National Health Service (Pay Dispute) (Hansard, 18 October 1982)

§ The Secretary of State for Social Services (Mr. Norman Fowler)
With permission, Mr. Speaker, I should like to make a statement on the pay dispute in the National Health Service. The House will debate these matters on Wednesday, but I felt that it would want to be brought up to date today on the latest position.
When I last reported to the House on 20 July I outlined the steps that the Government had taken to resolve the pay dispute and end the industrial action in the Health Service. I reminded the House then that we had twice increased the resources available for pay in the current financial year. The second increase announced in June would have allowed pay increases of between 6 and 7½ per cent. at a total cost of £418 million. These increases compared favourably with setlements for other large groups of workers in the public sector. We also offered talks on new permanent arrangements for determining the pay of all Health Service staff. We made it clear that this was the Government's final decision on the resources available for pay this year.
As the House will know, the Royal College of Nursing balloted its members in August on the new offer. The Health Service unions affiliated to the TUC on the other hand continued to refuse to negotiate. They remained committed to their claim for pay increases of 12 per cent. for all non-medical staff and rejected any idea of a differential for the nurses.
Following the vote by the membership of the Royal College of Nursing against acceptance of the revised offer, consultations continued on possible ways of breaking the deadlock. After detailed discussions, in particular with the TUC, I put further proposals to the professional bodies and the TUC health services committee on 16 September. I have arranged for a copy of the proposals to be placed in the Library of the House.
In brief, we offered to complete a two-year arrangement with Health Service staff. This would bring forward agreement on pay for 1983–84 and offered the possibility of giving staff higher percentage increases during the course of this year. Most important, the proposals would have paved the way for the introduction of new arrangements for determining the pay of nonmedical staff. The amount of money on the table for a two-year settlement was almost £1,100 million.
We had every reason to believe that the proposals would form an acceptable basis for negotiation. We had discussed them in detail with the Royal College of Nursing and representatives of the Health Service unions. I am pleased to be able to tell the House that the Royal College of Nursing, the Royal College of Midwives, the Health Visitors Association and the Association of Nursing Administrators accepted the invitation to talk about them. These discussions are still continuing. The whole House will hope that they will be successful.
In contrast, the health unions' reactions was to refuse even to talk to us. This was in spite of the fact that we had discussed in detail the proposals with the chairman of the health services committee, Mr. Spanswick, and the secretary, Mr. Jacques. The final proposals put to the committee had been altered to take account of the views 24 they expressed. For that reason, I consider the unions' refusal even to talk about the offer of £1,100 million quite indefensible.
Even more serious, however, was the decision by the TUC health services committee to call for a further campaign of industrial action.
There had been five days of industrial action in August, and this was followed by a further day on 22 September. As before, the form and intensity of action varied across the country. But there were several reports of a complete withdrawal of all cover, including emergency cover in some hospital departments. In some areas it was only because management and staff volunteers provided the necessary emergency cover that services could continue.
September 22 also saw an attempt to widen the industrial action to workers outside the Health Service. The effect was confined largely to the public sector. In the private sector, most people worked normally although some industries were badly affected, including the newspaper industry. Since then, the unions have called a series of regional strikes, but their effect has been less than on 22 September.
I should like to make it clear that the public owe a great debt to the majority of staff, particularly doctors and nurses, but also to many others in all groups within the Health Service who have continued to care for patients in recent months. Because of their action, the position is not worse, and I pay tribute to their dedication. However, in spite of their efforts, the effect of this dispute on patients is serious and will become more serious the longer it continues. We estimate that, since the industrial action began, 110,000 operations and 105,000 outpatient appointments have been cancelled, and waiting lists have increased by about 115,000. It was always quite wrong for the unions to claim that their action would not harm patients. There is no doubt that it has caused distress and suffering.
The fact is that, although the Government have made continued efforts to settle this dispute, the Health Service unions have not budged from their quite unrealistic claim—a claim which looks even more unrealistic with inflation now running at the lowest level for 10 years. The offer of £1,100 million on the table for two-year settlement leading to an agreement on new long-term arrangements was worked out with representatives of the TUC and offers a fair and honourable resolution to this dispute. I urge the Health Service unions to call off their industrial action and to return to the negotiating table.

