J. E. Hanger and Co. Ltd.

HC Deb 26 November 1986 vol 106 cc323-66

Mr. Deputy Speaker (Sir Paul Dean)

We now come to the second motion in the name of the Leader of the Opposition. Mr. Speaker has selected the amendment in the name of the Prime Minister.

7.13 pm

Mr. Frank Dobson (Holborn and St. Pancras)

I beg to move, That this House regrets the interruption of service to severely disabled people caused by the dispute at J. E. Hanger Ltd.; deplores the failure of Her Majesty's Government to end the crude intimidatory tactics of the owners of the company who have sacked 300 of their workforce; and calls upon Her Majesty's Government to resolve the current crisis and secure long-term improvement in the standards of the artificial limb service. This debate is about how a multimillion pound, multinational company is causing harm to severely disabled people in the hope of achieving a short-term advantage over some of its skilled, hard-working staff for the sake of private profit. For some years now there has been dissatisfaction with the service provided by the artificial limb service and concern about value for money. That was brought to a head by the findings and recommendations of the McColl report, but that cannot excuse the behaviour of BTR Industries, the owners of J. E. Hanger.

Amputees to whom I have talked do not complain much about the skill of the staff, or even about the standard of limbs or the skill of the fitters; they complain about the way in which the whole operation is organised and the way the service has declined since BTR took over. In other words, they complain about the owners and the managers. Typical of much of British industry today, those owners have not accepted their responsibility. Instead they have tried to visit the consequences of their failures on their work force and the limbless people whom the work force tries to serve.

It is typical of the Government to respond as they have done by saying, "This is not our responsibility. This is not our dispute. We leave it to managers to manage." That pursuit of blind Thatcherite ideology is bad enough, but it does not end there. It is wholly irresponsible and shiftless of Ministers to suggest that the Government have no responsibility to provide National Health Service patients with the service to which they are entitled. That remains a responsibility of the Government, whoever supplies the artificial limbs and does the fitting.

Mr. Toby Jessel (Twickenham)

Surely the Government had the Advisory, Conciliation and Arbitration Service put in to resolve the dispute, which is exactly what ACAS is for. Therefore, it is false to suggest that the Government have neither intervened, nor involved themselves, and are not taking any interest in the matter.

Mr. Dobson

The staff of J. E. Hanger have wanted the dispute resolved from the minute it started. They have been suggesting that if an outside body needed to be involved, ACAS was the one. Despite everything, it took seven weeks for the owners of the company even to agree to go to ACAS. Those talks have made no progress whatever.

The matter does not stop there. The Government's assertions about their position are legally unsound—not that there is anything unusual about that. The contract for supplying and fitting limbs is not between the company and those who need limbs, but between the company and the Government. The failure to provide a proper service is in breach of that contract, yet still the Government refuse to take resolute action to end the dispute which has been going on now for 10 weeks and one day.

The Hanger factory normally produces about 100 new or adjusted limbs every day, so the output lost by the dispute could, in theory, be over 5,000 limbs. The Labour party does not claim that the dispute has harmed that many people; we simply do not know. I suspect that Ministers do not know either. However, we know of individual cases.

A month ago I had to raise in the House the case of Mr. Rod Dixon, a constituent who was driven to attempt suicide by the pain from his ill-fitting limb which could not be properly fitted. Since then I have had contact with others, including Mr. John Baller who has appeared on radio and television during the past few days. Both his artificial limbs were broken. One is irreparable and the fitter cannibalised the two limbs to provide one adequate limb.

The Minister for Social Security (Mr. John Major)

If the hon. Gentleman has been besieged with those cases, why has he not taken advantage of the offer I made to him and others when I responded to his private notice question and referred the cases to me so that we could give them the priority action that we undoubtedly would? Why not?

Mr. Dobson

I have referred to the Minister the cases that I have received from my own constituency in writing. I am now talking about those I have been in touch with within the last day in preparation for the debate. If he and his officials will sit and listen and take note, no doubt they will be able to do something for those people because they have not done anything up to now.

Mr. Baller needed to have one leg produced from the two he already possessed. That is unsatisfactory. He works for a living, and if that leg conks out he no longer has a spare. If the Minister is so quick to get to the Dispatch Box, he should undertake to ensure that Mr. Baller gets his spare leg tomorrow, or as soon as it is humanly possible to provide it. Otherwise, he is at risk.

There are other cases. I have spoken again today to a Mr. Hughes who told me that last time he went to the factory one of the people who was waiting was having a storming row with a fitter. He felt that it was unfair to the fitter because it was not his fault that he could not provide the connection to the artificial foot for that other person. The fitter was incapable of supplying that part of the artificial limb because of the fault of the management. I shall not go on because I know that some of my hon. Friends wish to raise other cases.

Even a month ago, when we raised this matter on the first day after the summer recess, the Minister apparently proudly told us that only about 50 appointments had not been fulfilled. That is all very well for a Minister, a civil servant or the chairman of BTR Industries, who gets about £200,000 a year, but it is not so smart for those 50 or so people who have not had an appointment. It is from that point of view that we have to look at this matter.

It would be fair to try briefly to describe how the dispute came about. In July the company agreed to discuss all changes in timings and work rates with the staff. It also agreed to a procedure that would be followed in the event of failure to agree. Discussions went ahead, but in mid-September the company unilaterally ended discussions and announced the retrospective imposition of new timings and threatened disciplinary action against people who failed to meet the new timings, even though they had not known they existed and they were not in existence at the outset.

The joint shop stewards tried to activate the procedure which it had been agreed in July should operate in the event of a failure to agree. That was rejected by the company, and about 30 staff were threatened with disciplinary action. The stewards asked to be allowed to hold a committee meeting. That was refused. They asked to be allowed to hold a meeting of the full shop. That was refused. They therefore held a mass meeting off-site after 4 o'clock on a Friday. Despite it being 4 o'clock on a Friday, it was a well attended meeting. From the body of the meeting there were suggestions that the staff should impose an immediate overtime ban. The Committee, behaving responsibly, as elected representatives of working people nearly always try to do, persuaded the meeting not to impose an overtime ban because it believed that the agreement that had been reached with the company should be adhered to. In the event, that mass meeting decided to recommend that staff should not work on the immediately following Saturday morning, but that staff should make up their own minds. Six staff agreed to be at the gate to inform—I emphasise "inform"—anyone who was not at the meeting. I shall read the notice that was prepared to he handed out to anyone who turned up in case anybody here should suggest that there was intimidation. The notice stated: An emergency meeting took place of the joint shops at 4 pm yesterday to bring all members up to date re standards of performance and verbal warnings. A ban on overtime was called for (and rejected) after the chairman said we should stay fully in procedure to try to allow full time officials to resolve the situation on Monday. It was agreed by all, each individual member should decide for themselves if they wished to accept any agreed hours over 39 hours agreed between the company and the unions. The chairman stressed that no action would he taken against any member working outside the 39 hours. As agreed at previous joint shop meetings. all members should have the opportunity to have full information to decide for themselves. There was no intimidation and there were no threats. It was emphasised at the mass meeting and outside the gate the following day that if people, exercising their own judgment, decided to go in, it was up to them. In the event, only three people turned up for work. Two turned back, one of them joining the people on the gate because he so strongly supported them, and one person went in. On Monday, four of the six who had been on the gate were sacked. They were sacked for coercing employees not to work overtime. I urge the House to remember those words. Threats were even made to sue them for loss of production.

District union officials met the company, which refused to withdraw the dismissals but agreed to suspend them and hear appeals at 2 o'clock on Tuesday. A mass meeting agreed, with only two votes against, that if the four were sacked all members of the work force would withdraw their labour. The appeals were duly rejected by the managing director who had been party to the dismissals, breaching the rules of natural justice—not that they mean anything to a multinational company on the make. Having looked through the other companies that BTR owns, those rules would certainly not apply to a multinational company which owns another subsidiary called the Frankenstein Group Ltd. At about 3.20 pm all the staff concerned went home. Within one and a half hours notices of dismissal were issued, which even included employees who were off sick or on holiday.

On the Thursday a secret ballot endorsed a campaign to obtain reinstatement for all concerned by 234 votes to 17. Thus, 300 skilled and hard working staff who had followed agreed procedures and who were provoked beyond endurance were sacked and the people they wished to serve were put in difficulties.

The company has subsequently made offers to take back 70 staff and give the statutory minimum redundancy terms to most of the rest. It says that it does not need such a large work force. How strange. The dispute started because the company accused four staff of coercing others not to work overtime. The company cannot have it both ways. It said that it needed a work force of 300 who needed to work overtime, and then a week or two later it said it had no need for over 200 of them to work at all. It is absurd.

It is no good the Government trying to wriggle out of responsibility, because the industrial boot-boy tactics deployed at J. E. Hanger, no doubt learnt from BTR's activities in its South African subsidiaries, arc precisely the sort of approach that the Government have encouraged. That must be what the Prime Minister means when she talks about the management's right to manage. People should remember that that is what she means.

That sort of behaviour raises major questions about the future. The artificial limb service needs to be improved. My right hon. Friend the Member for Manchester, Wythenshawe (Mr. Morris), with his wealth of experience and concern, will deal with that when he winds up the debate. Fundamental questions include: should profit-seeking companies be involved in limb fitting at all? Is it right for a multinational monopolist to be the overwhelming source of supply for a service vital for severely handicapped people? Are the current owners and managers fit to be responsible for such a service? Why have Ministers sat on their hands during this dispute, pursuing a policy of non-intervention, which is designed to help the management of J. E. Hanger?

In view of what has happened at Wapping, and in other industrial disputes, why did the Metropolitan police take no action when one of the management assaulted the wife of one of the people who is out of work and damaged the camera of a press photographer? Why have Ministers not used the Government's legal powers as party to the contract? As shown by the fact that the the Press Gallery is nearly empty, why have the British press been so silent about this dispute? When staff at J. E. Hanger were on strike 17 years ago, the press harassed and harried them up hill and down dale, outside the factory and to their homes. There was no stinking smear that the British press did not put on these workers. Why is the same attitude not taken to the odious toads who own this company?

Some of these are longer-term matters to which the forthcoming Labour Government will swiftly give their attention. In the meantime, the Government should remember that severely disabled people who need the products of J. E. Hanger's factories are not getting them. They should act now to end the dispute. The trouble is that DHSS Ministers are a cheap and nasty combination of craven and complacent. They are just not up to the task. They would rather that patients suffered and workers and their families went without than risk offending the sort of acquisitive multinational company on which the Prime Minister dotes.

7.31 pm

The Minister for Social Security (Mr. John Major)

I beg to move, to leave out from "House" to the end of the Question and to add instead thereof: regrets the interruption of service to severely disabled people caused by the dispute at J. E. Hanger & Co. Ltd.; urges the management and workforce to resolve this dispute without delay; notes with approval the Government's initiatives to minimise inconvenience to patients; and congratulates the Government on the action it is taking to secure long term improvements in the standards of artificial limb services". The House has been treated, if that is the correct word, to a speech that was partisan, contemptuous, mischievous, contentious, and ill-informed and one that will do nothing to bring a resolution to this dispute. That was not the purpose of the hon. Member for Holborn and St. Pancras (Mr. Dobson).

Mr. Frank Cook (Stockton, North)

The Minister is not interested in resolving the dispute.

Mr. Major

That is exactly the point. The hon. Member for Holborn and St. Pancras is not interested in the resolution of the dispute. He is interested in causing the maximum amount of difficulty that he can in these circumstances. His was nothing more nor less than a picket line speech, clearly learnt when he has visited a picket line, and not with the intention of resolving the dispute.

Mr. Dobson

rose——

Mr. Major

I shall give way to the hon. Gentleman in a minute. He has already made sufficient blunders, but I shall give him every opportunity to make more. While the hon. Member for Stockton, North (Mr. Cook) sits jabbering at the back like a monkey on a pole, he will not get an answer to the questions that were asked. Should he care to listen, he might do so.

The hon. Member for Holborn and St. Pancras spoke of a number of cases, some of which he clearly looked for in the past 24 hours to use in the debate. I look forward to getting the details of those cases as swiftly as possible—tomorrow morning I hope. We shall see whether he is as swift in giving me the information as we shall be in putting it to good use.

Mr. Dennis Skinner (Bolsover)

The Minister will not do anything with the information when he gets it.

Mr. Major

It is nice to know that the hon. Member for Bolsover (Mr. Skinner) is with us this evening. I hope that he will make a sensible contribution rather than utter his usual nonsense from a seated position.

The hon. Member for Holborn and St. Pancras referred to his constituent, Mr. Rod Dixon. He did not mention—perhaps it has slipped his mind—that Mr. Dixon has been seen at Roehampton and is happy with the adjustments that have been made to his limb. I am sensitive about the cases of those who have been inconvenienced by the dispute. The hon. Gentleman mentioned Mr. Baller but not that the case had been picked up some time ago and is already substantially in hand. I am pleased to say that Mr. Baller will shortly have his limb. We have taken a series of material measures to ensure that we give priority to people facing such difficulties.

Mr. Dobson

As I have been pressing for a resolution of this dispute for a long time, when will I have a reply to the letter which I sent to the Secretary of State on 8 October?

Mr. Major

The hon. Gentleman says that he has been pressing for a resolution to the dispute. He has a curious way of doing so when he addresses the House as though it were a picket line. I shall examine where the hon. Gentleman's letter is tomorrow morning, and we shall see what the position is.

Mr. Skinner

Tomorrow morning?

Mr. Major

I see that the hon. Member for Bolsover is making his usual intellectual contribution to our proceedings. It would be agreeable to see the hon. Gentleman, sitting there in his hacking jacket as if he were about to go shooting with the Duke of Devonshire, make a proper contribution to the debate.

If the hon. Member for Holborn and St. Pancras had been interested in a resolution of the dispute, he might have taken the example of other hon. Members, in particular my hon. Friend the Member for Putney (Mr. Mellor), the Minister of State, Home Office, who has been in daily contact with both me and others to ensure not only that we get the best possible patient care, but that there is a solution. It might be helpful if the hon. Member were to take such a helpful attitude.

Mr. Martin Flannery (Sheffield, Hillsborough)

Get on with it.

Mr. Major

If the hon. Gentleman would listen, I would be able to get on with it, and perhaps the hon. Gentleman could encourage his hon. Friends to listen so that we could make a little more progress.

Before I respond to some of the specific concerns raised by the hon. Member for Holborn and St. Pancras, and the wider issues that follow from them, I shall set out the nature of the dispute and the Government's views on it. Despite the hon. Gentleman's mischievous remarks, this is an industrial dispute between a management and one part of its work force. As such it must be settled between them. It is not a dispute between the Government and management of J. E. Hanger, or the Government and the work force at J. E. Hanger, and I regret that the hon. Member for Holborn and St. Pancras does not seem to have understood that. I emphasise that the Government are not a direct party to the dispute.

