§ `(1) Each district health authority and health board shall make such arrangements as seem to them reasonable for the provision of hospital domestic services.
(2) The Secretary of State shall have no power to direct district health authorities or health boards on whether they employ outside contractors in making arrangements under subsection (1).
(3) Notwithstanding subsection (2) the Secretary of State may specify minimum standards of hygiene to be required of arrangements under subsection(1).'.—[Mr. Norman Hogg.]
§ Brought up, and read the First time.
§ Mr. Norman Hogg (Cumbernauld and Kilsyth)I beg to move, That the clause be read a Second time.
It is right that responsibility for domestic services in the National Health Service should lie with the district health authorities, or, in the case of Scotland, with the health boards. That may seem obvious, but there has been some activity on the part of the Government of late that leads us to believe that they take a different view. The DHAs and the health boards have responsibility for catering and cleaning. My colleagues and I believe it to be right that management should be as close as possible to the delivery of services.
The problems associated with domestic services have a great deal to do with poor pay and conditions, and little to do with poor management or lack of motivation. Recently the Government have sought means of privatising services through competitive tendering, and we have seen Whitehall telling the DHAs and health boards how it is to be tackled. There are more problems arising from under-investment in hospitals, low pay and buildings which are not conducive to efficient working than from the fact that the services are run by internal staff.
Circular letters have been sent by the Minister responsible for the Health Service in Scotland, the hon. Member for Stirling (Mr. Forsyth), and I am sorry that he is not here. Ah, he has just arrived. This is really something of an occasion, because we had hoped to have the services of the Scottish Health Minister in considering the Bill in Committee, but I can promise him that when we go into Committee next week on the School Boards (Scotland) Bill I will repeat all my speeches on the Health and Medicines Bill so that he will not have missed anything.
The Minister sent a letter to the health boards in Scotland telling them how they might proceed to privatise services, or, as he might prefer to say, to introduce competitive tendering. The result has been a fall in the morale of the staff of Scottish hospitals, culminating in days of action, and he must accept some responsibility for the present situation. One needs only to look at the experience of district health authorities in the privatisation of catering and cleaning to see that such a course is not in the best interests of patient care, which is the primary function of the Health Service.
The National Health Service provides a high standard of catering at extremely reasonable prices. I checked on that this afternoon and found that University College hospital, London, which has a staff of 72 in its catering service, provides 1,600 meals per day on a budget of just £1.28 per head per day. That shows how efficient the staff can be.
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I am sure that the Egon Ronay guide is widely read on the Government Benches, for reasons other than catering in the Health Service. It is certainly not widely read by the Refreshment Department of the House of Commons. The Egon Ronay guide commented favourably on National Health Service meals and concluded that the food at some of the private hospitals that were visited was little better than, and in one case was below, the average standard served by National Health Service hospitals in the same cities, despite the fact the private sector spends on average four times more per patient on food than does the state. The Egon Ronay guide was complimentary about the quality of the food and its presentation in the National Health Service. The same guide criticised private hospitals, describing their meals as "grossly over-priced". Therefore, when it comes to value for money, that is delivered by the staff in the National Health Service.
These days we hear a lot about cook-chill. I can remember the Minister telling us a lot about cook-chill in Committee. I believe that this system of providing food could prove misguided in terms of the needs in the National Health Service. Indeed, it could well prove disastrous. It can destroy up to 90 per cent. of the vitamins in the food, as well as reduce its palatability—
§ Mr. NewtonRubbish.
§ Mr. HoggThe Minister for Health says "Rubbish", but I am sure that if he has been asked to reply to the debate he will explain why. All the evidence that I have been able to gather on this subject suggests that that is not a good way for us to proceed in the National Health Service and that there are considerable dangers from wrongly treated food.
There is some evidence that many of the catering staff in the service give up because they find that they are no longer able to earn overtime because of the introduction of that system, which means that they are not able to sustain their standard of living. Indeed, the poverty level wages paid in the National Health Service are not adequate in the first place—
§ Mr. NewtonI am not sure whether I should intervene but I addressed a seminar of cook-chill on Sunday evening which was no doubt very good for my soul. The hon. Gentleman will doubtless further explain his concerns for the staff, but I advise him that the purpose of a hospital food system is to provide good quality palatable food for the patient, hot and at the right time. There is little doubt that cook-chill is capable of doing that better than most conventional systems.
§ Mr. HoggI do not know where the Minister delivered his lecture on cook-chill last Sunday evening. I did not realise that he was the Government's answer to the "Galloping Gourmet".
My point about the staff is that where they are employed for the job for which they are trained—that is the preparation, cooking, and serving of the food—they have to work overtime to sustain the service and their standard of living. The Government are using the process of cook-chill to achieve savings in the National Health Service, which results in those staff not being able to sustain their earnings and, therefore, leaving the service. There is some evidence that, to fill the gap, cleaning and domestic staff are being brought in by contractors to 273 prepare the food, and there are dangers in that. I make that point to the Minister, and I hope that he will consider it again.
Poor pay is a major contributory factor to the problems in the National Health Service and it will not be resolved by privatisation. Low wages lead to low morale which leads to low motivation and low standards. If that was better understood by the Government, perhaps we would begin to get somewhere.
Notwithstanding the pay award which is pending, and which I hope the Government will fund fully, auxiliaries in the NHS start at £4,565 a year. A fully trained staff nurse gets £65 a week less than a fireman, and £109 a week less than a policeman. [Interruption.] It has a great deal to do with the problem. About 70 per cent. of nurses are forced to moonlight. The purpose of the new clause is to protect the service from privatisation, but if privatisation is introduced the problems will be aggravated. I do not know why the Government cannot understand that.
The underpaid jobs have one redeeming feature. We raised this in Committee, but the point has still not been adequately answered. In the radio programme in which I took part with the hon. Member for Stirling he did not answer the point. If staff have to engage in competitive tendering for their own jobs, and if the tender is successful and they become private employees in the NHS instead of being NHS employees, is it not the case that they lose their superannuation rights? That point should be clarified, because the superannuation right is the only redeeming feature of the underpaid jobs. What happens to the superannuation rights of someone working for a private company who was previously a public service employee? This must be clarified, because superannuation is an important consideration for people with such poor employment conditions.
Privatisation threatens the whole of patient care, which is the primary function of the National Health Service. Privatisation moves out of the hospital responsibility for important functions, most notably hygiene. Conservative Members are enthusiastic about the introduction of private services, but they do not realise that work in a hospital is a team job and that everyone has a commitment to achieve the highest standards of hygiene as an aid to patient care.
