HC Deb 21 December 1984 vol 70 cc686-94

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Boscawen]

9.43 am

Mr. Jeremy Corbyn (Islington, North)

This short debate on privatisation in the National Health Service comes at the end of a week when the Government announced that they had appointed Mr. Victor Paige to the chair of the NHS management board. I understand that he is a subscriber to BUPA—the private medicine scheme. Therefore, he shows his commitment to the NHS in that alone. It later emerged, under close questioning of DHSS officials and Ministers, that he is being paid £70,000 per annum, which is about £1,500 a week. At the same time, the wage for most domestics and cleaners in NHS hospitals is £1.72 per hour. Indeed, cleaners at the Barking general hospital have had their wages reduced to such a level that they are now being offered £17 per week by a private cleaning company.

That shows the sort of contrast that we are facing within the NHS. The Government are prepared to spend such a large amount of money on appointing someone to streamline the NHS and at the same time they continue to pay disgracefully low wages to people working within the NHS. They threaten those people's jobs and existence by the promotion of privatisation within the NHS. The Government have an obsession with privatisation which is matched only by their obsessional hatred for trade unions in general. In an article in The Guardian, the Under-Secretary said that he hoped that in a few years people would wonder what all the fuss was about over contracting out of services in the NHS. In what poses for a philosophical piece, he went on to ask who should wash the sheets in NHS hospitals and whether that really mattered. It cannot matter much to the Minister concerned, but it matters a great deal to those who work in the NHS. It also matters a great deal to those who use and rely on the NHS and wish to be able to continue to rely on it.

Many, not necessarily Labour Members, but people in trade unions and others all round the country, believe strongly that if the NHS means anything it means a comprehensive Health Service which can take care of everybody within the community and which can provide a full Health Service under some form of democratic control. I want to see changes in the structure of the NHS to enable greater democratic control to be obtained, but I also believe that by contracting out of any particular services within the NHS that control is weakened and the service is weakened and seriously damaged.

The Government's plans for privatisation within the NHS go back some years. It is interesting to note—the Minister may care to refute this—that as far as I am aware there is no legal power whatever to make a district or regional health authority privatise any of its services. But there is an enormous amount of cajoling, arm-twisting and blatant brow-beating of individual members of district health authorities. Letters are frequently sent from the Under-Secretary of State to the chairmen of the regional and district health authorities saying whether their performance is satisfactory.

Let me quote from one, signed by the Minister, to Dame Betty Paterson, the chairman of the North-West Thames regional health authority. After saying that he is pleased at the level of commitment shown to competitive tendering by some districts in the region, he goes on to say: For the other districts you no doubt have action in hand to secure satisfactory programmes. Could I now ask you to get in touch immediately with those districts to inform them that their programmes are not acceptable to Ministers, and if they are not already doing so, to seek urgent action to improve that? I would like a further report from you by 17 September at the latest giving revised programmes for those districts, or, exceptionally, where this is not possible, a report of the action in hand to obtain satisfactory programmes.

The Minister does not say in that letter what he plans to do if he does not get satisfactory replies from those districts or if they do not go out to competitive tendering. But we know full well that he looks closely at the appointment of members of district health authorities. He looks closely at the form of tendering that is put forward by those authorities which eventually succumb to his iron fist and his threats. The Minister then goes on to encourage them to privatise. In privatising, he opposes the use of NHS wages and conditions and the use of the fair wages resolution which the Government have been kind enough to abolish so that there is now no minimum protection for the lowest-paid, predominantly women workers in Britain. The Government are then surprised when there is opposition to this disgraceful programme of destroying people's jobs.

Opposition comes from many people. Let me quote from a letter. Many will be surprised where it has come from. It is from someone who has resigned from a district health authority and says: My immediate occasion for taking this step is the so-called privatisation of the hospital cleaning services and the terms of the contract that we have accepted. You will recollect that when privatisation was first proposed, I expressed the view that for the hospital to be run in the spirit that it should be for the patients' sake, we ought to be concerned that all those working in it, and particularly those with direct contact with patients, should enjoy terms of service that would enable them to focus their main concern on the wellbeing of the public rather than their own. I believe that to save money by further separating the status of the professional from that of the ancillary staff would not serve this end if it means employing the latter as semi-casual labour. Certainly in my wards we value very highly the responsible and loyal work of our cleaners and the personal help that they often give to our patients and their parents.

