§ Question again proposed, That the amendment be made.
§ Mr. Cohen
There is concern that there could be ambiguity in the Bill. That is the reason why my hon. Friend the Member for Wrexham (Dr. Marek) put down an amendment. He sought to remove any ambiguity and to ensure that all health authority premises are properly covered under the legislation. It is important that there is no ambiguity. There are examples of the courts interpreting a measure in a way peculiar to themselves. The whole idea of the Bill is to ensure that health authorities cannot get away with having premises that are in such a bad condition that patients and staff are put at considerable risk.
My hon. Friend the Member for Wrexham referred to press reports about the abolition of Crown immunity and the necessity to ensure that premises are cleaned properly. My hon. Friend referred to an article entitled:Disease-carrying pests are 'taking over' hospitals, report. says".When I looked at the papers I had prepared for the debate., I found that I had that most interesting article in front of me. It stated: 99Cockroaches, rats, mice and other disease-carrying pests are 'taking over' hospitals and putting patients' health and lives at risk, the British Pest Control Association said yesterday.That was in September last year. The association made the case for more spending on pest control.
§ Mr. Corbyn
Is my hon. Friend aware that in a number of borough council areas, where rate-capping has been imposed, there has been a restriction on the number of pest control officers who can be employed by the relevant local authority? If such restrictions continue, there will be a risk to health, because the inspectors will not be available to find out where the pests are.
§ Mr. Cohen
That is a good point. That is one of the effects of the rate-capping penalties on local authorities. Great pressure has been placed on environmental health officers, who do an excellent job in my constituency. Local authorities are under great pressure because they are being squeezed by the Government's cuts. Very little money is spent on direct pest control. Despite the enormous problems, according to the British Pest Control Association, only £800,000 is spent on pest control. That must be regarded as inadequate.
In the same article, attention was drawn to a survey of 360 nurses conducted by Nursing Mirror last summer. That showed that 88 per cent. of the nurses surveyed had seen cockroaches in their hospitals, 53 per cent. had seen rats or dead mice, and 51 per cent. considered their hospital unclean. That is an atrocious comment on health authority premises and hospitals by those who work in them.
§ Mr. Nicholas Soames (Crawley)
Does the hon. Gentleman agree that it is an appalling indictment of those who work in those kitchens that they allow them to be so disgraceful?
§ Mr. Corbyn
Is my hon. Friend aware that many NHS employees are angry about the cheap way in which many Conservative Members have treated the outcome of the Stanley Royd report? The problems in many hospitals have nothing to do with the workers employed in them but everything to do with expenditure cuts and inadequate management in the NHS. I know from personal experience that on many occasions catering workers in hospitals have pointed out the dangers to health caused by inadequate control and Crown immunity with respect to hospital kitchens. Does my hon. Friend agree that the Government should address themselves to the need for the strictest control on all pests in hospitals and for an examination of management structures to ensure that patients and workers do not suffer from or are not held responsible for the existence of pests in hospitals?
§ Mr. Cohen
That is an excellent point and a direct answer to the intervention by the hon. Member for Crawley (Mr. Soames). I thought at one stage that my hon. Friend the Member for Islington, North (Mr. Corbyn) was trying to steal the rest of my speech, but I think that I shall get by.
100 I was referring to the survey of nurses who had seen the grossly unsatisfactory conditions in their hospitals as a danger to them and their patients. That is why it is vital to remove any ambiguity in the Bill, and why the amendment is right.
There has been an important victory in the wake of the Stanley Royd disaster and the pressure by my right hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley), who introduced a Bill to remove Crown immunity. The Government have responded to the pressure.
§ Mr. Cohen
That is right. The purpose of the amendment is to ensure that they keep to their word.
It is a matter not just of removing Crown immunity but of providing resources to increase standards of cleanliness in hospitals. Wholesale privatisation of cleansing and catering services in the NHS is making conditions worse. Less cleaning is being done and standards have been lowered because of privatisation.
§ Dr. Marek
My hon. Friend has made a valid point. Even if the amendment does not succeed and the Minister is right about there being no doubt and nurses' homes being subject to food legislation, substantial extra expenditure will be needed. No doubt my hon. Friend the Member for Leyton (Mr. Cohen) has read the preamble, which, under the heading "Financial Effect", states:Clause 1 has no implications for public expenditure.I cannot understand how the Government can square that with lifting Crown immunity, albeit only with respect to food legislation.
§ Mr. Cohen
My hon. Friend has,as always, made a telling point.
To remove Crown immunity would be only a token. If an individual or union takes a health authority to court and the health authority has to pay damages, those damages will have to be paid for out of its existing budget. That can only mean cuts in the health services that are provided. The Government are blind if they believe that there will be no expenditure implications. The hospitals will remain dirty and in a bad condition unless the Government provide health authorities with resources to get on with the job.
My hon. Friend was right when he said that it is a question not only of resources but of management in the health authorities. The introduction of business-style management has led to chaos in recent weeks. I have spoken to local trade unions about conditions in my local hospital. They are very worried about the standard of management. More and more assistant managers are being appointed, at high salaries, but those who have to provide the catering in hospitals and keep them clean are suffering immensely from the cuts in the number of hours that they work and in the number of jobs. The result is that their morale is very low and that standards have deteriorated.
As for the implications of the Health and Safety at Work etc. Act 1974, NUPE has already condemned the Bill's provisions as not going anywhere near far enough. It says that the removal of Crown immunity should be extended to premises covered by the Health and Safety at Work etc. Act and that sufficient resources should be 101 made available to the National Health Service to meet the new burdens that have been imposed by the 1974 Act and by the laws relating to food hygiene.
NUPE makes the telling point that in the past the Government have always expected health authorities to provide resources for health and safety from within their existing budgets and that no extra resources have been provided to help the NHS to meet its obligations under the Health and Safety at Work etc. Act. That must be wrong. If this Bill is to mean anything, we must remove any ambiguity in the wording and ensure that it covers all premises. The Government must accept the resource implications and provide money for the health authorities so that they can get on with the job and ensure that all health authority premises, in the interests of both patients and staff, are completely clean.
§ Mrs. Clwyd
My hon. Friend the Member for Wrexham (Dr. Marek) asked the Minister about the financial effects of lifting Crown immunity. It cannot be true that clause 1 has no public expenditure implications. If the Minister is serious about what he said, there are expenditure implications for the Health and Safety Executive. If the health and safety inspectors are to investigate the conditions in hospitals and other National Health Service premises, there must be an increase in the staff of the Health and Safety Inspectorate.
When we debated the Gas Bill we found that there were financial implications because the required increase in the number of Health and Safety Inspectorate staff. Earlier I made the point that since 1979, when the Government came to power, there has been a 15 per cent. decrease in the Health and Safety Inspectorate. Over the same period its staff has fallen by 13 per cent. The gas privatisation Bill alone will place a considerable extra strain on the depleted staff of the Health and Safety Executive, and now the executive is to be given additional burdens. We agree with those burdens being placed on the executive, but they have implications for public spending, because in order to meet its commitments the inspectorate must have extra inspectors.
It is interesting to look at the issue of Crown notices, because the statistics that are available show the reluctance of the inspectors to issue Crown notices without legal backing. In 1978 no Crown improvement notices were issued, and only three Crown prohibition notices were issued. In 1979, 12 Crown improvement notices and four Crown prohibition notices were issued. In 1980 the ratio was 24 to five; in 1981 it was 93 to 6; in 1982 it was 79 to 15; and in 1983 it was 38 to 10. Those figures were given in answer to a parliamentary question put down by one of my hon. Friends.
It is not a straightforward matter to draw comparisons between different industries, but it is difficult to believe that the health services are so safe that only 43 Crown prohibition notices were needed in six years. Many more notices were issued to private industry during the same period. That must say something about the strength of the inspectorate, because in 1978 industry was issued with 12,217 improvement notices and 3,434 prohibition notices. In 1979, 13,517 improvement notices and 3,674 prohibition notices were issued. In the last year for which figures are available for private industry, there were 12,784 improvement notices and 3,221 prohibition notices.
102 The inspectors are unable to police factories sufficiently and will not be able to do anything about National Health Service premises without a considerable increase in staff. I hope the Minister will tell us how much he expects the staff of the Health and Safety Executive and the inspectorate to increase. In February the Secretary of State for Energy told us in the Committee on the Gas Bill that there would have to be an increase in staff in the Health and Safety Executive and the inspectorate to deal with gas privatisation. He was unable to tell us how many extra people would be needed. That increase will involve public expenditure, and I should like the Minister to tell us how he expects Crown immunity to be lifted on NHS premises without implications for public spending. It is clearly nonsense to say that there are no such implications. I hope that he will answer that question, because unless the staff of the Health and Safety Executive and the inspectorate are increased, the promises that he has made will be null and void and worthless.
§ Mr. Corbyn
I should first declare an interest, in that I am sponsored in the House by the National Union of Public Employees, which has a substantial membership of well over 250,000 people employed within the NHS. The way that Crown immunity has applied to the detriment of the interests of our members who work in NHS premises, particularly in the catering departments, has been a matter of great concern to the union.
I am one of the Members of the House who have spent a great deal of time visiting hospital kitchens over the past years when I have been involved in disputes that kitchen employees have had, and I have often been in deep discussions with them about the standards of management, hygiene and cleanliness that apply in NHS kitchens. Within those places there is a wealth of manual workers' experience which has often come from outside the NHS. They are people who have been employed in the hotel and catering trade and in educational establishments, and they are well accustomed to the operation of the food hygiene regulations. They are often appalled at what they find in NHS catering establishments. I have seen cockroaches, mice, rats and all manner of things running around in NHS hospital kitchens.
What is incredible is that it has taken until now for the Government to do something about it. They could have done something about it in the past. Merely altering the regulations about Crown immunity does not of necessity solve the problem, as my hon. Friend the Member for Cynon Valley (Mrs. Clwyd) adequately pointed out. She said that we need costings from the Government to show how they will fund that change, and that is important. Even if Crown immunity is lifted completely tomorrow, which the Bill does not do, the problem will not be solved. The environmental health departments of all the local authorities are already inadequately staffed and unable to meet the demands upon them of inspecting dangerous structures and dirty kitchens in restaurants and workplaces. If they are now to be asked, as they must be, to inspect all the hospitals concerned, they will need the resources to do it.
When the Minister finally comes to reply to this important debate, I hope that he will tell us what discussions he has had with the Secretary of State for the Environment about ensuring that in the forthcoming year 103 the rate support grant settlement takes account of the needs of local authorities for the new responsibilities that will be thrust upon them.
§ Mr. Corbyn
The Treasury, too, as my hon. Friend points out, which will have to fund these things. The Government do not seem to have begun to think about the problems that they are about to meet.