§ Mrs. Gwyneth Dunwoody (Crewe)
If there had been anything of value in this statement, I could have understood the Minister's desire to keep it from the House until the last possible moment, but what we have had is regurgitated pap with no new offer of any kind. A new initiative would have been extremely welcome, with some new money on the table. Is this not simply a rearrangement of the existing package? Although the Minister talks glibly about the RCN's acceptance of talks, is it not true that on two occasions the members of the Royal College of Nursing have totally rejected the arrangements that were put to them?
I must make it clear that the TUC has never refused to negotiate with the Government on the pay package for 1982–83, but it has refused to accept a dressed-up rearrangement that offers no improvement of any kind. Will not the Minister now be honest and accept that, as 33 25 per cent. of the existing offer will come out of RHA budgets, the industrial action can have no effect in comparison with the cost of his cuts on long-term patient care? Hospital closures will have such a direct effect on patients that the existence of longer waiting lists will pale into insignificance in comparison with what the Minister is doing at present.
Is it not true that, in the tripartite talks, where the chairman was the Minister of State, there was a suggested deal for April 1983? The Minister now talks about April 1984. Are we to take that as a sign that when he talks about setting up new machinery he is no more serious than he was in offering a decent deal to the unions? This is a non-statement, and the sooner the Minister takes responsibility for the enormous damage that he is doing to the National Health Service the better.

§ Mr. Fowler
I do not know about a non-statement, but certainly that was a non-response. It is, I think, about time that the Opposition came out and said what they said in Government, and were prepared to condemn the hardship caused by industrial action inside the Health Service. At no stage has the Opposition Front Bench been prepared to do that. In my opinion, that is a disgraceful commentary on the Labour Party.
In answer to the questions asked by the hon. Member for Crewe (Mrs. Dunwoody), the advantages of the two-year agreement are that it gives the staff a higher percentage earlier, that it puts £1,100 million on the table as a basis for negotiation, and that it leads through to a commitment to talks on newer pay arrangements for the National Health Service, which is what many people in the Health Service and outside want.

§ Mr. Robert Hughes (Aberdeen, North)
When?

§ Mr. Fowler
We had put April 1984 as the aim for those talks.
As for progress, talks are continuing, as I said, with the Royal College of Nursing, the Royal College of Midwives and two other professional bodies. In my view, the House would welcome their decision to talk, and I believe that the House will hope for the success of those talks. Certainly, I am sure that the House does not expect a sudden result tomorrow, but I shall certainly tell the House as soon as there is something to report.
On the unions' refusal to talk, which was the hon. Lady's third point, I remind her that the proposals were carefully worked out after closed talks with Mr. Spanswick, the chairman of the Health Services Committee, and Mr. Jacques, the secretary.

§ Mrs. Dunwoody
No.

§ Mr. Fowler
Those were private talks, and I have revealed the content of one of those talks. If the hon. Lady says "No" to that, I am prepared to ask Mr. Spanswick and Mr. Jacques for their permission to give all the dates and venues of the talks that took place.
In answer to the hon. Lady's fourth point, we have shown our commitment by spending £14½ billion on the National Health Service. That is higher in real terms than any other Government have spent in the history of the Health Service.
The talks on permanent arrrangements are taking place under the chairmanship of the Minister for Health. Any delay is certainly no responsibility of the Government, although at times I doubt whether one or two of the health unions represented there actually want to make progress.

§ Mr. Speaker
Order. The House has heard that this matter is to be fully debated on Wednesday. I therefore propose that questions now should not last longer than 20 minutes. I shall allow 20 minutes and then move on.

§ Mr. Clement Freud (Isle of Ely)
As there is really nothing new in the Secretary of State's statement, will he explain to the House which particular paragraph took him so long to bring before those of us who were prepared to get a statement? Does he not agree that it cannot be surprising that negotiators are reluctant to meet him when he has announced that there is to be no overall increase in the offer? Why is he so frightened of putting the matter to independent arbitrators?

§ Mr. Fowler
I have already apologised for the fact that the statement was not available sooner. It was an administrative point, rather than a point of substance. I hope that the hon. Gentleman will at any rate have the grace to accept that. On the progress of the talks, I should have hoped, frankly, that the Liberal Party would be pleased that we were continuing talks with the nurses, the midwives and the Health Visitors Association. I should have thought that that fact would have given the Liberal Party some pleasure, and that it would have joined us in hoping that the talks would be successful.
We have already made our position clear on arbitration. Arbitration does not settle where the money comes from. We have already moved our offers in both the Civil Service and the teaching profession after arbitration.