That letter is not from a district officer of the National Union of Public Employees, which sponsors me in this House, or from any other union within the National Health Service. It is from Professor J. A. Davies, the professor of paediatrics at the University of Cambridge clinical school, department of paediatrics. He is passionately concerned about his patients in the National Health Service and is not prepared to see the service destroyed.

Throughout the country there have been a number of disputes on the issue of privatisation of jobs within the National Health Service. The Minister might sigh, as he sits down to his Christmas lunch next Tuesday, "Thank goodness I have not got to worry about Barking, Hammersmith, Addenbrooke's, High Royds, or any other hospital," but I warn him that if the Government continue on their ludicrous course of destroying employment prospects for part-time women workers in the National Health Service, and of destroying the Health Service by handing it over to their friends in the private contracting industry, they will have not three or four disputes on their hands next year but hundreds. Workers in the National Health Service, who have shown enormous dedication and loyalty to the patients, will show that they are not prepared to see their jobs destroyed.

The strike which has been running the longest is that at Barking hospital, which comes within the Redbridge district health authority. It has lasted almost as long as the miners' strike, and it is about the proposal of the contract cleaning company concerned, Crothalls, to make cuts of 40 per cent. to 60 per cent. in wages, and changes in working practices. The total hours of 87 cleaners in the hospital were to be cut by the same proportion—by 41 per cent., from 2,189 to 1,313 a week. Women earning £57 a week were expected to take cuts in hours which would mean that they would take home only £17 a week. Yet the Government show surprise at the opposition to the proposals, which involve the worsening of conditions with less sick leave, less holiday pay, less maternity leave and so on. Conditions which have been argued and fought for within the National Health Service for a long time are destroyed by privatisation.

At the Barking general hospital there have been numerous reports by people working in the hospital who are qualified to judge environmental health conditions. They say that the hospital is in a dirty, disgraceful and dangerous state, and will continue to be so as long as the authority allows a company such as Crothalls to continue to use very low-paid and unskilled labour, while other people are forced to stand outside the hospital on the picket line, trying to get themselves a decent living wage. The charge against the Government is that they are destroying the living standards of many very low-paid part-time workers within the National Health Service.

Recently there was a dispute at the Hammersmith hospital, which comes under the Hammersmith special health authority. The contract that was offered involved a cut in hours from 6,170 to 2,802 per week. Jobs were to be cut from 207 to 158, and full-time jobs were to be reduced from 122 to 28. There were to be only two weeks' annual leave after six months' service, instead of the usual NHS conditions. Disputes of that sort arise frequently throughout the country, and there will be more of them.

There is a dispute at Addenbrooke's hospital in Cambridge where Professor Davies has resigned from the health authority in disgust at the way that the Government have forced privatisation on the National Health Service. The strikers are standing outside the gates at Addenbrooke's hospital because they want the people who work there to have decent working conditions, decent standards of service and decent wages.

There are many question marks over the companies which are involved in contract cleaning, contract catering and other forms of contracting business. The firm involved in the Addenbrooke's dispute, OCS, has very limited experience of hospital cleaning, as have many other contract cleaning companies. They line up outside district health authority meetings and offer themselves as the lowest bidder for the cleaning contract in each year in each district health authority.

The National Health Service was set up to provide health care for the people of Britain. The health authorities were set up to ensure that there would' be a healthy population. Under privatisation, the district health authorities become conveyancing mechanisms for passing money from the public purse into the private purse. They become a mechanism for making huge profits out of low wages and inadequate and inferior service. The authorities will rue the day when they realise how much damage they have done to the National Health Service, and to the lives of so many people who have given long and dedicated service to health authorities.

The Parliamentary Under-Secretary of State for Health and Social Security(Mr. John Patten)

The NHS hospitals are treating more patients than they have ever treated.

Mr. Corbyn

The Minister can hardly contain his excitement at this point. I shall gladly give way to him if he has something useful to say.

