§ The Secretary of State for Social Services (Mr. Norman Fowler)With permission, Mr. Speaker, I should like to make a statement on pay negotiations in the National Health Service.
On 10 June I told the House that the Government were considering the points made by the Royal College of Nursing following the ballot on the pay offer of 6.4 per cent. I reported also the initiative I had taken in asking Mr. Lowry to undertake consultations with the Health Service unions affiliated to the TUC to establish whether there was any common ground between us. My objective has been to secure agreement so that negotiations can be resumed in the respective Whitley councils.
Following careful consideration of the position and after consultation with some of the chairmen of the management sides of the Whitley councils, I entered discussions with the representatives of the Health Service unions and professional bodies. I was able to tell them that the Government had decided that a further £90 million would be available in negotiating a new pay offer—partly from the Government and partly from the existing Health Service budget. Together with the additional resources made available in March this year, this would increase the average pay of nurses and midwives and the professions supplementary to medicine by 7½ per cent., ambulance men and hospital pharmacists by 6½ per cent. and other groups of staff by 6 per cent. The increases for particular grades would be for negotiation within the Whitley councils. These improved offers both maintain the special position of nurses and other staff providing direct patient care and bring offers to all groups of staff on a par with other recent awards in the public sector.
My hon. and learned Friend the Minister for Health and I have been in discussions over the last two days with the Royal College of Nursing and the Health Service unions affiliated to the TUC. I am glad to report to the House that the Royal College of Nursing, the Royal College of Midwives, the Health Visitors Association and the Association of Nurse Administrators have agreed to recommend to their responsible bodies that their negotiators be authorised to return to the negotiating table. I hope that their Whitley council will resume discussions very shortly.
Regrettably, the representatives of the Health Service unions rejected the improved offers out of hand and were unwilling to resume any negotiations. They intend to report that back to the full TUC health services committee with the proposal that industrial action should continue.
The Government have moved substantially to improve the offers to the Health Service. The average increases in pay offered for Health Service staff range between 6 per cent. and 7.5 per cent. That compares with 5.9 per cent. for civil servants, 6 per cent. for teachers and 6.1 per cent. for the Armed Services.
I do not believe that the Health Service unions are justified in rejecting this offer and I deplore their decision to continue a campaign of industrial action, which can only harm patient care. I hope that they, and in particular their members, will reconsider the position very carefully and I urge them to return to negotiations in the Whitley councils.
§ Mr. Bruce Millan (Glasgow, Craigton)Is the Secretary of State aware that it is no use his regretting the chaos and disruption in the National Health Service, which we all deeply regret, when that chaos and disruption has been caused directly by his pigheaded, maladroit and provocative behaviour? For evidence of that behaviour we need look no further than what happened yesterday, when the right hon. Gentleman attempted to reach an agreement with the Royal College of Nursing—which represents only a minority of the workers concerned in the present dispute—while letting the TUC unions kick their heels for no less than four hours, with the result that they had to find out the details of the new offer from the press conference that was held by the Royal College of Nursing. If the Minister behaves in such a way, does he not understand that he is bound to increase the anger and bitterness that are felt already in the National Health Service?
Is it not a fact that the present offer, apart from its divisive nature, will still mean a real reduction in he standard of living of some of the lowest-paid workers in the country? It is no use the Secretary of State mentioning carefully selected other groups of workers and omitting to mention some higher-paid sections of the community, such as judges and higher grades of civil servants, not to mention the police services, which have had vastly higher offers than those made to the National Health Service. Is it not also a fact that in any case much of the money for the new offer will have to be paid directly from cuts in the services to patients, about which the Minister keeps weeping crocodile tears during the industrial action?
All through the dispute the Secretary of State has refused to allow genuine negotiations in the Whitley councils. He is still doing that. He has refused to go to independent arbitration, which is completely indefensible. He has failed to persuade—because he cannot persuade—the workers in the National Health Service that there is any sense of justice or fairness in the way in which the Government are treating different groups of workers. As long as that continues, is not the dispute likely to be prolonged? If that happens, does not the Secretary of State bear a heavy responsibility for the damage that is being caused to the National Health Service?
§ Mr. FowlerI totally reject virtually everything that the right hon. Gentleman said. He should know that two separate negotiations were taking place from the beginning. The Royal College of Nursing and the other professional organisations are not affiliated to the TUC and the TUC does not negotiate for them. Therefore, it is necessary that two sets of negotiations take place.
I asked the unions yesterday whether it was procedure or handling that was keeping us apart. They said that that was not so and that they rejected the substance of the offers. Let us have no more of such nonsense. The fact is that at no stage did the unions mention any other figure than 12 per cent., which is totally unrealistic.
We have made a fair offer. It means an average increase of at least 6 per cent. It is on a par with the offers that were made to civil servants, teachers and the Armed Forces. [HON. MEMBERS: "Top salaries?"] I do not believe that industrial action can conceivably be justified in the context of the new offer. I hope above all that the Opposition will now take the opportunity of condemning industrial action that harms patient care.
