Lords amendment: No. 1, after clause 1, insert the following new clause—
. — (1) For the purposes of health and safety legislation—
(2) In this section—
the health and safety legislation" means—
(3) Section 125 of the 1977 Act and section 101 of the 1978 Act shall have no effect in relation to any action, liability, claim or demand arising out of the health and safety legislation.
(4) This section shall have no effect in relation to anything done or omitted before its commencement.
§ The Minister for Health (Mr. Tony Newton)
I beg to move, That this House doth agree with the Lords in the said amendment.
§ Mr. Deputy Speaker (Mr. Ernest Armstrong)
With this it will be convenient to consider Lords amendment Nos. 5 and 7. I should inform the House that these amendments involve privilege.
§ Mr. Newton
In line with your indication, Mr. Deputy Speaker, of what is acceptable, I should like to speak to amendments Nos. 5 and 7. In doing so I hope to restore that happy sense of harmony and unanimity in the House in response to our dealings with another place. Those dealings were rudely sullied by those hon. Members who spoke on the Housing and Planning Bill. In this case I hope that there will be agreement between both sides of the House about what I am recommending — the warm acceptance of a number of amendments made in another place to some aspects of the Bill.
Amendment No. 1 is a new clause inserted in another place together with some tidying up amendments that were inserted by the Government towards the end of proceedings in another place. The amendment seeks to remove from health authorities Crown immunity in respect of health and safety legislation, in the same way as clause 1 of the original Bill removed it in respect of food legislation.
977 In its new form, it defines the health authorities affected and the legislation, but it does not contain regulation-making powers originally envisaged in the amendment moved in another place. That is simply because it turned out to be unnecessary to have such powers, as they are already available in the Health and Safety at Work etc Act 1974. The application of the clause in its broader form is limited to events occurring after its commencement and applies in the same way as clause 1 of the original Bill about food legislation.
We have taken a further significant step in the legislation about Crown immunity affecting health authorities. We have gone significantly beyond the original proposal which, as the House will recall, arose in the aftermath of the Stanley Royd hospital inquiry into the outbreak of food poisoning. We have gone significantly beyond the Government's decision at that time to remove Crown immunity from food legislation, and we accept the argument put forward in the other place that that removal should also apply to health and safety at work legislation.
It might have been more difficult to say that at a much earlier stage, but now it seems to be an entirely sensible move and I welcome it. It represents a concordat not just between this House and another place, but also between the Government and those Opposition Members who expressed anxiety about the position. It is a useful piece of further progress and I hope that it will receive enthusiastic or at least warm-hearted support from hon. Members on both sides of the House.
The other two amendments are technical. Amendment No. 5 provides for clause 1 in the food legislation and Lords amendment No. 1 in the health and safety legislation to commence operation three months after the date on which the Act is passed. That short delay is necessary to allow health authorities to be advised of the changes in the law and in working procedures and to enable them to undertake any necessary training. As will be readily apparent to hon. Members who have looked at amendment No. 7, it simply extends the long title of the Bill to reflect the insertion of the new clause on the wider removal of Crown immunity. It provides cover within the long title of the Bill for Lords amendment No. 1.
§ Mr. Frank Dobson (Holborn and St. Pancras)
This is a bad day for cockroaches, because it sees the extension of the health and safety legislation to all hospitals and properties of health authorities. This bad day for cockroaches comes about because the Government were outvoted in the other place. We are being asked to agree with the Lords in the said amendment. The Opposition certainly agree with the Lords because we earlier moved amendments on the same lines. We suggested them on Second Reading and moved amendments in Committee and on Report, but the Government used the Whips to vote them down. I suspect that we are happier supporting the amendment than are Ministers—or perhaps I should say happier than their predecessors would have been had they remained in office long enough to carry out the duties being undertaken by the present Ministers.
It must be re-emphasised that hospitals are supremely dangerous places. They are full of germs and viruses, dangerous drugs and dangerous waste. Patients are especially susceptible to infection because they are ill and in need of special protection. The people who work in hospitals and people visiting patients need similar protection. Until the Lords exercised its force majeure, the 978 Government did not intend to do anything to help. They intended to keep Crown immunity for health and safety offences and they lifted it only from kitchens. That was a daft compromise because the well-informed cockroach faced with the Government proposal could simply move from the kitchen to the operating theatre in order to be in a safer environment.