There are numerous examples of the failure of contract cleaners in hospitals all over Britain. I have been unable to find any cleaning contract in any part of the NHS that has not been beset by problems of greater or lesser magnitude. Hospital administrators and health authorities are concerned that they have very limited control over the standards and the methods of cleaning in hospitals.

If the Government feel proud of their performance on cleaning, what will it be like when they move on to the privatisation of the catering services, and as we see the incompetence of some of the private catering companies as they try to provide special diets which they are not qualified or capable of doing? They have not the experience of the people who work directly in the NHS.

High Royds hospital, which is within the Leeds western district health authority, is a 900-bed hospital for the mentally ill. The authority terminated the contract with Home Counties Cleaning Group because of low standards and gave the new contract to Hospital Hygiene Services. A Sunday Times report in June 1984 said that Dr. Terry Nelson, head of the hospital's medical services committee, had complained to managers about the erratic standards of the contractors. One senior nurse had complained of faeces, urine and vomit on the floors, which remained uncleaned, and there were numerous other examples of the failure of that contract. As a result, the contractors were eventually changed.

At Hinchingbrooke hospital, which is within the Huntingdon district health authority, the contract for cleaning was run by B. A. Lester when the new hosptial opened in 1983. A report by Dr. William Newsen, a bacteriologist at Papworth hospital, in January 1984, records high levels of dust in clinical areas, including laboratories. He states: The contractor is in breach of the contract in failing to use impregnated mops. Mops with over one inch of dust were found in the cupboards. We grew coagulate positive staphylococci, i.e. potential disease producers from three samples of the dust in the Nursery and Rowan wards. That is not an untypical example of what happens when contract cleaning companies, with their lack of experience, work in NHS hospitals.

Why are the Government so obsessed with privatisation in NHS hospitals when they know the damage that is done by contracting services? The Government claim that the purpose of privatisation is to save money for the NHS and to allow more money to be spent on patient care. That is patently not proving to be the case. The Government have not created jobs. They have reduced wages and they have allowed enormous profits to be made by private cleaning companies. There has been a greater cost on the public purse at the other end of the DHSS, as former NHS workers become unemployed when they could be doing a good job in NHS hospitals.

My union, NUPE, has commented: This massacre of earnings, conditions and cleaning standards will be faced by thousands of health workers in the year ahead. That is exactly what is happening.

There are likely to be fewer jobs in the NHS and fewer jobs in total in contract cleaning services in hospitals as privatisation goes on. Fundamentally, the motive for privatisation is very different from the motive set up and led the National Health Service for so many years. Those contract cleaning companies are concerned to make money out of the NHS and are not concerned primarily with patient care, which is what those who work in the NHS are concerned with.

In pushing privatisation in the way that they have, the Government have ensured that wage levels are automatically lower. They have ensured that every year or every two years, whatever the contract period is, workers in NHS hospitals have to sell themselves to the lowest bidder who is prepared to exploit them and to exploit the NHS at the same time.

I have some examples of the pay and conditions offered by the Merton and Sutton health authority. When the Government say that in-house tenders are acceptable and that they are prepared to allow them to be considered, it is interesting to note that they deliberately say also that Whitley agreements are not binding on contract cleaners, but they know perfectly well that they are likely to be in any in-house tenders. It is a Hobson's choice for workers in the NHS. Either they accept the in-house tender, which probably will be on NHS wages and conditions but certainly will mean much lower staffing levels, more difficult hours of work and generally inferior working conditions, or they can go out to a private cleaning company where they will get what the Government euphemistically call "the going rate" for cleaning work, which is the most exploited section of the market. The Government have an obsession with exploiting part-time women workers, and the opposition to them is mounting.

Very little publicity is given by the Government to the reports which come out regularly about the way that contracts have failed. I have an excellent report published by the west midlands regional TUC health services co-ordinating committee. It is described as a preliminary report on the 47 companies approved by the West Midlands regional health authority as being eligible to tender for contracts within the NHS for catering, domestic and laundry services. It goes through in excruciating detail the background to these companies, who the shareholders are, who put up the money for them and the number of Conservative MPs who have shares in them—a matter that was referred to in the House during the debate on the NHS in July. The co-ordinating committee feels, quite rightly, first that there is no contract which has been successful and approved of fully by any district health authority, and, secondly, that there are untold elements of corruption or the potential for corruption within the contract cleaning process and the privatisation of NHS services.