We are discovering a catalogue of horror stories which must be attributed to the fact that privatisation has become such a factor in some places. In Bromley, 351 jobs are documented as having been lost through privatisation. In Greenwich, 150 jobs have been lost, the prices of meals for staff have increased, some kitchens have been closed and more housekeeping duties are being carried out by nursing staff.
In Wandsworth, which is famous—or infamous—for privatisation, there were 739 job losses, the majority of which were 402 domestics at St. George's hospital in Tooting. In Ealing 100 jobs were lost as a result of a catering contract being won by a private contractor. In south London 125 jobs were lost in one case alone, in which a private hospital contractor won a domestic contract for Westminster hospital. The Association of London Authorities advises—[Interruption.] The Minister does not care for elected authorities. She much prefers to tell them from Whitehall how to run their affairs.
274 We know that she subscribes to the view that Whitehall knows best. However, in the hospitals in which the Association of London Authorities made inquiries, there were dirty baths and showers, filthy sinks and draining boards, unclean sterile treatment rooms, patient day rooms left unclean, and low staff morale.
On top of that, private contractors have not known what is involved in the cleaning of hospitals. They have not been able to find equipment. They have carried out cleaning procedures when it was not suitable to the immediately important task of hospital patient care. Their untrained staff have cleaned wards and clinics while nurses and doctors have been changing wound dressings and treating patients. There was an example of that at Queen Mary's hospital in Roehampton.
That stems from the fact that the Government do not recognise that hospital staff work as a team for the promotion of patient care and that they must understand what is required of them in the promotion of patient care. That is simply not possible by having private companies do the job in such a temporary way and with such a turnover of staff. Privatisation has been to the detriment of patient care.
One aspect that worries me is the coercion of health boards by the Government. The Under-Secretary of State for Scotland will know what I am about to say. It was deplorable that the chairman of Grampian health board was sent for when he and his board hesitated to act on the Under-Secretary's edict that they were to introduce what he calls competitive tendering in hospitals. The chairman was sent for and given the Star Chamber treatment. On top of that, the Under-Secretary of State for Scotland and the Secretary of State for Scotland are recorded as saying that the role of health boards in Scotland is to be the Government's agent.
The onward roll of centralism and central Government is the hallmark of contemporary Conservatism. I do not know where it will end, but we in Scotland maintain that the Under-Secretary of State for Scotland has little authority for insisting on a devolved Government role in Scotland and that it is unacceptable that members of health boards should be addressed in such a way. We are weary of the fundamentalists of market forces, who seem to be determined to shove their doctrines down the throat of an unwilling people, as is the case in Scotland.
The Government have no place for patient care in their policies. The House should recognise that by supporting the new clause.
§ Mr. John Redwood (Wokingham)I oppose the new clause. It is always disappointing when the Opposition come forward with ideas which are backward-looking and which in many ways conflict with the principles for which the National Health Service should stand. The NHS should be a national service, and to be a national service it needs common standards, some central direction and mission and some common administration and management purpose. The Opposition propose the opposite and seem to wish for a degeneration into local anarchy with no sense of central direction or management control.
§ Ms. HarmanThe hon. Gentleman talks about common standards. Does he not recognise that of something like 400 performance indicators—statistics that the Government are now collecting—only about four 275 relate to the quality of service and all the rest relate to throughput and cost-cutting? Are those the common standards to which the hon. Gentleman refers?
§ Mr. RedwoodI do not entirely agree with the hon. Lady's analysis that only four of the performance indicators relate to the quality of care. Many of them relate to staff usage in relation to patient numbers and many people would suggest that that is a proxy for some elements of the quality of care. The majority of indicators are based on such ratios and calculations.
I hope that the House will agree that one should seek value for money in any health system. The Government have introduced proposals that attempt to provide better value for money. The new clause would reverse that process by resisting moves to provide better value for money in hospital domestic services.
I hope that most hon. Members will agree, too, that money should be concentrated where it is most needed—on patient care and on the services that go most directly to the patient. The fears that the Opposition express are strange. If it is true that the hospitals themselves can do the job best, they are free to bid for the business and to carry on as before, demonstrating that they are the cheapest and best and having pride in a job well done. It is curious that when competitions have been organised, the in-house services have often had to change their pricing, management style and many of their practices to win the bids. It is also curious that where the services have been put out to tender there have been substantial savings in most cases. That seems to give the lie to the idea that all the in-house services are absolutely perfect.
We have then to consider the question of quality. It is argued that quality falls down if services are provided by a private contractor. One of the advantages of a private contract, however, is that one can enforce the contract or sack the contractor. There is no advantage in the in-house system. It is a matter of regret that salmonella outbreaks occurring as a result of conditions in hospitals have often started in kitchens where no private caterers are involved. Such outbreaks would be possible under either system, but it is nonsense to let people believe that they happen only where services have been privatised given that the evidence points in the other direction.
If the NHS had a powerful chief executive with the necessary powers to put into place an efficiency drive across a range of activities, it would be quite easy for him, in a relatively short time to deliver £1,000 million of savings which could go straight into patient care. We should all be striving to achieve that. The National Audit Office has identified £300 million to £500 million of savings that could come simply from better use of properties. Several hundred million pounds more could come from the contracting-out of hotel-type services, and that is before considering the broad use of staff, which would be likely to produce savings if a sensible chief executive had the necessary powers.
The new clause would be a retrograde step which would stand in the way of better value for money, better patient care and better national management of the service.
§ Mr. GalbraithI should like to make two specific points to the hon. Member for Wokingham (Mr. Redwood). The first is on efficiency. When Conservative Members speak about efficiency, they use the word as a euphemism for cheapness. When they talk about services being better, 276 they mean services being cheaper. The hon. Gentleman had to add as an afterthought the question whether the service might be better. When we talk about efficiency we mean efficiency in the provision of care, getting patients operations when and where they want them and by whom in the surroundings that they want. We do not mean the sort of efficiency that the hon. Gentleman talks about—cheapness at the expense of already low-paid workers in order to fill the pockets of Members who have interests outside the House.
§ Mr. DickensThe hon. Gentleman is lecturing us on efficiency. Does he recall that when the Conservatives came back to power in 1979, the Government asked the regional health authorities for their manning levels and that hardly any of them could give us the up-to-date levels or, indeed, any levels? The ones that did give figures were 18 months out of date. That was the efficiency that was achieved under the Labour Government. How can the Opposition lecture us on efficiency in the Health Service?