Crown immunity has never been advocated in order that there should be more prosecutions. Nobody is enthusiastic about lawyers making money out of this proposition. Personally, I am not enthusiastic about lawyers making money out of anything. But the object of the exercise is that the threat of prosecution should force health authorities to take their obligations more seriously. The Association of Environmental Health Officers sent the DHSS a report on 1,000 hospital kitchens that had been inspected. Apparently, 60 per cent. of them, more than 600, had been in breach of regulations, and 97 of them would have been prosecuted if that power had been in the hands of the proper authorities.
But we are now going beyond kitchen hygiene, to applying the full rigours of the law on health and safety. The Government were very complacent in claiming that the law was operating even though prosecutions were not possible. Lord Young sent a letter to Mr. David Basnett, then general secretary of the General, Municipal, Boilermakers and Allied Trades Union, on 27 November 1985, which said:The Commission tell me that the Health and Safety Executive have looked carefully into the eight cases which you put forward relating to the operation of the Health and Safety at Work Act 1974. In three of these cases, the Executive were unable to substantiate your evidence. Two of these involved alleged exposure to asbestos. They did confirm however that in four of the five cases the Health and Safety Executive would have prosecuted under the Act were it not for Crown immunity.That suggests that when that union sent a list of eight cases, 50 per cent. of even that small number would have resulted in prosecutions if that possibility had existed.
I do not want to detain the House, but certain points now need to be put to Ministers, as we are for the first time facing the extension of health and safety legislation. The extension of the power to prosecute and the necessary response from health authorities will cost a lot of money. It was estimated that it would cost £600,000 to do up the kitchens at the Stanley Royd hospital to a proper standard. The health authority across the river estimates that it would cost no less than £1.5 million to do up the kitchens at St. Thomas's hospital. But these figures refer merely to applying the food hygiene legislation. In the time available, we have not had an opportunity to obtain estimates on how much it will cost health authorities to meet the health and safety legislation. But it is clear that it will cost tens of millions of pounds, in addition to the £100 million or so for extending the food hygiene legislation.
Before deciding whether to support the amendment, we need to know whether the Government have estimated the costs that will arise from it. If so, what additional funds do the Government propose to provide to health authorities so that they can protect themselves from prosecution? It is no good any Minister, new or old, saying that such a sum will be allowed for in next year's Estimates, so that hon. Members will not be able to indentify it. Similarly, Ministers cannot say that it is all 979 right, because that spending has already been allowed for in this year's allocation. This legislation has only just come from the other place, but it will be implemented in this financial year.
§ The Parliamentary Under-Secretary of State for Health and Social Security (Mrs. Edwina Currie)
We are, of course, looking at clause 2, which refers not so much to kitchens as to other Health Service premises such as laboratories. Is the hon. Gentleman aware of the large sums spent by many health authorities in the 1970s as a result of the Howie report on laboratory conditions? The health authority that I served on was obliged to spend a lot of money on bringing laboratories up to very high standards.
§ Mr. Dobson
Perhaps some health authority laboratories are of a high standard, but not long ago I was told by the consultant in charge of the laboratories at Worcester royal infirmary that the place was full of dangerous pathogens which were a threat to the staff, and that they broke practically every health and safety regulation in the land. Indeed, he subsequently resigned because he was so perturbed about it. Hospitals consist of much more than laboratories, and there are many places within hospitals that have come nowhere near meeting the requirements of the health and safety legislation.
If the amendment is accepted, the legislation will come into operation on 5 or 6 February 1987, which is in this financial year. Health authorities will break the law if they do not put right before then anything that is wrong now. I know that clause 1(8) saysThis section shall have no effect in relation to anything done or omitted before its commencement",but if the law is not being complied with on the day that this part of the Bill comes into operation, the law will be broken. Health authorities will be open to prosecution for anything wrong from that day onwards.
What efforts have Ministers or their predecessors made to ensure that the 97 kitchens that would have been open to prosecution according to the list submitted by the AEHO are brought up to standard? Have Ministers guaranteed those health authorities earmarked funds in order to meet the requirements before 5 or 6 February? If not, can the Minister be joined as a defendant if the health authority is prosecuted? After all, Ministers will have knowingly failed to allocate the sums necessary to ensure that health authorities comply with the law.
Perhaps Ministers are still covered by Crown immunity, even if health authorities are not. If Ministers do not come up with the funds, it may be to their advantage to be covered by Crown immunity, because any sensible health authority would attempt to join them in defending any action. What will the impact be on all those shifty private contractors who moved into the cleaning business? All over the country official reports produced by the health authorities who were forced to bring in those contractors have mentioned substandard cleaning targets and have said that targets have not been met. In one month last year Office Cleaning Services at Addenbrooke's hospital approached only 65 per cent. of the target standard of cleanliness in the operating theatres there. The truth is that standards have declined as privatisation has increased. The reports produced by health authorities provide evidence of that all over the country.