However, neither are the Government uninterested in the dispute, for our interest is in patient care, while the dispute continues and beyond. It is for that reason that I urged the two sides to refer the matter to ACAS when I replied to the hon. Gentleman's private notice question on 27 October. I was pleased that they speedily did so after that exchange. Discussions took place at ACAS on 7 November, 18 November and again yesterday. Contrary to what the hon. Gentleman said, I understand that some progress was made yesterday, and as a result a further meeting will be held next Wednesday. I hope that between now and then no one, notwithstanding the poor example set by the hon. Gentleman, will imperil those talks, and that they will be successful next Wednesday.

So that there is no doubt whatever about the Government's position, I make it clear that I urge both the company and the trade unions—I draw no distinction between them—to continue to meet and talk until they get a settlement. I have no doubt that both the company and the work force have an obligation to resolve the dispute without delay.

As the House knows, the Government have been pressed to intervene by the Opposition and the motion effectively endorses that decision. I have considered that option seriously but rejected it. I do not propose to intervene directly, because such action might become counterproductive. In any event, ACAS exists for such assistance, and is now being actively used, with a fourth meeting taking place next week. I am sorry that the hon. Gentleman appears to have so little faith in it.

Mr. Lewis Carter-Jones (Eccles)

Does the Minister really think that the dispute started as recently as this? Might this have something to do with the possible loss of the company's monopoly position for providing lower limb prostheses?

Mr. Major

The hon. Gentleman touches on matters that are directly germane to the McColl report, to which I shall refer later. I did not say that the dispute started on the date that I mentioned. I said that on that date I urged both parties to go to ACAS, and that soon afterwards they did so.

Although I do not propose to intervene in the dispute, I do propose to take sides, and I propose to take the patients side. It is a pity that the hon. Member for Holborn and St. Pancras has not taken such a practical step. The patients are my primary concern and they will remain so. Until the dispute is settled my concern is to minimise its effects on patient care. I do not underestimate for a second the effect in human terms of a delay or inconvenience caused as a result of the dispute to any individual who depends on the artificial limb service. It must be deeply distressing for the patients and nobody could, or would, deny that.

It is important to keep the general position in perspective. At present, the service has about 62,000 patients, of whom 53,000 are lower limb patients. Each week, across the country, there are between 2,500 and 3,000 patient appointments for measuring for limbs, for fitting, repair or for some other service. The House will know that most patients have their limbs prescribed for them, manufactured and fitted in workshops in the regional limb centres. Patients from those centres are generally unaffected.

The main effect of the dispute is being felt by patients at the Roehampton centre. Because of our concern at the delay created by the dispute, we have examined all the files for the 3,000 Hanger patients at that centre, and have found there are just 300 or so, who appear—I stress the word "appear" because inquiries have not yet been completed—to have been affected in some way by the dispute.

We are giving priority to the cases of greatest need to children, to primary amputees, and to anyone who is immobilised because he has perhaps just one leg that requires repair or replacement. Special arrangements have already been made, or are being made, for 116 such priority cases. Any further priority cases will be given similar urgent treatment.

The House may wish to know that this morning I met Dr. Hiddleston, the managing director of J. E. Hanger and Co. Ltd., to confirm that the company is taking all possible steps to maintain its services to our patients. I sought from the company, and was given by the company, an assurance that priority action is being, and will continue to be, taken in urgent cases. I have subsequently instructed my officials to keep in the closest possible contact with the company to monitor the process and progress of such cases.

I am also concerned that, with 62,000 amputees to care for, one cannot be certain that some are affected of whom we are not aware at present. Therefore, I wish to take the opportunity to say yet again that I hope that any patients in difficulty will not hesitate to contact their local limb centre in the usual way, so that, if necessary, we can bring our emergency arrangements into play and make arrangements to deal with their needs as soon as possible.

I repeat to the House generally the offer that I made to the hon. Member for Holborn and St. Pancras. If any hon. Members have specific instances of such difficulties, I hope that they will inform me without delay so that we can deal with them. I do not wish any patient to he inconvenienced if we are able to assist.

The dispute is clearly causing difficulties, which is why we wish it to be concluded as soon as possible. However, we should not lose sight of the improvements currently being made in the limb service following the publication of Professor McColl's report earlier this year.

Mr. Skinner

The Minister has just said that he met one of the doctors from the firm this morning, presumably to get some information relevant to the debate. Am I right—although the Minister has not yet mentioned this—that, in view of all the suffering, he called upon Dr. Hiddleston to allow people to get back to work? We have not yet heard whether the Minister made that request. Perhaps he will let us know at the end of the debate. We want an assurance that the Government, who came to power just after the so-called winter of discontent, said this morning to that company director, "Will you take back these people?" Could we have that assurance?

Mr. Major

The hon. Member for Bolsover is asking me to take sides in the dispute, and that is precisely what I have told the House I am not prepared to do however hard he may press me. I told the managing director of Hanger's that I expected the company to continue negotiations at ACAS, that I wanted to see a settlement as soon as possible and that I wanted priority action to deal with any urgent cases to minimise patients' inconvenience. Surely there is no doubt in anybody's mind that that is the Government's position [Interruption.] I am not on anybody's side.

I referred a moment ago to Professor McColl's report published earlier this year. It is clearly an exceedingly important report, to which the attention of the House has been drawn. We have still to reach conclusions on many of the major matters raised by the report. I hope to do so shortly and to advise the House of that as soon as possible. However, many operational and management changes have already been made in advance of the structural decisions on the McColl report and they are proving worthwhile.

The motion before the House calls upon the Government to secure long-term improvements in the limb service and I assure the House that we are as committed to that as is any hon. Member. The hon. Member for Holborn and St. Pancras can agree on that. Much has already been done. In particular, we have implemented a number of significant management changes to improve the limb service prior to the structural changes of ownership, and the related matters remaining. We have established a disablement services division, with its own general manager, a new director of operations, and a new director of procurement from the NHS, and a coherent line structure.

We are already using computers to improve patient and limb order information and for stock control purposes and have commissioned Coopers and Lybrand to undertake a consultancy study to identify the scope for further improvements. As a result of this, we have placed a contract with McDonald Douglas for the purchase of microcomputers for each artificial limb centre to hold patient details and up-to-date local information on delivery times. We hope that this will be operational in January and will enable us to identify and eliminate delays more effectively.

We are also taking urgent action to improve transport arrangements for patients and are testing initiatives—some in collaboration with local ambulance services—at various limb centres with a view to general implementation. I am also considering the possibility of a specific budget for limb centre transport to enable local solutions to resolve local problems.

I emphasise the changes—some of which are proving helpful during the dispute—to emphasise the high importance that I give to improving the service that we can offer to patients, even before we have reached conclusions on the structural changes recommended by Professor McColl.

Other changes are in hand. We are developing new strengthened management arrangements for each artificial limb and appliance centre, with a view to devolving more responsibility and discretion on local management to provide a good service at local level to patients. The emphasis must be on the delivery of service to patients, rather than on the central bureaucracy.

Mr. Michael McGuire (Makerfield)

The Minister has listed the improvements towards which his Department is working, and mentioned that other improvements are in the pipeline, or being talked about. Are the Government prepared to give a cash allowance for double leg amputees who may have to pay for the adaptation of the cars with which they are supplied under Motability? Adapting car controls for double leg amputees is costly. Is that one of the changes that the Minister has in mind?

Mr. Major

I was referring to the structural changes that are taking place in advance of McColl. The hon. Member for Makerfield (Mr. McGuire) is discussing an important matter, but it is a social security change which is important to the patients, but unrelated to the McColl report. Therefore, it is not part of the changes that we are considering.

We have also set clear objectives for the contract arrangements between the Department and all the artificial limb manufacturers. Last April, we put foward proposals for new contractual arrangements to the industry. Those proposals took account of the recommendations of the McColl working party, and of the concerns which the companies have expressed about the arrangements. They were based on separate contracts for the manufacture and fitting of artificial legs. The proposals are intended to lead to greater decentralisation—where desirable—and to a quicker and more flexible service to patients. They will make it possible to introduce competition into the business, either in the manufacture or fitting of artificial legs, and thus ensure that we give value for the taxpayers' money that is spent on those services.

There have been extensive discussions with the industry since we put forward the proposals. I have been deeply disappointed that its initial reaction was not more constructive and that it has not yet been possible to reach agreement on the way forward. But I have no doubt that the objectives that we have set are right and that they provide a sound basis for improving the service in the future and we shall pursue them. [Interuption.] Let me interrupt the no doubt exceedingly interesting conversation that the hon. Member for Holborn and St. Pancras is having because I am delighted to be able to tell him that a reply to his letter of 8 October was dispatched on 30 October and is no doubt somewhere in his files.

One aspect of the new contract proposals will be to enhance the role and status of prosthetists who fit artificial limbs. That is clearly important—I am glad that I carry the hon. Gentleman with me on that—because many of the difficulties experienced by patients arise from the difficulty of getting the artificial limb to fit correctly. For that reason, we have initiated discussions about the future training of prosthetists and are considering jointly with the Prosthetics Training and Education Council and the artificial limb industry how we might develop a centre for prosthetic training in England which has some of the good features apparent at the Scottish national centre at Strathclyde.

One consequence of our contract proposals should be to improve delivery times for artificial limbs, but we are also taking immediate action on that. Discussions with the industry have led to agreement to start a pilot project at Nottingham centre to test a system where delivery times and patient appointments are fixed flexibly in relation to the individual patient's needs. I hope and expect that that project will start in January and that it will lead to major improvements.

Another area where I see room for improvement lies in the range of artificial limbs available from the service. That range is already considerable and many of the systems developed in Britain are world leaders, such as the Endolite and Ultra-Roelite modern modular limb systems and Steeper's remarkable powered arm equipment. However, we remain anxious to improve the range of limbs available to patients and so have decided to introduce a lightweight plastic version of the patella tendon bearing conventional limb which is already available in Scotland, and was proposed in the McColl report. We are also testing the range of lightweight modular limbs manufactured by Otto Bock to establish whether they offer a useful addition to the range of limbs available to our patients.

A few days ago I took the opportunity to visit one of our regional limb centres to meet and talk to the staff and patients and to see at first hand the work that is being done there. Much of it is excellent and I came away impressed by the dedication and concern of the staff. It was clear at that limb centre, as I believe it is at others, that the distressing dispute at Roehampton has not generally affected the work done elsewhere, and that is entirely welcome. I hope that that remains the case in the future and that a satisfactory settlement at Roehampton can speedily be achieved.

I have no doubt that the dispute at Roehampton is causing distress, although thus far we have been able to minimise that. I hope that soon we shall have a settlement and will be able to eliminate the distress. But while it continues our central and prime objective will be to protect patient care.

It was precisely for that reason that I asked, as the House well knows, for daily reports on the situation at Roehampton and throughout the limb centre. It is precisely for that reason that I saw the management of J. E. Hanger this morning and, if necessary, I shall see them again if matters deteriorate. It was for that reason that we established the special arrangements that I have set out to deal with difficult cases and it is for that reason that I once again urge the company and the unions to reach a swift settlement. Nothing less will be acceptable. We wish to see a swift settlement. I hope that the two competing sides in the dispute want a swift settlement. Above all, the patients need a swift settlement. The two sides to the dispute have an obligation to meet and to talk until they have reached that settlement.

7.53 pm

Mr. Jack Ashley (Stoke-on-Trent, South)

The Minister has just accused my hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) of being interested in causing the maximum difficulty. That is an absurd charge, because my hon. Friend made a constructive speech. The Minister is rather confused. He told the House that this is a matter primarily for the trade unions and management concerned and that the Government have no real role in it, yet he spent half his speech boasting about what the Government have done. He cannot have it both ways. He cannot try to shrug off responsibility on to workers and management, and at the same time boast about the Government's accomplishments in the dispute.

This is a deplorable dispute. It is one of the saddest disputes that I have ever known, not only because of the intransigence of the mangement, but because of its terrible impact on disabled people. It is clear that the pressures resulting from the McColl report are having their effect on the firm. This report has played a major role, if not in causing the dispute, at least in sparking it off.

I hope that the management is listening when I say that sacking workers for going on strike is outrageous. It is becoming a common managerial tactic, and it will rebound on management. There is one lesson that all managements should learn, and this management in particular. It is that sacking a work force and agreeing only to reinstate a proportion of them before negotiations take place is a recipe for prolonged industrial misery. It simply will not work. Apart from the selective unfairness of that tactic, there is a basic trade union principle of no victimisation. That is something that management must never forget. When that tactic is tried, there is always the suspicion, to put it no higher, that active trade unionists will be victimised and excluded. I had personal experience of that when, years ago, I participated in strikes and the workers always stood together. The management in this case is making a grave error of judgment and the sooner it changes its tactics, the better for all concerned. That is one way forward.

The Minister was putting forward a naive and misleading argument when he said that this was a matter for the workers and management alone. That is not the case, because the firm's major customer is the Government. Obviously, the Government have a major role. They are not only considering the McColl report, as the Minister has readily acknowledged, but are taking steps, which he has just adumbrated in the Chamber, to do something about the situation. Therefore the Government have a prime responsibility. Terms of contract are being changed and they directly affect the firm, and many more changes, as the Minister has just said, are in the pipeline.

I hope that when the Under-Secretary of State replies to the debate he will answer a few questions. First, what sort of pressure is the new general manager putting on J. E. Hanger and Co. Ltd.? Secondly, what is the Health Service management board's role in the dispute? Thirdly, why are Hanger and Vassa suing the Government?

There is a rather murky whirlpool behind the bland statement by Ministers and others that this is just another industrial dispute,. This is a Government-related dispute, and the Government cannot shuffle off their responsibility. The House has a right to know what sort of pressures are being exerted by whom, and on behalf of whom, and whether by the Government and on behalf of the Government.

I want to make it clear that I do not object to the Government intervening. It is important that they should intervene in the system for providing artificial limbs. However, I am worried about the purpose of the intervention. If its purpose is to reduce the profit margins of this firm or to increase its efficiency, that is fine. The case for that is indisputable, and we have to thank Professor McColl for it. He has revealed excess profits and the need for increased efficiency. However, if the purpose of the intervention is to cut Government resources and to lower the standards of this vital service for disabled people, it will be bitterly opposed.

This industry has rendered a great service to disabled people. I echo Professor McColl's tribute to the dedication of the staff involved. They have been marvellous. Also, I pay tribute to Professor McColl for highlighting some of the weaknesses and for offering suggestions for change.

Let me describe to the House what I have done. I read the McColl report in detail, and the all-party disablement group discussed it with Professor McColl. We were very impressed by the report. Therefore, I tabled an early-day motion calling for the immediate implementation of the McColl report. It received wide support in the House. However, after visiting Roehampton, at the invitation of the trade unionists there, to meet them and the management, I suggested to the Secretary of State on 30 July that he should delay taking action on the report until the views of the trade unionists and the management and any other interested parties had been discussed and perhaps debated. Four months have passed, and we are now having this parliamentary debate. It is time to end the uncertainty that is unsettling the industry. The case for change has been made and generally accepted. Everybody knows that change is coming, so let it come quickly.