§ Sir William Clark (Croydon, South)
Since the British taxpayer is putting more money into the National Health Service in real terms than is being done in any other nation, and since an increase of the present offer would mean only that the British taxpayer must part with more money, will my right hon. Friend assure the House that one reason for low wages in some sections of the Health Service is gross overmanning and inefficiency? What action is being taken to cut the obvious overmanning in that huge service?

§ Mr. Fowler
My hon. Friend raises an important issue. We have already made efforts to ensure that the National Health Service can obtain the best value from the money that it uses. That includes checks on manpower. During the past few months we have begun regional reviews. We are setting manpower targets and are bringing in external advice from the private sector to check manpower and [ hope to make a statement soon. One reason for low pay is that the workers are paying high tax because of the burden of public spending.

§ Mr. William Hamilton (Fife, Central)
Is the Secretary of State influenced by the undoubted fact that the overwhelming mass of public opinion is solidly behind the Health Service workers' claim and that his attempt to set one section against another will be treated with the contempt that it deserves? When will he recognise that, unless he is prepared to come forward with additional money, no juggling with the existing money will bear fruit with the trade unions and that the industrial action will continue, with the support of the Labour side of the House?

§ Mr. Fowler
The hon. Gentleman's final statement is a great pity, because the Labour Government condemned industrial action that affected patients. This industrial 27 action is affecting patients. There is no question about that and I cannot understand the attitude of Labour Members, who only a few years ago were prepared to condemn such action, in now saying that they will support it. The hon. Gentleman's point about divide and rule is totally absurd, because the offer on the two-year settlement was put to the trade unions and to the professional bodies at the same time. It is to the credit of the professional bodies that they were prepared to talk about it, and, regrettably, to the discredit of the health unions that they were not.

§ Mr. Mike Thomas (Newcastle upon Tyne, East)
Is the Minister aware that he is Secretary of State for Social Services, not Pontius Pilate? He cannot abdicate responsibility for the results of the dispute. He can beat the health workers if he chooses, but the House is entitled to ask whether it is worth the price not just in the extended waiting lists about which he talked but in a legacy of bitterness and the effect on the current ballot on the no-strike rule in the RCN. Will he admit that he was wrong not to send the matter to arbitration, which is a long-established procedure in the Health Service, and will he now do so?

§ Mr. Fowler
It is not a long-established procedure in the Health Service. The way forward is by negotiation and I should have hoped that the SDP, for what its views are worth on such matters, would support the fact that talks are continuing between the Government and the nurses and other professional bodies. I am not sure of the SDP's present incomes policy—it went out of the window in Great Yarmouth—but its members should support the proposal that the unions should talk to the Government.

§ Mr. R. A. McCrindle (Brentwood and Ongar)
In view of the lengthy stalemate in this dispute, and notwithstanding the talks with the RCN and others, have the Government given consideration to a decision in the near future to pay the 6 per cent. now on offer, without prejudice to further negotiations, so that the minds of the trade unionists may be concentrated rather more on a lump sum back payment and their eyes lifted more to the 1983–84 round of negotiations than to the present, rather lengthy, round?

§ Mr. Fowler
We have not considered that. The way forward is by the present negotiations. Talks are in progress and that is the most constructive and only possible way forward.

§ Mr. David Ennals (Norwich, North)
Will the Secretary of State accept that this is by far the longest and most damaging dispute in the Health Service? Will he accept not only that, as he said, it is causing great damage to patient care but that as a result of combining it with cuts in funds available to the Health Service, morale within the service is at an all-time low? Does he agree that he has until Wednesday either to come forward with a new offer or to accept arbitration, about which there is strong feeling on both sides of the House?

§ Mr. Fowler
The House will not readily accept advice from the right hon. Gentleman, who presided over the winter of discontent. The Government have shown their commitment to the Health Service by providing a budget of £14½ billion. That is a 5 per cent. increase in real terms 28 and a gross national product increase from 4.8 to 5.5 per cent. We shall not take lessons from the Labour Party on that.

