§ The Secretary of State for Social Services (Mr. Norman Fowler)With permission, I should like to make a statement about the pay dispute in the National Health Service.
As I have reported to the House, revised proposals on Health Service pay were put to all the staff organisations on 16 September as a basis for discussion. They envisaged discussions about improved pay determination arrangements for all non-medical National Health Service staff groups, together with a two-year pay agreement to cover the period until 31 March 1984. I proposed that the financial basis of the two-year agreement should be the offer for this year of 7½ per cent. to nurses and midwives and professions allied to medicine and 6 to 6½ per cent. for other groups, together with an additional 4 per cent. for next year. The proposals made it clear that there could be no more money for this year.
As a result of this initiative, there have been lengthy exploratory discussions with the professional organisations representing nurses, midwives and health visitors. There have also been discussions with representatives of the professions allied to medicine. I am glad to say that in the past few days talks have been taking place with the Health Service unions affiliated to the TUC.
Following the Government's consideration of the outcome of the discussions with the professional nursing bodies and the TUC health services committee, I have authorised the management sides of the Whitley councils which negotiate the pay of nurses and midwives, and of the professions allied to medicine, to make revised pay offers covering the period until 31 March 1984. The financial resources that I have made available to them are on the general basis envisaged in the proposals put forward on 16 September, but the Government have agreed that, in formulating appropriate pay offers, these management sides may proceed on the basis that the money available for 1983–84 will be increased to allow average pay increases for that year of 4½ per cent. The distribution of the pay offers within the cash limits set by Government is for negotiation within the Whitley councils.
If this revised pay offer is accepted, the Government believe that better permanent pay arrangements should be established for nurses and other professions. As the House is aware, the Government are firmly committed to seeking improvements in the arrangements for determining nurses' pay. We put forward proposals as a basis of discussion as long ago as August 1980. Talks began in March this year, but the discussions have not shown the progress that we would want.
We should remember that we are dealing here with a group of dedicated and skilled staff who do not take strike action, because of the consequences of such action on patients. The Government believe that it is time that we settled upon more satisfactory arrangements. We have, therefore, decided to propose the establishment of a review body, which will have the task of making recommendations to Government about the pay of nurses, midwives and health visitors. We propose that it should have the further remit of making recommendations about the pay of the professions allied to medicine, such as physiotherapists and radiographers.
428 I shall shortly be launching consultations relating to the composition, terms of reference, coverage and method of work of the new review body. Like other review bodies, it would, in looking at levels of pay, need to take account of all relevant factors, including, for example, economic and financial considerations and service needs. It is intended that its first report should relate to the period beginning 1 April 1984, at the end of the two-year pay agreement now proposed.
I believe that this decision will give the professions concerned a much better basis for determining their pay and that it will be warmly welcomed by them. The Government regard their position as wholly exceptional. There can be no general extension of the review body principle to other staff groups.
This is an important step forward for the nurses and the other professional groups and, therefore, for the Health Service. The proposals that we have made offer a fair settlement for pay over two years, followed by the establishment of a review body. They provide an opportunity for stability in the National Health Service to make the service improvements that we all want and to recover from the damaging effect of the industrial action which has taken place this year.
On the pay of other Health Service staff, discussions with the health services committee are continuing. The aim must be to secure a resumption of negotiations in the relevant Whitley councils. That is the way forward and the proposals that I have announced today are a significant step in that direction.
§ Mrs. Gwyneth Dunwoody (Crewe)The whole House will welcome the Secretary of State's conversion to the principle of the Clegg commission, but it is clear that the offer of a review body is to be restricted to the nurses, midwives and health visitors Whitley council. Does the right hon. Gentleman intend to renege on the offer that he made earlier this year to other NHS workers of suitable machinery for negotiating their pay?
Are negotiations continuing with the TUC health services committee? Is it the right hon. Gentleman's intention to continue to try to divide one Health Service worker from another? Is it not clear that the negotiations could have been resumed much earlier and that it is only because the right hon. Gentleman has been prepared to go back to ACAS that there have been any grounds for negotiation?