§ Mr. Chris Smith
Does my hon. Friend agree that it is not simply the rate support grant settlement that matters, but the way in which the grant-related expenditure assessments are calculated, the way in which targets and penalties are operated, and the way in which rate limits are calculated for those authorities which are subject to limitations under the Rates Act 1984? It is the entire paraphernalia of the control of local government expenditure which the Government have introduced, which operates in such a malign way on the services which are provided by local government, which matters.
§ Mr. Corbyn
My hon. Friend is correct. As he and I represent the same borough, we are both faced with the terrible problem of the way in which our inner urban area has been treated by the Government. All that we can look forward to in the next 10 years is a 15 per cent. cut in real terms in health expenditure in the borough of Islington. The same applies in inner city areas all over the country. At the same time, local authority finance is being cut so that they are unable even to provide the social services back-up. My hon. Friend was right to point out that what we are speaking of this evening is part of a wider issue. The two amendments that we are discussing say that we should insert:provided by a health authority for the use by health authority staff for residential or other purposes".That is an important addition.
There is an enormous loophole. I do not know whether the Minister is aware of the organisation of NHS premises, but it seems to me that if our amendments are not passed and a hospital catering department is based, not within the hospital building but in nearby premises, is might not be covered by the Bill. I should be grateful if the Minister would say whether my view is correct. I have dealt with the NHS for a long time, and I know that it is good at finding loopholes.
Amendment No. 3, which would insert the word "user", is particularly important. I am not sure how the Bill will affect the use of buildings by private contractors after the privatisation of NHS catering departments. I should be happy if the Minister would assure us that there will be no more privatisation of catering departments, but will he at least give us an assurance that private contractors will not be able to evade the regulations by privatising a catering department or sub-letting it to third contractor?
I read in the papers today that one health authority is to consider allowing an American company to come here and build and run a hospital for the authority. I want to make sure that that company will be made to abide by the strictest possible regulations on food hygiene and kindred matters.
It is important to consider the background of the problems that hospital kitchens have faced for a long time. 104 Many hon. Members have referred to conditions in hospital kitchens and the presence of pests, and I have witnessed many of the problems at first hand. The Guardian Summary of 27 August last year reported the results of a survey into NHS facilities. It said:Health service hospitals where dirty kitchens and infestations of cockroaches, rats and mice were commonplace should lose their immunity to prosecution, according to the vast majority of nurses taking part in a survey. More than 93 per cent. responding to a Nursing Mirror survey believe that Crown immunity, which prevents an NHS hospital being taken to court should be removed.Those nurses have an enormous commitment to the NHS. The article says that the survey made clearthe scale and the range of health and safety hazards which exist in hospitals. More than half the 360 nurses questioned believed that their hospitals were not clean. 53 per cent. had seen rats and mice, including 96 nurses reporting sightings in the wards. 36 had seen vermin in the kitchens. More than 88 per cent. had spotted cockroaches or other pests, mainly in wards, kitchens, bathrooms and corridors.The article goes on to describe what is happening in our hospitals. There is a clear and urgent need to end Crown immunity.
As my hon. Friend the Member for Workington (Mr. Campbell-Savours) said when he quoted from a speech by the general secretary of COHSE, the Bill does not solve the problem. It is supposed to end Crown immunity and ensure that NHS hospitals will be safe places, but it applies only to hospital kitchens, and even then Ministers will be left with full powers to decide which parts of the law will apply in future. Worse still, other health and safety legislation, such as the fire prevention laws, the Health and Safety at Work, etc. Act 1974 and Housing and Rent Acts will still not apply to the NHS.
We have a mess before us. There are loopholes affecting food and hygiene legislation and the Health and Safety at Work, etc. Act. A number of disasters have occurred in NHS hospitals. The worst was the Stanley Royd disaster, but many others like it could happen again, because the legislation does not solve the problem.
§ Mr. Tony Banks (Newham, North-West)
It is not the removal of Crown immunity that will clean up the kitchens. Surely the kitchens will be cleaned up if kitchen staff are given the resources with which to provide an adequate service. My hon. Friend would like to stress that point, would he not?
§ Mr. Corbyn
Indeed, my hon. Friend is correct. As has been pointed out, it is no good passing regulations unless people are empowered to carry them out. Anyone who experienced the long-lost, unlamented operation of the Factories Acts prior to the introduction of the Health and Safety at Work, etc. Act 1974 would know that they were nothing more than a joke. I have direct experience of that. If a shop steward in a factory told the management that some machinery was dangerous and that he was going to call in the factory inspector, there would be a hollow laugh. People would know when the factory inspector was coming, because the yellow lines would be neatly painted in the factory and extra cases of wine would be imported. The problems were not solved. There should have been people who were empowered to go into factories on a day-to-day basis to do something about the dangers of the Factories Acts.
A Labour Government introduced the Health and Safety at Work etc. Act, which made an enormous 105 improvement, but unless there is back- up, and unless there is an inspectorate to deal with transgressions of the regulations and the staff in hospitals to deal with unhygienic kitchens, the problems will remain. The Government think that they have solved the problems. They think that they were getting a lot of bad publicity because of the existence of Crown immunity. However, in reality they have done nothing to solve those problems, and they will remain with us for a long time.
I hope that the Minister understands the point and that he will go tonight to one of any number of hospitals in London——
§ Mr. Corbyn
Well, perhaps not tonight. The Minister may be detained in the Chamber a little longer than that, but there is no reason why he should not pop along in the morning, just as staff have finished cooking breakfast in the hospitals, and have a good look at what is going on in those kitchens.
People should not be shocked, but unfortunately they are, because they do not know the facts, and automatically believe that hospital kitchens are safe places. Workers in the NHS and ancillary staff employed in hospital catering departments feel very passionately about this subject. They feel that the media have misused the issue and cast a slur on their desire to ensure that patients are treated properly and that the food is cooked hygienically. They have often protested about management's lack of attention to such matters and about the lack of resources. They see the abolition of Crown immunity as one step towards providing patients with the standard of catering that they deserve.
That is why those people are worried about the numerous loopholes in the legislation. I would be far happier if, instead of discussing the limited abolition of Crown immunity on some NHS premises, we were discussing the abolition of Crown immunity altogether. It is anachronistic that in a supposedly democratic country the Crown can declare whole areas, including the House, immune from certain laws. The only immunity that we should retain is the right of hon. Members to speak freely in the Chamber without fear of being prosecuted for what they say.
§ Mr. Maxton
That immunity has nothing to do with Crown immunity. It is a privilege won by Members of Parliament that has nothing to do with the Crown.
§ Mr. Corbyn
That privilege was gained against the wishes of the Crown. Immunity from the law is bequeathed by the Crown, in the interest of the Crown. That is why we should be debating wider issues.
Be that as it may, and I do not wish to be dragged away from the subject before us, I hope that the House will understand the strong feelings about this issue and accept the Opposition amendments. They are important amendments, but they do not solve the problem. The Government have not come clean on this matter. Either they do not understand the issue of hygiene in NHS hospitals, or they are trying to con the public into believing that once the Bill has been passed all the problems of hygiene will be solved. I assure the House that they will not, and it will take a Labour Government to introduce proper NHS legislation that will end this ridiculous 106 anachronism whereby NHS property can adopt inferior standards to those that apply to properties owned by local government or private concerns.
It is most important that the House agrees to these amendments this evening. It is also important that the House realises that the Bill is limited in nature.
§ Mr. Geoffrey Dickens (Littleborough and Saddleworth)
I shall make a brief contribution — [Interruption.] It is all very well for Opposition Members to jeer, but I wonder how many of them have spent two years in hospital as I have. During that time I did not catch any bugs or diseases from the kitchens. Opposition Members do a great disservice to the thousands of people throughout the United Kingdom who work in hospital kitchens. Only a few let the side down, while thousands do a good, dedicated job.
The most annoying part of Opposition speeches was the suggestion yet again that by shoving money into certain areas the problems would be solved. It does not cost money to be clean, to put the lid on the soup, to pick up droppings in the kitchen or to put the lid on the dustbin outside so as not to attract vermin. Why should we always put in resources——
§ Mr. Maxton
The hon. Gentleman is putting words into the mouths of Opposition Members that are not correct. We fully support those who work in the cleaning and other areas of the NHS. Indeed, we condemn this Government for ensuring that they are the lowest paid workers in the country. Many of those hard-working conscientious people have to work in appalling conditions, where the kitchens are insanitary because of the state of the equipment in them. It is nothing to do with the work force.
§ Mr. Dickens
The hon. Gentleman appears to be suggesting that if I visited a private or council house and found the kitchen dirty, shovelling in money would somehow make it sparkling clean.
Although the hon. Gentleman has clearly stated that the Opposition support those who work in hospital kitchens, I heard Opposition Members condemning what was happening in kitchens. One hon. Gentleman claimed that he had visited many hospitals — and I have no reason to disbelieve that — and said that he had seen vermin and cockroaches. I suggest that such instances are., thank goodness, fairly isolated. Opposition Members have done a great disservice to those who work in NHS kitchens and they should be ashamed of themselves.
§ Mr. Corbyn
This is an important and serious issue and it seems that the hon. Gentleman has not understood exactly what we have been trying to say. No Opposition Member has condemned NHS kitchen workers or the conditions that they maintain within them. The hon. Gentleman should realise that the design of a modern hospital often provides perfect breeding grounds for mice and cockroaches, for example, within the central heating system. It is not the kitchen staffs responsibility to clean the central heating system. It is the management's responsibility to ensure that cockroaches are not breeding in it. It is the local authority's responsibility to ensure, through the environmental health service, that the source of the vermin is removed. Members of kitchen staff often say to me, "It is not good enough to put the lid on the saucepan to keep out the mice if the mice are in the larder in the first place."
§ Mr. Dickens
Is the hon. Gentleman suggesting that maintenance workers should keep the central heating system clean? That is what we are arguing about. Nothing will be gained by throwing ratepayers' money into a bottomless pit. Money does not solve every problem, and every hon. Member knows that without me having to remind him.
It has been said that more resources will be needed for local government so that hospitals can be inspected. How are shops, restaurants and public houses inspected? They are subject to spot checks or random visits. That same system would apply to the hospital service. Every now and again spot checks would be made and that would keep the entire service on its toes. If there were defects in the kitchen and these had to be put right, funds would be found from the hospital's maintenance budget, as it would for other maintenance work throughout the hospital service.
It is easy to criticise the Government for not responding to the cry for more resources on every occasion when in many instances the answer lies in maintaining higher standards of hygiene and employing good management techniques, which would not involve spending a ha'penny more.
§ Mr. Ron Davies
The contribution of the hon. Member for Littleborough and Saddleworth (Mr. Dickens) was a disgrace to himself and the interests that he pretends to represent. It demonstrated all the prejudice, malice and ignorance that characterises the Government and Conservative Back Benchers, who support them.
