David
McWilliam, John	Strang, Gavin
Marks, Kenneth	Straw, Jack
Marshall, D (G'gow S'ton)	Summerskill, Hon Dr Shirley
Marshall, Jim (Leicester S)	Thomas, Dafydd (Merioneth)
Martin, M (G'gow S'burn)	Thomas, Mike (Newcastle E)
Mason, Rt Hon Roy	Thomas, Dr R. (Carmarthen)
Maxton, John	Thorne, Stan (Preston South)
Maynard, Miss Joan	Tilley, John
Meacher, Michael	Tinn, James
Mellish, Rt Hon Robert	Torney, Tom
Mikardo, Ian	Urwin, Rt Hon Tom
Millan, Rt Hon Bruce	Varley, Rt Hon Eric G.
Miller, Dr M. S. (E Kilbride)	Wainwright, E. (Dearne V)
Mitchell, Austin (Grimsby)	Wainwright, R. (Colne V)
Mitchell, R. C. (Soton Itchen)	Walker, Rt Hon H. (D'caster)
Morris, Rt Hon A. (W'shawe)	Watkins, David
Morris, Rt Hon C. (O'shaw)	Weetch, Ken
Morris, Rt Hon J. (Aberavon)	Welsh, Michael
Morton, George	White, Frank R.
Moyle, Rt Hon Roland	White, J. (G'gow Pollok)
Mulley, Rt Hon Frederick	Whitehead, Phillip
Newens, Stanley	Whitlock, William
O'Halloran, Michael	Willey, Rt Hon Frederick
O'Neill, Martin	Williams, Rt Hon A. (S'sea W)
Orme, Rt Hon Stanley	Wilson, Gordon (Dundee E)
Owen, Rt Hon Dr David	Wilson, Rt Hon Sir H. (H'ton)
Palmer, Arthur	Wilson, William (C'try SE)
Park, George	Winnick, David
Parker, John	Woodall, Alec
Parry, Robert	Woolmer, Kenneth
Pavitt, Laurie	Wrigglesworth, Ian
Pendry, Tom	Wright, Sheila
Penhaligon, David	Young, David (Bolton E)
Pitt, William Henry
Powell, Raymond (Ogmore)	Tellers for the Ayes:
Prescott, John	Mr. Ron Leighton and
Price, C. (Lewisham W)	Dr. Edmund Marshall.
NOES
Adley, Robert	Ancram, Michael
Altken, Jonathan	Arnold, Tom
Alexander, Richard	Aspinwall, Jack
Alison, Rt Hon Michael	Atkins, Rt Hon H. (S'thorne)
Amery, Rt Hon Julian	Atkins, Robert (Preston N)

Atkinson, David (B'm'th,E)	Fowler, Rt Hon Norman
Baker, Nicholas (N Dorset)	Fraser, Rt Hon Sir Hugh
Banks, Robert	Fraser, Peter (South Angus)
Beaumont-Dark, Anthony	Fry, Peter
Bendall, Vivian	Gardner, Edward (S Fylde)
Bennett, Sir Frederic (T'bay)	Garel-Jones, Tristan
Benyon, Thomas (A'don)	Glyn, Dr Alan
Benyon, W. (Buckingham)	Goodhew, Sir Victor
Best, Keith	Goodlad, Alastair
Bevan, David Gilroy	Gorst, John
Biffen, Rt Hon John	Gow, Ian
Biggs-Davison, Sir John	Gower, Sir Raymond
Blackburn, John	Grant, Anthony (Harrow C)
Blaker, Peter	Gray, Hamish
Body, Richard	Greenway, Harry
Bonsor, Sir Nicholas	Griffiths, E. (B'y St. Edm'ds)
Boscawen, Hon Robert	Griffiths, Peter Portsm'th N)
Bottomley, Peter (W'wich W)	Grist, Ian
Bowden, Andrew	Grylls, Michael
Boyson, Dr Rhodes	Gummer, John Selwyn
Braine, Sir Bernard	Hamilton, Hon A.