§ Mr. SpeakerOrder. The House is aware that the main business today falls under the allocation of time motion. Therefore, we must be fair to those who wish to debate the Northern Ireland Bill. I suggest that questions are finished in a quarter of an hour, at five minutes to four.
§ Mrs. Jill Knight (Birmingham, Edgbaston)Will my right hon. Friend be assured that the vast majority of hon. Members reject utterly the accusation that he is either pigheaded or maladroit? On the contrary, they recognise that he has listened most carefully and sympathetically to the case made by the National Health Service employees and has gone as far as possible to meet their demands. He has not only offered them the maximum that the country can afford but has also kept wisely in line with other groups of workers so that inflation shall not start again.
§ Mr. FowlerI am grateful to my hon. Friend. What she says is absolutely right. We are offering a 7.5 per cent. average increase to the Royal College of Nursing and to nurses in general. We want to see new permanent arrangements for nurses' pay in operation by 1 April 1983. The Government will do their utmost to achieve that.
§ Mr. William Hamilton (Fife, Central)Is the Minister aware that I have just returned from a big demonstration across the river on this matter, when it was evident that every union in the country, including the National Union of Mineworkers, the firemen and so on, were behind the National Health Service workers, who are low-paid workers by the Government's own definition? We on the Opposition Benches are determined to carry on the campaign of industrial action until the Government come to their senses. It makes no sense to reduce the standard of living of those who are among the most loyal and moderate of workers. The sooner that the Government and the Minister realise that we are determined to win the campaign for 12 per cent., the better. It is not an extravagant claim. Those concerned are merely asking to stand still. The Minister had better be warned that much more drastic action will be taken unless he is much more flexible.
§ Mr. FowlerThe hon. Gentleman has confirmed exactly what I said. He is sustaining a case for a 12 per cent. increase in pay, which will cost an additional £750 million. That is an utterly ludicrous claim for the hon. Gentleman to support. The hon. Gentleman must decide, when he mentions the other supporters, whether it is a dispute about pay or a political dispute.
§ Mr. HamiltonIt is both.
§ Mr. FowlerI believe that the hon. Gentleman will lose any remaining credibility if he turns this into a political dispute.
§ Mr. David Alton (Liverpool, Edge Hill)Is the Secretary of State aware that there is anxiety among some members of the Royal College of Nursing that the impression has been given—before local consultations take place tomorrow—that the offer has in some way been accepted? Will the Secretary of State say something about the long-term consequences of the divide-and-rule policy of coming to an agreement with one set of people and not another?
§ Mr. FowlerIt is in no sense a divide-and-rule policy. We are meeting the special case of the nurses. I should have thought that the Liberal Party—for whom I assume 302 the hon. Gentleman speaks—would be in favour of that. I said that the professional bodies have agreed to recommend to their responsible bodies that their negotiators be authorised to return to the negotiating table, which means the Whitley council. I hope that the Liberal Party will support that.
§ Mr. Anthony Nelson (Chichester)May I assure my right hon. Friend that he enjoys widespread support for the way in which he has managed what have been undeniably difficult negotiations? Does he agree that the guidelines for the Conservative Party and the Government should be that the patient comes first? It is no way forward for increased provision for the National Health Service to be consistently pre-empted by excessive wage settlements.
§ Mr. FowlerI entirely agree with my hon. Friend. The Government have increased the resources available to the National Health Service over the past two and a half years. We are spending over £12 billion on the National Health Service, and it is a matter of regret that some of the money for the additional pay will have to come from the National Health Service. There is no way round that.
§ Mrs. Renée Short (Wolverhampton, North-East)Is the Secretary of State aware that no less than 62 per cent. of full-time staff employed in the National Health Service earn less than £100 a week? Within that figure, 7.4 per cent. earn less than £60 a week. It is phoney to compare the miserable increase of 6 per cent. that he is offering them with the increase that was offered to teachers and civil servants who are on much higher salaries. Will he look at this again in all equity and produce more money to make them a better offer?
§ Mr. FowlerI want to make it absolutely clear that this is the Government's final decision. Industrial action will not force us into providing more money. The sooner that that is taken on board, the better it will be.
§ Mr. Mike Thomas (Newcastle upon Tyne, East)If the nurses and hospital workers are a special case, can the Secretary of State explain why they are not on a par with the miners and the power workers, who are not special cases?
§ Mr. FowlerWhat I have just said to the House—it is an important part of what we are offering the Royal College of Nursing and the nursing profession in general—is that we want a new permanent arrangement for nurses' pay in operation by 1 April 1983.
I also said to the trade unions—this is a point that the hon. Gentleman raised with me on a previous occasion—that if they want to talk to me about new arrangements for pay, I am perfectly willing to do so. We have had no response to that offer.
§ Mr. ThomasWhy are they not on a par with the miners?
§ Mrs. Sheila Faith (Belper)Does the Secretary of State agree that, although the House is delighted that the nurses have been made a special case, it is always unwise for them to link their pay claim with that of the ancillary workers? Although ancillary workers do important work, they do not have the long training that nurses have, nor do they have the life and death responsibility. Also, they have often not taken due notice of patient care when pursuing their pay claims.