This Government are intent on destroying the NHS in many ways — by cuts, by privatisation and by the promotion of private medicine. They are also destroying the working conditions of many people who have given loyal service to the NHS for many years. For example, on 7 December this year, which is fairly up to date, of the 240 health authorities and boards, 14 were not complying and 26 had adopted fair wages clauses. As we look through the contracts increasingly being awarded, lower and lower wages are being offered as the Government use the hammer of the dole queue to force down wages of part-time workers in the NHS and to destroy the service by the same process.

It is a scandal of the highest proportions. Here we are on the eve of Christmas. The Minister might have a little compassion, although I have my doubts, and think of the fear in the minds of thousands of NHS employees next year when privatisation is threatened, with their jobs being taken away, their livelihoods destroyed and their being forced to work for private cleaning companies on lower wages and with longer hours and worse and worse working conditions.

The Government believe in the free market economy. For many of the poorest of our people, that means poverty and the dole queue. That is what the Government are trying to do through privatisation. But I can assure them that the workers in the NHS who have loyally supported the service for so long will continue to oppose privatisation. There will be disputes and there will be opposition for as long as the Government are in office. They look forward to its being replaced by a Labour Government who are determined to provide good, decent working conditions and a good, decent NHS.

10.5 am

The Parliamentary Under-Secretary of State for Health and Social Security (Mr. John Patten)

The hon. Member for Islington, North, (Mr. Corbyn) has not exactly enhanced his reputation in the House in recent days, and I have just listened to one of the most unpleasant speeches that I have had to sit through in my five years here. The hon. Gentleman raised groundless fears and made groundless allegations. His speech was a tissue of allegations without substance.

The hon. Member for Holborn and St. Pancras (Mr. Dobson) has been in his place on the Opposition Front Bench throughout his hon. Friend's speech. I do not seek to do the hon. Member for Holborn and St. Pancras any personal or political damage when I say that there is a wide gap between the way in which he and his hon. Friend express their strongly held views on this issue. I always listen to the hon. Member for Holborn and St. Pancras because he talks reasonably about these issues rather than in the fatuous way that we have just heard from the hon. Member for Islington, North, who demonstrated clearly the different attitudes to the NHS between him and other right hon. and hon. Members.

Government supporters regard the NHS as being there primarily to provide a service for patients, and for no one else. We are proud that this year the NHS is treating more patients than ever before. From what the hon. Gentleman said with his repeated references to the trade union that sponsors him in the House and to the needs of trade unionists, it is clear that he believes that the NHS exists primarily for the benefit of the staff. Ancillary workers do an excellent job in the NHS, but it is the patients whom the service seeks to serve most of all. There is an unbridgeable gap between me and the hon. Member for Islington, North. Sadly, with his curious perception of the NHS, the hon. Gentleman has completely missed the point of our competitive tendering policy.

Our policy is about competitive tendering. It is not about privatisation pure and simple, because that is not its purpose. We have called for competitive tendering in the NHS to test the way in which it provides catering, cleaning and laundry services. It is a very successful policy.

We have asked domestic, catering and laundry services, which cost the NHS about £1 billion a year, to subject themselves to the same close scrutiny as that to which the private sector is subjected. It might be more comfortable to leave matters as they are. But, for too long, health authorities have accepted without question that they should provide services in hospitals by direct labour when for years they should have been asking what is the best way of providing those services in the interests of the needs of patients.

Mr. Frank Dobson (Holborn and St. Pancras)

Will the Minister give way?

Mr. Patten

I have only a very short time. I hope that the hon. Gentleman will forgive me if I do not give way to him. I must try to reply to those matters that his hon. Friend raised.

Mr. Dobson

I do not think that I will forgive the Minister.

Mr. Patten

Health authorities should have been asking themselves what is the most cost-effective way of providing these services, because the NHS—

Mr. Dobson

rose—

Mr. Patten

—is not in the business of providing laundry, catering or hospital services.

Mr. Dobson

rose—

Mr. Patten

I shall not give way to the hon. Gentleman. If I did, it might encourage his hon. Friend the Member for Islington, North to seek to intervene and, while I am prepared formally to answer his debate, I am not prepared, after what he has done in recent weeks, to extend to him any of the normal courtesies.