Bright, Graham	Hamilton, Michael (Salisbury)
Brinton, Tim	Hampson, Dr Keith
Brittan, Rt. Hon. Leon	Hannam, John
Brooke, Hon Peter	Haselhurst, Alan
Brotherton, Michael	Havers, Rt Hon Sir Michael
Brown, Michael (Brigg & Sc'n)	Hawkins, Sir Paul
Browne, John (Winchester)	Hawksley, Warren
Bruce-Gardyne, John	Hayhoe, Barney
Bryan, Sir Paul	Heddle, John
Buck, Antony	Henderson, Barry
Budgen, Nick	Heseltine, Rt Hon Michael
Bulmer, Esmond	Hicks, Robert
Burden, Sir Frederick	Higgins, Rt Hon Terence L.
Butcher, John	Hill, James
Butler, Hon Adam	Hogg, Hon Douglas (Gr'th'm)
Cadbury, Jocelyn	Holland, Philip (Carlton)
Carlisle, John (Luton West)	Hordern, Peter
Carlisle, Kenneth (Lincoln)	Howe, Rt Hon Sir Geoffrey
Carlisle, Rt Hon M. (R'c'n)	Howell, Rt Hon D. (G'ldf'd)
Chalker, Mrs. Lynda	Howell, Ralph (N Norfolk)
Channon, Rt. Hon. Paul	Hunt, David (Wirral)
Chapman, Sydney	Hunt, John (Ravensbourne)
Churchill, W. S.	Hurd, Rt Hon Douglas
Clark, Hon A. (Plym'th, S'n)	Irvine, Rt Hon Bryant Godman
Clark, Sir W. (Croydon S)	Jenkin, Rt Hon Patrick
Clarke, Kenneth (Rushcliffe)	Jessel, Toby
Clegg, Sir Walter	Johnson Smith, Sir Geoffrey
Colvin, Michael	Jopling, Rt Hon Michael
Cope, John	Joseph, Rt Hon Sir Keith
Cormack, Patrick	Kaberry, Sir Donald
Corrie, John	Kellett-Bowman, Mrs Elaine
Costain, Sir Albert	Kershaw, Sir Anthony
Cranborne, Viscount	Kimball, Sir Marcus
Crouch, David	King, Rt Hon Tom
Dickens, Geoffrey	Kitson, Sir Timothy
Dorrell, Stephen	Knight, Mrs Jill
Douglas-Hamilton, Lord J.	Knox, David
Dover, Denshore	Lamont, Norman
Dunn, Robert (Dartford)	Lang, Ian
Durant, Tony	Langford-Holt, Sir John
Dykes, Hugh	Latham, Michael
Eden, Rt Hon Sir John	Lawrence, Ivan
Edwards, Rt Hon N. (P'broke)	Lawson, Rt Hon Nigel
Eggar, Tim	Lee, John
Elliott, Sir William	Lennox-Boyd, Hon Mark
Emery, Sir Peter	Lester, Jim (Beeston)
Eyre, Reginald	Lewis, Kenneth (Rutland)
Fairbairn, Nicholas	Lloyd, Ian (Havant & W'loo)
Fairgrieve, Sir Russell	Lloyd, Peter (Fareham)
Faith, Mrs Sheila	Loveridge, John
Farr, John	Luce, Richard
Fell, Sir Anthony	Lyell, Nicholas
Fenner, Mrs Peggy	McCrindle, Robert
Finsberg, Geoffrey	Macfarlane, Neil
Fisher, Sir Nigel	MacGregor, John
Fletcher, A. (Ed'nb'gh N)	MacKay, John (Argyll)
Fletcher-Cooke, Sir Charles	Macmillan, Rt Hon M.
Fookes, Miss Janet	McNair-Wilson, M. (N'bury)
Forman, Nigel	McNair-Wilson, P. (New F'st)

McQuarrie, Albert	Royle, Sir Anthony
Madel, David	Rumbold, Mrs A. C. R.