Surely the Government will now accept that the actions of Ministers and their direct assaults upon groups of Health Service workers have been nothing but counter-productive since the beginning of the dispute and that if they had been prepared to take the advice of the Opposition and return to negotiations there would have been a much earlier end to this unhappy affair.
§ Mr. FowlerThat was a typically churlish and unworthy response from the hon. Lady. I remind her that one of the most disreputable actions of the Opposition has been to support industrial action throughout the dispute.
Let me make it absolutely clear that, contrary to what the hon. Lady appears to think, the review body is not in any sense based on the Clegg commission. That commission was based solely on comparability and was wholly inflationary, and no one was better off in the end. If the hon. Lady wants confirmation of that, I suggest that she asks the nurses for their views on the Clegg commission. They certainly do not want it. 429 Talks are continuing with the TUC and the Health Service unions. I suggest that the whole House would want them to be successful. In relation to the hon. Lady's question about the longer term, the offer stands that we made on 16 September to have talks on the long-term arrangements for others in the Health Service. The talks will involve factors such as comparability, recruitment and retention of staff and what the nation can afford.
Finally, I remind the hon. Lady that the Government offers were put forward on 16 September and we have been having talks and negotiations with the professional organisations since then. Those offers are the basis of what is now coming forward. There is no truth in the hon. Lady's comments about the Government having gone to ACAS. The Government did not go to ACAS. The Health Service unions went to ACAS and as a result of that the talks continued. I stress, however, that the talks and the offer date from 16 September.
§ Mr. John Peyton (Yeovil)Does my right hon. Friend agree that the term "review body" is not one to set the heart racing or cause great enthusiasm? Does he agree that, historically, such bodies have been the repositories for difficult decisions that other people do not want to take rather than successful solvers of any problems?
§ Mr. FowlerNo, I do not agree with that—certainly in view of the experience of the doctors and dentists review body, which is the nearest comparison. The new review body recognises the special position of nurses and other professional groups who do not take industrial action and on whom we have relied heavily in the past six months. The professions have always wanted better permanent arrangements and the review body will ensure that they have them. The fact that these groups do not take industrial action has now been adequately recognised.
§ Mr. Clement Freud (Isle of Ely)Would it be convenient for the Secretary of State to give the House a guideline as to how long an industrial dispute must go on before the position is wholly exceptional?
§ Mr. FowlerThat is a rather foolish question. If the hon. Gentleman takes the trouble to study these matters, he will see that my offer was made on 16 September.
§ Mrs. Jill Knight (Birmingham, Edgbaston)Is my right hon. Friend aware that many people in the House and outside wish to congratulate him on his firmness, his realism and his patience, and particularly on his determination to ensure that the differentials between the pay of nurses and other Health Service workers are maintained, especially as they are always careful not to make their patients suffer in the pursuit of more money? Will my right hon. Friend also never fail to recognise that there are substantial savings to be made within the Health Service which could lead to more money being available for the deserving sections of it?
§ Mr. FowlerI am grateful to my hon. Friend. The differential of 1½ per cent. for nurses has been preserved and it is absolutely correct that that should be so. I am sure that many people in the nursing profession will greatly welcome this step. It is precisely what they have been fighting for year after year and it is right that we should recognise that.
§ Mr. FowlerI announced some weeks ago that we intended to take action on manpower and I shall have more to say about the manpower management inquiry in the next few weeks.
§ Mr. SpeakerOrder. I propose to allow questions on this statement to run until 4 pm and then to take the second statement.
§ Mr. Reg Race (Wood Green)Will the Secretary of State clarify the position for the nurses and the professions supplementary to medicine? If the proposed review body makes a recommendation that the Government do not like, will the Government implement the award or will they retain a power of veto? Is he aware that offering an additional ½ per cent. to the one million Health Service workers next year is an insult that will not solve the problem of low pay and will deeply shock many Health Service workers who believe that they do a decent job for the community?