980 Health authorities that fall foul of the health and safety legislation as a result of contractors being imposed on them by ministerial fiat along with lower standards, because Ministers are not providing the necessary funds, will no doubt wish to join Ministers in defending any action brought against them by the Health and Safety Executive.
I congratulate all those involved in the campaign to remove Crown immunity. Ministers stood out against this sensible proposition, but it is now acknowledged as being eminently sensible by the new Minister. The Health Service trade unions conducted a long campaign. In recent years, the AEHO also played a major part in the campaign as did the Royal College of Nursing and the British Medical Association.
I pay particular tribute to my right hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) for his constant harassment of Ministers, and anyone else in his sights. Agreement is almost universal that Crown immunity should be lifted in full. We in the House of Commons should have made the decision ourselves. That would have led to a more efficient use of parliamentary time. It should have been accepted when first put forward. We won the arguments but lost the votes. Now it looks as though we shall win the votes as well.
On a sad and serious note: but for the outbreak of salmonella poisoning and the deaths which followed at Stanley Royd hospital, none of these changes would have been proposed by the Government. One of my hon. Friends lost a relative in that outbreak. Nothing can bring back those who died, but many of the people involved will gain some satisfaction from the thought that as a result of what happened measures are, at long last, being taken which should reduce the possibility of another such outbreak.
§ Mr. Jack Ashley (Stoke-on-Trent, South)
The Minister for Health made as good a job as possible out of a very weak case. He tried to assert that the Government are in favour of the proposed amendments, although any reading of the debates in another place shows that only a few weeks ago the Government were against the amendments. Ministers spoke out very strongly indeed against them. The Minister tried to put his best face on it. My hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) has just made a powerful speech in which he made a number of points that must be answered. I hope that the Minister for Health, or his sidekick, will respond.
For all the diplomacy shown by the Minister—he should go to the Foreign Office — this is the one hundredth crippling and embarrassing defeat for the Government. It is a significant defeat. The amendments are a landmark in the battle to erase Crown immunity from the face of all establishments where it now reigns. The Government's acceptance of the amendments is very reluctant.
Cash must now be found. The Minister's speech must be followed by the provision of abundant money. These are not cheap amendments. They will cost many millions of pounds. We cannot prevent accidents and protect the safety of Health Service workers for nothing.
The campaign began with John Edmonds of the General, Municipal, Boilermakers and Allied Trades Union and the deputation which I took to the Secretary of State for Employment on 18 June 1985. Since then early-day motions and parliamentary questions have been 981 tabled. The Minister said that the amendments go further than the original proposition. He is not quite right. My hon. Friend the Member for Holborn and St. Pancras has played a leading part in the campaign and will agree that throughout we have always demanded the removal of both food hygiene and health and safety regulations from Crown immunity. We were all disappointed that only kitchens were included at the beginning. That was the thin end of the wedge. We have made it clear that we are seeking wide extension of the removal of Crown immunity. The bodies involved in the campaign include the environmental health officers, the General, Municipal, Boilermakers and Allied Trades Union, the British Medical Association and the Royal College of Nursing. Their efforts laid the basis for success.
If anyone doubts the need for the change he should check parliamentary answers, which show a 20-fold difference in the incidence of health and safety enforcement notices between Crown and non-Crown premises. That shows the need for the amendments.
It is imperative that the new law be enforced. The quota system for disabled workers is often not enforced. The Minister knows that, as a former Minister responsible for the disabled. We shall fight to ensure that this new law is enforced because if it is not it will be brought into disrepute. We give notice to the Government that when the amendments are accepted and the Bill enacted we shall demand enforcement of the law.
Although the proposed change goes further than the Government originally accepted, it is only the beginning. Much more remains to be done. Even when the Bill is enacted, over 10,000 Government premises will still be protected by Crown immunity from food and hygiene regulations and from health and safety regulations.
We want the removal of Crown immunity to be extended to such places as prisons, defence establishments, Department of Health and Social Security offices and Ministry of Defence kitchens.
A fortnight ago I visited the forces in West Germany and I pay tribute to what the Ministry of Defence is doing, but I want Crown immunity to be removed from Ministry of Defence kitchens. I shall press for that. This anachronism should be swept away.
This is only the second step. The first step was kitchens. The second step is these amendments. We shall press for the new law to be implemented and then we shall press for the law to be extended to all the areas which I have mentioned.