The motive for change is crucial. It must he solely to provide a better and a more efficient service. There must be efficiency, but not cuts masquerading as economy. Improvements must be made in the transport system. I am glad that the Minister for Social Security said that he was attempting to improve it. Improvements must also be made in the appointments system, which is a shambles. People have told me that after waiting all day they have been sent away without satisfaction. We cannot tolerate that for seriously disabled people. The system of delivering limbs is also bad. That too must be improved. Many of the weaknesses have been revealed by Professor McColl.

There is one other problem that extends beyond the confines of this particular debate. Surgeons involved in amputations must take account of the problem for those who are to have limbs fitted. I have been told that some surgery is not attuned to the requirements of a comfortable fit for prosthesis. It is claimed that in as many as 37 per cent. of cases the amputation precludes the fitting of a comfortable limb.

The background of all these changes must be recognition of the fact that artificial limb provision is a bespoke service. The patient must have adequate choice. Specialised provision and individual fittings are vital. We will not accept, under any circumstances, a few standard National Health Service limbs, with the best ones available only for private patients.

It has been demonstrated that it is unsatisfactory to provide only standard hearing aids instead of individual hearing aids. We are also moving rapidly towards a deplorable private sector provision for spectacles. We cannot have private provision for artificial limbs. They are too important to be standard products that are not tailored to the needs of the individual disabled person.

One vital change that would also help is a change in management. At present, civil servants are supposedly in control. I am not blaming civil servants. I am just stating a fact when I say that they have not been in control. In the interim period, we have a Government general manager whose role is far from clear. The question is whether control should be exercised by civil servants or by a management board. Other more wide-ranging alternatives have been suggested by my hon. Friend the Member for Holborn and St. Pancras. I know that the trade unions are not in favour of a management board, but I should prefer a management board in the short term to feeble control by civil servants. In the longer term we must re-jig the whole system and make sure that never again will there be a monopoly by one firm or by a few firms in the provision of limbs for severely handicapped people. That must be done. Then we must move forward and ensure that disabled people have the finest possible artificial limbs. That is their right.

8.6 pm

Mr. Peter Temple-Morris (Leominster)

It is a pleasure to follow the right hon. Member for Stoke-on-Trent, South (Mr. Ashley). He made a number of interesting points. I shall refer to some of them during my speech. He asked various questions that were directed at the Government Front Bench to which he wants answers. He will get them from my hon. and learned Friend the Parliamentary Under-Secretary of State for Health and Social Security.

First, let me explain my presence here. As most hon. Members know, when I address the House I usually inhabit the more tranquil area of foreign affairs. I come to this debate from the rural fastness of Leominster because I have an interest to declare. I am the salaried parliamentary adviser to Intermed and therefore to J. E. Hanger and Co. Ltd. [Interruption.]. I thought that that would result in a reaction from the Opposition. At least those on the Liberal Bench only smile and do not exclaim. I was appointed last April, though not to be an advocate in this dispute. I was appointed in succession to various hon. Members who had held the appointment before me. Because of the sheer volume of dealings that Intermed and J. E. Hanger and Co. have with Government, Parliament and the Department of Health and Social Security, it is right and proper that they should have an adviser. It is also important that in this debate their case should be stated.

Mr. Skinner

What does the hon. Gentleman get?

Mr. Temple-Morris

I am being paid £5,000 per annum. I am in no way embarrassed by the hon. Gentleman's question. If he asks similar questions, I shall reply to them. If he intends to continue to interrupt me, I hope his interventions will be less personal than his first. But he will get his answers. The atmosphere that he endeavours to create in this kind of debate does not help us to reach a settlement.

I appreciate that I have to be partisan in this debate, but I intend to state in as fair and dispassionate a way as I possibly can the case for Hanger and to suggest a sensible way forward in trying to reach a practical solution. When patients are involved, the last thing that I want to do is to turn this into a hack party dispute.

As for the basic situation, a bitter industrial dispute exists. I do not intend to go into the rights and wrongs on both sides of the dispute. The hon. Member for Holborn and St. Pancras (Mr. Dobson) referred, quite rightly from his point of view, to the rights and wrongs of the dispute from the trade union point of view. I could provide a great catalogue from the other side. I could refer to the difficulties over co-operation. I could also refer to the efforts over two years to modernise, to the lack of co-operation, to demarcation disputes, even to arguments over the air conditioning system. However, I do not intend to do so.

There have been a large number of dismissals because of the dispute. I hope that all hon. Members agree that the dispute must be solved in the interests not only of the workers—I put them right at the beginning—but of management and, above all, of the patients. We all have a duty to help.

I am delighted to see in his place my hon. Friend the Member for Putney (Mr. Mellor), the Minister of State. For once in his political life, because of his distinguished ministerial role, he is rendered speechless in this debate, although as the hon. Member for Putney he is probably more anxious about the situation than any other hon. Member. I can say with authority that he has been in constant contact on behalf of all his constituents with the management and work force at Hangers. Officially, the work force is not permitted to come and see my hon. Friend, but I am delighted to know that he maintains contact with that work force and that he has its interests at heart.

Since the start of the dispute my hon. Friend has been in contact with Hangers several times a week trying to get a solution. It is sad that he cannot speak as an hon. Member in the debate and I would certainly not pretend to make a speech for him. If he could speak as an hon. Member he would probably deal even more vigorously than I can with a somewhat odd publication which I gather has been leafleted around his constituency today. It is a salubrious journal called the West Putney News. Apparently, it comes from an organisation called the Putney Labour party. This misleading publication says: While Putney MP David Mellor supported the sackings, Peter Hain and local Labour councillors demanded their reinstatement, and pressured both management and the Government to end the conflict and settle the dispute. I hope that my hon. Friend will forgive me for saying that I think I have his agreement when I say that that is absolute and utter rubbish. It is an example of party political means being used in an effort to take advantage of a problem which we should all be trying to solve. There is no question of my hon. Friend supporting any sackings.

Mr. Alfred Dubs (Battersea)

rose——

Mr. Temple-Morris

I shall give way in a moment.

My hon. Friend has made his position clear in the constituency. Obviously, he wants a practical settlement and the best possible offer, in employment or in financial terms, for the work force and for his constituents.

Mr. Dubs

The hon. Gentleman is assiduous in defending the hon. Member for Putney (Mr. Mellor). We understand why the hon. Member for Putney cannot speak for himself, but will the hon. Member for Leominster (Mr. Temple-Morris) comment on an extract from the Wandsworth Borough News of 21 November. It says: Meanwhile Putney MP David Mellor has urged the sacked workers to adopt a 'more flexible' negotiating position. Is that a fair quote, and what does it mean?

Mr. Temple-Morris

I cannot carry on a vicarious dialogue for somebody else. If my hon. Friend the Member for Putney said that, he was quite right because we need more flexibility on both sides. In ACAS at the moment—[Interruption.] The hon. Member for Liverpool, Broadgreen (Mr. Fields) hisses. I should have thought he would want flexibility in seeking a solution. I am delighted to say that, whatever he may think, and whatever the hon. Member for Battersea (Mr. Dubs) may think, both sides are beginning to show flexibility. It is not for us to go into the details of negotiation before ACAS, but there seems to be some flexibility, and that is the best way towards a solution.

I shall try to state fairly the main elements of the practical situation. It has hardly been mentioned, let alone stressed, that overall we have a most important classic situation which has, sadly, been repeated in other parts of British industry—new technology and its effect on traditional labour practices. A traditional and distinguished craft has been practised for many years by a distinguished and highly skilled work force, but now, sadly, the role of that work force is diminishing, although it will not end.

Some three quarters of current demand is for new modular limbs and not for the old type of traditional and conventional limbs. I am not an expert in this field, but I know that machines and computers are required to make those limbs and their manufacture does not require as many craftsmen as the old type. Therefore, there are fewer jobs.

Mr. Carter-Jones

It was said in an intervention that at one moment people were sacked for not working overtime and the next moment they were sacked because the company did not want as large a work force. That seems to be a contradiction in terms. The hon. Member for Leominster (Mr. Temple-Morris) would be well advised to look at the causes of this dispute and at the point that the contract has not been signed or agreed. He should look at those issues when examining the matter of employment.

Mr. Temple-Morris

I shall certainly look at the issue to which the hon. Gentleman directs my attention. I know that he has followed closely the history of this dispute and that we are in his area of interest, but from whatever side one looks at this matter one sees that there is a certain, almost awful, inevitability about what has happened and about the clash that has taken place. It is not just a matter of dismissals because problems were building up for some time. It is important to take the situation as it stands. There is no point in harking back and going into great catalogues of calamity perpetrated by one side or the other.

I have dealt with the technological and practical aspect of the matter and I now want to speak about the reaction of Government to this problem. It has been a gradual build-up and the reaction is that, dare I say it, of any Government, because in the use of resources we must have the best value for money. I say somewhat critically that the old cost-plus system that existed under successive Governments between the DHSS and management and workers was somewhat cosy. As a result of a number of factors, including especially the policy of Government, the McColl report and management, that sort of relationship is finished and the pressure is on for a new and better system.

That has led to several things happening during the build-up to the dispute. The first was price negotiations in December 1985, and it is fair to say that in some quarters the Government's proposals at that time were called somewhat severe. However, in the circumstances, they were necessary in the drive away from cosiness and towards efficiency. There were abrasive negotiations, and objectively it is fair to say that my hon. Friend the Member for Putney played a large part in them. Indeed, it was thanks more to him than to anyone else that the basic settlement was considerably improved with price increases of between 6 and 8 per cent.

Parallel with the price increase and following shortly after it, we had the McColl report and its implications. The terms of reference for the people who prepared that report were to examine and look at ways to bring about better quality and better management, and to promote efficiency and cost effectiveness. Subject to Government reaction to that report, many hon. Members want it to be examined in more detail in the House. Its recommendations stress competition and—this is relevant to Roehampton—the report stresses decentralisation.

Following the publication of the McColl report, and rightly linked to it, new DHSS contract proposals appeared on 15 April. I shall not enumerate them, but their effect upon Hangers and upon any management was considerable. Those completely new contract proposals were aimed at getting the best deal for the patient and greater efficiency. They were to be implemented by the end of this year, and that is highly relevant for Hangers. Because of what has happened, it is now likely that they will not be implemented until the middle of next year.

The pressure was on management and union alike and the management had no option but to try to modernise because such changes must come eventually. As hon. Members have said, the management started consultations with the work force. The consultations went on between April and September 1986, which was after the introduction of the new proposals. The work force had all the natural fears of job losses and technological changes and those fears came to the fore, the work force dug in and no progress was made in the consultations. We then get the sequence leading to the dismissals and the situation that we face today.

I wish to stress—and it would be a good thing if it sank home—that there are no longer 300 jobs at Roehampton. It is all very well to say, "Let us go back, boys, and then we will talk", but the 300 jobs are no longer there. As part of the original proposals to settle this matter there would have been more than 80 jobs, but the extra jobs that could have existed over and above the 80 have dispersed around the country in order to deal with the dispute. Incidentally, the way in which Hangers has dealt with it nationally has been very creditable indeed—[Interruption.] It is all very well for Members on the Opposition Front Bench to laugh, aided and abetted by the hon. Member for Bolsover (Mr. Skinner). That does not surprise me.

The Minister of State referred to some detailed figures, and I compliment him on doing so. I concede straight away that obviously there is potential suffering—I dare say actual suffering—and difficulty as a result of a situation such as this. There is no way in which anyone can pretend that everybody is as well as if nothing had happened, but so far that suffering has been very limited. It was indicative that on the "Today" programme this morning the best that could be done in terms of producing a patient was to get someone whose two legs had been made into one and who at least was mobile. Indeed, everyone's mobility has been maintained by Hangers.

Hangers is supplying 80 per cent. of the service, and that proportion is increasing. We are therefore dealing with the remaining 20 per cent. which is delayed. However, it is moving. As the Minister said, there are 3,000 appointments a week throughout the country, but only about 70 deferred appointments. That is not at all bad.

There are three kinds of limb—the modular, the conventional and the complex to deal with congenital deformity. The latter is a problem area, and in that respect Roehampton is much more necessary than any other part of the country. The modular limb accounts for 75 per cent. of the current trade. There is no reason for delay. Such limbs are easy to produce, and they can be produced elsewhere. The difficulty can therefore be narrowed down to the conventional and special limbs, in respect of which great care is taken over priority for children and the extremely disabled. There is spare capacity throughout the country which increasingly is being used.

I appreciate that the situation is difficult and that I cannot provide an ultimate answer. However, Hangers is doing its best. It has dealt with all communicated emergencies. It knows of no patient who is immobile. Anyone who is immobile need only get in contact with Hangers or the local limb centre, and action will be taken. I give the Minister and the House an undertaking on behalf of Hangers that it will do all it can to maintain the service, and it will co-operate in any way in respect of any individual case.

As for the work force, the official line is, "All back to work and we will talk about it." We are deluding ourselves if we think that that is practical. The fact that the ACAS talks are going on is an indication of that. My hon. Friend the Member for Putney has made it clear that, while all the work force cannot necessarily be reinstated, we must go for a practical solution and the best possible deal for the work force.

That brings me to ACAS. There is no option but to work within ACAS, and the fact that that is being done is good news. There was an introductory meeting on 3 November followed by two substantial meetings on 18 November and 25 November. I believe that yesterday's meeting went on for two and a half hours. Both sides have made proposals to each other, and both sides are considering them. The next meeting is scheduled for next Wednesday 3 December.

The main thing is that the parties are talking. It is important that no hon. Member should exacerbate the conflict so that either side might be tempted to think that it can get a better deal than is possible in all the circumstances. The people represented on the management side are quite prepared to do all that they can to achieve a settlement. They realise the importance of it, but we must bear in mind the practical situation that I have outlined. It must be a realistic settlement, but a settlement is perfectly possible.

8.25 pm

Mr. Michael Meadowcroft (Leeds, West)

I am not sure whether the debate will improve the prospects of settling this dispute or whether it shows the House at its best. The speech of the hon. Member for Holborn and St. Pancras (Mr. Dobson) was way over the top and will do nothing but exacerbate the difficulty that we face. The Minister may have been lured into it, but at times he responded in like manner, and that again does not help to deal with the dispute. I also wonder whether the discussion of an industrial dispute across the Floor of the House is the right way to assist in the process of conciliation that must follow in any kind of dispute.

A particularly nasty part of the motion refers to the crude intimidatory tactics of the owners of the company". It may be that those words are true——

Mr. Dobson

Has the hon. Gentleman ever been sacked?