§ Mr. FowlerThere is no truth in the hon. Gentleman's charge. The offer means that there is now more than £660 million on the table for the nurses and other professional groups. That shows the Government's commitment to the nursing profession.
§ Mrs. Sheila Faith (Belper)Is my right hon. Friend aware that the current issue of the magazine Marxism Today shows a picture of two pretty nurses with the caption, "The New Shock Troops"? Will he hasten the setting up of the review body so that nurses are not put in this reprehensible position in the future?
§ Mr. FowlerWe shall do our best to make progress in setting up the review body. We intend to make the consultation process as short as possible so that the review body can be established as early as possible in 1983 and can present its first report in time for the 1984 settlement.
§ Mr. Bob Cryer (Keithley)Why has it taken the Government so long to conclude that the Clegg commission or something like it has some role to play? Is it not typical of the Government's intransigent, hardhearted attitude that the Royal College of Nursing, for example, has been closer to strike action than ever before in its history, and that only the tolerance and good will of the unions has saved the day? Does the Secretary of State agree that his statement that the unions and not the Government went to ACAS shows the willingness of the trade union movement at all times to enter into meaningful negotiations?
§ Mr. FowlerThat is an interesting rewriting of history, but it bears little relation to the facts. We made proposals for long-term arrangements as long ago as August 1980 and we have been having talks since March this year. There has been no delay by the Government. We have tried to make progress. As no progress was possible, we have taken this initiative, which I believe will be widely welcomed.
§ Mr. Mike Thomas (Newcastle upon Tyne, East)Although we welcome the review body, do we take it that there is now no question but that the Government will strong-arm the rest of the Health Service workers into submission in pursuance of his "divide and rule" policy? Is the right hon. Gentleman aware that he must still face the question why the industrial action was necessary and 431 the extent to which he is to blame for not sending the matter to arbitration before all the bitterness and argument occurred? Does he appreciate that if he had done that on the basis of the first offer the settlement would have been no different from the one that he has now obtained?
§ Mr. FowlerThe hon. Gentleman at least welcomes the review body. With regard to his comments about a "divide and rule" policy, I remind him that the offer of 16 September was carefully worked out and was made specifically not only to the professional organisations but to the Health Service unions as well. It was to avoid exactly that kind of charge that the offer was made.
§ Sir William Clark (Croydon, South)May I congratulate my right hon. Friend on the resumption of talks in the dispute? Does he agree that the Clegg commission had damaging effects on the economy? Will he give an assurance that the new review body will not become like that commission so that the Government of the day lose their flexibility in paying the wages of the public sector?
§ Mr. FowlerI assure my hon. Friend that the new review body will certainly not be like the Clegg commission—first, because the Government have no intention that it should be so, and secondly, because the nurses themselves would not want it to be that way. As I have said, I think that the comparison is with the doctors and dentists review body. The Government have lost no flexibility there. The DDRB is regarded as fair and Government policy has in no way suffered as a result.
§ Mr. Doug Hoyle (Warrington)Will the Secretary of State accept some responsibility for the prolonged dispute? Does he accept that it has been largely due to the small-minded and parsimonious way in which he has handled matters when he could have gone to arbitration at any time? Will he also clarify the Government's intentions? If the review body comes up with a recommendation that is not acceptable to the Government, will the Government accept it and not stand in the way? That is what we want to know.
§ Mr. FowlerWe should not be setting up the review body if our purpose were to ignore its findings. That is clear. Obviously, we must reserve the right not to accept recommendations in response to compelling national reasons. That is the normal position with review bodies and the assurance that my hon. Friend the hon. Member for Croydon, South (Sir W. Clark) sought. I am not prepared to take lectures from the hon. Gentleman on industrial action when over the last month he has supported industrial action, and many of his colleagues have appeared on the picket line.