§ Mr. Archy Kirkwood (Roxburgh and Berwickshire)
I agree with the right hon. Member for Stoke-on-Trent, South (Mr. Ashley) that the amendments are only the first step. I endorse what the Government have done and I warmly welcome the extension of the Health and Safety at Work, etc. Act provisions. I agree with the right hon. Member for Stoke-on-Trent, South that we should now consider some other opportunities to remove Crown immunity. Initially I was not prepared to be as ambitious as the right hon. Gentleman, although I agree with him in principle.
I have looked at reports of the debates in the other place relating to the amendment and the extension of the Health and Safety at Work etc. Act 1974. I was concerned that the health and safety at work provisions covering waste, medical, nursing, dental, veterinary, pharmaceutical and 982 other practices, as well as human and animal tissue, excretions, drugs, medical and medicinal products, swabs, dressings and similar items, are included and are therefore changed in so far as the amendment affects the Bill.
What worries me is that large areas with a slightly wider extension start to impinge on the provisions of the Control of Pollution Act 1974. Some of the latter overlap the provisions of the Health and Safety at Work etc. Act 1974, Debates in another place on the amendment suggested to me that the noble Lord Ennals, who introduced the amendment, thought in his original drafting that the conclusions of the 11th report of the Royal Commission on environmental pollution, asking for a review of wider issues such as incineration, fencing and other matters relating more directly to pollution, would be covered by the amendment. However, from a strict reading of the amendment and the Bill, I understand that unhappily, that will not happen as a result of the Government's acceptance of the amendment. I ask the Government to look at that and to reconsider the recommendations of the 11th report of the Royal Commission on environmental pollution as soon as possible.
However, I welcome the amendment unreservedly as a step forward. I should also like to underline the comments of the hon. Member for Holborn and St. Pancras (Mr. Dobson). It would be remiss if the House did not cross-examine the Minister a little more about how he and his Department will cope with the undoubtedly increased demands, whether financial or administrative, which have been visited upon them. I accept that they may not have been able to work out the fine detail of the circulars and the guidance that they will give, but the Minister is obliged to give us a little more information about how he proposes to implement the Bill, and what will happen in practice in February next year when the provisions start to bite.
References were made in the other place to newspaper reports that a certain amount of leeway would be allowed to health authorities in that replies could be made within 28 days, and that they would be able to plead poverty as a defence against proceedings or notices that may be raised against them. The Minister should comment on that because it concerns my hon. Friends and me. The costs of implementing the provision may well be substantial but they must be faced.
Another difference between the noble Lord Ennals' proposals and our discussions this afternoon is the inclusion in the noble Lord's amendment affecting regulation powers. Those powers have been deleted in the amendment. The Minister may be able to tell us that perfectly adequate provisions exist under present legislation and that, therefore, the regulation powers are not necessary. I hope that that is the case, and that the Government are not trying in some way to emasculate the Lords amendment.
Perhaps I can clear up that point by a brief intervention. The hon. Gentleman may have missed what I said when opening the debate. The powers had been left out, as they were already contained in the National Health Service (Scotland) Act 1978.
§ Mr. Kirkwood
I am grateful to the Minister. I suspected that that was the case and apologise if I did not catch the Minister's earlier remarks.
The general thrust of the amendment is acceptable to us. It is the first stage in what I hope the Minister will 983 accept as a continuing march towards a more open and less protectionist environment within which Government Departments operate. I warmly endorse what the Government are doing and they are supported in this by myself and my right hon. and hon. Friends.
§ Mr. Laurie Pavitt (Brent, South)
My right hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) commented in passing— I think that all hon. Members will pay tribute to him for his work on this matter—that the Government have come, rather reluctantly, to this position. I can tell my right hon. Friend that there is more joy in heaven over one sinner coming to repentance than over 99 who need no repentance.
My hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) made a powerful speech. The amendment is really a long-stop. The points made by my hon. Friends underline the fact that by removing Crown immunity a situation arises where, if things go wrong, a penalty will be incurred. However, things ought not to go wrong. I am pleased that we have at least got this far. It used to be possible for employees to gain severe damages in the courts if their ears had been damaged because of inadequate controls over the level of decibels to which they were subjected. It was not until heavy damages were awarded by a court against a company that there was a tremendous change in the level of decibels allowed under Common Market legislation, and also in the way in which the problem was dealt with in this country.
I rejoice that it is a long-stop. However, the amendment should concentrate the minds of authorities, administrators and, under the Griffiths arrangements, the new general managers a little more upon the important points made regarding the health and safety of people in hospitals.