Mr. Meadowcroft

Twice, actually. If the hon. Gentleman will interrupt from a sedentary position, he should beware of the reply that he might receive.

Even if the words that I have quoted are true, it does not help to solve a dispute by referring to events that are history. The question in any dispute is how to solve it, rather than to refer back to the very things that are part and parcel of the problems that the company faces.

The Minister said that the Government were on the side of the patients. Everyone is. The hon. Member for Holborn and St. Pancras is, and I accept his bona fides. That is why he has tabled the motion. I disagree with its terms and with the way in which he introduced it, but nevertheless he is on the side of the patients.

It is also crucial that we should be on the side of ACAS. If we are to have a body such as ACAS in industrial relations, and if we are to rely on it for the kind of action that we now expect to be taken, it is vital to support that body in its work rather than make its job more difficult. I do not see how some of the comments made tonight have assisted the cause of ACAS.

As the hon. Member for Leominster (Mr. Temple-Morris) said, the debate falls between two crucial meetings—one yesterday and the other next Wednesday. I do not understand how it can be suggested that some of the comments that we have heard will assist ACAS in its work. We should recognise that it is nonsense to suppose that after reading Hansard one side or the other will capitulate and say, "Now that we read it in Hansard, of course we were wrong. Of course we will give way."

This debate is important, not because of the vote or the wording of the motion, but because of the signals that it will give to the participants in the dispute. Even if the company has behaved as badly as has been suggested, the crucial question is whether this debate adds to the bitterness that is part and parcel of the dispute. There is clearly a lot of confusion within the company, the work force, the management and, it would appear, the Government about what is happening in the dispute and the means of settling it. For example, there is a crucial distinction between whether the company and the Government are relying on market forces as the way forward, or whether they are relying on Government direction of the company via the NHS. That is the crux of the dispute.

The personnel manager of Hangers wrote to the work force on 24 October and said: in order to re-establish a viable business and restore consumer satisfaction, it is essential to reorganise the company". The personnel manager was talking about market forces. However, unfortunately for that point of view the Wandsworth Borough News on Friday 21 November reported the managing director of Hangers, Dr. James Hiddleston, as saying: the DHSS now wanted the majority of limbs to be produced at Hanger's branches and not the central Roehampton factory and had changed contract procedures. As a result the Roehampton factory can no longer support a workforce of 300 people. If that is true, it has nothing to do with market forces. Rather, it is related to the NHS and the Government's decision about the future structure of the industry—and therein lies the Minister's problem. He may say that he is not part of the dispute—and that is perfectly true—but he has a part to play. The clue to the problem lies in the words of the managing director.

The Minister referred to the McColl report and its contents. It is important that we consider that report and the way in which it has an impact on the dispute. The key phrase in that report occurs in paragraph 54: We were surprised to find no evidence of competition on price between the companies, and when we attempted to inquire further into the so-called cost-plus contracts we found it impossible to compare costs per item supplied between one company and another. There we have it. Hon. Members find themselves in difficulty when discussing the dispute. They must decide where the balance of interest lies—between sorting out the problem and assisting the work force, which is part and parcel of that decision, or solely behind finding the best solution for the client, the patient, wherever that can be met.

The right hon. Member for Stoke-on-Trent, South (Mr. Ashley) said that he had enjoyed meeting Dr. McColl, and had enjoyed reading the report and thought it very valuable. Does he accept the problem faced by the staff at Hanger? If the implications of reorganisation that a rise as a result of the report mean that the work force of 300 cannot be sustained, it is crucial to recognise that that leads to the problem of the industrial dispute that we face. It is difficult to say on the one hand that McColl is right and good, and on the other that the work force is right and deserves to have its case made. It is impossible to have both.

Mr. Ashley

As the hon. Gentleman is playing a good tune at the moment, I must tell him that, when I said that I agreed with some of the points in the McColl report, that did not mean an overall endorsement of the report. I do not want to be placed in the false position of accepting parts of the McColl report and thereby being blamed for its being instrumental in the dispute.

Mr. Meadowcroft

I am glad that the right hon. Gentleman made that distinction, which is important to the debate. If he is drawing attention to the splendid work set out in the report in the types of provision, but distancing himself from its commercial aspects, that is a useful contribution to the debate.

The Minister has a role to play in the dispute over the question whether he has been dilatory in his response to the McColl report. If it had been possible for the Minister to respond earlier, it is conceivable that we might not have been here this evening discussing the matter. In reply to a private notice question on 27 October the Minister said: I am urgently studying its recommendations together with the comments made on it, not least by the Royal College of Physicians in its report on physical disability. I shall endeavour to produce conclusions and proposals for action as soon as possible and shall naturally keep the House informed as soon as conclusions are reached."—[Official Report, 27 October 1986; Vol. 103, C. 24.] That is fine as far as it goes. However, in the light of the problems, and in light also of the distress that has been caused, it is strange that the Minister has not come forward sooner with his comments on whether the restructuring of the commercial implications set out by McColl will happen. It is impossible to settle the dispute at Roehampton without the context of the dispute being settled by the Minister. Will a solution lie in market forces, through the DHSS, or through some way in which direction will come from outside the company and the work force?

Originally the Government made no commitment to take up any of the report's 49 recommendations and referred it instead to the National Health Service management board for comment. However, on 11 April this year the then Minister with responsibility for the disabled, now the Minister for Health, announced the Department's plan to deal with some of the problems identified in the report through the appointment of a civil servant—Mr. Ian Burns—as general manager of the DHSS disablement services. On subsequent questioning of the Department's real intentions behind that appointment, and its general position with regard to the McColl report, the Minister has been somewhat evasive. Sadly, the Minister did not today deal with that aspect of his involvement with the problem.

Mr. Carter-Jones

The hon. Gentleman has made an extremely valid point. We are all talking about implementing McColl, but in some respects the decision to establish this other Civil Service committee to a large extent sabotaged the McColl report.

Mr. Meadowcroft

That adds to the point and increases the problem. Given that we must accept the bona fides of hon. Members on both sides of the House that they want the dispute settled, and to improve the supply of appliances to the unfortunate people who need them, we must consider the ways and means of achieving that.

In conclusion, the Minister must act to clarify the future of the industry and its structure and establish where the NHS imperative lies in relation to the industry's structure. Although it is a pity that he did not do that this evening, the Minister must come forward as quickly as possible and make conclusions about McColl and its implications for the structure of the industry, because that is of great significance to the dispute. If the Minister were to do that quickly, it would assist ACAS, the work force and the management to produce a conclusion to the dispute in the best interests of all, and in particular of patients.

8.36 pm

Mr. John Whitfield (Dewsbury)

The dispute at and the circumstances surrounding the business of J. E. Hanger and Co. Ltd. contain all the ingredients that explain what has been so wrong with Britain in the post-war era which this Government, since 1979, have done so much to correct. The description of the position at Hangers that we have heard tonight reveals that there is still much work to be done to change the attitudes of managers and work forces in some parts of British industry. It also shows how important it is that a Conservative Government be returned at the next general election. The position at Hangers provides support for the argument that the Government should make maximum use of their time in office and not go rushing off to the polls before they need to do so. We need all the time that the electorate has made available to change the sort of attitudes of which the dispute at Hangers is a sorry example.

In this debate we are concerned about attitudes with regard to the way the DHSS should be managed as well as the attitudes of trade unionists and of contractors to the DHSS. The McColl report revealed that there was a great deal wrong with the artificial limb services. A damning indictment is contained in the second paragraph of the summary of the main findings and recommendations. Professor McColl and his working party discovered that as inquiries continued we became increasingly conscious of the large numbers of customers who were not satisfactorily served, of the dignity and patience with which many of them endured unnecessary pain and discomfort and of the apparent complacency with which this situation was regarded by many, but not all, of those supplying these services. Although we were told at the outset that there was a great degree of satisfaction with the supply of artificial limbs, a recent survey showed that 23 per cent. of amputees complained of uncomfortable limbs. We were told there was no need to consider foreign limbs because the British limbs supplied to our patients were unequalled. Evidence we received showed that this was far from the case in terms of making comfortable sockets to fit amputation stumps and aligning the limbs correctly… British amputees are restricted not only to limbs made in this country but often to only one of three suppliers; and to make matters worse 50 per cent. of new limbs are delivered late. Professor McColl further found: After careful examination of the contracts which the limb manufacturers have with the DHSS, we came to the conclusion that they— the DHSS itself— are not capable of controlling the costs, prices or profits of the companies. That view was confirmed by Coopers and Lybrand, which added that in many areas the system appears to reward inefficiency and delay while providing no incentive for suppliers to make improvements. The working party further considered the position of the companies supplying the artificial limbs and concluded that there was virtually no competition between them. Faced with those widespread deficiencies, the working party unanimously concluded that only a total break with the current organisation and its historic evolution could jolt these services into the state of caring efficiency which is required and which we are sure that the taxpayer, who funds them would demand. One would have assumed that the Opposition would be as concerned as the Government about the findings of the report and would urge the earliest implementation of the recommendations of Professor McColl and his working party for the benefit of the 63,000 amputees in the community. But not a bit of it. We have on the Order Paper in the name of the hon. Member for Holborn and St. Pancras (Mr. Dobson) early-day motion 43, principally concerned with the 300 sacked workers at Hangers as opposed to the many thousands of long-suffering amputee customers. In the motion that we are now debating in the name of the Leader of the Opposition there is a suggestion that the Government should intervene and require Hangers to reinstate the whole of its work force to resolve the current so-called crisis.

I have no doubt that the 63,000 amputees will find it incredibly uncaring of the Opposition not to have referred to the McColl report in either of those motions. Professor McColl and his colleagues discovered about the limb makers—J. E. Hanger is the principal one—the following matters. In its detailed recommendation No. 25, the committee recommended: The suppliers and manufacturers…should be responsible for their products' fitness. To a lawyer such as myself, it seems a fairytale world where a manufacturer is not responsible for the fitness of his product, particularly when that manufacturer's own technicians, the prosthetists, are involved in designing and fitting the limbs for their individual amputee patients.

Mr. Ernie Ross (Dundee, West)

It is clear that the hon. Gentleman does not know how the industry works. Does he not know that there is an individual relationship between the fitter and the person who receives the limb, on a weekly and daily basis? Does the hon. Gentleman understand how the industry works?

Mr. Whitfield

That is exactly what I was saying. I do not think that the hon. Gentleman could have been listening to me. I said that, because of that personal, daily relationship, it is extraordinary that so many of the limbs do not fit the patient.

The second point that the McColl report made about the limb makers related to customer service. At paragraph 34, McColl found that the manufacturers themselves admitted that 50 per cent. of all limbs were being delivered late, and 40 per cent. of major repairs and 25 per cent. of general repairs were behind schedule. There was evidence that those figures understated the position. The report went on to say: Within the average, however, are concealed some shocking delivery delays. We were moved by the distressing evidence of individual cases of delay and the modest and self-effacing way they were put to us. These delays are not just exasperating. They can of themselves cause further delay in rehabilitation, because stumps can and do change over time and a cast taken 6–8 weeks before delivery of the socket may well not fit at all so that the process has to start all over again. The Committee found: The companies are failing to deliver many limbs within the limes specified in their contract. They are therefore in breach of contract…even the agreed delivery times are too long. The major cause of the delays arises from the central fabrication of sockets and limbs in the contractors' main factories. As my hon. Friend the Member for Leominster (Mr. Temple-Morris) said, that is the central cause of the dispute.

Mr. Carter-Jones

I should like to tell the hon. Gentleman, who is labouring a little, that it was his hon. Friend the Member for Hornsey and Wood Green (Sir H. Rossi) who realised that that was happening and over four years ago invited Professor McColl to lead the committee. That was the causal factor. Those worries were there all the time. The report has vindicated the hon. Member for Hornsey and Wood Green.

Mr. Whitfield

I am not sure how the hon. Gentleman's point relates to my speech. I would go along with what he says. The point that I am trying to make is that little emphasis has been placed on the recommendations and findings of the McColl report and far too much on the labour relations side of the dispute. No detailed analysis has beeen made by the Opposition of the reasons behind that difficulty.

The committee's harsh criticism hardly fits in with early-day motion 43, urging the House to recognise that the work force, including the managers at Hangers, have always shown outstanding devotion to the care of disabled people. Before anyone says that the criticisms that Professor McColl has made do not apply to Hangers, let me remind the House that the latest recorded figures show that Hangers and its closely associated company, Vessa Ltd, supplied 78 per cent. of all lower limb patients, 69 per cent. of new lower limb patients, and took 73 per cent. of total orders for new and replacement limbs and 79 per cent. of total orders for repairs. Not surprisingly, McColl found that market concentration to be unhealthy and recommended that the market should be opened up to new entrants by encouraging new companies and their different limb systems and by actively encouraging individual prosthetists to set up business independently. McColl further found that there was no evidence of competition on price between the four—or really three—companies that supply limbs and that it was impossible to compare costs per item supplied between one company and another.

It is instructive to note the enormous gap between the industry's perception of itself and the findings of Professor McColl. In its evidence to McColl, the industry claimed a competitive entrepreneurial spirit that in no way conflicted with service to the patient.

Therefore, the situation as McColl found it was pretty unsatisfactory. First, the artificial limb and appliance centre services were not efficiently managed. Secondly, the limb manufacturers, particularly Hangers, were enjoying a cosy and profitable monopoly, and had done for many years. Thirdly, the monopoly was not in the interest of the taxpayer, but, more importantly, it was certainly not m the interest of the 63,000 long-suffering amputees. The monopoly was and is being enjoyed at their expense.

Amputees have made several representations to me in my constituency, and I have received some from representatives of the British Limbless Ex-Service Men's Association. Like Professor McColl, I have found them to be long-suffering, self-effacing, good people, not wanting to make a fuss. But many of those amputees have endured a service for years that has supplied them with ill-fitting limbs—limbs the basic design of which has not altered for over 50 years, limbs that break down and disappear for weeks while they go away for repairs. They are denied access to the far more modern and aesthetically attractive artificial limbs available abroad, principally in Germany, Japan and the United States, while British manufacturers, especially Hanger and Vessa, through their tight monopoly, prevent new entrants from coming into the industry and have done little, if anything, to improve their own products, at any rate until now.

The motion effectively says that the Labour party wishes that situation to continue. The party which claims a monopoly of care in fact cares only about the few hundred jobs which for years have benefited from a most unfair monopoly and about the preservation of restrictive working practices which directly result in discomfort, delay and despair among 63,000 severely disabled people. Not infrequently, amputees have to undergo further operations because of the inadequacies of their appliances. Unfortunately, the Labour party has a vested interest in delay, discomfort and despair because those conditions provide their only firm recruiting ground. Such modern-day Socialism is a despicable philosophy which Conservative Members utterly reject. The 63,000 amputees also utterly reject it. Like me, they look forward to the earliest implementation of the McColl recommendations.