§ Mr. FowlerThe Government say that a differential for nurses' pay is justified, and that is what we are fighting for. We recognise that the nurses are a special case, and I pay tribute to the fact that even on a day of action the vast majority of nurses are working.
§ Mr. David Ennals (Norwich, North)Is it not extremely unwise for the Secretary of State to negotiate separately with one organisation that represents less than half the nurses and with other organisations that represent the majority? Is that not a recipe for dispute? The Secretary of State has said that the growth rate for the National Health Service in the future is only 0.5 per cent., while 0.7 per cent. is needed just to keep pace with the rising aged population. Is it not absolutely wrong that any part of the new increase should be taken from patient care when the right hon. Gentleman has said that patients must come first?
§ Mr. FowlerThe right hon. Gentleman is in no position to lecture either me or the House on recipes for dispute.
§ Mr. EnnalsAnswer my question.
§ Mr. FowlerThose people who remember the winter of discontent remember that. To respond to the two questions—the Royal College of Nursing and the other professional organisations are not affiliated to the TUC. They have a perfect right to say that they do not want to be represented by the TUC. It gives me no pleasure to say that money will have to come from the National Health Service budget. I have made that clear throughout. The majority of the money will be new money provided by the Government, but I must make it clear that some money will have to come from the substantial National Health Service budget, and that that will have implications.
§ Mr. Dafydd Wigley (Caernarvon)Has not the Secretary of State been too clever by half in differentiating between the groups? Has that not hardened attitudes and led to the present reaction? Does he not accept that there is a widespread feeling that he should evenhandedly put on the table an offer that at least keeps everyone up with the cost of living?
§ Mr. FowlerI have no idea what the hon. Gentleman believes the offer should be or how it would compare with the other offers made in the recent round of pay increases. I believe that the public are in favour of the Government's stance that the nurses are a special case.
§ Mr. Peter Bottomley (Woolwich, West)Does my right hon. Friend agree that the National Union of Mineworkers and others who have pay settlements coming up next year can show their support for the special position of the nurses and ancillary workers by asking for a pay increase lower than that which the nurses and ancillary workers are getting?
§ Mr. FowlerThat is right. It would be wrong if the issue was turned into a political dispute and against the interests of the Health Service.
§ Mr. George Foulkes (South Ayrshire)Why can the Government provide unlimited finance for the task force and promise unlimited finance to garrison and to supply the Falkland Islands but cannot find the money to meet the nurses' justified and reasonable claim?
§ Mr. FowlerThe Government are already providing over £12 billion for the NHS. That is not only more in cash but more in real terms than any other Government have provided.
§ Mr. Toby Jessel (Twickenham)If a doctor believes that a patient needs an operation, is permission now to be required not only from the hospital porters but from the NUM?
§ Mr. FowlerThere is absolutely no question of that. The only people who can make decisions about medical care are medically qualified staff. I hope that the Opposition will at least agree with that.
§ Mr. Laurie Pavitt (Brent, South)Will the right hon. Gentleman study with humility the leader in The Times health supplement of 11 June which shows that to bring the nurses' pay up to the Halsbury award under the Labour Secretary of State, Barbara Castle, would require a 50 per cent. and not a 12 per cent. increase? Does he agree with the hon. Member for Liverpool, Edge Hill (Mr. Alton) that there has been no decision by the Royal College of Nursing to advise its members to accept the 7£5 per cent. award, but that it will be meeting tomorrow and offering the advice at that time? Is he aware that if he pursues his present tactics and strategy of trying to split into different categories members of the Health Service who work under the same roof he will sow discord and destroy morale to such an extent that it will take 10 years for the Health Service to recover?
§ Mr. FowlerThat is not the case. The Royal Collge of Nursing is entirely committed to the principle of differentials. It is rubbish to talk of splitting the Health Service. A standard percentage increase year after year for over 1 million people working in the Health Service is not realistic. It is right to show a preference on this occasion for the nurses.
§ Mr. W. R. Rees-Davies (Thanet, West)Will my right hon. Friend accept my congratulations on what he said about the special case for the nurses? If there is to be industrial action, will he give an undertaking that he will not permit unlawful action and that the hospitals will be protected against unlawful picketing or any other unlawful measures, especially if other unions try to come in to engage in unlawful action, so that the Health Service can be fully and properly protected?
§ Mr. FowlerWe issued a circular at the end of 1979 giving advice to health authorities in the event of industrial action, but the decision rests with the health authorities. If damage is done to the Health Service by people who do not work in it, there is a remedy under the industrial relations legislation.
§ Mr. Laurence Cunliffe (Leigh)Does the Minister not understand that the 12 per cent. claim was based on need and not greed and that if we are to have good health care it is imperative to have fair pay in the Health Service? If the right hon. Gentleman is so confident about public support for what he considers to be a fair offer, will he conduct an opinion poll to see whether the public, who have given massive support to the case of the Health Service workers, are willing to pay the additional cost?
§ Mr. FowlerThe Government must take decisions based on the resources available. We have made the decision. It is final and I believe that it is fair.