I ask the hon. Member for Littleborough and Saddlesworth two questions. He was quick on his feet to tell us that he had spent two years in hospital, but he did not tell us what treatment he was receiving. He did not tell us either whether he was in a National Health Service hospital. I invite the hon. Gentleman in a moment to answer those questions. It is obvious that the hon. Gentleman is now deep in thought pondering his answer to me.
If the hon. Gentleman is so complacent about the standards that apply in the NHS and so satisfied that all that is needed in the NHS is a little extra bit of spit and polish and some more sweat from the brows of NHS workers, why is he voting in support of the Government this evening? I invite the hon. Gentleman to answer my questions before I move on to other matters.
§ Mr. Dickens
I spent two years in Edgware general hospital, which was then called Redhill hospital, with infantile paralysis, which is now called poliomyelitis. It was an NHS hospital and it was spotless, I must tell you, because care was taken. You know that care does not cost money.
§ Mr. Davies
I hesitate to intervene in the personal dialogue between the hon. Gentleman and yourself, Mr. Deputy Speaker. Perhaps the hon. Gentleman will give us the whole of his medical history and tell us on how many occasions he has been in hospital over the past 10 or 15 years and how often he has been in NHS hospitals. No doubt he will tell us whether he is a subscriber to——
Mr. Deputy Speaker
Order. I hope that the hon. Member for Caerphilly (Mr. Davies) will not tempt the hon. Member for Littleborough and Saddleworth (Mr. Dickens) to go out of order, as he is doing.
§ Mr. Davies
I do not wish to be distracted by the hon. Gentleman, Mr. Deputy Speaker, and I accept your stricture. I shall return to the amendments.
I should like to address myself to two points. First, when the Minister replied to the opening speech by my hon. Friend the Member for Wrexham (Dr. Marek), he said that the provision would apply to the entire National Health Service estate. [Interruption.] I realise that Ministers are possessed of many talents, but I have yet to meet one who is capable of replying to a debate to which he has paid no attention. It may be of interest to the House to know that throughout the debate, the Minister has paid no attention to any of the comments of or questions asked by my hon. Friends, and is now busy chatting to one of the Government Whips. Presumably he has no interest in the debate, and has little intention of listening to any of the questions. I am glad to see that he has now put his head back in his file. Presumably the House now has his attention.
During the opening part of his speech, the Minister referred to the entire NHS estate. I am trying to work out exactly what that means. First, let us assume that we have an NHS hospital, which, under the direction of the Government, is in the process of privatising some or all of its services. Let us assume that during the process of privatisation, the area health authority decides that it is appropriate to set aside part of the NHS premises for use by a private contractor. At what point during the time scale, from when the hospital is under NHS management to when it ultimately becomes part of the private sector, will the provisions cease to apply?
Secondly, let us assume that the area health authority, or hospital management, sublets premises—the laundry, which was formerly part of the NHs hospital, or the kitchen, which has equally far-reaching implications—to a private interest, a private contractor. The Minister referred to the entire NHS estate. Does he agree that when part of an NHS hospital is privatised, the provisions will no longer apply? It is a specific point. I hope that the Minister will address it when he replies.
A further point impinges on the ruling of Mr. Speaker. I do not wish to challenge it, but I seek clarification. I am not sure whether the clarification should come from you, Mr. Deputy Speaker, or from my hon. Friend the Member for Wrexham. We are dealing with two amendments, Nos. 2 and 3. I want to work out, either with your assistance, Mr. Deputy Speaker, or that of my hon. Friend, the essential difference between those two amendments.
As I understand it, amendment No. 2 is specific. It provides for the insertion in line 9, page 1, after "authority", of the words:or provided by a health authority for the use by health authority staff for residential or other purposes.I think that all of us can understand the wording of that amendment. It could mean a residential hospital or teaching block, or any other premises provided by the health authority for use by its staff. That is clear and specific. It refers to staff employed by the NHS in services directly involved with or ancillary to the hospital. Nevertheless, they are employees of the NHS.
109 Amendment No. 3 is different. It requires the insertion in line 12 of the word "user" after the word "the". A user does not necessarily have to be an employee or someone who is directly involved with the services provided by the hospital. It does not have to be someone who is employed by the hospital, either directly in medical care, in ancillary work, or in any other service provided by the hospital. It might be someone whose work is related and who might come into conflict with the health authority. I think, for example, of community health councils.
When the community health council in my area was established it used premises provided by the area health authority. The office was established by the Secretary of State for Wales, and it was deemed appropriate for area health authority premises to be made available for use by the secretary of the community health council. In no circumstances could premises which, as amendment No. 2 suggests, areprovided by a health authority for the use by health authority staffbe deemed to include users such as community health councils.
§ Mr. Chris Smith
I have followed by my hon. Friend's argument with considerable care. He will he aware that I have expressed some reservations about amendment No. 3. My hon. Friend has, to some extent, changed my mind, however. Does he agree that he is identifying the possibility that the discretion given by amendment No. 3 could enable a health authority to expand the definition of user? I was anxious that it might exclude some users, but my hon. Friend has said that it might be used to include extra users and that it might therefore be useful.
§ Mr. Davies
That is an important point and emphasises the importance of getting the legislation right. It is all very well for the Government to say that the intention is quite clear, but it is a matter for interpretation by the judiciary and it is our constituents — not those of Conservative Members, who opt out of the NHS and into private health care—who will suffer.
My hon. Friend the Member for Islington, South and Finsbury (Mr. Smith) said that he has reservations about amendment No. 3. He is right. We do not know what it could do. I am inclined to support it because it will empower the Minister to include users who might otherwise be excluded.
§ Mr. Corbyn
My hon. Friend has touched on an important matter. The Government seem increasingly to introduce permissive legislation which gives Ministers enormous rein on where regulations should apply. Does he agree that it would be much better to have something clear which proviced that there was to be no Crown immunity in any NHS property of any sort, rather than this mishmash of half-baked ideas?
§ Mr. Davies
I welcome my hon. Friend's comments. As a matter of principle, I agree with him. Abolition of Crown immunity would be the end of the problem. In the absence of abolition, if the Government want to introduce permissive legislation, I am prepared to welcome it, provided that I am satisfied that the Government are well motivated. That is the problem, and in these circumstances I am not satisfied that the Government are well motivated. I suspect that, rather than using the discretion available to extend the powers, they will use it to restrict the provisions.
110 My hon. Friend the Member for Islington, North (Mr. Corbyn) spoke of his reservations. As I understand it, at the end of the debate we shall not be offered the opportunity to vote on amendment No. 2 because Mr. Speaker, in his wisdom, has decided that amendment No. 3 will be taken with it. I do not wish to challenge that ruling and, indeed, it would be wrong to do so, but that decision puts some of my hon. Friends in an invidious position. While I accept the logic of it and appreciate that the amendments have been put together, some of my hon. Friends will he more than happy to support amendment No. 2 but would have reservations about supporting amendment No. 3.
During the rest of the debate could you, Mr. Deputy Speaker, ponder the wisdom of putting amendments Nos. 2 and 3 together? I wonder whether my hon. Friend the Member for Wrexham will consider whether it is to the advantage of the House to take them separately. Even on the Government side there may be some hon. Members who are prepared to support either amendment No. 2 or amendment No. 3 but who would not necessarily agree that both amendments can be disposed of on the same vote. I await with interest your ruling on that.
I look forward to hearing whether my hon. Friend supports my contention that the two amendments offer the House something different and that there is a strong case for voting separately on them.
Mr. Deputy Speaker
We are debating amendments Nos. 2 and 3 together, and clearly that cannot be altered as we are well into the debate. However, I shall consider the possibility of a separate Division on amendment No. 3 when the House has reached a conclusion on amendment No. 2, and give my decision in due course.
§ Mr. Corbyn
On a point of order, Mr. Deputy Speaker. Further to that advice, I hope you will be aware that many hon. Members would be grateful if you could allow a separate vote on these two amendments.
Mr. Deputy Speaker
I have said that I shall consider that. When we come to a decision on amendment No. 2 I shall consider the possibility of allowing a separate Division on amendment No 3.
§ Mr. Clay
This has been a most interesting debate on an extremely important matter. However, I am becoming confused and worried that something fishy is going on.
Some time ago the Minister gave what in my innocence, appeared to be a clear statement which seemed to meet what the Opposition are seeking to achieve through amendment No. 2. Since then some of my hon. Friends have spoken, including my hon. Friend the Member for Workington (Mr. Campbell-Savours) who read out some criticisms made by the COHSE journal. He asked the Minister to say whether those criticisms were misinformed because he was sure that COHSE members would be delighted to receive that information because the matter would be cleared up.
My hon. Friend the Member for Islington, South and Finsbury (Mr. Smith) said that he welcomed the Minister's assurances, but wanted to be clear that there was no room for doubt. Many Labour Members have made similar remarks. I know that my hon. Friends are anxious to make progress on the Bill. Other important matters need to be discussed. I assume that the Government do not want to be here all night discussing the amendment.
111 11 pm
I started to ask myself why, when all that the Minister has to do is to repeat his clear assurance and say that all the doubts that we are expressing are because we have misunderstood the matter, this has not happened. A simple way to proceed would be for the Minister to say that the Government will accept the amendment. That would be the end of the matter.
§ Mr. Chris Smith
Does my hon. Friend agree that, even if the Minister is not prepared to take the sensible course of accepting the amendment, he could make clear what he means by "the entire NHS estate"? Does he mean everything that is owned, rented or in the control of the NHS or any health authority, or does he mean something different? An answer would clarify the matter once and for all.
§ Mr. Ron Davies
For the past two and a half hours, there has been no representative of either the Liberal party or the SDP present in the Chamber. Is my hon. Friend trying to put a new mantle around his shoulders—that of being the representative of moderate consensus politics?
§ Mr. Clay
I am trying to be the representative of decent common sense. That has not been shown by either side of the so-called alliance. No doubt it is because we have been having a common sense discussion tonight that no alliance representatives have been around.
A number of specific points have been raised and questions put that the Minister could have clarified. For example, what did he mean by "the entire NHS estate"? Hon. Members have asked whether this includes NHS property that has been leased to a private contractor. There has been no Government response.
§ Mr. Corbyn
Would my hon. Friend care to reflect on the fact that unless the Minister is prepared to be clear on this subject, the NHS administration, if it were so minded, could get away from the so-called removal of Crown immunity by leasing the property to a private company to do the work for it, and then buying that product—for example, catering? That could lead to a serious infringement of the will of Parliament.
§ Mr. Clay
My hon. Friend has identified an extremely sinister possibility. That is why it is all the more important that we have an absolute and unequivocal assurance from the Minister to clarify what he said earlier.