We greatly regret the minor interruptions in service to severely disabled people caused by the dispute at J. E. Hanger and Co. Ltd. which, in the terms of the motion, seems to have the support of the Labour party, and we congratulate the Government and my hon. Friend the Minister on the steps that have been taken to protect amputees from what might otherwise have been most damaging effects.

8.51 pm

Mr. Lewis Carter-Jones (Eccles)

I have to declare an interest as parliamentary adviser to the British Lim bless Ex-Service Men's Association for the past 18 years. The majority of the association's members are in my age group. It is, incidentally, an unpaid job. I am also probably the only Member of the House to have given evidence to the McColl inquiry, a task for which I was volunteered by the all-party disablement group. I gave evidence on two occasions. I am very proud of the McColl working party, which was well led and questioned us extremely closely.

On the first occasion the all-party group asked me to give evidence on the limb service. I had access to the submissions made by the Royal Association for Disability and Rehabilitation and BLESMA. I also had access to civilian amputees. On that occasion, my brief was prepared by Mary Holland, researcher for MENCAP and an upper limb amputee. We were well received by Professor McColl and his well-informed associates and he probed the matter in great depth.

On the second occasion, again volunteered by the all-party group, I was asked to give evidence about wheelchairs, as cases had been brought to us by women from the north-east. On that occasion, my brief was prepared by Fidelity Simpson, secretary of the all-party disablement group, who also joined me, and I had a second opportunity to appreciate how thoroughly the working group operated.

Having said that, I should make it clear that people were worried about the amount of money being spent on the limb service and the kind of service being provided to both upper and lower limb amputees as well as to users of cosmetic arms and glass eyes. There was so much concern that I am baffled as to why the companies do not admit that there were so many complaints. At Easter, the Minister will be invited to the BLESMA annual conference, at which, as I know from 18 years' experience, a whole range of motions will be discussed and resolutions drafted, copies of which will be sent to the Department, to receive, in the fulness of time, a reply from the Minister. So people cannot pretend that they did not know that there were problems with the limb service.

My next comment will upset some hon. Members. I believe that the Minister is being used as a fall guy. I believe that he is being pressured by Hanger through the work force. This incident has not just begun. It had been building up for a long time. It can easily be pinpointed at the time when Professor McColl was asked to form his working party, which was well before the last general election, and the invitation was sent out by one of the Minister's predecessors. So there had been concern about this for a long time.

The hon. Member for Dewsbury (Mr. Whitfield) pinpointed some of the problems and read eloquently from the McColl report, but his speech became rather weak when he departed from the text to try to make party political points. He should have stuck to the script because McColl has lessons for us all. No one is innocent in this. The Minister mentioned new developments in upper limb prosthesis. As long ago as 1977, my right hon. Friend the Member for Manchester, Wythenshawe (Mr. Morris) brought the myoelectric arm from Sweden to be tried out in this country, so let us not have any party political accusations about this. There is a major problem relating to upper and lower limb prostheses. There have been changes in structure and materials.

The BLESMA group, who are my age, may be dying out—there have not been many new war amputees—but the number of civil amputees has grown. The prosthetists' job is also made more difficult as the population grows older and they have the problem of fitting limbs to stumps for people suffering from age-related cardiovascular diseases. There is thus a massive problem to be faced.

The structure set up by the Minister's predecessor—a friend of mine, although he is a Tory—in my view thwarted the proper implementation of the McColl proposals. To put it kindly to the present Minister, I think that it will be extremely difficult to marry the McColl concept of an independent management committee reporting to the Minister, which I thought was a good structure, into a committee of civil servants which has been set up within the Department to report to the Minister. No doubt some of those civil servants are present today. They may be very genuine and just the right kind of people, but one cannot marry the major concept of McColl into that structure. The Minister may have to come up with a compromise, but it will be difficult because it looks as though the main McColl recommendation was sabotaged when that committee of civil servants was established. I do not know how he will overcome that. It will be a major problem for him as it would provide some independence.

I can understand why skilled limb fitters worry about their future. J. E. Hanger and Co. Ltd. should not have gone down the path that it pursued, because it has so many inconsistencies. I believe that the company is trying to get at the Minister and his Department and McColl through the work force. I believe that honestly and sincerely.

I am an old hand. I shall say something to the Minister that I shall not be saying after the next election, so he need not worry about that. Whatever the Minister does in future on this matter, for God's sake will he consult the amputees, who could give him much advice? That was writ large into McColl. Tiny Bunch, Duke Hussey and Liz Fanshaw from the Disabled Living Foundation served on the McColl committee. They are disabled. One is a double lower limb amputee and the other is a wheelchair bound, experienced occupational therapist. Those people could give the Minister positive help and advice. Who better to give the House advice on the problems of the deaf than my right hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley)? Who knows more about the problems of stump difficulties? It has been said that one recommendation made by the experienced people on the McColl committee was that consideration should always be given to the nature, shape and size of the stump because that must bear the limb. When surgeons amputate, it is final. If a surgeon fouls that up in the first instance, he has fouled up the life of the individual who has lost a limb.

All those matters are before the Minister. Through no fault of his own, he is faced with an industrial dispute. However, he has a major responsibility. He is the "target for tonight" from outside the House. He should go to J. E. Hanger and Co. Ltd. and say, "Do not take it out on the employees because you are dissatisfied with me or because you are dissatisfied with McColl. We have tried to produce a contract for you". That is possibly ultimately a subject of litigation. The possibility is there all the time. In that respect, the Minister has my deepest sympathy.

The Minister has a clear bounden duty, possibly with the Minister of State, Home Office—the constituency Member who is statute-barred from speaking tonight—to go to J. E. Hanger and Co. Ltd. together and say, "Enough of this messing. You should not have called in ACAS on this matter. You know the difficulties that you are creating for people in need."

The Minister can take care of himself. It is not so easy for a person who has lost a limb or two limbs. We should not be taking it out on them. Will the Minister please take my advice and ask for a return match with the managing director of J. E. Hanger and Co. Ltd. and say, "Enough of this nonsense. Get back to the original position. Do not make people suffer because of your problems and the fact that you have a dispute with my Department." I hope that the Minister will resolve the problem by that method. I am sure that it can be done and that many more people will be happy and satisfied.

9.2 pm

Mr. Lewis Stevens (Nuneaton)

The hon. Member for Eccles (Mr. Carter-Jones) pointed us towards an interesting possibility as to why the dispute at J. E. Hanger and Co. Ltd. came about. What is certain from what the hon. Gentleman said is that the problem did not arise suddenly. Behind it was something that had been going on for some time. That is typical of confrontations that result from problems that appear to have arisen from a relatively short discussion period, but have been dragging on for some considerable time. It is no compliment to the work force or the management that we have reached this position. As the Minister rightly said, the patient is all-important in such circumstances, and an early resolution of the problem is imperative.

It is wrong for the Opposition and the hon. Member for Holborn and St. Pancras (Mr. Dobson) to put it all down to a one-sided approach and to suggest that it was a simple matter and that everything had been done badly by management during the latter period. As the hon. Member for Eccles said, the McColl report was behind what happened, although it did not intend to create the problem.

The report accepted that many of the people involved in providing a service to the limbless and to others have the right motivation and intend to do good, but it queried strongly the effectiveness and suitability of those services. That should have provoked the response that there was something decidedly wrong. My hon. Friend the Minister said that the report highlighted much that was not good enough about the service and that could be improved. That included the cost of the services. The figures quoted in the McColl report were £38 million being spent on the provision of artificial limbs and £32 million on wheelchairs, and it suggested that as much as £11 million could be saved and used elsewhere. I hope that it would *he used for the benefit of the limbless, but such a reduction in cost would be bound to affect the companies which produce the limbs.

This may have been partly an attempt to frighten the work force, but when significant changes in productivity are wanted, if the matter is not handled well and there is no genuine consultation, all that will happen is this great punch-up, which often results in neither side being prepared to give way, and eventually there are sackings, and so on.

It is to the great credit of my hon. Friend the Minister that he pressurised the management to use ACAS to try to resolve the problem. That is the right way to go. It is not suitable for Governments to start meddling in industrial relations. Some Opposition Members believe that it is a good idea, but almost inevitably it brings the wrong results and little satisfaction to anyone. The Government's policy is not to meddle, and that is right. I hope that the procedure which has been encouraged by the Minister will bring an early resolution of the problem.

I was pleased to hear the Minister say that some computerisation had been introduced. The McColl report also recommended the appointment of a manager. I accept the point made by the hon. Member for Eccles that it might be difficult to impose a different structure later, but with care it is possible. I accept that, having done one thing, a second change could be a little more difficult to achieve, but 1 hope that the Minister will seriously consider introducing the management board that was proposed by McColl. It must also be encouraging for limbless people that the Government and the service have started to consider more widely the supply of limbs to the disabled. McColl made it clear that the provision of limbs and the service given to the limbless were inadequate, so the Government's action in this area is encouraging.

Other matters mentioned in the report have not yet been tackled. They include the upgrading of the professional training of prosthetists, and the combination of surgeons, prosthetists and others in the Department to provide the best service and the rehabilitation of limbless people. We need a more strongly co-ordinated effort. McColl was not satisfied with the apparent fragmentation of some of the help that was being given. The Government have made a start on the placing of contracts. If the service is to become more accessible, the various specialists who are involved must he integrated at some speed.

I hope that my hon. Friend the Minister will consider closely when the House can receive a full report on the conclusions that have been reached. The report was produced in January, nearly 12 months ago, and I am pleased that there has been some movement it is excellent that things are happening—but it is important that the House should receive at the earliest moment the Government's conclusions and intentions following the McColl report. The report has long-term implications, and it is recognised in the report that some of them will take a long time to work through. That makes it even more urgent that we know about the Government's conclusions in the near future.

9.10 pm

Mr. Terry Fields (Liverpool, Broadgreen)

When the Minister addressed the House he said that he was not taking sides on this issue. Having said that, he and his Back-Bench collegues took the part of the bosses in the Hanger dispute. It will not escape the attention of workers who are listening to the debate, or who read about it, that trade union disputes that are discussed in the House invariably result—it could be said that this result is 100 per cent. assured—in Labour Members standing up for the workers against the bosses while Conservative Members support the bosses.

Mr. Meadowcroft

Will the hon. Gentleman give way on that point?

Mr. Fields

No; I do not have time.

Conservative Members have introduced a mire of distortion and many contradictions. We know that the .300 employees at the Hanger factory are involved in the fitting of 500 limbs a week and that when overtime was offered to them they refused to work it. It was that which led to the strike. The management is now talking about reducing the work force from 300 to 80. That is ludicrous. Such a proposal does not make sense and lacks all reason.

When we try to ascertain the effect that the strike is having, we find that it is having only a minimal effect on a small percentage of patients". We know, however, that the 300 workers were dealing with 500 limbs a week, which means that over 10 weeks they handled 5,000 patients. We know also that the strike has been running for 10 weeks. If we listen to Conservative Members, however, we are given to understand that the strike is having only a "minimal effect". No information on this score is available at the limb centres that I have contacted. That is not surprising if the Minister has been trotting around trying to keep the lid on the effect that the strike is having on those in need.

It is important to remember that the firm makes bespoke limbs. It goes beyond some firms which make only small, medium and large limbs. We are talking about a firm which makes limbs to fit the needs of particular individuals. Other firms supply stump stockings for ill-fitting limbs, or alternatively patients are sent to Hanger to have their needs met.

Unlike the hon. Member for Leominster (Mr. Temple-Morris), who has received £5,000 from the bosses, I have been on the Hanger picket line. I met Hanger workers at the Labour party conference and I give total support to them and to any other workers who are involved in industrial disputes against managements of the sort that prevails at Hanger and the backer of Hanger, which is BTR. Morale on the picket line and among the workers generally is extremely high. Despite having been 10 weeks on strike, the pickets have the support of the majority of the work force. As late as 13 October a mandate was given to the union's negotiators to act as observers at ACAS and to bring any decisions back to the work force so that it can decide what is to happen.

Conservative Members have made great play about ACAS, and they should realise that the Hanger management is making a mockery of conciliation in this dispute. Initial offers of redundancy pay of £130 for every year of service have since been forgotten or withdrawn by the management. We can hope only that the representative of J. E. Hanger on the Conservative Benches will be able to influence the management. I hope that he will insist that when discussions take place with ACAS next week the management will have some concrete proposals for the resolution of the dispute.

Since the dispute started, 23 people have left the factory but only six of them have found jobs. That blows sky high the Tory myth that the unemployed in the north-west should come south to look for jobs. There are no jobs, particularly around Roehampton, where workers have been seeking jobs since being kicked out of work. I have spoken to those involved, and they are not the mindless militants that reactionaries in the Tory party like to think. They are just decent workers, who are dedicated to providing a service for the disabled. The average age of those whom I have seen is between 40 and 50, and many of them have given a lifetime of service to the industry.

Hon. Members talk about flexibility in negotiations, but the bosses have already said that no one aged over 50 will be given his job back. Although they have a wealth of experience and have given a lifetime to the industry, those people are being treated like that. Incidentally, two of the workers recently received trade union badges to commemorate 40 years of union membership, and most of that time was spent working in the industry.

Tory Members talk about terrible workers who make too many demands, want restrictive practices, and so on, but they should look behind the scenes and at who is pulling J. E. Hanger's strings. The hon. Member for Leominster is getting £5,000 for it, but the parent company, BTR, should be given even greater scrutiny. It is the key to the whole affair.

In the year ending June 1985, BTR made a profit of £151 million through its investment and involvement in industry round the world. For the most part, that profit was made by paying poverty wages to South African workers in breach of the EEC code, to which Great Britain is a signatory. It is an absolute scandal that that should be allowed to happen, and that we should have contracts with industries that have such records. The majority of black workers employed by BTR are in receipt of about 385 rand per month, which is eqivalent to about £100 per month. The starting rate for the majority of black workers is 40 per cent. below the South African poverty level, and it only just about keeps them alive. The profits made by that man and by the subsidiary companies should be contrasted with the standards of living experienced by those whom they employ. For example, the salary of the managing director of BTR, Sir Owen Green, increased from £97,000 a year in 1984 to £147,000. His attitude towards industrial relations is well documented. For him, profits reign supreme and his relationship with the personnel is nonexistent. That of course permeates British management. His ideology is to treat British workers similarly.

Prior to the dispute, the unions allowed the introduction of new technology, withdrew demarcation lines, and were seen by the company to be bending over backwards to accommodate management. Of course, that was also seen by the company as a sign of weakness, and there were further attacks on conditions. Perhaps I have a vested interest, as I have a comrade in Liverpool, Cathy Wilson, who is disabled and who has a limb made by Hanger. She fears that the sackings may be part of a rationalisation plan to cut the number of factories in the limb-making business. The McColl report revealed that, although six firms are contracted to the DHSS for artificial limbs, there are in reality only two, and they are both owned by the BTR subsidiary, which is also the main contractor for wheelchairs for the DHSS.