§ Mr. GalbraithI shall resist the temptation to lecture the hon. Gentleman because, even if I spoke to him quietly, he would not understand what I was talking about.
When the hon. Member for Wokingham talked about efficiency, he said that we needed to know more about the Health Service and the various factors that operate in it. Nobody disagrees with that, but there is more to efficiency than Conservative Members seem to think. There is more to it than cutting costs and looking at the financial aspect. As Ministers are always telling us, the purpose of the National Health Service is to provide care for patients. That must be the motivating factor, and it is done by increasing efficiency in the provision of care. Financial efficiency is cheapness, but it comes second to efficiency in the provision of care, in patients being seen when they want, by whom they want arid in the surroundings that they want.
The hon. Member for Wokingham spoke about releasing money for patient care. I do not think that the hon. Gentleman appreciates the point made by my hon. Friend the Member for Cumbernauld and Kilsyth (Mr. Hogg), that everyone in the Health Service is involved in patient care. If we move anyone, care is affected. Conservative Members must agree, because when porters withdraw their labour they are told that it affects patient care. There is a contradiction in the points made by the hon. Gentleman. We have had enough hypocrisy from Conservative Members. Let us concentrate on efficiency in the delivery of patient care and stop using euphemisms about efficiency when what is meant is simply cheapness.
I should like to speak to the new clause, which is more than the hon. Member for Wokingham did. It should commend itself to Ministers because it is all about democracy, devolving power and giving it back to the people. It is about devolution and letting decisions be taken where it matters. The hon. Gentleman talked about central control. How can things be controlled centrally if they are privatised to umpteen companies over which we have absolutely no control? That is the problem. Health boards wish to retain central control and Ministers ought to be keen to accept that, especially in view of the reassurances that they gave us about clause 4. The 277 Minister will remember that in Committee we discussed that clause. Clause 4(1)(g) provides that the Secretary of State
may give directions—(i) for the exercise of any of those powers by any body constituted under the National Health Service Act 1977 or the National Health Service (Scotland) Act 1978; and(ii) with respect to the manner in which any such body is to exercise any such power".We wish to remove that power from the Minister, but he says that there is no problem about the matter, because it is power not to direct health authorities to do anything but to prevent them from doing silly things. The Minister said that it was to prevent them from putting up adverts for undertakers and charging money for them. For that reason, I am sure that the Minister will accept the new clause because it goes along with the philosophy that he put forward in Committee.The other reason for the new clause is to prevent what recently happened in Scotland with health boards. Here I come to the hon. Member for Stirling (Mr. Forsyth). Michael Forsyth Ltd.—[Interruption] Michael Forsyth Ltd. has nothing whatever to do with the hon. Member for Stirling. I want to make it clear that, when I mention Michael Forsyth Ltd., it has nothing to do with the hon. Member for Stirling.
Here we have the great proponent of democracy who said that he wants parents to have power in education and wants to set up school boards but who will not allow local health boards to do anything. He directs them in a jackboot fashion against their wishes. He calls up the chairmen of the health boards and instructs them to tear up agreements. The health boards had agreements with the trade unions which brought about significant savings for the NHS and the hon. Member for Stirling—not related to Michael Forsyth Ltd.—told them to tear up the agreements. Can you imagine, Mr. Deputy Speaker, what Conservative Members would say if the trade unions were to tear up agreements? I remember Conservative Members saying that it is about time that trade unions stuck to agreements. Well, there were agreements and the hon. Member for Stirling—not related to Michael Forsyth Ltd.—told them to tear them up.
§ Mr. DickensBoring.
§ Mr. GalbraithWell, I am going to bore hon. Members a little longer. As I have said, Michael Forsyth Ltd. is not related to the hon. Member for Stirling.
As a result of those agreements—I shall quote the figures of the hon. Member for Stirling—Scotland saved £20 million. The savings from privatisation in England and Wales are £100 million. The equivalent savings in Scotland from agreements with the trade unions are double those from privatisation in England and Wales. Therefore, that is an argument in favour of retaining the arrangements between the health boards and the unions and against privatisation.
We want to give the power back to the health boards to ensure that decisions are taken locally, that all people benefit and that decisions are not made by Michael Forsyth Ltd., which is not related to the hon. Member for Stirling.
§ Mr. David Hinchliffe (Wakefield)My hon. Friend the Member for Cumbernauld and Kilsyth (Mr. Hogg) set out coherently the arguments in favour of this clause. I was particularly interested in the fact that he referred to the cook-chill system. I was gratified to hear that the Minister has become an expert on cook-chill. I invite him to stick around until we reach clause 4 because I intend to refer in some detail to the cook-chill system in Wakefield and I would very much welcome his comments on that. I have tried endlessly to get some response from the Government on it. I hope that he will stay around until 3 or 4 o'clock tomorrow morning, or whenever we reach clause 4.
My hon. Friends have set out the reasoning behind new clause 7. It is about the need to ensure proper standards of hygiene within the NHS and about the rights of working people to fair wages and decent working conditions. Competitive tendering, as the hon. Member for Wokingham (Mr. Redwood) has said, is advanced by the Government for two main reasons. First, on ideological grounds, bringing private companies into the NHS is a move towards breaking up the state, with which the Government are obsessed. Secondly, there is the issue of financial savings, which the hon. Member for Wokingham referred to as value for money. Those savings are supposedly made by privatising various services.
I am sure that the hon. Gentleman will have heard on many occasions, as I have, the figure of £105 million quoted by Government supporters, as being the cumulative saving that has accrued as a direct result of the competitive tendering process. The figures have been used endlessly by Ministers and Government Back Benchers as a justification for turning the screw even further on more and more public services, particularly within the NHS. One can drive a coach and horses through the figure of £105 million; it simply is not accurate. I shall give a few pointers to why it is open to the gravest doubt.
First, the supposed savings do not take account of the time spent by district and regional health authorities on preparing and monitoring tenders. I understand that more than a year ago the National Audit Office estimated that that cost was at least £15 million per annum. Secondly, different accounting methods have been used by district health authorities to assess the base-line cost and to measure the so-called savings of competitive tendering. Consequently, the figures are highly unreliable. Thirdly, redundancy costs have not been accounted for in the savings advanced by Conservative Members, which have supposedly been achieved through competitive tendering. In many areas where people have been made redundant because of competitive tendering those costs are high. Fourthly—this is crucial if one is to assess the real figure involved in this issue—there is the financial cost of forcing hospital workers to be dependent on unemployment and social benefit.