§ Mr. Anthony Nelson (Chichester)Does the Minister accept that there will be widespread recognition of the restraint and the responsibility that he has shown in these negotiations, as any excessive wage offer can only be at the expense of medical facilities for patients? Will my right hon. Friend clarify one aspect of his statement? I understood him to say that the cash limit would be revised to accommodate the increased offer. If this is the case, can he give an undertaking that all local health authorities will be underwritten in any extra marginal costs that they may 432 have to meet in paying these extra wages, or will they have to make futher economies to accommodate this incremental increase?
§ Mr. FowlerYes, I assure my hon. Friend that no further increases will be made for this year, and I have made that clear. Next year the amount is allowed for in the public expenditure figures that we have put forward. Therefore we shall not be requiring a contribution from the health authorities.
§ Mr. Ioan Evans (Aberdare)Is the Secretary of State happy with offering only 6 per cent. to Health Service workers, some of whom have a take-home pay that is less than £2,500, while his Government offer judges on over £40,000 a year an 18 per cent. increase? Is the Government's policy to be generous to the well-off while being mean and Scrooge-like to the low paid?
§ Mr. FowlerOur policy is to seek to be fair within the Health Service resources to all those working in it. With regard to the TUC Health Service unions, I repeat that negotiations are continuing.
§ Mr. Peter Bottomley (Woolwich, West)Will my right hon. Friend accept my good wishes for the settlement of the whole of the dispute? Does he accept that if the 4½ per cent. is accepted by NHS workers for the following year, other groups who are higher paid should accept that or less, so that the noises made to the lower paid have some meaning? Will my right hon. Friend add his voice to mine in talking the Prime Minister into trying to get an increase in child benefit so that the lower paid with family responsibilities can accept continuing low pay settlements?
§ Mr. FowlerI hear what my hon. Friend says about child benefit. However, he will know that decisions on that are made at the time of the Budget.
§ Mr. William Hamilton (Fife, Central)Is the Minister aware that, even if these figures are acceptable, the nurses and other skilled and dedicated people, as he described them, will have suffered a considerable reduction in their standard of living over the years? Will the Minister give an assurance that if, as is likely, the rate of inflation increases beyond the 5 per cent. anticipated by the Government at the beginning of next year, that 4½ per cent. will be increased pari passu?
§ Mr. FowlerThe hon. Gentleman is wrong in the premise that he uses. If he takes the staff nurse as an example of what this 7½ per cent. and 4½ per cent. will mean taken together, there will be an increase of between £12.33 and £15 a week. That is what it means, and that cannot, in any fair sense, be described as a cut.
§ Mr. Anthony Beaumont-Dark (Birmingham, Selly Oak)Is my right hon. Friend aware that a peaceful settlement will be widely welcomed? However, is it not true that one of the reasons why he did not offer the Health Service more before was that it was rightly said that the country could not afford to pay more? If we have a review body, how will it arrive at a different formula as to what the country can afford? If the settlement is to mean anything, the review body has to know what that means.
§ Mr. FowlerThe review body will arrive at a formula in the same way as the doctors and dentists review body in the light of the evidence and the ground covered. We shall be able to give it evidence of the national economic 433 and financial position, on NHS resources, recruitment and any changes in terms of services. Therefore, it will be done in the same way as the DDRB.
§ Mr. John Maxton (Glasgow, Cathcart)If the Minister believes that the establishment of a review body will improve industrial relations in the NHS for nurses and professional bodies, why does he not extend that belief to the other workers in the NHS who should equally be covered by the review body? Secondly, does the right hon. Gentleman agree that the best thing that he could do for industrial relations in the NHS would be to get rid of his provocative friend, the Under-Secretary of State, who has made so many outspoken remarks about the Health Service workers and caused further problems in this dispute?
§ Mr. FowlerThe hon. Gentleman is calling for the resignation of the wrong person. [Laughter.] I have absolute confidence in the Minister for Health, to whom I think the hon. Gentleman was referring. The review body is intended to recognise the fact that nurses and the other professional bodies do not take industrial action. We rely upon their commitment and we wish to devise a fair means by which their pay is determined.