In our motion, we demand that the Government should stop hiding behind Hanger's mangement—which is, of course, BTR—and should accept that they have a responsibility for the patients who so desperately need attention and limbs fitted through the DHSS. Sole responsibility for the dispute lies with Hanger's management. The Tory Government, by their inactivity in an area where they clearly have a locus, are abrogating their responsibilities. The disabled should be made aware of that.

The caring face of the Tory party is betrayed by the fact that, although letters have been written by the striking workers to the Parliamentary Under-Secretary of State for Health and Social Security, the hon. Member for Derbyshire, South (Mrs. Currie), and to the Minister of State, Home Office, the hon. Member for Putney (Mr. Mellor), no response to date has been given.

The Minister of State, Home Office (Mr. David Mellor)

Rubbish.

Mr. Fields

If that is rubbish, the Minister, whom I saw being carried around the Strangers' Lobby by Hanger's workers, will no doubt take it up with them. My information, as late as this evening, is that he has refused to reply to letters. If he wants to make anything of it, we shall talk to the workers. I have nothing to hide, even if he has.

To compound the complicity in this affair, since the workers have been sacked, the Government have turned down applications for unemployment benefit and other social security benefits. The excuse is that the workers are on strike and are not unemployed. All the dismissed workers at J. E. Hanger are in receipt of P45 forms. If that is the case, clearly they come under the provisions of the Act.

In the interim, the workers demand a flexible approach, reinstatement and negotiation. It is a moderate demand, given the high-handed attitude of the management, who want to sack 300 workers and then redeploy 80 of them.

I should go further than the Labour party's motion on the Order Paper. In the long term, the only security for these and other workers, who are only pawns in the profit game being played by the Tory party backers, is for the total takeover of the Health Service and ancillary service industries, under democratic worker control and management, as part of a national plan, to cater for the desperate needs of ordinary people, not the greedy and acquisitive few who exploit workers for the sake of profits in the way they exploited the workers previously employed by J. E. Hanger & Co. Ltd.

Mr. Speaker

It may be for the convenience of the House if I say that I understand that the Opposition Front Bench spokesman will seek to reply at half-past nine.

9.23 pm

Mr. Toby Jessel (Twickenham)

The loss of a leg, an arm, a foot or a hand is a severe form of disablement and is also a great hardship. It can be a tremendous misfortune and disabled people require the utmost compassion and support from Parliament, the Government and the public. Some of those who have lost limbs have risked their lives so that others may live in freedom and peace. They may have lost limbs in the second world war, in the Falklands, in Northern Ireland, or in other places where secondary wars have taken place. We do not always show enough honour and respect to these people. The French, for example, have special seats on buses for those who were mutilated in time of war. People with other ailments take second priority.

We must show concern to anyone who, through illness, has lost a limb or part of a limb. Often, their employment prospects are damaged. It can be difficult, with missing limbs, to enjoy the enforced leisure that may ensue. It is a tragedy that such people have been caught in the crossfire of this foolish dispute. The work force, in most cases consisting of excellent people, are some of my constituents, because Twickenham is not far from Roehampton.

My hon. Friend the Member for Putney (Mr. Mellor), whom I see on the Front Bench tonight, also has many constituents among that work force. It is a pity that this matter has become so politicised. I hold no brief for either side. From what I have heard tonight, the management is unimpressive. They have shown poor leadership qualities.

I was glad to hear my hon. Friend the Minister say that he hoped for a swift settlement. He said that there were 62,000 amputee patients in this country and that every week 2,500 or 3,000 appointments are made for limb fitting or repair. At present, 58 patients have not been treated. As there are about 150,000 appointments a year, they represent about one patient in 2,500, but even that is one person in 2,500 too many, and I wish that there were none.

I should like to tell my hon. and learned Friend the Minister about a constituent who needed an artificial leg replaced and was suffering because the previous one did not fit well. She wrote to me and I telephoned the manager of the Richmond, Twickenham, and Roehampton health authority. Within a matter of days the lady, who is a lecturer at Richmond upon Thames tertiary college, had a new limb supplied. That is consistent with what the Minister said at the beginning of the debate, that if hon. Members get in touch with the health authorities about particular cases of hardship, action will be taken and the hardship dealt with, albeit in difficult circumstances.

This tragic strike is undoubtedly all the more noticeable because these days there are few strikes compared with 10 years ago. I am glad to support the amendment, which is couched in a balanced way, contrasting with the somewhat intemperate language of the motion, which I hope will be defeated.

9.26 pm

Mr. Ernie Ross (Dundee, West)

Earlier in the debate my hon. Friend the Member for Eccles (Mr. Carter-Jones) pointed out that the real patsy in the dispute was the Government. He said that the antecedents of the strike lay in the McColl report. If I could bring the Parliamentary Under-Secretary of State more up to date, on 9 January 1986 the Hanger management made it clear who was to blame and made clear the type of Russian roulette that it was playing both with its work force and with the people to whom it is responsible—those to whom it supplies limbs.

The following notice appeared on the notice board at Hanger, Vessa and Kellie, which is in my constituency: As you will know, the Companies were threatened with nationalisation at the end of last year and only on the intervention of our local MP, David Mellor, with the Minister, Tony Newton, was this set aside. Following that, we found that the DHSS would not agree to any price increase for the Companies and refused to conduct business on the basis that we have done for the last 30 years. Instead, they offered a contract more than halving profit levels, increasing bureaucratic control of 30 per cent. of our orders and imposing swingeing penalties for failure to deliver on time… This meeting was arranged to apprise you of these facts and to give you"— that is the work force through its representatives— 90-day notice of redundancies as a consequence of the closure of the Companies. The notice went on to say that there had been four hours of negotiations in which the Ministers participated. Only then did the Secretary of State intervene and the DHSS pull back.

The notice continued: The problem is by no means resolved because, in agreeing to this interim arrangement, we have been forced to accept immediate discussions aimed at introducing a commercially-based contract which will mean substantial changes in methods of conducting our business and in the conduct of working practices. In addition to other changes, this will mean output per man must go up and delivery times must come down. No doubt it is the DHSS's intention to have in place a commercially-based contract. Then a company notice went up, advising the work force to get its finger out. If the workers have to get their fingers out, the managers can pay for it. Contrast that with the efforts of the work force to supply limbs to those who require them and who, through the negotiating and disciplinary procedures, agreed to pursue the dispute reasonably to a successful conclusion. Clearly, the patsy is the Government.

The Government are absolutely responsible and the Hanger management has made that clear to the work force. It is the Government's decision to change the method of awarding contracts that has led Hanger to take this action against its work force. That has precipitated the strike. It is trying to induce the work force to accept unreasonable terms. Given the record of the work force, it is unreasonable to ask it to accept those terms. The management is suggesting, not only that those terms be accepted in the meantime, but in the future. It is against that background that the debate is taking place tonight.

We need to hear from the Minister that he will tell the company that it cannot be allowed to use the work force to settle the dispute. The dispute is between the Government and J. E. Hanger. The Government have a responsibility. The Minister knows that if the company decided to pull out or cease trading, the contracts awarded historically contained a clause which gave the Department the right, under certain conditions, to take over the Company at an agreed evaluation. There can be no doubt that the Government have an overriding responsibility to those who require the limbs and to the dedicated work force to intervene and ensure that J. E. Hanger starts negotiating with the people concerned, who for the past few years have been providing a very good service to patients.

9.31 pm

Mr. Alfred Morris (Manchester, Wythenshawe)

No industrial dispute can be judged as to its importance by the number of people directly involved; there are also the tests of the principle or principles at stake and the effects of the dispute on others. This melancholy, bitter and protracted dispute is about deeply important issues of principle. It is a dispute that affects many thousands of severely disabled people. They include young mothers, anxious parents of disabled children and, among others, people with severe war disabilities. The work people at Roehampton, whose skills have helped them, have a prescriptive right to the attention of the House, and it is much to the credit of my right hon. Friend the Leader of the Opposition that it was he, not the Government, who provided the parliamentary time to debate the dispute.

There have been many notable contributions to the debate, not least those of my right hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) and my hon. Friend the Member for Eccles (Mr. Carter-Jones). As the House knows, both are tireless friends of disabled people and all who work to help them. Other Members speaking from this side of the House informed the debate with speeches that wholly vindicated the parliamentary time that we have provided. My hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) fully documented our concern about the dispute when he opened the debate. He pressed the Minister to act purposefully to help bring the dispute to an end on terms that will meet the legitimate claims of the work people involved, many of whom are themselves disabled. Their devoted service to amputees has so very often, in my experience, gone far beyond the calls of duty.

A ballot of the work force at Roehampton endorsed with virtual unanimity the call for reinstatement of all—I stress all—who have lost their livelihood. The case put by my hon. Friend the Member for Holborn and St. Pancras was well argued and compelling. Anyone who thinks otherwise should reflect on the statement of the hon. Member for Putney (Mr. Mellor), who described the lock-out of the 300 workers in his constituency as a gross over-reaction to a minor dispute. The hon. Gentleman is, of course, not only the hon. Member for Putney but a Minister.

If the Minister responsible for the disabled feels that he has no direct role in ending the dispute, what contact has he had with his right hon. and noble Friend the Secretary of State for Employment about trying to have it resolved? What steps, if any, did he or his right hon. and noble Friend take to bring the parties together? The impression of many of us is that Employment Ministers are too busy trying to massage the employment statistics to help resolve disputes of this kind. They have now performed the trick 18 times. In fact, nowadays, Whitehall seems to have been turned into one huge statistical massage parlour. We now know that people who work with the Prime Minister at 10 Downing street can be "economical with the truth." Many Whitehall watchers are convinced that the masseurs at the Department of Employment and the DHSS are becoming not just economical but even parsimonious, at least with statistical truth.

For the purposes of this debate, however, my concern is to emphasise that DHSS Ministers could and should have found time to do much more to end this dispute. What is incontrovertible is that if, when we were in power and I was the Minister, there had been a dispute of this length affecting the special interest and well-being of severely disabled people, Conservative Members would have been up in arms and screaming with charges of ministerial indifference, inactivity and incompetence.

Baroness Trumpington said in the other place many weeks ago that the dispute is a matter for the company and its employees and that it would be inappropriate for Her Majesty's Government to intervene. She went on to say: My Lords, our main responsibility is to make sure that the effects of the dispute at Hanger's Roehampton factory on the service to patients in the country as a whole is minimal with a relatively small number of appointments being cancelled. We do not envisage any amputee being left immobile as a result of the J. E. Hanger dispute."—[Official Report, House of Lords, 17 October 1986; Vol. 480, c. 1024.] Within days of that statement, the DHSS press office was acknowledging that more than 50 severely disabled people had already been left immobile as a result of the dispute. Many hon. Members on both sides of the House with knowledge of cases of extreme hardship in their constituencies would have regarded that as a conservative estimate.

The House has heard, among others, of the distressing case of a constituent of my hon. Friend the Member for Holborn and St. Pancras who was found unconscious after extensive bleeding from his stump and extreme discomfort. Ought we not now be told just how many people, at the latest date for which figures are available, have been made immobile as a result of the dispute?

The Minister for the Disabled has tonight taken much the same stance as his noble Friend in regard to the Government's responsibilities and priorities in their approach to the dispute at J. E. Hanger. I must, therefore, very strongly stress that any case of an appointment being cancelled is a serious matter for the disabled person left waiting for help. To talk about "a relatively small number" of appointments being cancelled, as the Government have done, can mask unmerited suffering on a disturbing scale.

On 27 October I raised with the Minister, at the request of the Royal Association for Disability and Rehabilitation, the case of a disabled young mother who had visited an artificial limb and appliance centre no fewer than 23 times without her problem being solved. She had damaged her artificial leg after falling in a shopping centre while carrying her baby son earlier this year and wrote to RADAR on 23 October. I was authorised to pass on her letter of complaint to the Minister, and, in pressing him to give it his immediate attention, I asked on 27 October when and how the Government would act to resolve the case. From that day to this I have had no response. It is for that reason that I baulk when I read that the Government's main concern is with service to patients.

Again, take the case of 22-month old Kris Aston of Plymouth who was born with no legs and the use of only one arm. He can only walk with artificial legs. I quote from the Western Morning News after a visit by Kris and his parents to Roehampton. It says: Kris is already outgrowing his present set of legs, but the company which makes them has just shut down and sacked its 300-strong work force. His mother has been told that Kris may not be able to have a new pair of legs. Without them Kris will be totally immobile. He has already been forced to cut down on the number of hours he spends wearing his present set of legs each day because they are causing him pain… He cries every time we try to put on the old legs, but nobody seems to care. That is another of the many cases that are causing deep concern. It is one that affects a grievously disabled child in pain and calls very much into question the Government's claim that service to patients is their paramount concern.

When he replies, I hope that the Minister will tell us how many of the disabled people affected by the dispute are being allocated to other centres for the provision of limbs. Will he also inform the House how the waiting lists have been affected by the dispute? Will he give the numbers of people waiting for artificial limbs, one year ago and six months ago, and the length of the waiting lists at both the Hanger factory in Roehampton and at Blatchfords in Northern Ireland?

The dispute at Roehampton cannot be meaningfully considered in isolation from the McColl report and, more particularly, from the Government's piecemeal approach to its recommendations. The importance of the recommendations to the dispute was readily conceded in the House of Lords on 17 October and the Government's inordinate delay in making a definitive statement about them is highly culpable. In one parliamentary question after another I and other right hon. and hon. Members have pressed for a full and definitive response from the Government. That is much more than we have had from the Minister for the Disabled in this debate.

In a written answer on 17 June, the former Minister for the Disabled, the hon. Member for Braintree (Mr. Newton), said that he hoped to announce the Government's decisions on the report before the summer recess. That announcement was not made, and even now, in late November, we are still awaiting a definitive statement a year after the McColl report was presented to Ministers.

The McColl report was published in January 1986, yet there is still no public indication of how the Government will respond to many of its most important recommendations. That has created both anguish and uncertainty among the organisations of and for disabled people, among the companies involved in the production of artificial limbs and their workers, among the approved repairers and, most importantly, among disabled people themselves. They were and are entitled to much more consideration from the Government.

The Minister should now tell us to what extent his Department's contracts with Hanger—unreported in the House—were themselves a factor in provoking the dispute. The Wandsworth Borough News on 21 September reported: Dr. Hiddleston"— the managing director of Hangers— claimed unions at Roehampton had been kept 'fully informed' of the new DHSS requirements but 'attempts to change Roehampton to meet the new situation were unsuccessful'. The Minister owes it to the House to spell out the "new requirements" and to say to what extent they were a factor in causing the dispute. What in detail were the "new requirements" and how do they relate to the McColl report?