Major, John	Sainsbury, Hon Timothy
Marland, Paul	St. John-Stevas, Rt Hon N.
Marlow, Antony	Scott, Nicholas
Marshall, Michael (Arundel)	Shaw, Giles (Pudsey)
Marten, Rt Hon Neil	Shaw, Sir Michael (Scarb')
Mates, Michael	Shelton, William (Streatham)
Maude, Rt Hon Sir Angus	Shepherd, Colin (Hereford)
Mawby, Ray	Shepherd, Richard
Mawhinney, Dr Brian	Shersby, Michael
Maxwell-Hyslop, Robin	Silvester, Fred
Mayhew, Patrick	Sims, Roger
Mellor, David	Skeet, T. H. H.
Meyer, Sir Anthony	Smith, Dudley
Miller, Hal (B'grove)	Smith, Tim (Beaconsfield)
Mills, Iain (Meriden)	Speed, Keith
Mills, Sir Peter (West Devon)	Speller, Tony
Miscampbell, Norman	Spence, John
Mitchell, David (Basingstoke)	Spicer, Jim (West Dorset)
Moate, Roger	Spicer, Michael (S Worcs)
Monro, Sir Hector	Squire, Robin
Montgomery, Fergus	Stainton, Keith
Moore, John	Stanley, John
Morgan, Geraint	Steen, Anthony
Morris, M. (N'hampton S)	Stevens, Martin
Morrison, Hon C. (Devizes)	Stewart, b. (E Renfrewshire)
Morrison, Hon P. (Chester)	Stewart, Ian (Hitchin)
Mudd, David	Stradling Thomas, J.
Murphy, Christopher	Tapsell, Peter
Myles, David	Tebbit, Rt Hon Norman
Neale, Gerrard	Temple-Morris, Peter
Needham, Richard	Thatcher, Rt Hon Mrs M.
Nelson, Anthony	Thomas, Rt Hon Peter
Neubert, Michael	Thompson, Donald
Newton, Tony	Thorne, Neil (Ilford South)
Normanton, Tom	Thornton, Malcolm
Nott, Rt Hon John	Townend, John (Bridlington)
Onslow, Cranley	Townsend, Cyril D, (B'heath)
Oppenheim, Rt Hon Mrs S.	Trippier, David
Osborn, John	Trotter, Neville
Page, John (Harrow, West)	van Straubenzee, Sir W.
Page, Richard (SW Herts)	Vaughan, Dr Gerard
Parkinson, Rt Hon Cecil	Viggers, Peter
Parris, Matthew	Waddington, David
Pattie, Geoffrey	Wakeham, John
Pawsey, James	Waldegrave, Hon William
Percival, Sir Ian	Walker, B. (Perth)
Peyton, Rt Hon John	Wall, Sir Patrick
Pink, R. Bonner	Waller, Gary
Pollock, Alexander	Walters, Dennis
Porter, Barry	Ward, John
Prentice, Rt Hon Reg	Warren, Kenneth
Price, Sir David (Eastleigh)	Watson, John
Proctor, K. Harvey	Wells, Bowen
Pym, Rt Hon Francis	Wells, John (Maidstone)
Raison, Rt Hon Timothy	Wheeler, John
Rathbone, Tim	Whitelaw, Rt Hon William
Rees-Davies, W. R.	Whitney, Raymond
Renton, Tim	Wilkinson, John
Rhodes James, Robert	Williams, D. (Montgomery)
Rhys Williams, Sir Brandon	Winterton, Nicholas
Ridley, Hon Nicholas	Wolfson, Mark
Ridsdale, Sir Julian	Young, Sir George (Acton)
Rippon, Rt Hon Geoffrey
Roberts, M. (Cardiff NW)	Tellers for the Noes:
Roberts, Wyn (Conway)	Mr. Anthony Berry and
Rossi, Hugh	Mr. Carol Mather.
Rost, Peter

Question accordingly negatived.