A case in point is hepatitis B, which was such a disaster in renal dialysis units and which led to deaths of nurses in Edinburgh. Without the provision that we are now discussing, authorities have tightened up, and safety procedures are automatically in place in renal dialysis units. This means that the incidence of hepatitis B has been virtually eliminated. However, the danger is there and the fact that the new amendment will enable the regulations to be tightened up will be of some value.
My hon. Friend the Member for Holborn and St. Pancras referred to the damage caused by privatisation. When the Under-Secretary of State for Health and Social Services inherited the file from her predecessor, she will have seen long correspondence from me about what happened when Crothalls and Pritchards were the cleaners at Westminster hospital. She will also have received the report by the Riverside health authority. I hate to bring personal matters into this, but my wife was the unfortunate person who had to scrub out the lavatory because it was unhygienic. Nothing concentrates a Member of Parliament's mind upon cleanliness more than having to take into a hospital the necessary cleaning equipment to ensure that infection does not set in. Sadly, I have to report that on a second operation my wife got a further infection from precisely the same origin. The nurses and all the staff concerned naturally had sterilised gloves and instruments, but the bath and toilet facilities were rife with infection.
984 With privatisation monitoring is very loose. Previously a ward sister was in charge of her ward and was the captain of a tight ship. As a result of privatisation, she has to go through a number of procedures in relation to cleanliness, food and laundry before she can obtain satisfaction and the right standards of cleanliness.
Following the acceptance of this excellent additional safeguard, will the Minister look at the mechanisms whereby we can arrive at a position where Crown immunity will not have to be dispensed with because problems will not arise? At the moment, the proverbial coach and horses can be driven through the method of monitoring cleanliness in public places, wards and out-patients' departments. That applies in particular to geriatric hospitals, where the problem of incontinence arises and laundry is put out to outside contractors who do not have the same standards as a hospital hygiene officer.
In the light of this debate, those procedures should be revamped and revised. As a good Labour party member for more years than I care to remember, I never thought that I would thank the good Lord for the House of Lords. However, as in so many cases these days, we are most grateful for what happens in the other place, which enables the Government to concentrate their minds on a reform that has been long overdue.
§ Mr. William Cash (Stafford)
On Second Reading of the National Health Service (Amendment) Bill, which followed a Bill that had been sponsored by my hon. Friend the Member for Aldridge-Brownhills (Mr. Shepherd) and others, including myself, we were given some dispensation over Crown immunity as a result of the outbreak of food poisoning at the Stanley Royd hospital, Wakefield. On Second Reading, some of us, including myself, suggested that it would be helpful if that immunity were extended to hospital premises and activities other than those purely in respect of food poisoning. It seemed clear that it would be difficult to determine where an outbreak had begun and ended, to make sure that people were properly and consistently protected, and that the Crown could not fall back on what in the event would turn out to be a spurious immunity. We wanted further protection for the patients in a given hospital.
In my constituency of Stafford we had the terrible tragedy of legionnaires disease which caused the death of 37 people. The cause of that has been partially reported on by a public inquiry for which I called and which I was delighted the Government agreed to set up. During the course of that inquiry it became apparent that there was defective machinery and that cooling towers needed to be replaced. They have now been replaced and for that we are extremely grateful to the Minister, the Government and the regional health authority. That has, so far as can be judged, ensured that such a tragedy will not recur in my constituency.
On one occasion I was sitting with members of the press who had gathered for a press conference. Although they did not know it at the time, every person in the room—representatives from virtually every newspaper in Britain — was liable to catch legionnaires disease because at that time nobody knew the cause of the outbreak. Therefore, there was a serious risk to a large number of people.
985 I welcome the amendment. I appreciate that the scope of the Bill precludes the extension of the abolition of Crown immunity to matters outside NHS hospitals. I apologise to my hon. Friend the Minister for not being here when he opened the debate. I regret that I was caught up in another meeting. However, I feel strongly that these provisions are of great importance. They go a long way to removing, for practical purposes, many of the difficulties that can arise in hospitals. The health and safety legislation is extremely broad. It covers a wide range of activities. As time goes on, it will be discovered that the amendment goes a lot further than many people may have thought in the first instance.
In 1978, the Health and Safety Executive wrote a report on Crown immunity and required the Government to abolish Crown immunity in a wide range of matters. I am sure that my hon. Friend the Minister is well aware of that report. However, we are dealing here with the NHS and the Government have properly gone as far as they can in this legislation. I congratulate Ministers, not only on what the Government have done in respect of this legislation, but on their many achievements since they took office.
I should particularly like to thank my hon. Friend the Under-Secretary for coming to Stafford recently to see the hospital in action in the aftermath of the terrible rail crash tragedy on the outskirts of Stafford. Many people in that hospital expressed deep appreciation for the time and care that she spent, which helped enormously to restore confidence in the hospital in the aftermath of the legionnaires tragedy.