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The Prime Minister constantly says that no Government have spent more than the present one on social security benefit. Of course that is true, but it is because they have made so many people redundant. They have put hospital workers on the dole and shoved their jobs out to private contractors. Those people are now claiming state benefit. That should be taken into account when considering the savings made by competitive tendering. About 2,000 jobs have been lost in the Yorkshire health authority since 1985, primarily because 279 of the competitive tendering process. Many of those people are now in receipt of state benefit. That fact should be taken into account when talking about the tremendous savings made through competitive tendering.
The savings made through competitive tendering are a fraud; they are a complete con trick. I would argue that it has cost public money to introduce competitive tendering, regardless of the problems of filth, catering difficulties and the major failures of numerous contracts that my hon. Friend the Member for Strathkelvin and Bearsden (Mr. Galbraith) mentioned.
I know that on any issue the Government think only in terms of cash, but recently the Prime Minister started lecturing the Church of England and the bishops about morality. Is it morally right that the Budget gave more money per week to some people by way of tax concessions than many National Health Service workers in a year? Is it morally right that people earning less than £70 per week should have their wages driven down? In Committee I gave the example of a taxi driver in Wakefield who collects me who has to moonlight. He showed me his pay slip. He receives £81 per week working as a porter, and that includes a 25 per cent. bonus. He has to keep a family on that sum of money, and when his job is put out to competitive tender shortly, even if the in-house tender is successful, his wages will be driven down further.
Is it morally right that people working in the most basic conditions should have them made even worse? Is it morally right that Tory Members, who have interests in private contracts, should speak in debates on the Health Service and vote on issues when they stand to gain financially? That happens time and again because the Government Benches are riddled by people who stand to gain from this issue. [HoN. MEMBERS: "Name them."] It would take me all night to name them.
As a policy, competitive tendering has been a complete and dismal failure. It has been a failure for the district health authorities and health boards that have had to bring it in. It has been a failure for the patients, and, most of all, it has been a failure for the loyal and hard-working employees of the National Health Service. I urge all hon. Members with a conscience to give their full support to new clause 7.
§ Mr. CorbynAt last we have an opportunity to debate the hypocrisy that we have heard so often from Ministers and from the Government about privatisation and the alleged efficiencies that emanate from it. They know that it is complete nonsense. In promoting privatisation they are really after a featherbedded system to produce enormous profits for private contractors for cleaning or catering in hospitals. They know perfectly well that the end result of privatisation is a starvation wage for those who work for those private cleaning companies, and enormous profits for the companies, and filthy hospitals.
If the Government bothered to examine the results of the privatisation of cleaning in hospitals, they would find that there are quite appalling and astounding statistics about the number of contract failures. They would discover the number of times that doctors have refused to work in hospitals that are not clean enough, and the number of times that nurses have stopped doing nursing work because the wards are so filthy that the first priority is to clean the wards, not to carry out the necessary treatment of the patients.
280 The new clause, in a very modest way, is trying to improve the situation. Subsection (1) states:
Each district health authority and health board shall make such arrangementsas it wishes for catering services, cleaning services or any other services within a hospital.
§ Mr. Gerald Howarth (Cannock and Burntwood)Will the hon. Gentleman give way?
§ Mr. CorbynI shall complete my point and then give way. The hon. Gentleman may have something useful to say, although I have my doubts.
§ Mr. HowarthI am grateful to the hon. Gentleman for giving way. He said that the new clause states that health authorities shall make such arrangements as they wish. That is not what the new clause says. It says:
as seem to them reasonable".Will the hon. Gentleman give the House his definition of reasonable?
§ Mr. CorbynThe hon. Gentleman raises an interesting point, as there is a great deal behind it. My idea of reasonable is reasonable wages for the staff, a high standard of cleanliness and a high standard of service. Above all, the motives behind the provision of that service should be a clean hospital and good quality food for the patients, not the motive of rip-off profits for the fly-by-night companies that seek to run away from the Health Service at the first opportunity.
The hon. Gentleman knows perfectly well that it is wrong to have a Health Service dominated by private enterprise values that are interested only in making money out of the Health Service. Rather, it should consist of people who are determined to ensure the best possible standards for those who use the Health Service, namely, the patients.
The House should be aware of some of the issues referred to by my hon. Friend the Member for Wakefield (Mr. Hinchliffe). A large number of Conservative hon. Members who have substantial shareholdings in contract cleaning companies regularly put pressure on the Government with regard to the Health Service—as they did at the Carlton Club private lunch, and as they do in boardrooms throughout the country and at dinner tables in this building. They try to convince the Government—who are readily convinced about such matters—that the one thing we need is central direction of health authorities by the Government—who are supposed to be against centralisation—to force them to hand contracts to private cleaning and catering companies. It is a corruption of our political system that that is allowed to happen in this building.
The lid should be taken off the hypocrisy that accompanies this issue and the claims by Conservative Members that there are great savings to be made in the Health Service if we privatise everything. The savings are to be made in the form of profits for companies at the expense of the standards of treatment for patients, of clean hospitals and of good quality food. The profits are made because of dirty hospitals, poor quality food and a high level of unemployment among people who formerly cleaned hospitals and cooked food there. If the Government doubt my word, they should go to hospitals where private companies now do the cleaning, examine standards and talk to people who previously were able to take pride in their work but who are now doing the jobs of 281 three of four people for a pittance. It is a disgraceful way to treat people who have given long service to the NHS and who are dedicated to it.
In reality, Conservative Members have nothing but contempt for manual workers in the NHS, who have kept the hospitals clean for so long. My hon. Friend the Member for Cumbernauld and Kilsyth (Mr. Hogg) said that hospitals cannot be run without catering and cleaning staff. It is about time that hon. Members understood the community of interest in hospitals. Those who clean hospital floors, empty bed pans, wash soiled sheets and do all the unspeakable jobs that Conservative Members would not do in a thousand years, never mind for the wages that manual workers are paid, are every bit as dedicated to the NHS as are doctors, nurses and research chemists. I make no apology for saying that or for reminding the House that I am sponsored by the National Union of Public Employees, which does not pay me one penny piece for making this speech. It exists to represent the interests of low-paid manual workers. It recognises that privatisation is the enemy of decent working conditions, decent staff morale and a good Health Service.