We are all anxious to make progress. The longer this goes on, with the Minister refusing to clarify his interesting remark, which came as a great surprise no doubt not only to Labour Members but to NHS workers and everybody else interested in the matter, the more confusing the matter will become. For a few minutes, my hon. Friends wondered whether we had made a great step forward and scored a small victory. Is this a major concession? As time goes on I worry more and more about what the Minister said. He said that he was acting on the best legal advice and that the Bill covered our suggestion in the amendment. I do not know what his best legal advice was. Perhaps it was the same legal advice as was given to the Secretary of State when he tried to introduce regulations for board and lodging allowance. DHSS Ministers have fallen on the wrong side of the courts more than once. One must assume that Ministers act only after having taken legal advice.
§ Mr. Ron Davies
The Minister certainly cannot have sought the Solicitor-General's advice. If he had, it would have been leaked by letter.
§ Mr. Clay
How does one follow that?
I wonder about legal advice. What about the legal advice given to the Secretary of State for Transport on legislation that he has tried to introduce? He has been through the courts more times since the general election than all Opposition Members put together. That is going some.
We must ask what the Minister means by saying that he has had the best legal advice. What he says from the Dispatch Box is no protection for anyone who finds that that best legal advice is wrong. If the Minister makes a fool of himself, that will be of little comfort to the person who finds that the best legal advice does not achieve the objectives of our amendment. We are so used to Ministers making fools of themselves that, when they do, it is of little public interest.
§ Mr. Brian Sedgemore (Hackney, South and Shoreditch)
My hon. Friend says that the Minister was saying, hypothetically, that on the basis of legal advice we might be about to take a great step forward. Then he paused and rethought and said that, hypothetically, on the basis of the Minister's legal advice, we might be experiencing a small but significant victory. Can my hon. Friend tell me, hypothetically, what is the difference between a great step forward and a small but significant victory?
§ Mr. Clay
I have no legal training, and that was a legalistic question. If I were to stray into that fascinating semantic issue, I might incur the Chair's displeasure. It is not for me to divine such matters or to work out exactly what the Minister was trying to tell us. The Minister should answer all worries expressed by my hon. Friends since he made that interesting statement.
§ Mr. Clay
That is an extremely useful suggestion which, even at this late stage, the Minister could take up. It might save a lot of time and serve the purpose that the Minister is trying to achieve if he were to accept the amendment. I hope that the Minister will do so. It would enable us to make progress.
As one who must take into account pessimistic possibilities, bearing in mind the kind of Government with whom we are dealing, I address a few words to my right hon. and hon. Friends on the Front Bench. One or two Labour Members have commented on the difficulties regarding a vote on amendments Nos. 2 and 3. My right hon. and hon. Friends on the Front Bench—indeed, all hon. Members—must decide whether they are satisfied with the assurances that the Minister has given about amendment No. 2.
One can envisage circumstances, both in the Chamber and in Committee, in which, on the basis of the Minister's assurances, the Opposition would not press an amendment to a vote. In the light of the comments made in the past few hours and the extraordinary prolonged silence of the Minister, the right hon. Gentleman will need to take quite 113 a long time to satisfy Labour Members that what he said was as simple as it seemed to be in order for them not to press amendment No. 2 to a Division.
§ Mr. Maxton
On a point of order, Mr. Deputy Speaker. I listened carefully to my hon. Friend's interesting and good speech. However, it was disrupted at the end by constant conversations by Conservative Members. Those hon. Members obviously believe that a vote is about to take place. They think that if they come into the Chamber and make that sort of noise, somehow or other the vote will take place earlier. I assure them that their behaviour will extend the debate, because there will be further points of order about their behaviour. I hope that you, Mr. Deputy Speaker, will ask them to remove themselves to the various parts of the House where they can carry on conversations without interrupting the debate.
Mr. Deputy Speaker
Order. Discussion is going on both inside and outside the Chamber. I hope that hon. Members in the Chamber will listen to the debate.
§ Dr. Marek
There has been a useful debate on the two short amendments. It is significant that on this occasion, contrary to his conduct on previous amendments, the Minister rushed into the Chamber to assure us on certain matters, but after further questions put by my hon. Friends he was unable to reply. with the result that there is now considerable uncertainty on the Opposition Benches about the state of the National Health Service, whether particular premises are part of an estate if the premises are tenanted, and so on.
The hon. Member for Littleborough and Saddleworth (Mr. Dickens) said, by way of intervention, that money does not keep hospitals clean. I must say that money goes a long way towards keeping hospitals clean. Hospitals and nurses' homes— in fact any part of a National Health Service estate, however it is defined—cannot be kept clean unless there is money available for materials and to pay for staff, adequately and fairly, and unless the management of the National Health Service is able to operate without worrying constantly about shortage of finance, shortage of resources, and shortage of capital equipment. If the management of the National Health Service is always worrying about resources, finance, and so on, however good that management is it cannot do as good a job as it should be doing on the matters that it has to consider.
§ Mr. Corbyn
Does my hon. Friend accept that the whole management of the NHS in the past seven years has resulted in significant reductions in the total number of staff employed, and that the reductions have taken place almost exclusively among the manual worker grades within the NHS — the cleaners, and catering and portering staff? When the privatisation of cleaning services takes place in hospitals, the average number of jobs lost will be between 40 and 60 per cent. of the complement employed by the National Health Service. Does my hon. Friend accept that the loss of jobs among directly employed staff through the introduction of bonus schemes or through the introduction of private contracts inevitably leads to insufficient staff to do the cleaning and necessary back-up work in the catering departments'? Does he agree that that is the real enemy of a good Health Service and good standards of hygiene in hospitals?
§ Dr. Marek
My hon. Friend is right. It is undeniable that in the past five or six years many health authorities which have been faced with cuts have had to choose how much to invest in the fabric of the estate. With respect to revenue expenditure, they have had to choose between protecting medical services and protecting ancillary services. In many cases they have cut ancillary services to protect medical services.
§ Mr. Dickens
Does the hon. Gentleman accept that I was saying that the vast majority of hospital kitchens are run well and hygienically? In many cases one could almost eat the food off the floor. I am praising the people who work in the hospital kitchens. I agree that one or two kitchens have let the side down. Cleanliness costs nothing. Every kitchen has the materials needed. We are well served by the hospitals. Because there are those that let the side down, the Government's legislation is worth while. It should correct the position.
§ Dr. Marek
The hon. Gentleman's first comment was fair but I cannot agree with him that cleanliness costs nothing. There is certainly a problem with pest control in old hospitals in which sewers and sumps lead directly from the kitchen. Modern kitchens avoid that. Hospitals get older. Some hospitals are 50 to 100 years old, and some are about to open next week. Their numbers are declining. The old hospitals have defects, simply because of the technology available when they were built or because of fair wear and tear. More costs are incurred in terms of effort, staff and capital investment to keep such hospitals clean than are incurred in keeping modern hospitals open. Of course, there must be costs in terms of cleaning materials and staff. On top of that, there are the costs of fair wear and tear and the costs associated with the antiquity of the systems. Older hospitals are just that much more difficult to keep clean.
I stand by what I said. If there are sufficient staff and they are paid a reasonable wage, their spirits are high, their morale is good, they feel that they are doing a service for the patient, and we get a little extra from them. Before I am misquoted—I am not accusing the hon. Member for Littleborough and Saddleworth (Mr. Dickens) of intending to do so—I must say that staff in the NHS do an excellent job, but they could do an even better one if the resources were provided. That is what is at the back of the amendment.
We are not sure what will, be included in the Bill. We hope that nursing homes and similar institutions will be included. The Minister says that they are included, but lie has not backed up his assertion. If they are to be included, additional resources will be required.
The Government did not say on Second Reading or in Committee, and they have not said this evening, that they recognise that there is a problem, that some hospital facilities must be cleaned up and that additional resources will be needed. They have said nothing that will give any hope to health authorities which want to provide clean premises for their staff. The British Pest Control Association says that in recent years the problem has grown much worse and that it has now grown to crisis proportions. For that reason, I am glad that the Bill has been introduced, but it could have been a much better Bill.
I do not want to take up the time of the House. The Opposition are not convinced by the Minister's 115 explanation. It came too quickly and too early. There are many questions that ought to be answered but have not been answered. We believe that amendment No. 2 should be taken to a Division. When we know the result of that Division, we shall decide what to do about amendment No. 3.
§ Mr. Hayhoe
The Official Report will show that some time ago I responded in clear and unambiguous terms to amendments Nos. 2 and 3. I stand by the words that I used then and I shall be happy to read them in Hansard. I doubt whether as much could be said for many of the other speeches that we have heard on these amendments.