§ Dr. John Marek (Wrexham)
The hon. Gentleman must get the record right. First, it is not the Government who have seen the light. That was forced upon them by the other place. Secondly, the hon. Gentleman might care to explain why he voted against the Bill on Report.
§ Mr. Cash
The hon. Gentleman is making a fairly cheap point. At that time we had every reason to suppose that we had gone a long way towards achieving the principle of the abolition of Crown immunity in respect of health authority legislation. The reality is that at that time we had got as much out of the Government as we had hoped for. We wanted more. We expected that in due course we would get more, and in private discussions it was suggested that we might well get more. Therefore, it would have been churlish at that point not to have accepted what was on offer.
The hon. Gentleman may be prepared to concede, if he is good enough to look at my speech on Second Reading, that I called for an extension of the abolition of Crown immunity. Furthermore, that was taken up by the House of Lords and the provisions that we are discussing today mirror exactly the provisions for which I called, which were as much as could have been provided for within the scope of the Bill. I have no reason whatever to complain, and it is churlish of the hon. Gentleman to deny the Government credit for accepting the amendment. We are used to reasonable debating points and I do not deny the hon. Gentleman credit for trying to make one, but the trouble is that he is failing.
The real point here is that the Government are already in a dialogue with the other place on the consideration of Lords amendments. I was a member of the Committee which considered 589 amendments to the Financial Services Bill and it is by no means unusual for the Government to be given credit for accepting amendments.
§ Mr. Maxton
Does the hon. Gentleman seriously believe that if the other place had considered the Bill three months ago, which would have given the Government time to return to the House with the clause that we are now considering and still have time to reject it and return it to the other place before prorogation, it would not have rejected it?
§ Mr. Cash
My right hon. Friend the Leader of the House has been congratulated on allowing sufficient time to enable the Government to see the wisdom of the amendment. The Government deserve to be congratulated on the way in which they have dealt with this matter.
The problem of viral hepatitis was raised quite properly by the hon. Member for Brent, South (Mr. Pavitt). When the application of the exemptions to health and safety legislation are fully understood, having regard to section 4 of the 1974 Act, it will be appreciated that it is not confined to matters such as viral hepatitis B, which is a serious disease, and embraces the problems of AIDS. The Minister may or may not wish to comment at this stage, but he will know that there is an early-day motion in my name and the names of about 90 other hon. Members of all parties that calls for better provision for education about AIDS through television.
§ Mr. Cash
Indeed, Mr Deputy Speaker. Where matters were to arise in which AIDS was known to have been transmitted within the context of the health and safety legislation—in other words, there being grounds under the 1974 Act for someone to sue the Crown because AIDS had been contracted—I believe that the Bill's provisions would be of considerable benefit to any potential litigants.
§ Mr. Dobson
Surely people have always been able to bring civil actions against health authorities, or any part of the NHS, in circumstances which might result in death or illness.
§ Mr. Cash
I am not disputing that there are circumstances in which a person would be able to set up a claim for damages where AIDS or any other disease had been transmitted through the use of facilities of an NHS hospital. I am saying that the basis on which it could be done is being widened. It is extremely important that the public should know that the Government are dealing with the problem of AIDS, among other things, extremely seriously. I think that I have dealt sufficiently with the issues that I wish to raise, and I wish finally to congratulate Ministers on everything that they have done to ensure that the Bill is enacted.
§ Mr. Ken Weetch (Ipswich)
I shall take only a few minutes of the time of the House. I wish to contribute to the debate because I spoke on Second Reading and I was a member of the Committee which considered the Bill. In Committee I argued the case for the extension of clause 1 into other areas. I was interested to learn how the Government could continue to prop up a system that is logically indefensible, and it seems that they have sought to make virtue out of necessity. When I read the final speech of defence from the Government's spokesman in another place, Baroness Trumpington, I noticed that she fell back on the argument that the voluntary procedures had worked well over the years. Indeed, the Crown notice system has worked well, and from the system's inception 987 about 330 notices have been issued. In every instance there was ready compliance and none of them had to be referred to the Secretary of State.
I have no sympathy with anyone who would wish to resist the amendment and I have some sympathy with one or two of the remarks that were made in another place. Since the health and safety at work legislation was placed on the statute book, there has been accumulated a good deal of experience of putting safety legislation into operation in hospitals throughout the country. When I telephoned East Anglia this morning to brief myself on what is happening in the area, I was pleased to learn that the local health authority has become much more safety-conscious in recent years. This is because shop stewards and management have worked hard to identify and pinpoint matters of concern. In so doing they have eradicated many of the problems, and that is an encouraging feature to note. Much hard work has been done thoughout the country.