I want the Health Service to be free at the point of use and available to all. I also want it to operate on the basis of not causing fear among its staff, not putting low-paid workers' jobs on sale once a year to the lowest bidder and not forcing low-paid health workers to offer their services for even lower wages to some fly-by-night company that will exploit them for a year, after which somebody else will exploit them.
Ministers should revert to the direct employment system and end fear of low-paid workers in the National Health Service. I hope that the House will return to this issue again and again, so that the scandal of the appalling standards and working conditions that private cleaning and catering companies provide, their attitude towards their staff and their contempt for the Health Service can be further exposed. Then we shall return to a decent system of centralised employment that guarantees proper working conditions and jobs.
§ Mrs. CurrieAs the hon. Member for Islington, North (Mr. Corbyn) has just reminded us, this is the trade union clause—the NUPE and COHSE clause. It was supported eloquently by the hon. Members for Islington, North and for Wakefield (Mr. Hinchliffe), who is also sponsored by NUPE. They are proud of that, and quite rightly, too. The hon. Member for Cumbernauld and Kilsyth (Mr. Hogg), who moved the new clause, is sponsored by NALGO. It includes among its members many senior managers in the National Health Service and in local government who know that much of what he said is wrong. They are running the system, and they are right to be proud of their achievements.
As for the comments of the hon. Member for Peckham (Ms. Harman) on the performance indicators, I cannot resist the comment that what she said suggests that she has not looked at them, any more than she looked at the General Practice Finance Corporation's annual report. I suggest that she takes another look at them. They are all about getting cost-effective patient care.
New clause 7 deals with hospital domestic services, which I understand mean services that vary widely throughout the Health Service from basic cleaning to a 282 fully developed hotel service, from internal linen distribution to pest control. Rather than improving the present service, the new clause would stifle the competitive tendering initiative that is being shown by managers, many of them members of NALGO, over domestic support services.
I was a little surprised, therefore, to hear all that was said about cook-chill. That is not a domestic service and it has nothing to do with the new clause. It is catering. But perhaps the hon. Member for Cumbernauld and Kilsyth normally eats his dinner off the floor.
§ Mr. Norman Hoggrose—
§ Mrs. CurrieI am delighted to give way to the hon. Gentleman.
§ Mr. HoggThe Minister is drawing a very narrow definition of "domestic". Perhaps that is because she does not really know much about domestic services. She probably has people to do them for her.
§ Mrs. CurrieYou bet. The hon. Gentleman put down the new clause, and, judging by his opening speech, he clearly did not read it.
However, if we are to talk briefly about cook-chill, let me say that, as 387 catering contracts in England were won in-house and only 11 were won by outside contractors, the odds are that all the cooking that the hon. Gentleman and his hon. Friends have described—both good and bad—has been done by NHS staff who won their contracts through open competition.
Incidentally, the hon. Gentleman asked what would happen to superannuation. Let me remind him that when NHS staff win a contract they stay as NHS employees, just as local government employees who do the same stay as local government employees. Nothing happens to the superannuation of those employees. They retain all their superannuation rights, and all their other rights as well. If the hon. Gentleman and his hon. Friends are really putting about that kind of rubbish in Scotland, it is no wonder that his constituents—
§ Mrs. CurrieI shall give way in a moment. I listened to the hon. Gentleman with all the dignity and courtesy that I could muster, and I have not finished my sentence yet.
If the hon. Gentleman and his hon. Friends have really been putting about that kind of rubbish in Scotland, it is no wonder that his constituents are upset, but it is not true. Nothing will happen to that superannuation, and if he even hints at it he is going much too far.
§ Mr. HoggOne of the Minister's roles in the House is to answer reasonably questions that are put reasonably to her about Government policies as they apply to constituents of hon. Members on both sides of the House. The question was put to her because the position was not clear. No one has been putting about any rubbish in Scotland, and I am sorry that she has addressed me in that tone. She would do better simply to give us the facts. If she stuck to that, perhaps she would manage to win some support for herself in the country.
§ Mrs. CurrieI always listen to advice, even from Opposition Members. However, if the hon. Gentleman had even tried to consult members of NALGO, his own 283 union, they would have given him the facts as I have given them. Indeed, if he had listened to the speeches of my right hon. and hon. Friends in Scotland, he would have heard the same many times.
I listened to what was said by the Association of London Authorities. I felt that I would much rather the authorities used their rates in London to look after local ratepayers—for example, by improving services in the community which might assist patients being discharged from hospital—and not go poking around looking for very thin material to make political points that do no service whatever to the House.
The hon. Member for Strathkelvin and Bearsden (Mr. Galbraith) waxed eloquent about democracy. He impressed me during the Committee stage of the Bill because it was clear that he was one of the few Opposition Members who had read the Bill and the White Paper, and he kept surprising himself by saying that he agreed with most of it. We appreciate that very much. Perhaps, however, the hon. Gentleman has not quite understood the new clause. I know that his name was not on it, so perhaps he was not consulted in the way that Opposition Members like.
The effect of subsection (1) would be to undermine the powers established under section 17 of the National Health Service Act 1977 and the National Health Service (Scotland) Act 1978 whereby the Secretaries of State can ensure the cost-effective delivery of the whole range of hospital services. Instead, health authorities and health boards would be permitted to act independently of central initiatives for domestic services, and would be able to choose to ignore the Secretaries of State. That is not acceptable, and is not in the interests of either patients or taxpayers.
The powers that the new clause seeks to annul were provided by a Labour Government. They are wise and essential, and we want to retain them. On that basis, I feel that the hon. Gentleman has got himself in a bit of a twist. The approach of the sponsors of the new clause is very disappointing, particularly because other Opposition Members are trying to be much more helpful.
I do not know whether hon. Members on either side of the House were able to hear the Leader of the Opposition taking part in a discussion over the weekend, which I thought very interesting and helpful. He said that not all public service was good and that not all private service was bad. That is entirely sensible and right and I commend that kind of approach—and perhaps some of that style—to the hon. Gentleman.
Competitive tendering arouses strong feelings. That is a pity because, in the end, it is a method of achieving better service and better value for money. Competitive tendering is of proven value. More than £100 million has been saved and ploughed back into other patient services. There is also much greater emphasis now on setting and achieving standards in all these hotel services, and on tighter budgetary discipline and more flexible forms of provision. Eighty per cent. of the domestic service tenders to which this clause refers have been won in-house and, on average, costs have fallen by 23 per cent. That is a tribute to the managers concerned, most of whom are members of NALGO, and perhaps most of all to their staff, most of whom are members of NUPE and COHSE.