§ Question put, That the amendment be made:—
§ The House divided: Ayes 27, Noes 168.116
|Division No. 214]||[11.22 pm|
|Banks, Tony (Newham NW)||Hogg, N. (C'nauld & Kilsyth)|
|Barnett, Guy||Lewis, Terence (Worsley)|
|Bennett, A. (Dent'n & Red'sh)||McWilliam, John|
|Campbell-Savours, Dale||Marek, Dr John|
|Clay, Robert||Maxton, John|
|Clwyd, Mrs Ann||Patchett, Terry|
|Cook, Robin F. (Livingston)||Pike, Peter|
|Corbyn, Jeremy||Powell, Raymond (Ogmore)|
|Craigen, J. M.||Skinner, Dennis|
|Davis, Terry (B'ham, H'ge H'l)||Spearing, Nigel|
|Dixon, Donald||Thompson, J. (Wansbeck)|
|Fatchett, Derek||Tellers for the Ayes:|
|Foster, Derek||Mr. Ron Davies and Mr. Chris Smith|
|Garrett, W. E.|
|Alexander, Richard||Cranborne, Viscount|
|Alton, David||Currie, Mrs Edwina|
|Amess, David||Dickens, Geoffrey|
|Arnold, Tom||Douglas-Hamilton, Lord J.|
|Ashby, David||Dover, Den|
|Aspinwall, Jack||Dunn, Robert|
|Baker, Nicholas (Dorset N)||Durant, Tony|
|Beaumont-Dark, Anthony||Edwards, Rt Hon N. (P'broke)|
|Beith, A. J.||Eggar, Tim|
|Bellingham, Henry||Emery, Sir Peter|
|Benyon, William||Fairbairn, Nicholas|
|Best, Keith||Fallon, Michael|
|Biggs-Davison, Sir John||Favell, Anthony|
|Blackburn, John||Forsyth, Michael (Stirling)|
|Blaker, Rt Hon Sir Peter||Forth, Eric|
|Bonsor, Sir Nicholas||Fowler, Rt Hon Norman|
|Bottomley, Peter||Franks, Cecil|
|Bowden, Gerald (Dulwich)||Fraser, Peter (Angus East)|
|Bright, Graham||Freeman, Roger|
|Brinton, Tim||Gale, Roger|
|Brittan, Rt Hon Leon||Galley, Roy|
|Brooke, Hon Peter||Garel-Jones, Tristan|
|Brown, M. (Brigg & Cl'thpes)||Gorst, John|
|Bruce, Malcolm||Gower, Sir Raymond|
|Bruinvels, Peter||Greenway, Harry|
|Buck, Sir Antony||Gregory, Conal|
|Budgen, Nick||Griffiths, Peter (Portsm'th N)|
|Burt, Alistair||Ground, Patrick|
|Butterfill, John||Hamilton, Hon A. (Epsom)|
|Carlisle, Kenneth (Lincoln)||Hamilton, Neil (Tatton)|
|Cash, William||Hampson, Dr Keith|
|Chope, Christopher||Hargreaves, Kenneth|
|Clarke, Rt Hon K. (Rushcliffe)||Harris, David|
|Conway, Derek||Hawkins, Sir Paul (N'folk SW)|
|Coombs, Simon||Hawksley, Warren|
|Cope, John||Hayes, J.|
|Corrie, John||Hayhoe, Rt Hon Barney|
|Couchman, James||Hayward, Robert|
|Heathcoat-Amory, David||Mitchell, David (Hants NW)|
|Heddle, John||Moate, Roger|
|Henderson, Barry||Moore, Rt Hon John|
|Hicks, Robert||Moynihan, Hon C.|
|Hind, Kenneth||Nelson, Anthony|
|Hirst, Michael||Newton, Tony|
|Howarth, Gerald (Cannock)||Nicholls, Patrick|
|Hubbard-Miles, Peter||Norris, Steven|
|Hughes, Simon (Southwark)||Onslow, Cranley|
|Hunt, David (Wirral W)||Ottaway, Richard|
|Hunter, Andrew||Page, Richard (Herts SW)|
|Jackson, Robert||Percival, Rt Hon Sir Ian|
|Jenkin, Rt Hon Patrick||Portillo, Michael|
|Jessel, Toby||Powell, William (Corby)|
|Jones, Gwilym (Cardiff N)||Powley, John|
|Jones, Robert (Herts W)||Price, Sir David|
|Joseph, Rt Hon Sir Keith||Raffan, Keith|
|Kellett-Bowman, Mrs Elaine||Rathbone, Tim|
|Kennedy, Charles||Rhodes James, Robert|
|Key, Robert||Rhys Williams, Sir Brandon|
|Knight, Dame Jill (Edgbaston)||Ridley, Rt Hon Nicholas|
|Knowles, Michael||Sackville, Hon Thomas|
|Lang, Ian||Sainsbury, Hon Timothy|
|Latham, Michael||Sayeed, Jonathan|
|Lawler, Geoffrey||Shaw, Sir Michael (Scarb')|
|Leigh, Edward (Gainsbor'gh)||Silvester, Fred|
|Lennox-Boyd, Hon Mark||Sims, Roger|
|Lester, Jim||Skeet, Sir Trevor|
|Lilley, Peter||Smith, Tim (Beaconsfield)|
|Lloyd, Peter (Fareham)||Soames, Hon Nicholas|
|Lord, Michael||Squire, Robin|
|Lyell, Nicholas||Taylor, Teddy (S'end E)|
|McCurley, Mrs Anna||Thompson, Donald (Calder V)|
|Macfarlane, Neil||Thompson, Patrick (N'ich N)|
|MacGregor, Rt Hon John||Thorne, Neil (Ilford S)|
|MacKay, Andrew (Berkshire)||Thurnham, Peter|
|MacKay, John (Argyll & Bute)||Townend, John (Bridlington)|
|McLoughlin, Patrick||Wakeham, Rt Hon John|
|Major, John||Walden, George|
|Malins, Humfrey||Wallace, James|
|Marland, Paul||Waller, Gary|
|Marlow, Antony||Watson, John|
|Mather, Carol||Whitney, Raymond|
|Maxwell-Hyslop, Robin||Yeo, Tim|
|Mayhew, Sir Patrick|
|Merchant, Piers||Tellers for the Noes:|
|Miller, Hal (B'grove)||Mr. Francis Maude and Mr. Gerald Malone.|
|Mills, Iain (Meriden)|
§ Question accordingly negatived.
§ Mr. Corbyn
On a point of order, Mr. Deputy Speaker. During the previous debate my hon. Friend the Member for Caerphilly (Mr. Davies) and I asked whether you would be prepared to allow a separate Division on amendment No. 3. You said that you would consider our request and inform the House of your decision. Are you prepared to allow a separate Division on amendment No. 3? There is significant differences between amendments Nos. 2 and 3.
§ Mr. Deputy Speaker (Sir Paul Dean)
I understood that the official Opposition did not wish to vote on amendment No. 3. However, if the hon. Member for Islington, North (Mr. Corbyn) wishes to have a vote, I am prepared to allow it.
§ Amendment proposed: No. 3, in page 1, line 12, after 'the', insert 'user,'—[Mr. Corbyn.]
§ Question put, That the amendment be made:—
§ The House divided: Ayes 23, Noes 166.118
|Division No. 215]||[11.37 pm|
|Banks, Tony (Newham NW)||Clay, Robert|
|Bennett, A. (Dent'n & Red'sh)||Clwyd, Mrs Ann|
|Campbell-Savours, Dale||Cook, Robin F. (Livingston)|
|Corbyn, Jeremy||Maxton, John|
|Davis, Terry (B'ham, H'ge H'l)||Patchett, Terry|
|Dixon, Donald||Pike, Peter|
|Dobson, Frank||Powell, Raymond (Ogmore)|
|Evans, John (St. Helens N)||Skinner, Dennis|
|Fatchett, Derek||Smith, C.(Isl'ton S & F'bury)|
|Hogg, N. (C'nauld & Kilsyth)||Tellers for the Ayes:|
|Lewis, Terence (Worsley)||Mr. Frank Haynes and Mr. Ron Davies.|
|Marek, Dr John|
|Alexander, Richard||Harris, David|
|Alton, David||Hawkins, Sir Paul (N'folk SW)|
|Amess, David||Hawksley, Warren|
|Arnold, Tom||Hayes, J.|
|Ashby, David||Hayhoe, Rt Hon Barney|
|Aspinwall, Jack||Hayward, Robert|
|Baker, Nicholas (Dorset N)||Heathcoat-Amory, David|
|Beaumont-Dark, Anthony||Henderson, Barry|
|Beith, A. J.||Hicks, Robert|
|Bellingham, Henry||Hind, Kenneth|
|Benyon, William||Hirst, Michael|
|Best, Keith||Howarth, Gerald (Cannock)|
|Biffen, Rt Hon John||Hubbard-Miles, Peter|
|Biggs-Davison, Sir John||Hughes, Simon (Southwark)|
|Blackburn, John||Hunt, David (Wirral W)|
|Blaker, Rt Hon Sir Peter||Hunter, Andrew|
|Bonsor, Sir Nicholas||Jackson, Robert|
|Boscawen, Hon Robert||Jenkin, Rt Hon Patrick|
|Bottomley, Peter||Jessel, Toby|
|Bowden, Gerald (Dulwich)||Jones, Gwilym (Cardiff N)|
|Bright, Graham||Jones, Robert (Herts W)|
|Brinton, Tim||Joseph, Rt Hon Sir Keith|
|Brittan, Rt Hon Leon||Kellett-Bowman, Mrs Elaine|
|Brooke, Hon Peter||Kennedy, Charles|
|Brown, M. (Brigg & Cl'thpes)||Key, Robert|
|Bruce, Malcolm||Knowles, Michael|
|Bruinvels, Peter||Lang, Ian|
|Buck, Sir Antony||Latham, Michael|
|Budgen, Nick||Lawler, Geoffrey|
|Burt, Alistair||Leigh, Edward (Gainsbor'gh)|
|Butterfill, John||Lester, Jim|
|Carlisle, Kenneth (Lincoln)||Lilley, Peter|
|Chope, Christopher||Lloyd, Peter (Fareham)|
|Clarke, Rt Hon K. (Rushcliffe)||Lord, Michael|
|Coombs, Simon||Lyell, Nicholas|
|Cope, John||McCurley, Mrs Anna|
|Corrie, John||Macfarlane, Neil|
|Couchman, James||MacGregor, Rt Hon John|
|Cranborne, Viscount||MacKay, Andrew (Berkshire)|
|Currie, Mrs Edwina||MacKay, John (Argyll & Bute)|
|Dickens, Geoffrey||McLoughlin, Patrick|
|Douglas-Hamilton, Lord J.||Major, John|
|Dover, Den||Malins, Humfrey|
|Dunn, Robert||Marland, Paul|
|Durant, Tony||Marlow, Antony|
|Edwards, Rt Hon N. (P'broke)||Mather, Carol|
|Eggar, Tim||Maude, Hon Francis|
|Emery, Sir Peter||Maxwell-Hyslop, Robin|
|Fairbairn, Nicholas||Mayhew, Sir Patrick|
|Fallon, Michael||Merchant, Piers|
|Favell, Anthony||Miller, Hal (B'grove)|
|Forsyth, Michael (Stirling)||Mills, Iain (Meriden)|
|Forth, Eric||Mitchell, David (Hants NW)|
|Fowler, Rt Hon Norman||Moate, Roger|
|Franks, Cecil||Moore, Rt Hon John|
|Freeman, Roger||Moynihan, Hon C.|
|Gale, Roger||Nelson, Anthony|
|Galley, Roy||Newton, Tony|
|Garel-Jones, Tristan||Nicholls, Patrick|
|Gorst, John||Norris, Steven|
|Gower, Sir Raymond||Onslow, Cranley|
|Gregory, Conal||Ottaway, Richard|
|Griffiths, Peter (Portsm'th N)||Page, Richard (Herts SW)|
|Hamilton, Hon A. (Epsom)||Percival, Rt Hon Sir Ian|
|Hamilton, Neil (Tatton)||Portillo, Michael|
|Hampson, Dr Keith||Powell, William (Corby)|
|Hargreaves, Kenneth t.||Powley, John|
|Price, Sir David||Taylor, Teddy (S'end E)|
|Raffan, Keith||Thompson, Donald (Calder V)|
|Rathbone, Tim||Thompson, Patrick (N'ich N)|
|Rhodes James, Robert||Thorne, Neil (Ilford S)|
|Rhys Williams, Sir Brandon||Thurnham, Peter|
|Ridley, Rt Hon Nicholas||Townend, John (Bridlington)|
|Ridsdale, Sir Julian||Wakeham, Rt Hon John|
|Sackville, Hon Thomas||Walden, George|
|Sainsbury, Hon Timothy||Wallace, James|
|Sayeed, Jonathan||Waller, Gary|
|Shaw, Sir Michael (Scarb')||Warren, Kenneth|
|Silvester, Fred||Watson, John|
|Sims, Roger||Whitney, Raymond|
|Skeet, Sir Trevor||Yeo, Tim|
|Smith, Tim (Beaconsfield)|
|Soames, Hon Nicholas||Tellers for the Noes:|
|Squire, Robin||Mr. Mark Lennox-Boyd and Mr. Gerald Malone.|
|Steel, Rt Hon David|
§ Question accordingly negatived.11.45 pm
§ Mr. Sedgemore
On a point of order, Mr. Deputy Speaker. The debate is taking an enormous amount of time and there is now a rumour going around that the Government are going to cede the private Member's day, so Conservative Members can go home to bed early tonight. If there are these sort of private machinations going on behind the scenes, should we not have a statement from the Leader of the House as to what is being arranged and offered to the Opposition? At the moment only a couple of individuals are privy to it
§ Mr. Deputy Speaker
With this, we may take the following: amendment No. 5, in page 1, line 14, leave out 'in' and insert 'to extend'.