About 96 per cent. of the speech which I prepared will have to be abandoned, to my relief as well as everyone else's, because of what has transpired. I constructed an elaborate argument which I called Morton's fork. It went something like this: if the situation is serious, the Government will have to do something about it because it is serious; if there has been a good deal of improvement, it will not cost the Government very much to act accordingly, so they can very well take the appropriate action.
I do not think that there will be a rush of litigation. I discern that there is much good will on the part of those who are involved in the problems that we are discussing. Tribute should be paid to trade unions and management for the way that they have co-operated in many areas. I conclude by saying that the Minister's statement at the beginning of the debate should be welcomed in all parts of the House.
§ Mr. Newton
I am pleased that the debate is coming towards its end in slightly happier terms than when it was introduced by the hon. Member for Holborn and St. Pancras (Mr. Dobson) at the outset. I hesitate to describe the manner of his introductory remarks as his characteristic charm. They contained a degree of abrasiveness which I thought went beyond the tone that I had hoped to set in introducing the debate on behalf of the Government.
The hon. Member for Ipswich (Mr. Weetch) must be one of the most reasonable of hon. Members —I hope that this will not be a killer blow to him—on both sides of the House. I can see from the expression of Labour Members that that is regarded as a fatal charge. In an important respect, the hon. Gentleman has given the answer to some of the rhetoric of a rather routine character with which the hon. Member for Holborn and St. Pancras sought to embellish his speech. He suggested, for example, that the problem is yet another one that can be solved only by the Government finding a large and unspecified sum to be thrown at it.
The Government's view is exactly that which was set out in the concluding remarks of the hon. Member for Ipswich. No one can pretend that everything is perfect —if it were, we would not be bothering to have this 988 debate — but there is no reason to doubt that most health authorities have responded to the pressures of the Crown notice system and successive waves of guidance and have made substantial progress towards improving the position that obtained a decade ago. If that were not the position, and if I were to respond to the hon. Member for Holborn and St. Pancras in the terms he used, I should be tempted to ask what the previous Labour Government thought they were doing in 1977 when they allowed cockroaches, to take up the hon. Gentleman's phrase, to continue having their field day for another decade without seeking to take the action that is now being urged.
§ Mr. Newton
My hon. Friend reinforces my argument. Out of courtesy, I should let the hon. Member for Holborn and St. Pancras have his say.
§ Mr. Dobson
I cannot expect the Minister to plough through the previous debates on this matter but, had he done so, he would have noted that my view is that the Labour Government were wrong in their judgment at the time. They introduced what they regarded as an improvement in the system, which, until this year, the present Government regarded as adequate. Ministers are on record as saying so, despite mounting evidence that it was not satisfactory. That mounting evidence was not available to the last Labour Government, although I think that they misjudged the matter at the time.
§ Mr. Newton
In view of the entirely generous acknowledgement by the hon. Gentleman of his views of the action of the Labour Government, I do not wish to pursue this point further. We are now back on the track that I hoped we could have stayed on. We all now recognise that in certain important respects, of which the most obvious was food legislation — we have now extended acceptance to health and safety legislation—the previous situation could not be regarded as entirely satisfactory. It is right to have made these moves. They are now represented in the combination of what the Government put into the Bill in the first place and what they have accepted in response to continuing pressure, including that in the other place in the past few days, which I put before the House at the outset in welcoming terms.
There was a reference to repenting sinners in one of the more jocular contributions to the debate. Neither my hon. Friend the Under-Secretary of State for Scotland—the hon. Member for Galloway and Upper Nithsdale (Mr. Lang)—whom I should not wish to call a sinner in any case, nor I can conceivably be described as sinners in this context because we were metaphorically unborn at the time.
§ Mr. Dobson
The first words of the financial memorandum of the Bill, as originally published in April this year, state:Clause I had no implications for public expenditure.The Bill as drafted did not extend the lifting of Crown 989 immunity to health and safety legislation as a whole. Does the Minister still say that the rigorous application of health and safety legislation and the liability to prosecution will not cost a penny? That is what the Bill states.
§ Mr. Newton
I am saying no more than was said by the hon. Member for Ipswich in the last speech from the Back Benches.