§ Mr. GalbraithThe Minister has used the same figure mentioned in my speech—that £100 million had been 284 saved in England and Wales through privatisation. Does she agree that the savings made in Scotland from the agreement trade unions have with the health boards without privatisation is £20 million, which is equivalent to double the savings in England and Wales?
§ Mrs. CurrieI heard what was said by the hon. Gentleman the first time because, whatever my public reputation might be, I do listen and I have an answer ready for him. He spoke of a figure of £20 million saved in Scotland. That is the accumulated figure over a number of years in Scotland.
§ Mr. GalbraithOver how many years?
§ Mrs. CurrieThe figure of more than £100 million is the English annual saving, and so the two are not exactly comparable. Even so, I cannot see what the hon. Gentleman is so upset about. The money goes straight back into the National Health Service for patient care. That involves employing people, too, and it involves looking after patients.
Indeed, when it comes to the matter of employment and the point made by the hon. Member for Wakefield the National Health Service has more than done its bit in recent years. It now employs some 1¼ million people, which is not only a national record but makes it the biggest employer in western Europe. The NHS now employs far more people than it did in the days when Labour last lost its grip on power, which I believe was way back in 1979.
We are now starting the second round of tendering in England. Progress is being made in Wales, and the first round is under way in Scotland. All the health boards in Scotland are now engaged in the preparatory work that is necessary before seeking tenders. Indeed, I understand that some tenders have already been let. We expect that the exercise will be as fruitful in Scotland as elsewhere, and to the benefit of patients.
The total amount involved in respect of domestic services in Scotland is more than £50 million, and if the savings are even close to those we have experienced elsewhere many millions of pounds are likely to be involved.
The same fears that have been expressed today were expressed in England some time ago when our competitive tendering exercise began. They proved to be unfounded. We believe they will prove to be unfounded in Scotland as well. We deplore the methods by which some views have been expressed outside.
Due to industrial action in Scotland, some 3,500 operations have been cancelled; 3,500 Scots people are suffering unnecessarily. Knowing hon. Members as I do, I doubt very much whether some of them—at least the hon. Members for Strathkelvin and Bearsden and for Cumbernauld and Kilsyth—are proud of the fact that 3,500 Scots people have been suffering unnecessarily. They did not intend that it should happen, but it has. During the recent industrial inaction, 90,000 meals were disrupted in Scottish hospitals. I am sure the food there is very good—certainly it was when I was in Scotland recently—but it helps patients if the food is actually served and if meal times are not disrupted.
We strongly agree about the importance of public health and hygiene and we have taken strong action in the past 18 months to safeguard hygiene standards throughout Britain through sections 1 and 2 of the National Health Service (Amendment) Act 1986. It gave 285 me great pleasure, as one of my first tasks at the Dispatch Box, to be involved in the passage of that legislation. The result has been a greater awareness of locally determined control of infection policies and improved understanding and collaboration between health staff, environmental health officers and health and safety inspectors, many of whom are members of NALGO.
All health authorities have responsibility for maintaining standards, whoever does the work. We have no plans to change that system. I note the comment of Opposition Members about private companies, but, as my hon. Friend the Member for Wokingham (Mr. Redwood) hinted, all the successful prosecutions since the removal of Crown immunity have concerned in-house, not private, contracts. We want the highest standards whoever does the work and we hold the health authorities responsible.
The hon. Member for Wakefield commented on catering standards in his constituency. Let me gently remind him that it was the appalling events in the kitchens of one of the hospitals there which were perpetrated by NHS staff and which resulted in a number of deaths of patients which resulted in the changes in the law that I have just described. The health authority in Wakefield was responsible then for the standards achieved—if that is what one could call them—and it is responsible now for the standards that are achieved, and we shall continue to hold it responsible.
§ Mr. HinchliffeThe Minister should look again at the inquiry report on the Stanley Royd hospital, because she does not seem to have grasped exactly what it said. It referred to the conditions in the kitchen, which had nothing to do with the staff. The appalling fact was that they were working in an old workhouse building because of lack of investment in the NHS. The Minister might also care to comment on the fact that the new £1 million kitchen has been ready for a year but has not been used because of cuts in the NHS.
§ Mrs. CurrieI have just made my comments about the previous incident and about current catering in Wakefield. The health authority is responsible and will continue to be so.
The new clause seeks to destroy the initiative being shown by Ministers, health authorities and boards in our aim, which I think that some Opposition Members would share, to combine high quality service with value for money. Dare I suggest that some of the dislike of competitive tendering of NUPE and one or two other unions stems from a dislike of open competition, a fear of public scrutiny and a concern about the subsequent disappearance of the so-called Spanish practices which have plagued the NHS for far too long. The fact that the system in England is working should not upset them so, but it upsets NUPE and COHSE because they have most to lose.
We are pleased to see the success of competitive tendering and we do not intend to let that be damaged or destroyed in the way proposed. If Opposition Members decide to press the new clause to a vote, we shall vote it down.
§ Mr. Norman HoggOpposition Members have listened carefully to the Minister. I regret that we are far from persuaded that she is anything other than just a believer in 286 what she says, but cannot really substantiate it with fact. Her figure of £100 million, which we have heard endlessly, has been challenged time and again, whereas the figure of £20 million, which has been produced for Scotland. has not been satisfactorily dealt with. That figure was founded on trade union agreements, not on privatisation.
However, the Opposition have come to understand that we are never able to persuade the Government of anything because they have closed minds. They do not believe in the NHS, they voted against its formation in the late 1940s, and they are destroying it now. We shall not let them do it and we shall press our new clause to a vote.
§ Question put, That the clause be read a Second time:—
§ The House divided: Ayes 202, Noes 307.