Whatever else the Minister might argue about Dr. Hiddleston's statement, he cannot possibly now deny that the DHSS has had a direct role in the dispute and that it was involved from the outset. The hon. Member for Leeds, West (Mr. Meadowcroft) and my hon. Friend the Member for Dundee, West (Mr. Ross) touched on that important point. We are entitled now to an unambiguous response from the Government.

It is central to our case in the debate that the DHSS, like the Department of Employment, could and should have done much more to end the dispute. My right hon. and learned Friend the Member for Monklands, East (Mr. Smith), who is with me on the Opposition Front Bench tonight, in a speech at Roehampton on 30 October, charted the way to the settlement of a dispute which is damaging both to a work force which has given front-line service in patient care over many years and to the disabled people whom it serves. The work people merit much more consideration than they have received so far and deserve well of this House as a whole.

9.44 pm

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

We are debating an industrial dispute which, albeit to a small extent, is affecting patients and which ought to be resolved. The debate is timely for several reasons and it has covered several important aspects. Those aspects are, first, the crucial matter of maintaining services to the patients; secondly, the need for the company and the trade unions who represent the work force to get together to resolve their difficulties, using the good offices of ACAS; and, thirdly, the wider issue of the future of the artificial limb and appliance centres and the service to patients as a whole, including the wheelchair service.

Despite the somewhat choppy tone of the early stages of the debate, there have been valuable contributions from both sides of the House. The need to resolve the dispute, which must be one of the first matters of concern, and the need to involve ACAS has been stressed by the hon. Members for Leeds, West (Mr. Meadowcroft) and for Eccles (Mr. Carter-Jones), who made a most distinguished speech, and also by my hon. Friend the Member for Twickenham (Mr. Jessel). Although he was unable to take part in the debate, I think that it will be recognised by the whole House that nobody has played a greater part in seeking to bring this dispute to an end and to resolve it constructively than my hon. Friend the Member for Putney (Mr. Mellor), in whose constituency Roehampton is situated and who has been present in the Chamber throughout the debate.

Emphasis has been placed by a number of hon. Members upon the action that the Department should take to meet the needs of patients during the dispute. They have emphasised the importance of bringing ACAS into the dispute. I was glad and not at all surprised that the right hon. Member for Manchester, Wythenshawe (Mr. Morris) raised the absolutely crucial matter of the future of patient care as his first concern. It is common ground that it should be the concern of us all.

I shall deal in a moment with the way ahead for the service, with the significance of the McColl report and with the action that we are taking. This matter was referred to in particular by the right hon. Member for Stoke-on-Trent, South (Mr. Ashley). He made a distinguished and constructive contribution, to which I shall refer in some detail. It was taken up by my hon. Friends the Members for Dewsbury (Mr. Whitfield) and for Nuneaton (Mr. Stevens), and by my hon. Friend the Member for Leominster (Mr. Temple-Morris) who, in a most constructive contribution on behalf of the company, clearly recognised that the McColl report shows the way ahead.

I return to the matter that concerns us most of all: the way in which the dispute might be affecting patients. I shall try to meet at once the anxieties that were expressed by the right hon. Member for Wythenshawe, and I shall also try to correct some of the misunderstandings.

The Government are in no sense complacent. In a dispute of this nature there is always a danger that patients may be adversely affected. We have taken a number of steps to try to avert that danger. It is not correct to suggest that 50 people have been left immobile. I suspect that that might have been a slip of the tongue by the right hon. Member for Wythenshawe. It was said at the time that 50 appointments had been postponed.

It is important to emphasise that Mr. Bailer, who works at Gatwick airport and who had a jury rig repair made to two artificial limbs, has been able to remain at work. His concern, rightly but moderately expressed this morning on radio, is that he should have his proper artificial limb repaired, in case anything should happen to the jury rig. That repair is in hand. In fact the repair had been in hand for some time before he spoke on radio. The limb ought to be completely repaired by 5 December and we hope to be able to make an appointment for him on 8 December.

We are taking further specific action concerning a small child, Kris Aston. Despite the difficulties, the case was brought to light and action was taken. New limbs are being manufactured and should be ready next week. The finishing work will be carried out in Exeter and the case will be dealt with at Exeter, mainly to avoid the journey to London which is no fun for a small child or for any disabled person. The family has said that it is very satisfied so far. We take the point about "so far" because our duty is to see that patients are not inconvenienced and are not made to suffer and that any problems caused by the dispute are kept to an absolute minimum. We have taken a number of steps to seek to protect patients as far as possible from the effects of the dispute. First, our attention has been focused on the vulnerable patients. These are of course Hanger's patients whose care is based on its Roehampton premises or whose limbs must come directly or indirectly from Roehampton. I should like to indicate the scale of the problem, in part to keep it in perspective, and to reiterate what we are doing.

On the matter of scale, it is important to stress that of our 53,000 lower limb patients—and we are talking here entirely about lower limb patients—29,000 are J.E. Hanger patients. The 9,000 upper limb patients are wholly supplied with those limbs by Hugh Steeper Limited, a quite separate firm. The great majority of them look not to Roehampton, but to the 18 ALACs and nine satellite centres countrywide. It is on the 3,000 patients who look to Hanger at Roehampton that our attention is focused. Of these—and every case had been checked—315 appear to have been affected in some way by the dispute and of those 315 we have identified 116 priority cases, including 13 children. Every case has been looked at with great care. The process is one of identifying potential problems and taking action to overcome those problems.

Without in any way implying complacency, I can say that so far we have managed to succeed in keeping people mobile or in keeping problems to a minimum. We have received fewer than 10 complaints and on each of them action has been taken. I must repeat, and I hope that it will go far and wide, that any patient listening to this debate or any patient who has been in touch with any hon. Member because he is experiencing difficulty should get in touch at once with his nearest ALAC or with the Department of Health and Social Security and he will be attended to at the earliest possible date.

I should stress two points. First, we have instructed all 19 ALACs to maintain contact with local Hanger staff on a continual basis. This procedure was established very early in the dispute and it has been extended where necessary. Additionally, we have been examining all outstanding files to try to tell whether an individual patient may be in trouble. For example, a patient may have visited his or her ALAC many weeks ago but has not returned to the centre despite an expected further visit; or a patient with a specific order for a limb may still be waiting with the limb overdue.

It will be recognised that the ALAC service is essentially reactive. It is part of its pride that there are no waiting lists. As far as possible, it provides an on-demand service for repairs and fittings. It has about 150,000 contacts a year with its 62,000 patients. That is 3,000 contacts a week, and of these a high proportion of problems, whether for repair or replacement or for some fitting attention, will be resolved immediately. Because the service is reactive, we must rely on patients to tell us if they are in difficulty, and that is why I repeat what my hon. Friend the Minister has said, that if anyone is in trouble as a result of the dispute or for any other reason or is known to be in trouble he or someone else should contact his nearest ALAC or the Department.

Before I discuss the need for the company and the work force to get together to resolve their dispute, I want to answer the specific points that were put to me by the right hon. Member for Stoke-on-Trent, South. These specific points will, I think, be of interest to the whole House, as is the concern for patients.

The right hon. Gentleman asked what pressure the general manager was putting on Hangers. The simple answer is that he is pressing Hangers to talk to the unions through ACAS to resolve the dispute and—to be fair, we have received a response to the request—to minimise the disruption to patients. The right hon. Gentleman also asked about the role of the NHS management board. The role of the general manager is to report not to implement but to anticipate—on some of the views of McColl and the benefit of management expertise that that will help to bring to bear.

He also asked why Hangers and Vessa were suing the Government. The answer seems to be because the Government are seeking, as McColl recommended, to improve the contractual position in order to get a better service for patients. Of course we regret that, but we do not intend to be deflected. Nevertheless, that seems to be the reason.

I, like other hon. Members, was encouraged to hear the constructive remarks of my hon. Friend the Member for Leominster. I hope that we shall see a change of heart and movement across a broad front with the assistance of the company.

I acknowledge the tribute of the right hon. Member for Stoke-on-Trent, South to Professor McColl and his working party and the support given to it by the all-party disablement group. I thank the right hon. Gentleman for recognising that these issues are complex. I emphasise that in no sense are we seeking to make changes to implement cuts. In fact, far from there being cuts, our intention is to use all the resources better, against a background of help for the long-term sick and disabled which is now £1.9 billion higher than when the Labour Government had control of these matters. That £1.9 billion, with £400 million in real rises in the value of individual benefits, is a significant sum that ought to be of interest to the whole House. It is, rightly, a matter of pride to the Government in their help for the long-term sick and disabled.

Having answered the right hon. Member for Stoke-on-Trent, South, and having welcomed his constructive support for McColl, I now turn to the duty to look to the future and the Government's approach. Following the recommendations of the McColl working party, which this Government set up—tributes have been properly paid to my hon. Friend the Member for Hornsey and Wood Green (Sir H. Rossi) who anticipated it—we have done a number of things. Despite the fact that the company may not like it, we are pressing for separate contracts for the provision of limbs and appliances and for the provision of prosthetic services. These provide an opportunity for wider competition.

We wish to see a less privileged and protected position for any individual supplier, major or minor. It is fair to say that there is much that is good in the equipment of our existing suppliers, but let them retain their pre-eminence by their ability to compete rather than by a form of annual contract which chokes competition from others. We wish to see an improvement in the quality of prosthetic services. A key aspect—here I pay tribute to the hon. Member for Eccles arid all the work that BLESMA is doing and which the hon. Gentleman so ably represents—is better training for prosthetists. We have initiated discussions with their training body and the industry about this. Our contract proposals will also make it possible for prosthetic firms or independent self-employed prosthetists to work at centres.

In summary, we have dealt with three aspects, but our primary concern is care of patients. The care of patients is——

Mr. James Hamilton (Motherwell, North)

rose in his place and claimed to move, That the Question be now put.

Question, That the Question be now put, put and agreed to.

Question put accordingly, That the original words stand part of the Question:—

The House divided: Ayes 167, Noes 246.

Division No. 10]	[10.00 pm
AYES
Abse, Leo	Foulkes, George
Adams, Allen (Paisley N)	Fraser, J. (Norwood)
Anderson, Donald	Freeson, Rt Hon Reginald
Archer, Rt Hon Peter	Garrett, W. E.
Ashley, Rt Hon Jack	Godman, Dr Norman
Atkinson, N. (Tottenham)	Golding, Mrs Llin
Banks, Tony (Newham NW)	Gould, Bryan
Barnett, Guy	Gourlay, Harry
Barron, Kevin	Hamilton, James (M'well N)
Beckett, Mrs Margaret	Hamilton, W. W. (Fife Central)
Benn, Rt Hon Tony	Hardy, Peter
Blair, Anthony	Harrison, Rt Hon Walter
Boothroyd, Miss Betty	Hart, Rt Hon Dame Judith
Boyes, Roland	Hattersley, Rt Hon Roy
Bray, Dr Jeremy	Healey, Rt Hon Denis
Brown, Gordon (D'f'mline E)	Heffer, Eric S.
Brown, Hugh D. (Provan)	Hogg, N. (C'nauld & Kilsyth)
Brown, N. (N'c'tle-u-Tyne E)	Home Robertson, John
Brown, Ron (E'burgh, Leith)	Howarth, George (Knowsley, N)
Buchan, Norman	Hughes, Dr Mark (Durham)
Callaghan, Jim (Heyw'd & M)	Hughes, Robert (Aberdeen N)
Campbell, Ian	Hughes, Roy (Newport East)
Campbell-Savours, Dale	Hughes, Sean (Knowsley S)
Canavan, Dennis	Janner, Hon Greville
Carter-Jones, Lewis	John, Brynmor
Clark, Dr David (S Shields)	Jones, Barry (Alyn & Deeside)
Clarke, Thomas	Kaufman, Rt Hon Gerald
Clay, Robert	Lambie, David
Clelland, David Gordon	Lamond, James
Clwyd, Mrs Ann	Leadbitter, Ted
Cocks, Rt Hon M. (Bristol S)	Leighton, Ronald
Cohen, Harry	Lewis, Ron (Carlisle)
Coleman, Donald	Lewis, Terence (Worsley)
Cook, Frank (Stockton North)	Litherland, Robert
Cook, Robin F. (Livingston)	Lloyd, Tony (Stretford)
Corbett, Robin	Loyden, Edward
Corbyn, Jeremy	McCartney, Hugh
Cox, Thomas (Tooting)	McDonald, Dr Oonagh
Craigen, J. M.	McGuire, Michael
Cunliffe, Lawrence	McKay, Allen (Penistone)
Dalyell, Tam	McKelvey, William
Davies, Ronald (Caerphilly)	MacKenzie, Rt Hon Gregor
Davis, Terry (B'ham, H'ge H'l)	McNamara, Kevin
Deakins, Eric	McTaggart, Robert
Dewar, Donald	McWilliam, John
Dobson, Frank	Madden, Max
Dormand, Jack	Marek, Dr John
Dubs, Alfred	Martin, Michael
Duffy, A. E. P.	Mason, Rt Hon Roy
Dunwoody, Hon Mrs G.	Maxton, John
Eastham, Ken	Maynard, Miss Joan
Fatchett, Derek	Meacher, Michael
Faulds, Andrew	Michie, William
Field, Frank (Birkenhead)	Mikardo, Ian
Fields, T. (L'pool Broad Gn)	Millan, Rt Hon Bruce
Fisher, Mark	Miller, Dr M. S. (E Kilbride)
Flannery, Martin	Mitchell, Austin (G't Grimsby)
Foot, Rt Hon Michael	Morris, Rt Hon A. (W'shawe)
Forrester, John	Nellist, David
Foster, Derek	Oakes, Rt Hon Gordon