§ Mrs. Sheila Faith (Belper)
The House must welcome the fact that the nurses and other professional bodies are considering the two-year agreement, but will my right hon. Friend draw the attention of the health workers to the London ambulancemen, who have tumbled to the fact that Arthur Scargill and others are not interested in the future of the Health Service but are using the dispute to defeat the Government's anti-inflation policy?

§ Mr. Fowler
My hon. Friend is right. There are those outside the Health Service who have no interest in its future but who are trying to use the dispute against the Government and against the Government's success with their anti-inflation policy. That is another reason why we should continue with our policy.

§ Mr. Laurie Pavitt (Brent, South)
Will the Secretary of State confirm that the two-year settlement, whether under option A or option B, would mean an increase of £45 for a ward sister in two years? Will he do something about the iniquitous position whereby, since 1 April, nurses in residence have suffered an increase of 10 to 12 per cent. in the cost of meals and residence charges but have not received a pay increase? Will he come clean about the increase in inflation since their previous pay increase?

§ Mr. Fowler
The estimated increase in earnings for a ward sister on the 6 to 7½ per cent. option would be a minimum of £9.23 and a maximum of £11.84. That does not coincide witht the hon. Gentleman's figure.

§ Mr. Cyril D. Townsend (Bexleyheath)
Is my right hon. Friend aware that during the recess I discovered in my constituency great respect, as always, for nurses and others in the Health Service but nothing other than contempt for those who wish to exploit the issue for political purposes at the expense of the elderly and the sick? Will my right hon. Friend remind the House how many public sector groups have already accepted pay increases of about 6 per cent., such as the civil servants and policemen? Did they not accept those increases partly in the belief that the Government would stick to their part of the bargain?

§ Mr. Fowler
About 9 million workers have accepted average pay settlements of about 7 per cent., but the teachers, the civil servants and the Armed Forces have accepted about 6 per cent.

§ Mr. J. W. Rooker (Birmingham, Perry Ban)
Will the Secretary of State admit in the House that the nation and the National Health Service owe a debt to those who clean the lavatories and drains in the National Health Service as they do to every other Health Service worker? It is invidious that the Secretary of State should continually single out the nurses and doctors. Does the Secretary of State know that his Department, in reply to hon. Members who have raised the matter in writing, is sending out a fact sheet that refers to analogies with the mining industry? Can he tell us which jobs in the mining industry are analogous with this dispute?

§ Mr. Fowler
The fact sheet and the analogies which the hon. Gentleman mentions refer to the general level of wages. I have never sought to disguise or play down the contribution which the ancillaries have made to the 29 successful running of the National Health Service. In my statement I paid tribute to ancillary workers who have continued to work and care for patients, and I condemn those who have not.

§ Mr. Tony Marlow (Northampton, North)
Would my right hon. Friend take the opportunity to explain to members of the Labour Party—generous to a fault, as they always are with other people's money—that on the figures given so far the Health Service is costing the average individual in Britain the massive sum of £250—plus per annum? Is my right hon. Friend aware that the generous figure of £1,100 million that he has put on the table will add an extra £80 a year to the bill of the average family of four, which is the equivalent of £1.60 a week for each family, just to pay the increase?

§ Mr. Fowler
That is right, although some of the figures have to be changed. The sum of £1,100 million is on the table for negotiation, as my hon. Friend the Member for Northampton, North (Mr. Marlow) said. As he also said, that money must come from somewhere. It comes from the taxpayer and it is time that the Opposition took that message on board.

§ Mr. Reg Race (Wood Green)
If the National Health Service is safe with the Conservative Party, as the Prime Minister has said, why are the Government considering that in addition to making local health authorities pay for one-third of the increase this year, they will make local health authorities responsible for all of any wage increase for Health Service workers next year? If that proposal were implemented, would it not cause scandalous cuts in services? Will the Minister take the opportunity to assure the House and the chairmen of regional and district health authorities, who have raised the matter with me, that the Government have no intention of pursuing that course?

§ Mr. Fowler
I must ask the hon. Gentleman to wait a few weeks for a full answer to his question about the effects of such a proposal being implemented.

§ Mr. Barry Henderson (Fife, East)
Meeting the Health Service workers' claim in full has not been suggested. Could that be partly because 1.2 million taxpayers work in the Health Service or because the increase in nurses' pay since the present Government came to office has been 12 per cent. beyond the rate of inflation?