289| Division No. 256] | [11.30 pm |
| AYES | |
| Abbott, Ms Diane | Douglas, Dick |
| Adams, Allen (Paisley N) | Duffy, A. E. P. |
| Allen, Graham | Dunnachie, Jimmy |
| Alton, David | Dunwoody, Hon Mrs Gwyneth |
| Archer, Rt Hon Peter | Eadie, Alexander |
| Ashdown, Paddy | Ewing, Mrs Margaret (Moray) |
| Ashley, Rt Hon Jack | Fatchett, Derek |
| Ashton, Joe | Fearn, Ronald |
| Banks, Tony (Newham NW) | Field, Frank (Birkenhead) |
| Barnes, Harry (Derbyshire NE) | Fields, Terry (L'pool B G'n) |
| Barron, Kevin | Flynn, Paul |
| Beckett, Margaret | Foot, Rt Hon Michael |
| Beggs, Roy | Foster, Derek |
| Beith, A. J. | Fraser, John |
| Bell, Stuart | Fyfe, Maria |
| Benn, Rt Hon Tony | Galbraith, Sam |
| Bermingham, Gerald | Galloway, George |
| Bidwell, Sydney | Garrett, John (Norwich South) |
| Blair, Tony | George, Bruce |
| Boateng, Paul | Gilbert, Rt Hon Dr John |
| Boyes, Roland | Godman, Dr Norman A. |
| Bradley, Keith | Graham, Thomas |
| Bray, Dr Jeremy | Grant, Bernie (Tottenham) |
| Brown, Gordon (D'mline E) | Griffiths, Nigel (Edinburgh S) |
| Brown, Nicholas (Newcastle E) | Griffiths, Win (Bridgend) |
| Brown, Ron (Edinburgh Leith) | Grocott, Bruce |
| Bruce, Malcolm (Gordon) | Hardy, Peter |
| Buchan, Norman | Harman, Ms Harriet |
| Buckley, George J. | Hattersley, Rt Hon Roy |
| Caborn, Richard | Haynes, Frank |
| Callaghan, Jim | Heffer, Eric S. |
| Campbell, Menzies (Fife NE) | Henderson, Doug |
| Campbell, Ron (Blyth Valley) | Hinchliffe, David |
| Campbell-Savours, D. N. | Hogg, N. (C'nauld & Kilsyth) |
| Canavan, Dennis | Home Robertson, John |
| Carlile, Alex (Mont'g) | Hood, Jimmy |
| Clark, Dr David (S Shields) | Howarth, George (Knowsley N) |
| Clarke, Tom (Monklands W) | Hoyle, Doug |
| Clay, Bob | Hughes, John (Coventry NE) |
| Clelland, David | Hughes, Robert (Aberdeen N) |
| Clwyd, Mrs Ann | Hughes, Simon (Southwark) |
| Cohen, Harry | Illsley, Eric |
| Cook, Frank (Stockton N) | Janner, Greville |
| Cook, Robin (Livingston) | Jones, Barry (Alyn & Deeside) |
| Corbyn, Jeremy | Jones, leuan (Ynys MÔn) |
| Cousins, Jim | Jones, Martyn (Clwyd S W) |
| Cox, Tom | Kaufman, Rt Hon Gerald |
| Crowther, Stan | Kilfedder, James |
| Cummings, John | Kirkwood, Archy |
| Cunliffe, Lawrence | Lambie, David |
| Cunningham, Dr John | Leadbitter, Ted |
| Dalyell, Tam | Leighton, Ron |
| Darling, Alistair | Lewis, Terry |
| Davies, Rt Hon Denzil (Llanelli) | Litherland, Robert |
| Davies, Ron (Caerphilly) | Lloyd, Tony (Stretford) |
| Davis, Terry (B'ham Hodge H'l) | Lofthouse, Geoffrey |
| Dewar, Donald | Loyden, Eddie |
| Dixon, Don | McAllion, John |
| Dobson, Frank | McAvoy, Thomas |
| Doran, Frank | McCartney, Ian |
| Macdonald, Calum A. | Richardson, Jo |
| McFall, John | Robertson, George |
| McKay, Allen (Barnsley West) | Robinson, Geoffrey |
| McKelvey, William | Rogers, Allan |
| McLeish, Henry | Rooker, Jeff |
| McTaggart, Bob | Ross, Ernie (Dundee W) |
| McWilliam, John | Ross, William (Londonderry E) |
| Madden, Max | Rowlands, Ted |
| Mahon, Mrs Alice | Ruddock, Joan |
| Marek, Dr John | Salmond, Alex |
| Marshall, David (Shettleston) | Sedgemore, Brian |
| Marshall, Jim (Leicester S) | Sheerman, Barry |
| Martin, Michael J. (Springburn) | Sheldon, Rt Hon Robert |
| Martlew, Eric | Short, Clare |
| Meacher, Michael | Skinner, Dennis |
| Michael, Alun | Smith, C. (leton & F'bury) |
| Michie, Bill (Sheffield Heeley) | Smith, Rt Hon J. (Monk'ds E) |
| Michie, Mrs Ray (Arg'l & Bute) | Snape, Peter |
| Milian, Rt Hon Bruce | Soley, Clive |
| Mitchell, Austin (G't Grimsby) | Spearing, Nigel |
| Molyneaux, Rt Hon James | Steel, Rt Hon David |
| Moonie, Dr Lewis | Stott, Roger |
| Morgan, Rhodri | Taylor, Mrs Ann (Dewsbury) |
| Morley, Elliott | Taylor, Matthew (Truro) |
| Morris, Rt Hon J. (Aberavon) | Turner, Dennis |
| Mowlam, Marjorie | Vaz, Keith |
| Mullin, Chris | Walker, A. Cecil (Belfast N) |
| Murphy, Paul | Wall, Pat |
| Oakes, Rt Hon Gordon | Wallace, James |
| O'Brien, William | Walley, Joan |
| O'Neill, Martin | Wardell, Gareth (Gower) |
| Orme, Rt Hon Stanley | Wareing, Robert N. |
| Parry, Robert | Welsh, Andrew (Angus E) |
| Patchett, Terry | Welsh, Michael (Doncaster N) |
| Pendry, Tom | Williams, Rt Hon Alan |
| Pike, Peter L. | Williams, Alan W. (Carm'then) |
| Powell, Ray (Ogmore) | Winnick, David |
| Prescott, John | Worthington, Tony |
| Quin, Ms Joyce | Young, David (Bolton SE) |
| Radice, Giles | |
| Randall, Stuart | Tellers for the Ayes: |
| Redmond, Martin | Mr. Ken Eastham and |
| Reid, Dr John | Mrs. Llin Golding. |
| NOES | |
| Adley, Robert | Bright, Graham |
| Aitken, Jonathan | Brittan, Rt Hon Leon |