§ Mr. Geoffrey Dickens (Huddersfield, West)Will my right hon. Friend reaffirm that this Government, unlike all previous Governments, are determined that there shall be a proper wage structure throughout the nursing profession which reflects the fact that nurses and midwives do not strike and give their dedication to the nation?
§ Mr. FowlerThat is what we are trying to do in setting up the review body. It is something that many of those inside the nursing profession have pressed for and wanted over many years. It will be recognised and welcomed by the nursing profession, and will be seen as a step forward.
§ Mr. Kenneth Marks (Manchester, Gorton)The Minister seems to think that the Health Service workers enjoy striking, but they do not. What offer would he make to them in return for no-strike pledges?
§ Mr. FowlerIf the unions wish to give that pledge, we are willing to talk on the point. Talks are continuing. I pay tribute to all staff who have not taken strike action. That includes managers and ancillary workers as well as nurses. That is why it is so surprising and reprehensible that the Labour Party has not at any time in the dispute condemned industrial action.
§ Mr. Michael English (Nottingham, West)Why do the Government think that the Health Service differs from other services of the State? Why do we need another pay quango? We already have the top salaries review body, which deals with civil servants other than in the Health Service, judges and army officers. Why can it not deal with top people in the Health Service, such as regional officers? We already have a Health Service quango for doctors and dentists. Why cannot that body deal with the rest of the Health Service? Why can we not have one system of pay in the Health Service as we have for all three Armed Services?
§ Mr. FowlerThe response of the official Opposition was to welcome the setting up of the review body. The 434 hon. Gentleman appears to be going on a course of his own. The comparison, which I think that the hon. Gentleman has missed, is the most obvious one between the doctors and dentists review body. The link there is something that we shall be examining in the consultations.
§ Mr. Leslie Spriggs (St Helens)Is the right hon. Gentleman aware that the answer that he has given today to my right hon. and hon. Friends, that he is prepared to talk and talk again, is useless until he puts some real money on the table?
§ Mr. FowlerThere is over £1,100 million on the table already. I am not sure what the hon. Gentleman's definition of real money is.
§ Mr. Robert Parry (Liverpool, Scotland Exchange)The offer to the ancillary workers is a miserable offer to the lowest-paid workers in the NHS. Is the Secretary of State aware that I have the wage slip of a NUPE member, who is a caretaker in a health centre in Liverpool which shows that after five and a half days' work on split duties, this person takes home less than £40 a week? Is this not disgraceful, when the judges and the generals received an increase of between 18 and 19 per cent.?
§ Mr. FowlerThe ancillary workers' pay is one matter being negotiated.
§ Mr. D. N. Campbell-Savours (Workington)This November, will not 350,000 Health Service workers be earning a gross wage lower than the eligibility level for family income supplement? Will the Minister give an undertaking that, whatever final arrangements are made, that number will be substantially reduced, and in the statement that he finally makes on the dispute will he tell us how many Health Service employees still remain below that level of eligibility?
§ Mr. FowlerI will certainly do the latter. In his first question the hon. Gentleman was using the April figures before the increase. The situation is not as he states.
§ Mr. Stanley Cohen (Leeds, South-East)Have not successive Governments, and particularly this one, traded on the dedication and commitment of the nurses and ancillary staff in the hospital service? Will the Minister assure us that the review body's recommendation will be implemented?
§ Mr. FowlerThe purpose of the review body is to ensure that no one trades on the loyalty of the nursing profession. We are trying to find a fair way to determine their pay so that there is no question of industrial muscle being used.
§ Mrs. DunwoodyWill the Secretary of State now give an unequivocal undertaking that he will regard the review body's finding as binding in the same way as this Government regarded the findings of machinery set up to determine police pay?
§ Mr. FowlerWe cannot give such an undertaking. We must reserve the right, if there are compelling national reasons, not to accept the findings. That is the normal situation with review bodies.