§ Mr. Newton
The hon. Member for Ipswich specifically referred to health and safety legislation rather than to food legislation. He said that as a result of the activities of trade unions, to which he rightly paid tribute, and the seriousness with which the 1977 changes had been taken by health authorities, substantial progresss had been made in respect of health and safety requirements. It is on that basis that I, too, wish to say that there is no reason to suppose—
§ Mr. Newton
The hon. Member for Ipswich specifically expressed doubt whether large sums of money were needed, on the basis that he thought that significant progress had already been made. In that respect, there is total unanimity between the hon. Member for Ipswich and myself from the neighbouring county of Essex. That is our view of the position.
§ Mr. Kirkwood
I wonder whether we could put the question the other way around. Supposing an unforeseen problem arises and money is required to comply with the provisions of the new amendment. What view will the Government take? Does the Department expect the local health authority, whatever it may be and in whatever context it finds itself, to find the money from its existing budget?
§ Mr. Newton
The hon. Gentleman will understand that I am not prepared to be drawn into speculation about hypothetical situations of that kind beyond saying that, in the Government's view, the amount of money spent on the National Health Service ought reasonably be expected to be sufficient to ensure reasonably clean kitchens and reasonably safe working practices. In the first instance, should a problem of that kind occur, we would expect it to be examined by the district health authority — if necessary, in co-operation or discussion with the regional health authority—before it was suggested that the only way in which it could be overcome was by some further substantial sum of public money being found.
The hon. Member for Roxburgh and Berwickshire (Mr. Kirkwood) referred to the Control of Pollution Act 1974. He has sought to raise this point in various ways, and I recognise that it might be worthy of consideration in the longer term. He will understand that we have sought in a pragmatic way to meet those problems which had clearly been revealed as carrying a degree of urgency and proper public concern and to respond to continuing discussion in both House about other aspects. None of that rules out further changes in future. Equally, I must say, for the benefit of the hon. Member for Roxburgh and Berwickshire and the right hon. Member for Stoke-on-Trent, South (Mr. Ashley), that it cannot be taken as committing us to further changes in the future, still less to my committing my colleagues in other Departments to a 990 certain view of parallel problems. I note the point raised by the hon. Member for Roxburgh and Berwickshire. I do not dismiss it out of hand, but it is manifestly not a matter with which we can deal by further legislative change at this stage.
The hon. Member for Brent, South (Mr. Pavitt) urged us to ensure that the mechanisms for avoiding any consequences arising from the removal of Crown immunity in these respects are applied. I agree with him. Indeed, one point that did not emerge during this debate —it lent a slightly artifical flavour to some comments—is that it was clear from the Stanley Royd inquiry that the primary failure was that of hospital management to manage well. Whether we have Crown immunity or no Crown immunity, Crown notice systems or local environmental health officers crawling all over the place, if management is not equipped to manage hospitals properly, whether in respect of catering or cleaning, things will go wrong.
One thing that I hope will unite all hon. Members is the need—we all expect that these proposals will create a little pressure — for good quality management of the provision of these services and the application of proper standards, whatever the law may be. We are seeking to achieve that by a variety of means.
§ Mr. Ashley
Although the Minister said that he could not commit himself to further legislation, may we take it that he would be favourably disposed to extending the abolition of Crown immunity?
§ Mr. Newton
The right hon. Gentleman and I have known each other long enough to know the terms in which we conduct these exchanges. I will not attempt further to interpret for him the demeanour I have sought to show at the Dispatch Box. I shall leave him to draw his own conclusions from the way in which I have approached the subject.
§ Mr. Pavitt
The Minister, when responding to a comment I made, said that the mechanisms should be applied. That is not the point I made. My point was that the present mechanisms are inadequate. I asked him to revise the mechanisms in the light of the new situation that has developed in the past three years. I asked the Minister to look at the mechanisms and at the gap between present monitoring in certain areas in the ward and possible monitoring to ensure that the mechanisms are effective.
§ Mr. Newton
Essentially, the hon. Gentleman described in different terms what I meant by management. It is a responsibility of management to ensure that proper standards, and in particular those standards required by legislation, are applied. That process sometimes involves monitoring—it can involve various processes—but it is certainly a responsibility and function of management. If management is not operating well, we shall not achieve the objective. I do not think there is anything between the hon. Gentleman and myself on this point.
I regret that my hon. Friend the Member for Stafford was not present when the debate started and that my hon. Friend the Member for Aldridge-Brownhills (Mr. Shepherd) was not able to be here either. Now that they are present, I am able to pay tribute to the part they played in this argument over many months. I express my gratitude to them and to other hon. Members on both sides of the House for the way in which they have welcomed the 991 proposals in their different ways, even if they have not entirely congratulated the Government on the proposals that we hope will shortly become law.
Question put and agreed to. [Special Entry.]