§ Mr. Fowler
The average increase in nurses' pay has been 61 per cent. in the lifetime of the present Government. The suggestion is that no Opposition Member supports the 12 per cent. If that is so, their attitude has changed in the last three or four months.

§ Mr. Robert Hughes (Aberdeen, North)
Does the Secretary of State accept that his offer to the Health Service workers must be measured not in terms of today's inflation but in terms of the 15.6 per cent. increase in the tax and price index in the 12 months covered by the 12 per cent. increase? Does he also accept that the postponement from April 1983 to April 1984 of the operation of the new agreement on pay is a gross betrayal? Would he not do better to examine the dispute afresh than to try to prove his virility to his right hon. Friend the Prime Minister?

§ Mr. Fowler
The hon. Gentleman must accept that the Government, by sticking to their policies, have brought inflation down to the lowest level for 10 years. That was the aim of the Opposition. The Conservative Government have achieved it.

§ Mr. Michael Colvin (Bristol, North-West)
Is my right hon. Friend aware that on the question of priorities for limited resources, the use of outside contractors to provide ancillary services in the NHS could save about £400 million a year—that is, 20 per cent. of the cost of such services? Is he aware that if that were done he would be able to pay every nurse an extra £1,000 a year?

§ Mr. Fowler
I do not know about the last part of my hon. Friend's question. The Government support using outside contractors where that makes sense and reduces costs.

§ Mr. Stanley Newens (Harlow)
Is it not hypocritical to say that patients suffer because of industrial action and to remain silent about the greater suffering of patients because of the Government's financial policy and the closure of facilities? Is the Secretary of State aware of the proposed closures in my constituency of a casualty department, a female surgical ward and an alcoholic treatment centre as a result of his policies? Will he agree that damage to patients results from that?

§ Mr. Fowler
I shall have to examine the details of what the hon. Gentleman says. All closure proposals will come to us. The hon. Gentleman fails to understand, or to concede, that the Government are not cutting the Health Service budget but are increasing spending on health. That is incontrovertible.

§ Mr. Dennis Skinner (Bolsover)
In view of the hundreds and thousands who have been added to the waiting lists, how much will it cost the National Health Service, and so the Government and/or the taxpayer, to deal with them, especially since the increased waiting lists are the result of the Government's intransigence? Does rot the right hon. Gentleman have a cheek to talk about other workers such as miners joining picket lines and demonstrations in support of the Health Service workers because they are supporting their Health Service, unlike Tory ranks, almost all of whom do not believe in the National Health Service and take out private insurance?

§ Mr. Fowler
Not many hon. Members would think that Mr. Arthur Scargill appeared on the picket line because of his concern about the Health Service.

§ Mr. Speaker
Order. We have only a minute to go, but since only two hon. Members wish to ask further questions I shall call them both.

§ Mr. Campbell-Savours
The Secretary of State said that the claim was unrealistic. Is he not being unrealistic in demanding that over 100,000 low-paid health workers, already taking home little more than £50 a week, should be subject to a 6 per cent. increase which will give them coppers, when the majority of people, if they knew that to be the truth, would support the health workers arid demand that they be paid additional money?

§ Mr. Fowler
The hon. Gentleman raises the whole question of low pay. There has been much talk about low pay which is not peculiar to the Health Service. The only progress that we can make is by negotiation. One of the essential parts of that negotiation is to achieve new permanent arragements inside the Health Service which might hold out hope for Health Service workers generally.

§ Mr. Canavan
Is the Secretary of State oblivious to the fact that his irresponsibility has led to the dispute dragging on for over six months? Is he aware that Health Service workers have the support of the public, as will be seen again during the Scottish day of action on Wednesday? Is it not time that the Secretary of State stopped trying to divide the nurses from other Health Service workers and instead ensured a full 12 per cent. increase for all—and back dated at that?

§ Mr. Fowler
I should be interested if the Opposition's official case were that we should pay 12 per cent. in full. If that were so, they would be more than usually irresponsible in terms of public spending. There is no question of seeking to divide and rule. The September offer was made to the professional bodies and the TUC. The TUC refused to talk about it and refused to negotiate. That is indefensible.