If we had allowed matters to carry on as they were in the NHS, we would have missed a golden opportunity to save money that could be spent on patients. That. is what this policy is about. I fail to see the logic of the complaints of the hon. Member for Islington, North. Is he saying that he does not wish to have patient services improved and that the money saved on these services should not be spent on patients? That is ludricous.

We have told health authorities that, through competitive tendering, they should check that they are getting the best possible deal, and that they should get services provided by whoever can provide them best—in the interests of the service and of patients—whether that is a contractor or the excellent NHS in-house staff.

If a hospital's own service and staff can provide what is necessary, that is a good thing. If not, someone from the private sector should be given the opportunity. There is nothing dogmatic about that. It is a fair and even-handed policy, which is leading to substantial savings. Costs in the NHS are reduced when contracts are awarded within the service as a result of tendering.

We already have evidence that substantial savings are being made, not only by letting contracts to the private sector, but by driving down the cost of providing services within the NHS. For example, 37 contracts have been let privately and have resulted in annual savings of about £6.5 million for health authorities.

Mr. Dobson

Publish the evidence.

Mr. Patten

Two of the contracts have saved over £1 million a year.

Mr. Dobson

On a point of order, Mr. Deputy Speaker. Is it not contrary to our rules for the Minister to mislead the House? He is asserting that savings have been made—

Mr. Deputy Speaker (Mr. Ernest Armstrong)

Order. The hon. Gentleman must not accuse another hon. Member of deliberately misleading the House. He must withdraw that statement.

Mr. Dobson

Further to that point of order, Mr. Deputy Speaker. May I seek your advice about what I should do if I have reason to believe that what the Minister has told the House is at variance with the facts?

Mr. Deputy Speaker

Hon. Members have various views about speeches, but each hon. Member is responsible for his own speech.

Mr. Patten

The hon. Member for Holborn and St. Pancras is falling lamentably below his usual quite high standards of debate.

Two of the contracts that have been let will save £1 million a year. The Hammersmith contract, to which the hon. Member for Islington, North referred, will save between £500,000 and £600,000 a year. Is the hon. Gentleman really saying that he would wish that money to be taken away from patients and spent on unnecessary costs? That is a ludicrous argument; it is an anti-NHS argument. It may be a pro-NUPE argument, but it is not a pro-patient argument.

The NHS has obviously been running some parts of its services inefficiently. It must examine critically the way in which it provides services and they must be provided at a high standard.

The hon. Member for Islington, North alleged that a substantial number of problems had occurred in private contracts. Because the hon. Member for Holborn and St. Pancras has interrupted me with fatuous points of order, I have only two or three minutes in which to deal with the matters raised by the hon. Member for Islington, North.

The comments of the hon. Member for Islington, North about the Barking hospital dispute are scandalous. He said that what has been going on at the hospital is dangerous. He should substantiate that allegation or withdraw it. Even the trade unions have stopped picketing the hospital. The only people there now are representatives of a fatuous local organisation called Health Emergency, which is funded by Mr. Ken Livingstone and the GLC.

In recent days, the hospital has suffered vandalism and a series of break-ins. Hospital lavatories have been blocked and staff have been put to extreme inconvenience. None of that is in the interests of patients. It is in the interests only of the hon. Member for Islington, North and his extremist colleagues.

Mr. Corbyn

No facts, only a smear.

Mr. Patten

The hon. Member for Islington, North ought to reflect about what the hon. Member for Fermanagh and South Tyrone (Mr. Maginnis) said about him in the debate on Northern Ireland last night. How right the hon. Gentleman was in what he said about the behaviour of the hon. Member for Islington, North in recent weeks in encouraging terrorism.

I believe that we should look at the overall benefits that our policy will bring, the savings that will be achieved, the improvements in local services for NHS patients and the improvements in the efficiency of NHS management that will flow from that policy. I find it difficult to see any arguments against that cause and I shall be surprised and disappointed if the Opposition wish to deny the public such benefits, either for doctrinaire reasons or because of their associations with trade union interest groups that support the hon. Member for Islington, North.

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