O'Brien, William	Skinner, Dennis
Park, George	Smith, C.(Isl'ton S & F'bury)
Parry, Robert	Smith, Rt Hon J. (M'ds E)
Patchett, Terry	Soley, Clive
Pavitt, Laurie	Spearing, Nigel
Pendry, Tom	Stott, Roger
Pike, Peter	Straw, Jack
Radice, Giles	Thomas, Dafydd (Merioneth)
Randall, Stuart	Thomas, Dr R. (Carmarthen)
Raynsford, Nick	Thorne, Stan (Preston)
Redmond, Martin	Tinn, James
Rees, Rt Hon M. (Leeds S)	Wardell, Gareth (Gower)
Richardson, Ms Jo	Wareing, Robert
Roberts, Ernest (Hackney N)	Weetch, Ken
Robertson, George	Welsh, Michael
Robinson, G. (Coventry NW)	White, James
Rogers, Allan	Wigley, Dafydd
Rooker, J. W.	Williams, Rt Hon A.
Ross, Ernest (Dundee W)	Winnick, David
Sedgemore, Brian	Woodall, Alec
Sheerman, Barry	Young, David (Bolton SE)
Sheldon, Rt Hon R.
Shore, Rt Hon Peter	Tellers for the Ayes:
Short, Ms Clare (Ladywood)	Mr. Don Dixon and
Short, Mrs R.(W'hampt'n NE)	Mr. Ray Powell.
Silkin, Rt Hon J.
NOES
Adley, Robert	Cormack, Patrick
Aitken, Jonathan	Corrie, John
Alexander, Richard	Cranborne, Viscount
Amess, David	Critchley, Julian
Ancram, Michael	Crouch, David
Arnold, Tom	Dickens, Geoffrey
Ashby, David	Dicks, Terry
Aspinwall, Jack	Dorrell, Stephen
Atkins, Robert (South Ribble)	Douglas-Hamilton, Lord J.
Baker, Nicholas (Dorset N)	Dunn, Robert
Banks, Robert (Harrogate)	Dykes, Hugh
Batiste, Spencer	Emery, Sir Peter
Beaumont-Dark, Anthony	Evennett, David
Bellingham, Henry	Fairbairn, Nicholas
Bendall, Vivian	Fallon, Michael
Benyon, William	Farr, Sir John
Best, Keith	Favell, Anthony
Biggs-Davison, Sir John	Fletcher, Alexander
Blackburn, John	Fookes, Miss Janet
Blaker, Rt Hon Sir Peter	Forman, Nigel
Body, Sir Richard	Forsyth, Michael (Stirling)
Bottomley, Peter	Forth, Eric
Bottomley, Mrs Virginia	Fowler, Rt Hon Norman
Bowden, A. (Brighton K'to'n)	Fraser, Peter (Angus East)
Boyson, Dr Rhodes	Freeman, Roger
Braine, Rt Hon Sir Bernard	Gale, Roger
Brandon-Bravo, Martin	Gardner, Sir Edward (Fylde)
Bright, Graham	Gilmour, Rt Hon Sir Ian
Brinton, Tim	Glyn, Dr Alan
Brittan, Rt Hon Leon	Gow, Ian
Brown, M. (Brigg & Cl'thpes)	Gower, Sir Raymond
Browne, John	Grant, Sir Anthony
Bruinvels, Peter	Greenway, Harry
Buck, Sir Antony	Gregory, Conal
Budgen, Nick	Griffiths, Sir Eldon
Bulmer, Esmond	Grist, Ian
Burt, Alistair	Grylls, Michael
Butcher, John	Hamilton, Hon A. (Epsom)
Butler, Rt Hon Sir Adam	Hamilton, Neil (Tatton)
Butterfill, John	Harris, David
Carlisle, John (Luton N)	Hayes, J.
Carlisle, Kenneth (Lincoln)	Heddle, John
Cash, William	Heseltine, Rt Hon Michael
Chapman, Sydney	Hickmet, Richard
Chope, Christopher	Hicks, Robert
Clark, Dr Michael (Rochford)	Higgins, Rt Hon Terence L.
Clark, Sir W. (Croydon S)	Hirst, Michael
Cockeram, Eric	Hogg, Hon Douglas (Gr'th'm)
Colvin, Michael	Holland, Sir Philip (Gedling)
Conway, Derek	Holt, Richard
Cook, Frank (Stockton North)	Howell, Rt Hon D. (G'ldford)
Coombs, Simon	Hubbard-Miles, Peter

Irving, Charles	Price, Sir David
Jessel, Toby	Proctor, K. Harvey
Jones, Robert (Herts W)	Raffan, Keith
Joseph, Rt Hon Sir Keith	Raison, Rt Hon Timothy
Kellett-Bowman, Mrs Elaine	Rathbone, Tim
Kershaw, Sir Anthony	Rhys Williams, Sir Brandon
Knight, Greg (Derby N)	Ridsdale, Sir Julian
Knight, Dame Jill (Edgbaston)	Rifkind, Rt Hon Malcolm
Knowles, Michael	Rippon, Rt Hon Geoffrey
Knox, David	Roberts, Wyn (Conwy)
Lang, Ian	Roe, Mrs Marion
Latham, Michael	Rossi, Sir Hugh
Lawrence, Ivan	Rowe, Andrew
Lee, John (Pendle)	Rumbold, Mrs Angela
Lennox-Boyd, Hon Mark	Sackville, Hon Thomas
Lewis, Sir Kenneth (Stamf'd)	Sainsbury, Hon Timothy
Lightbown, David	Scott, Nicholas
Lilley, Peter	Shaw, Sir Michael (Scarb')
Lloyd, Peter (Fareham)	Shelton, William (Streatham)
Lord, Michael	Shepherd, Colin (Hereford)
Lyell, Nicholas	Shepherd, Richard (Aldridge)
McCrindle, Robert	Shersby, Michael
McCurley, Mrs Anna	Sims, Roger
Macfarlane, Neil	Skeet, Sir Trevor
MacGregor, Rt Hon John	Smith, Sir Dudley (Warwick)
MacKay, Andrew (Berkshire)	Smith, Tim (Beaconsfield)
MacKay, John (Argyll & Bute)	Soames, Hon Nicholas
Maclean, David John	Speller, Tony
McLoughlin, Patrick	Spencer, Derek
McNair-Wilson, M. (N'bury)	Spicer, Jim (Dorset W)
McQuarrie, Albert	Spicer, Michael (S Worcs)
Madel, David	Squire, Robin
Major, John	Stanbrook, Ivor
Malins, Humfrey	Stanley, Rt Hon John
Malone, Gerald	Steen, Anthony
Maples, John	Stevens, Lewis (Nuneaton)
Marland, Paul	Stewart, Allan (Eastwood)
Mather, Carol	Stewart, Andrew (Sherwood)
Mawhinney, Dr Brian	Sumberg, David
Mellor, David	Tapsell, Sir Peter
Merchant, Piers	Taylor, John (Solihull)
Meyer, Sir Anthony	Taylor, Teddy (S'end E)
Miller, Hal (B'grove)	Temple-Morris, Peter
Mills, Iain (Meriden)	Terlezki, Stefan
Miscampbell, Norman	Thomas, Rt Hon Peter
Mitchell, David (Hants NW)	Thompson, Patrick (N'ich N)
Moate, Roger	Thurnham, Peter
Monro, Sir Hector	Townend, John (Bridlington)
Montgomery, Sir Fergus	Tracey, Richard
Morris, M. (N'hampton S)	Trippier, David
Morrison, Hon C. (Devizes)	Twinn, Dr Ian
Mudd, David	van Straubenzee, Sir W.
Murphy, Christopher	Vaughan, Sir Gerard
Neale, Gerrard	Viggers, Peter
Needham, Richard	Waddington, David
Nelson, Anthony	Wall, Sir Patrick
Neubert, Michael	Waller, Gary
Nicholls, Patrick	Walters, Dennis
Norris, Steven	Ward, John
Onslow, Cranley	Wells, Bowen (Hertford)
Oppenheim, Phillip	Wheeler, John
Osborn, Sir John	Whitfield, John
Page, Sir John (Harrow W)	Whitney, Raymond
Page, Richard (Herts SW)	Wilkinson, John
Parkinson, Rt Hon Cecil	Winterton, Mrs Ann
Patten, J. (Oxf W & Abgdn)	Winterton, Nicholas
Pawsey, James	Wolfson, Mark
Peacock, Mrs Elizabeth	Wood, Timothy
Percival, Rt Hon Sir Ian	Young, Sir George (Acton)
Pollock, Alexander
Portillo, Michael	Tellers for the Noes:
Powell, William (Corby)	Mr. Tony Durant and
Powley, John	Mr. Francis Maude.
Prentice, Rt Hon Reg

Question accordingly negatived.

Question, That the proposed words be there added, put forthwith pursuant to Standing Order No. 30 (Questions on amendments):—

The House divided: Ayes 210, Noes 21.

Division No. 11]	[10.12 pm
AYES
Alexander, Richard	Gardner, Sir Edward (Fylde)
Alison, Rt Hon Michael	Glyn, Dr Alan
Amess, David	Gow, Ian
Ancram, Michael	Gower, Sir Raymond
Arnold, Tom	Grant, Sir Anthony
Ashby, David	Greenway, Harry
Aspinwall, Jack	Gregory, Conal
Atkins, Robert (South Ribble)	Griffiths, Sir Eldon
Baker, Nicholas (Dorset N)	Grist, Ian
Banks, Robert (Harrogate)	Grylls, Michael
Batiste, Spencer	Hamilton, Hon A. (Epsom)
Beaumont-Dark, Anthony	Hamilton, Neil (Tatton)
Bellingham, Henry	Harris, David
Bendall, Vivian	Hayes, J.
Benyon, William	Heddle, John
Best, Keith	Heseltine, Rt Hon Michael
Biggs-Davison, Sir John	Hickmet, Richard
Blackburn, John	Hicks, Robert
Blaker, Rt Hon Sir Peter	Higgins, Rt Hon Terence L.
Body, Sir Richard	Hirst, Michael
Bottomley, Peter	Hogg, Hon Douglas (Gr'th'm)
Bottomley, Mrs Virginia	Holland, Sir Philip (Gedling)
Boyson, Dr Rhodes	Holt, Richard
Braine, Rt Hon Sir Bernard	Howell, Rt Hon D. (G'ldford)
Brandon-Bravo, Martin	Jessel, Toby
Bright, Graham	Jones, Robert (Herts W)
Brinton, Tim	Joseph, Rt Hon Sir Keith
Brittan, Rt Hon Leon	Kershaw, Sir Anthony
Brown, M. (Brigg & Cl'thpes)	Knight, Greg (Derby N)
Bruinvels, Peter	Knight, Dame Jill (Edgbaston)
Buck, Sir Antony	Knowles, Michael
Budgen, Nick	Knox, David
Burt, Alistair	Lang, Ian
Butterfill, John	Latham, Michael
Carlisle, John (Luton N)	Lawrence, Ivan
Carlisle, Kenneth (Lincoln)	Lee, John (Pendle)
Cash, William	Lennox-Boyd, Hon Mark
Chapman, Sydney	Lewis, Sir Kenneth (Stamf'd)
Chope, Christopher	Lilley, Peter
Clark, Dr Michael (Rochford)	Lloyd, Peter (Fareham)
Clark, Sir W. (Croydon S)	Lord, Michael
Cockeram, Eric	Lyell, Nicholas
Colvin, Michael	McCurley, Mrs Anna
Conway, Derek	Macfarlane, Neil
Coombs, Simon	MacGregor, Rt Hon John
Cormack, Patrick	MacKay, Andrew (Berkshire)
Corrie, John	MacKay, John (Argyll & Bute)
Crouch, David	Maclean, David John
Dickens, Geoffrey	McLoughlin, Patrick
Dicks, Terry	McNair-Wilson, M. (N'bury)
Dorrell, Stephen	McQuarrie, Albert
Douglas-Hamilton, Lord J.	Madel, David
Dunn, Robert	Major, John
Durant, Tony	Malins, Humfrey
Emery, Sir Peter	Malone, Gerald
Fairbairn, Nicholas	Maples, John
Fallon, Michael	Marland, Paul
Favell, Anthony	Mather, Carol
Forman, Nigel	Maude, Hon Francis
Forsyth, Michael (Stirling)	Mellor, David
Forth, Eric	Merchant, Piers
Fowler, Rt Hon Norman	Meyer, Sir Anthony
Fraser, Peter (Angus East)	Miller, Hal (B'grove)
Freeman, Roger	Mills, Iain (Meriden)
Gale, Roger	Miscampbell, Norman

Mitchell, David (Hants NW)	Smith, Sir Dudley (Warwick)
Moate, Roger	Soames, Hon Nicholas
Monro, Sir Hector	Spencer, Derek
Montgomery, Sir Fergus	Spicer, Jim (Dorset W)
Morris, M. (N'hampton S)	Spicer, Michael (S Worcs)
Murphy, Christopher	Squire, Robin
Neale, Gerrard	Stanbrook, Ivor
Needham, Richard	Stanley, Rt Hon John
Nelson, Anthony	Steen, Anthony
Neubert, Michael	Stevens, Lewis (Nuneaton)
Nicholls, Patrick	Stewart, Allan (Eastwood)
Norris, Steven	Stewart, Andrew (Sherwood)
Oppenheim, Phillip	Sumberg, David
Osborn, Sir John	Tapsell, Sir Peter
Page, Sir John (Harrow W)	Taylor, John (Solihull)
Page, Richard (Herts SW)	Temple-Morris, Peter
Patten, J. (Oxf W & Abgdn)	Terlezki, Stefan
Pawsey, James	Thomas, Rt Hon Peter
Peacock, Mrs Elizabeth	Thompson, Patrick (N'ich N)
Percival, Rt Hon Sir Ian	Thurnham, Peter
Pollock, Alexander	Townend, John (Bridlington)
Powley, John	Tracey, Richard
Price, Sir David	Trippier, David
Proctor, K. Harvey	Twinn, Dr Ian
Raffan, Keith	van Straubenzee, Sir W.
Rhys Williams, Sir Brandon	Viggers, Peter
Rifkind, Rt Hon Malcolm	Waddington, David
Rippon, Rt Hon Geoffrey	Waller, Gary
Roberts, Wyn (Conwy)	Ward, John
Roe, Mrs Marion	Wells, Bowen (Hertford)
Rossi, Sir Hugh	Wheeler, John
Rowe, Andrew	Whitfield, John
Rumbold, Mrs Angela	Whitney, Raymond
Sackville, Hon Thomas	Winterton, Mrs Ann
Sainsbury, Hon Timothy	Winterton, Nicholas
Scott, Nicholas	Wolfson, Mark
Shaw, Sir Michael (Scarb')	Wood, Timothy
Shelton, William (Streatham)	Young, Sir George (Acton)
Shepherd, Colin (Hereford)
Shersby, Michael	Tellers for the Ayes:
Sims, Roger	Mr. David Lightbown and
Skeet, Sir Trevor	Mr. Michael Portillo.
NOES
Banks, Tony (Newham NW)	Pike, Peter
Beith, A. J.	Shields, Mrs Elizabeth
Bruce, Malcolm	Skinner, Dennis
Carlile, Alexander (Montg'y)	Steel, Rt Hon David
Freud, Clement	Thomas, Dafydd (Merioneth)
Hancock, Michael	Wainwright, R.
Howells, Geraint	Wallace, James
Kirkwood, Archy	Wigley, Dafydd
Livsey, Richard
Madden, Max	Tellers for the Noes:
Maynard, Miss Joan	Mr. David Alton and
Mikardo, Ian	Mr. Michael Meadowcroft.
Nellist, David

Mr. Speaker forthwith declared the main Question, as amended, to be agreed to.

Resolved, That this House regrets the interruption of service to severely disabled people caused by the dispute at J. E. Hanger & Co. Ltd.; urges the management and workforce to resolve this dispute without delay; notes with approval the Government's initiatives to minimise inconvenience to patients; and congratulates the Government on the action it is taking to secure long term improvements in the standards of artificial limb services.