§ Government amendment No. 6.
Amendment No. 7, in page 1, line 16, at end insert
'to secure proper hygiene standards throughout all of the premises.
(2A) Vermin shall for the purposes of the Public Health Act 1961 and any regulations or orders made under this Act or the food legislation include rats, mice, insects, mites, birds and feral cats.
(2B) For the purposes of section 35 of the Public Health Act 1961 no part of health authorities premises shall be considered as controlled by the Factories Acts.'.
Amendment No. 8, in page 1, line 16, at end insert
'to secure proper hygiene standards throughout all the premises'.
Amendment No. 12, in page 1, line 16, at end insert—
'(2A) Vermin for the purposes of the Public Health Act 1961 and any regulations or order made under this Act, which shall apply to National Health Service premises, or the food legislation shall include rats, mice, insects, mites, birds and feral cats.
(2B) For the purposes of section 35 of the Public Health Act 1961 no part of health authorities premises shall be considered as controlled by the Factories Acts.'.
§ Mr. Dobson
As it stands, the Bill would allow the Secretary of State to set aside the new legislation by way of regulations. Amendment No 4 would leave out the provision allowing him to set it aside. Amendment No. 5 would permit him to change it, but only by extending it. To be fair, the Government's amendment attempts to meet the points that we made in Committee, but we are not 119 convinced about it. We should like to know what evidence there is of any need for the Government to have any power to change this law.
In Committee, we asked the Minister why it was necessary for the Secretary of State to be able to set aside or vary the provision that lifts Crown immunity from food regulations in hospitals. The answer that the Minister gave was that parliamentary counsel had advised him that the clause needed to be included asa prudent contingency provision to cover the possibility that the application of food legislation may not fit the way in which health authorities are constituted.Even more surprisingly, he then said:Lawyers, from their vast experience of legislation, have seen that difficulties could arise over implementing a provision to remove Crown immunity from food legislation." —[Official Report, Standing Committee E, 29 April 1986; c. 12.]At our subsequent sitting, the right hon. Gentleman amended that statement ever so slightly to tone it down. However, we do not understand why the Secretary of State should take this power to vary the law on food hygiene.
Have the Government actually sought advice on whether these peculiar powers that they are seeking are necessary? For instance, have they asked the Health and Safety Executive whether its experience of vetting the kitchens of private hospitals — for which it is responsible, as they are not covered by Crown immunity —suggests that it might be difficult to impose the food hygiene regulations on NHS hospitals? Have the Minister's officials reported any possible problems with imposing the regulations on NHS hospitals? Are the problems that are envisaged by those far-sighted lawyers —if those words are not a contradiction in terms—not to do with the practical workings of the hospital but with the way that health authorities work or do not work? Is this demand one not of practicality in the hospitals but of administrative convenience?
Many businesses find regulations inconvenient. Most businesses, if asked, would say that the Health and Safety at Work etc. Act is inconvenient. Certain stupid people, including Lord Young, would say that health and safety at work legislation is an intolerable burden on private industry. Everyone would accept that it is a burden, but not many would agree with Lord Young and say that it is so intolerable a burden that it should be removed. Burdens may be imposed by the regulations, but they are worthwhile burdens because they protect the health and safety of people at work.
In the circumstances, if others accept the inconvenience of health and safety at work and food legislation, we must tell health authorities that if it is simply administratively inconvenient for them to obey the law, that is tough—they can get on with obeying it like everyone else. We would rather inconvenience a few health authorities than have people suffer from salmonella poisoning.
We need an explanation from the Minister of exactly why this provision is necessary. We come back to the point:I was advised by parliamentary counsel that the clause needs to be included as a prudent contingency provision".When parliamentary counsel says that, we should consider carefully what the ulterior motives might be. No doubt the same parliamentary counsel who thought that the clause 120 as drafted was spot on is the one who has come up with Government amendment No. 6 which accepts the variation, provided that it isnecessary for its effective operationof the regulations in relation to health authorities.
We are not entirely clear what that means. Is it intended to sharpen the food regulations in case they are not sufficiently strong, powerful and thorough-going in respect of health authorities? If there is evidence to that effect, they should be extended, as sharpened, to all the premises that are now covered. If it is not intended to sharpen the law, the intention must be to blunt it. It is intended either to sharpen it to make it more worth while or to blunt it. If its effect is neutral, there is no need to include the proposition that is before us.
We still want to hear from the Minister what circumstances are envisaged which would make it difficult for health authorities if the law that applies to shops, hotels, restaurants and other premises serving food is applied to them. There was not a shred of a suggestion, in Committee from the Minister or his colleagues of what they envisaged. The proposition is advanced on the basis that it will deal with apprently unimaginable problems that might occur in future. We do not think that any Government—even a Labour Government —should be assisted by a power that will allow them to waive certain laws because of the possibility of unimaginable problems in future.
Amendments Nos. 7 and 12 seek to secure the extension of the definition of "vermin".
§ Mr. Dobson
Labour's most famous Minister of Health had a definition which I recall was related to the Conservative and unionist party, so he cannot have been far off the mark. I would not wish to be controversial as the witching hour approaches. We are talking about experts on infestation, and they advise that it is ——
§ Mr. Dobson
If the hon. Gentleman were to speak to the Institution of Environmental Health Officers or the British Pest Control Association, which are in favour of the amendments, they might tell him that they consider skunks to be necessary. So far as I know, skunks are not currently infesting hospitals. I do not know whether a hospital in the hon. Gentleman's constituency is in that position. The Opposition are still in the realms of reality. The hon. Gentleman obviously is not.
We wish to redefine public health legislation and to relate the application of the law on food to Health Service premises so that rats, mice, insects, mites, birds and feral cats can be defined as vermin and dealt with appropriately.
§ Mr. Dobson
My understanding is that it is a cat that has gone wild. In certain hospitals, considerable numbers of feral cats roam round the premises, just as some hospitals within this city and other cities are infested by birds going into kitchens. But because they do not fall within the definition of vermin, it is difficult to deal with them under the law. Some Conservative Members who have been talking while I have been talking might be happy to tell their constituents that their local hospital is 121 infested with rats, mice, insects, mites, birds or feral cats, but people who know their job — by definition, that makes them superior to most Ministers —are advising us, Ministers and the health authorities that the law needs to be changed and that we need to change the definition of "vermin", which would strengthen the law and improve the cleanliness and general hygiene in hospital kitchens. We believe that is right. It should be done.
I do not want to detain the House at enormous length at this time of night, so I refer finally to amendment No. 8. That aims, as it says in plain words,to secure proper hygiene standards throughout all the premises".I think everyone is agreed that we need to sort out food hygiene in kitchens. We should be able to maintain good food hygiene in the rest of the hospital premises once the food has been prepared in clean hospital kitchens—in some cases, for the first time for a few years. We are advised that, as presently worded, the Bill does not apply to the food once it is on the ward. The law should be changed to provide for that. We are also advised that the Bill does not apply to food in a nurses' home. Nurses are entitled to clean, decent and edible food. If the food is tipped out and becomes refuse in the back end of the ward or in another part of the hospital rather than in the kitchen, we are not convinced that that is covered by the food hygiene regulations.
We all know that all the food that is not consumed, the bits and pieces that are left over, is not necessarily returned to the kitchens. So there is food that is being moved about, food that is in the process of being consumed, food waiting about before being eaten and food that has not been eaten hanging about for a considerable time which should be treated as refuse. As far as we can see, all that food is not caught by the Bill as drafted, and we think that it should be.
Those are not fears that we are inventing. Those views are held by those whose profession it is to inspect premises to see whether they conform with the food hygiene regulations. Frankly, if I had to choose between the professional view of an environmental health officer and that of a Minister, I would go along with the person who knew something about food hygiene through his professional knowledge and experience.
I hope that the Government will explain why they are taking unto themselves this extraordinary power to vary the law to suit themselves. I hope also that the Minister will accept our proposition that the amendments should be accepted, because they would strengthen the Bill that they have drafted.
§ Mr. Hayhoe
These amendments deal with the regulation-making powers to make modifications to the food legislation's application to health authorities by regulations which require an affirmative resolution of both Houses.
I assure the House that the Government do not intend to use the modification power to undermine the commitment to apply the food legislation to health authorities. The hon. Member for Holborn and St. Pancras (Mr. Dobson) acknowledged that Government amendment No. 6 is a response to anxieties that were expressed in Committee. Opposition Members expressed a suspicion about the presence of a modification power in the Bill, which they suggested might be used to undermine 122 the application of the food legislation to health authorities, notwithstanding the Government's declared intention to apply that legislation in full.
In response to an undertaking that I gave the Committee, I have brought the amendment forward. It will restrict the power to make regulations that modify the food legislation to modifications that are necessary to make the application of the food legislation to all health authorities more effective. I hope that I have therefore removed the anxiety that Opposition Members properly expressed.
The hon. Gentleman has raised matters of which he made a great deal in Committee. He asked why the power is required. I refer him to our first sitting in Committee, when I said:Lawyers, from their vast experience of legislation, have seen that difficulties could arise over implementing a provision to remove Crown immunity from food legislation." —[Official Report, Standing Committee E, 29 April 1986; c. 12.]As I said in Committee, the power to seek modification has been introduced as a safeguard to provide for the exceptional should unforeseen difficulties arise. The hon. Member for Holborn and St. Pancras asked what are the unforeseen difficulties. If I knew what they were, they would not be unforeseen and we would not be doing this. He knows that such provision is included in other legislation and requires an affirmative resolution of both Houses. If the House accepts amendment No. 6, modifications can be only those to make application of food legislation to all health authorities more effective. I should have thought that that is what all hon. Members want.
Amendment No. 5 would confine the modification power in clause 1(2)(b) to extending food legislation to health authorities. The clause does that already. We discussed the other amendments generally in Committee. The proposed subsection (2A) is not relevant. It aims to introduce a requirement that certain categories of vermin should be included in the definition of vermin in the Public Health Act 1961, but the Bill is about food legislation and health authority premises, not public health legislation. As for the definition of vermin, adding mites, birds and feral cats is a matter for the food hygiene regulations, not this primary legislation. As I made clear, the inclusion of those categories of vermin in the definition of vermin in these regulations is under close examination, and if appropriate I shall introduce amendments.
I commend Government amendment No. 6 to the House and advise the House that the other amendments are either redundant or are now covered by the undertakings that I have given.
§ Mr. Maxton
Any concession from the Government welcome, and their amendment to insert the words:necessary for its effective operation in relation to themis a step forward, but some of us do not understand why it is necessary to table the amendment in that way.
Essentially, the Government are saying that present food hygiene is insufficient, yet for years they have argued that it is not necessary to introduce food hygiene regulations into the NHS. In other words, they have gone a step further and said that present legislation is insufficient for the NHS and that regulations to increase the ability of health authorities to deal with food hygiene problems are needed.
123 I accept that the standard of cleanliness in hospitals and other NHS establishments should, if anything, be above the norm for hotels, cafes and factory canteens, but hospital authorities, because they are public bodies, are much more likely to have a high standard of cleanliness than is the private sector, where standards are not normally anything like as high.
The Bill is wide ranging in terms of the premises that it covers. Earlier the Minister made it clear that the food hygiene regulations did not cover only hospital kitchens, but covered kitchens for any employee's use, whether in nurses' hostels or flats. The new general manager of the Greater Glasgow health board has for six months been living in a four-star hotel at the expense of that health board, and I wonder whether that hotel has been subject to Crown immunity during that period, and whether when he travels on the shuttle between Glasgow and his home, again at the expense of the health board, the galley on the aeroplane is covered by Crown immunity because he is an employee using those facilities under the food regulations. As I read the Bill, those facilities will have been covered by Crown immunity. It is an appalling indictment of a man who is suggesting that £20 million can be cut from the Greater Glasgow health board that during the past five months he has taken about £15,000 in expenses, not to mention his salary.
We welcome the Government amendment, but still have reservations about the effectiveness of the clause, as it remains open to interpretations which may reduce the food hygiene powers.
§ Amendment, by leave, withdrawn.
Amendment made: No. 6, in page 1, line 16, leave out 'appropriate' and insert
'necessary for its effective operation in relation to them'. —[Mr. Hayhoe.]
'(c) require every health authority to report annually to the Secretary of State on the action taken to improve food hygiene in such premises, any action remaining outstanding and the estimated costs thereof.'.
§ Mr. Deputy Speaker
With this it will be convenient to take amendment No. 11, in page 1, line 16, at end insert—
'(c) require the Secretary of State to present to Parliament an annual report on food hygiene in health authority premises.'.
§ Mr. Dobson
The motto for these amendments is a quotation from Dr. Johnson:Depend upon it, Sir, when a man knows he is to be hanged in a fortnight, it concentrates his mind wonderfully.'The obligation on health authorities to produce annual reports to Ministers on hygiene in the kitchens would concentrate their minds wonderfully, and similarly, if the Secretary of State had to publish an annual report to Parliament, it would concentrate his mind too. If I am not digressing too far, I shall read a further quotation from Dr. Johnson, which may be appropriate. It is:Every hour takes away part of the things that please us and perhaps part of our disposition to be pleased.If hon. Members feel less and less pleased as time goes by, the doctor knew what he was talking about. 124 The object of the annual reports is to fix deadlines and attract publicity. Deadlines are a great incentive to anyone who has to produce anything. Without deadlines, nothing would get done. It would be extremely salutary if the health authorities had to produce an annual report on this matter. Therefore, we have tabled two amendments. One is to oblige the Minister to report to Parliament, and the other is the logical one that would make it possible for him to produce such a report — an obligation on health authorities to report to him.
The merits of this are that every year there would have to be an annual report from both the health authorities and the Minister. As a result of that obligation, the health authorities would have to monitor what is going on in the kitchens in their hospitals, as they have manifestly failed to do in the past. They would have to identify all the arrangements that have been made for food hygiene in their kitchens, as many of them have demonstrably failed to do in the past. If the situation was not right, they would have to explain what was wrong.
The next question is whether the reporting has to be a statutory duty. Can the Minister rely on sending a circular to every health authority and getting a response? The answer is that he cannot. As reported by the Comptroller and Auditor General, when he sent a circular to health authorities about cervical cancer last year, 10 of the health authorities which were asked question on this vital matter failed to reply. As far as we can ascertain, the Secretary of State did not do anything about it, because without issuing an instrument in writing requiring them to reply he could not do anything. Therefore, it is necessary for there to be a statutory duty, which will make the health authorities concentrate on this problem.
The obligation to produce a report would show who was responsible for anything that was going wrong. It would show who was causing delays, which bureaucrats were arguing with one another and delaying improvements, and who was not providing the necessary money and other resources. I refer to the report of the inquiry into the food poisoning outbreak at Stanley Royd hospital. In many ways the most disturbing part of the whole report is paragraphs 238 to 271. Those 33 paragraphs spell out all the ludicrous machinations and arguments that went on between officials of the Wakefield district health authority, the Yorkshire regional health authority and officials of the DHSS about what would happen to the kitchens at the hospital.
I shall not delay the House by quoting vast extracts from that report, but it contained innumerable arguments, discussions, changes of plan and indications that the necessary money would not be forthcoming from the Ministry or the regional health authority for essential spending on Stanley Royd hospital.
All this was going on at a hospital where there had been a salmonella outbreak in 1979. For over three years people argued and did what can only be described as sod-all—if it is in order to use that phrase. As a result, 20 people died. If the health authority had had to produce a report to identify what was going on, if it had had to report to the Ministry and the Minister had had to report to Parliament, somebody outside that place might have noticed what was—or what was not—going on. The obligation to produce an annual report would emphasis to those responsible the seriousness of the matter and its high priority.
125 Ministers have other ways of demonstrating priorities. For example, on privatisation issues Ministers at the DHSS employ more than 60 officials——
§ Mr. Dobson
So says one of the Trappist Whips. He says "not enough" to further the interests of Government Members who have financial interests in the promotion of private interests in health authorities. They spend much time on that. We understand that when Ministers have meetings with regional health authorities, district health authorities, or the chairs of those bodies, they are constantly——
§ Mr. Dobson
Chairs, yes. Conservatives understand what I mean. If they do not, they are out of date. Ministers attach high priority to privatisation, but they do not attach high priority to other matters. An obligation to produce reports annually would create the necessary publicity and high priority.
The amendment also requires the health authorities to produce an estimate of the cost of putting things right. The highest estimate for the cost of putting the kitchens right at Stanley Royd hospital was no less than £600,000. The estimated cost of putting right the kitchens at St. Thomas's hospital across the river is 1½ million. If those sums had to be spelt out, it would become clear who was responsible for providing—or not providing—the funds.
The amendment would reduce the element of irresponsibility that exists within the DHSS and the National Health Service. Ministers say that they have an intention, but that they cannot interfere with the priorities determined by health authorities.
I am sorry that the hon. Member for Renfrew, West and Inverclyde (Mrs. McCurley) has left the Chamber, because it is important to emphasise the extent to which cleanliness and good food hygiene in health authority kitchens depend upon spending and hardware. The environmental health officers found that in 85 per cent. of the places that they considered to be substandard the major problems were substandard premises and general requirements for equipment. Food handlers were responsible for 15 per cent. of the problems. There has been a great effort both at Stanley Royd and other places to blame the staff, who work in lousy conditions, with lousy and unsatisfactory equipment, and not enough money. There has been a great tendency to blame them —the people at the bottom of the pile. Another reason for having an annual report is that the responsibilities of those a bit further up the pile, or pyramid, would be identified.
We are asking the health authorities to report to the Minister, but we do not think that it is satisfactory only for health authorities to report to the Minister. Ministers receive many reports which they sit on and hide. If reports are embarrassing, they ignore them. The last thing that they do— unless there is a statutory obligation to do so — is disclose them. Therefore, we believe that if the Minister receives reports annually, the House should get reports annually, setting out what has been happening. We want these things out in the open, and we want a comprehensive national report.
Other reports have been produced on the state of kitchens in the National Health Service by a number of 126 trade unions, the Institution of Environmental Health Officers and the British Pest Control Association. It would be better if we did not have to rely on what might be described as the private initiatives—however welcome they may be — of such professional organisations. We should not have to rely on them. We should be able to rely on the Government annually——
§ Mr. Kennedy
I agree with the thrust of the hon. Gentleman's argument. He said that he wants a comprehensive national report, as it were. His amendments Nos. 10 and 11 specifically refer to "health authority". Other parts of the Bill talk about. in the Scottish context, "health boards". I assume that his amendments would extend to Scottish health boards as well as to health authorities in England and Wales. Can the hon. Gentleman clarify that?
§ Mr. Dobson
My understanding is that the part of the clause that we are considering refers to "health authorities" but, by some wild extension of the way in which we would go on in this place, that turns into "health boards" when it refers to Scotland. In my view, the Scottish health boards should prepare such reports and should submit their reports, as they would in the normal course of events, to the Secretary of State for Scotland. I understand that the Bill provides for that. Certainly that is what our amendments are intended to provide for, If passed, they would do so without any additional wording to cover Scotland.
We are in favour of such reports. There are a number of examples of Ministers having to report to the House. They must present a report to Parliament, under the Chronically Sick and Disabled Persons Act, on certain aspects of the implementation and progress in implementation of the Act. The Minister of Agriculture Fisheries and Food must report on the intervention board for agricultural products, and so on.
I add those examples in an effort to convince even the most conservative of Members that there are sound precedents for our proposal. I hope that even if the Under-Secretary of State cannot accept the exact wording of our proposals, he will accept the principle that lies behind them and our desire to improve performance and to increase publicity. [Interruption] The hon. Member for Crawley (Mr. Soames) is having a bit of a moan. I hope that even if the Under-Secretary of State cannot accept the amendments, he will accept the principle and introduce in the other place amendments along these lines.
§ Mr. Kennedy
I am glad that at this late hour the debate is back on track, that those Labour Back Benchers who were released from their cages are once again chained up, and that we are again discussing the Bill more seriously.
§ Mr. Kennedy
I was not referring to the hon. Gentleman. [Interruption.] The hon. Member for Crawley (Mr. Soames) should not be too delighted at such a reference. One side is as bad as the other. Last week's events were no better than some of the incidents this afternoon.
I should like to support the amendments and return to a point that I raised in Committee with the Minister. Perhaps the Parliamentary Under-Secretary of State for Scotland with responsibility for health, the hon. Member 127 for Argyll and Bute (Mr. MacKay), will refer to the matter which I raised then and which was not answered satisfactorily. It is an important and worthwhile matter, and I trust that the response will be positive.
The Opposition have argued that the legislation will have serious financial implications for the health authorities and for the health boards in Scotland. The Government have denied that, as the explanatory financial memorandum makes clear. They say that there are no such significant implications. Therefore, I ask the government to allow the health authorities and the health boards north of the border to submit to the Department of Health and Social Security and to the Scottish Home and Health Department a breakdown of the costs that may be incurred to meet the demands imposed by the legislation. That seems to be a reasonable request. It should not cause the Government any discomfort, because they have argued consistently that the costs associated with the Bill will be zero. Presumably, if they are confident about that, they will not face major bills at the Elephant and Castle or in Edinburgh in-the Scottish Home and Health Department.
§ The Parliamentary Under-Secretary of State for Scotland (Mr. John MacKay)
At St. Andrew's House.
§ Mr. Kennedy
I thank the hon. Gentleman. In that case, they will not face major bills from health authorities or the health boards to meet the demands imposed by the legislation. I hope that the Minister, who did not give a clear answer to my request in Committee, will do so tonight. I shall pay careful attention to him when he replies, as I always do. I hope that we shall be given an unequivocal reply one way or the other.
I support the comments of the hon. Member for Holborn and St. Pancras (Mr. Dobson) on amendments Nos. 10 and 11. If the legislation is to be as effective as possible, it is sensible to measure annually the improvements that flow from it to the different parts of the country. Therefore, I support the encouragement of health authorities to take that type of action. I agree with the hon. Gentleman that it is not sufficient for the information to be transferred to Ministers, never again to see the light of day, or for it to be transferred to whoever Mr. Victor Paige's successor may be, without it being made available to the public. The information should be made available to Parliament so that hon. Members can judge, on a local basis, and parties can judge, on a political basis, the progress, or lack of it, that is being made towards full implementation of the Bill's provisions.
I support the amendments and again put my specific inquiry to the Minister, in the hope that he will give a constructive response.
§ Mr. Corbyn
I shall be brief, because I hope that there will be an opportunity to debate the important matters that are provided for later in the Bill.
I support the amendment that has been moved by my hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson), and I hope that the House will see fit to agree to it. I should like the Minister to state clearly the cost implications of the envisaged changes. The removal of Crown immunity would, I hope, result in much closer examination of hygiene standards in Health Service catering departments. Implicit in the removal of Crown immunity is cost. There may be additional staff costs, or 128 new equipment may involve additional cost. In the longer term, I think that significant changes in the design of Health Service catering departments will involve additional cost.
Many of the hygiene problems in the new NHS hospitals are to be found in the design of the buildings. They have nothing to do with hospital administration. There is scope for a serious research project into the problem of vermin in catering departments because of hospital design. Reference was made earlier to cockroaches having absolutely perfect breeding grounds in warm air central heating systems. Those who have to maintain such buildings say that when cockroaches start to breed in warm air central heating systems it is extremely difficult to get rid of them.
I hope the Minister will accept that it is sensible that an annual report should be prepared. The Minister should also take account of the curious concept of the Cinderella services. I have never quite understood what a Cinderella service is, apart from the fact that it appears to require money, over and above everything else, during the year for which a health authority is considering the distribution of its budget. The Cinderella services tend to change, depending upon the particular needs that are identified at the time. Improvements in the hygiene regulations and in the administration of hygiene in NHS kitchens are particularly important, and the Minister should consider the inclusion of such a requirement.
Much has been made of the report into the outbreak of food poisoning at the Stanley Royd hospital. My hon. Friend the Member for Holborn and St. Pancras was right to refer to the original outbreak of salmonella poisoning and then to the very serious outbreak some years later which tragically resulted in a number of deaths. That underlines more than anything the need for health authorities, the Minister and, of course, Parliament to become much more aware of the needs of NHS hospital catering departments.
If we do not ensure that not only is Crown immunity totally removed but that there is some sort of annual reporting system, tragically, what happened at the Stanley Royd hospital could happen at another hospital. It could happen in an old building like the Stanley Royd hospital or in one of the modern hospitals, such as those in London and other big cities. I hope the Minister will recognise that and accept the amendment, which would give Parliament year in, year out, an opportunity to debate the issues. That would put at rest many of the anxieties not only of people who, tragically, have relatives detained in hospitals, but of Health Service employees by ensuring that they are not wrongly maligned for unhygienic catering and the resultant food poisoning.
All the reports produced by the trade unions and professional bodies and other people about Health Service catering are well intentioned and timely. Their authors should be congratulated on producing them and on the efforts they have put into them. It is not good enough for us to rely on voluntary bodies, however good they are, to keep us up to date and up to scratch about Health Service catering. It is a matter of public concern, and one way to overcome that concern is by the production of an annual report, such as that outlined by my hon. Friend the Member for Holborn and St. Pancras.
§ Mr. Whitney
The hon. Member for Holborn and St. Pancras (Mr. Dobson) began his speech with a couple of 129 quotations that he raided from a bumper fun book of quotations from Dr. Johnson. If it were anyone less affable than the lion. Gentleman, I might recall for the benefit of the House the quotation by Dr. Johnson about the talking dog —it was remarkable, not that he talked well, but that he talked at all.
The hon. Gentleman spoke about the "ludicrous machinations and arguments" that went on in the extremely sad affair at the Stanley Royd hospital. I am delighted to have the hon. Gentleman's support and endorsement, which I take by inference, for the system of general management which we have introduced and which we are confident will avoid precisely the "ludicrous machinations and arguments" which caused the difficult and regrettable trouble at the Stanley Royd hospital.
§ Mr. Dobson
If there is another salmonella outbreak in a hospital with a general manager, will the Minister sack the manager?
§ Mr. Whitney
That is a hypothetical question that I shall be happy to consider should the need arise.
I hope that the hon. Gentleman will consider the situation that the Stanley Royd hospital inquiry revealed and address his mind to the possibility that, given the clear acceptance of responsibility inherent in the general manager system, it would have been highly unlikely, to put it at its lowest, for that sort of thing to occur had such a system existed at the Stanley Royd hospital.
The hon. Member for Ross. Cromarty and Skye (Mr. Kennedy) reminds one of another quotation by Dr. Johnson, but I had better avoid that, because to cite it might lose us votes in Scotland.
The hon. Member for Islington, North (Mr. Corbyn) spoke about additional costs that might be incurred. I remind the House not only of the increased real expenditure that the Government have already devoted to the National Health Service, and to which I have referred at least once already in the course of an earlier debate, but of the 6.7 per cent. increase in resources that is being made available to the Health Service this year. That is set against inflation, which is about 3 per cent. The savings that are being achieved by the cost improvement programme an by the sale of the estate, and the savings that are being achieved by the competitive tendering programme, offer a fruitful source of funding for any necessary bringing up to standard should that be necessary in any health authority or in any Health Service unit. It has always been accepted that despite Crown immunity the standards that we expect should nevertheless be observed.
§ Mr. Corbyn
I thank the Minister for giving way. Will he for one moment leave the fairytale land in which he lives about increased resources for the NHS and answer the question in the debate? When a report is made which clearly shows that more money is needed in NHS catering departments to overcome the difficulties, will the Department provide the funds and not take money from the patient care budget, as it has done with every other thing in the NHS?
§ Mr. Whitney
If the hon. Gentleman wishes to talk about reality. I remind him again of the reality of a 24 per cent. increase in spending real terms since 1979, of a 6.7 per cent. increase this year against 3 per cent. inflation of about £150 million available in the next year and a similar 130 amount that will be made available from the sale of real estate, and the fact that there is also the additional funding that will be available from competitive tendering. That is the reality.
§ Mr. Whitney
I am answering the hon. Gentleman's hon. Friend. If the hon. Member for Islington, North (Mr. Corbyn) wants a little reality, let him read carefully tomorrow what I have said in Hansard and he may learn a little about the funding of the NHS.
§ Mr. Whitney
No, I shall not give way. Sit down.
The hon. Members for Holborn and St. Pancras and for Ross, Cromarty and Skye—we do not know whether or not the Liberals will join in this these days—are offering a whole bundle of paper which is to be shipped yet again into the Vote Office and the Library in the form of annual reports to Parliament from some 191 health authorities. That is a completely unnecessary procedure, set against the fact that the purpose of clause 1 is to apply the food legislation, including its enforcement provisions, to health authorities, so that their premises will he inspected by environmental health officers who will be able to require improvements to comply with the legislation, and, if necessary, will be able to prosecute and, indeed, to seek closure of premises. So in future any health authority which has failed to follow our long-established policy of complying on a voluntary basis with the legislation will, once the Bill comes into effect, be obliged by the force of law to comply or face the consequences.
When my right hon. Friend announced the Government's intention to seek to remove Crown immunity under the food legislation from the NHS, he said that we would also be revising the central guidance in the light of the Stanley Royd report and other developments. We are now consulting other interested bodies, such as the Institution of Environmental Health Officers, on a draft of this guidance. This makes it clear that district health authorities should receive each year, in the public part of their meetings, a summary of EHO inspection reports. It also asks regional general managers to see that food hygiene standards are monitored in their districts.
This guidance, along with the force of law applied through the enactment of clause 1, will ensure good food hygiene standards in all our hospitals. The Government see no need to introduce the large volumes of extra paper which would be the main effect of the statutory reports envisaged by these amendments supported by the Labour and Social Democratic parties. I urge the House to reject the amendments.
§ Amendment negatived.
§ Mr. John MacKay
I beg to move amendment No. 15, in page 2, line 26, after 'means', insert'the Milk Dairies (Scotland) Act 1914 to 1949,'.This technical amendment is required to bring the statutory provisions relating to milk in Scotland within the effect of clause 1. Legislation in Scotland on milk is largely separate from the main provision on food—the Food and Drugs (Scotland) Act 1956 —and this amendment completes the references to Scottish provisions relating to food.
§ Mr. Maxton
I rise merely to welcome the Scottish Minister to the debate. This is the first time that he has 131 been in the Chamber. [Interruption.] The hon. Gentleman managed to dash in on the previous occasion that I spoke —he was obviously told by a Government Whip that I was attacking him for not being present—but he has hardly been present. Yet the Bill covers the whole of Scotland.
I assume that there will have to be a drafting amendment to the Government amendment, because I assume that it should refer to the "Acts" of 1914 to 1949 and not just the "Act". No doubt that will be put right.
I also assume that the Minister has got the amendment right—though it will be unusual if he has. However, I intervene merely to welcome the Minister on one of his rare appearances in our debates on the Bill.
§ Amendment agreed to.