| Alexander, Richard | Brooke, Rt Hon Peter |
| Allason, Rupert | Brown, Michael (Brigg & Cl't's) |
| Amery, Rt Hon Julian | Bruce, Ian (Dorset South) |
| Amess, David | Buchanan-Smith, Rt Hon Alick |
| Amos, Alan | Buck, Sir Antony |
| Arbuthnot, James | Budgen, Nicholas |
| Arnold, Jacques (Gravesham) | Burns, Simon |
| Arnold, Tom (Hazel Grove) | Burt, Alistair |
| Ashby, David | Butcher, John |
| Aspinwall, Jack | Butler, Chris |
| Atkinson, David | Butterfill, John |
| Baker, Rt Hon K. (Mole Valley) | Carlisle, John, (Luton N) |
| Baker, Nicholas (Dorset N) | Carlisle, Kenneth (Lincoln) |
| Baldry, Tony | Carrington, Matthew |
| Banks, Robert (Harrogate) | Carttiss, Michael |
| Batiste, Spencer | Cash, William |
| Bellingham, Henry | Chalker, Rt Hon Mrs Lynda |
| Bennett, Nicholas (Pembroke) | Chapman, Sydney |
| Benyon, W. | Chope, Christopher |
| Bevan, David Gilroy | Churchill, Mr |
| Biffen, Rt Hon John | Clark, Dr Michael (Rochford) |
| Blackburn, Dr John G. | Clark, Sir W. (Croydon S) |
| Braker, Rt Hon Sir Peter | Clarke, Rt Hon K. (Rushcliffe) |
| Body, Sir Richard | Colvin, Michael |
| Bonsor, Sir Nicholas | Conway, Derek |
| Boswell, Tim | Coombs, Anthony (Wyre F'rest) |
| Bottomley, Peter | Coombs, Simon (Swindon) |
| Bowden, Gerald (Dulwich) | Cope, John |
| Bowis, John | Cormack, Patrick |
| Boyson, Rt Hon Dr Sir Rhodes | Couchman, James |
| Braine, Rt Hon Sir Bernard | Cran, James |
| Brandon-Bravo, Martin | Currie, Mrs Edwina |
| Brazier, Julian | Curry, David |
| Davies, Q. (Stamf'd & Spald'g) | Janman, Tim |
| Davis, David (Booth ferry) | Jessel, Toby |
| Day, Stephen | Johnson Smith, Sir Geoffrey |
| Devlin, Tim | Jones, Gwilym (Cardiff N) |
| Dickens, Geoffrey | Jones, Robert B (Herts W) |
| Dorrell, Stephen | Jopling, Rt Hon Michael |
| Douglas-Hamilton, Lord James | Kellett-Bowman, Dame Elaine |
| Dover, Den | Key, Robert |
| Dunn, Bob | King, Roger (B'ham N'thfield) |
| Durant, Tony | King, Rt Hon Tom (Bridgwater) |
| Dykes, Hugh | Kirkhope, Timothy |
| Eggar, Tim | Knapman, Roger |
| Emery, Sir Peter | Knight, Greg (Derby North) |
| Evans, David (Welwyn Hatf'd) | Knowles, Michael |
| Fallon, Michael | Knox, David |
| Farr, Sir John | Lamont, Rt Hon Norman |
| Favell, Tony | Lang, Ian |
| Field, Barry (Isle of Wight) | Latham, Michael |
| Fookes, Miss Janet | Lawrence, Ivan |
| Forman, Nigel | Lee, John (Pendle) |
| Forsyth, Michael (Stirling) | Lester, Jim (Broxtowe) |
| Forth, Eric | Lightbown, David |
| Fowler, Rt Hon Norman | Lilley, Peter |
| Fox, Sir Marcus | Lloyd, Sir Ian (Havant) |
| Franks, Cecil | Lloyd, Peter (Fareham) |
| Freeman, Roger | Lord, Michael |
| Fry, Peter | Luce, Rt Hon Richard |
| Gale, Roger | Lyell, Sir Nicholas |
| Garel-Jones, Tristan | McCrindle, Robert |
| Gill, Christopher | Macfarlane, Sir Neil |
| Glyn, Dr Alan | MacKay, Andrew (E Berkshire) |
| Goodlad, Alastair | Maclean, David |
| Goodson-Wickes, Dr Charles | McLoughlin, Patrick |
| Gorman, Mrs Teresa | McNair-Wilson, M. (Newbury) |
| Gorst, John | McNair-Wilson, P. (New Forest) |
| Gow, Ian | Madel, David |
| Gower, Sir Raymond | Major, Rt Hon John |
| Grant, Sir Anthony (CambsSW) | lvialins, Humfrey |
| Greenway, Harry (Ealing N) | Mans, Keith |
| Greenway, John (Ryedale) | Maples, John |
| Gregory, Conal | Marlow, Tony |
| Griffiths, Sir Eldon (Bury St E') | Marshall, John (Hendon S) |
| Griffiths, Peter (Portsmouth N) | Martin, David (Portsmouth S) |
| Grist, Ian | Mates, Michael |
| Ground, Patrick | Maude, Hon Francis |
| Grylls, Michael | Mawhinney, Dr Brian |
| Gummer, Rt Hon John Selwyn | Maxwell-Hyslop, Robin |
| Hamilton, Hon Archie (Epsom) | Mayhew, Rt Hon Sir Patrick |
| Hampson, Dr Keith | Mellor, David |
| Hanley, Jeremy | Meyer, Sir Anthony |
| Hannam, John | Miller, Hal |
| Hargreaves, A. (B'ham H'Il Gr') | Mills,Iain |
| Hargreaves, Ken (Hyndburn) | Mitchell, Andrew (Gedling) |
| Harris, David | Mitchell, David (Hants NW) |
| Haselhurst, Alan | Moate, Roger |
| Hawkins, Christopher | Monro, Sir Hector |
| Hayes, Jerry | Moore, Rt Hon John |
| Hayhoe, Rt Hon Sir Barney | Morris, M (N'hampton S) |
| Heathcoat-Amory, David | Morrison, Hon Sir Charles |
| Heddle, John | Moss, Malcolm |
| Heseltine, Rt Hon Michael | Neale, Gerrard |
| Hicks, Mrs Maureen (WoIv' NE) | Neubert, Michael |
| Hicks, Robert (Cornwall SE) | Newton, Rt Hon Tony |
| Higgins, Rt Hon Terence L. | Nicholls, Patrick |
| Hind, Kenneth | Nicholson, David (Taunton) |
| Hogg, Hon Douglas (Gr'th'm) | Nicholson, Emma (Devon West) |
| Holt, Richard | Onslow, Rt Hon Cranley |
| Hordern, Sir Peter | Oppenheim, Phillip |
| Howard, Michael | Page, Richard |
| Howarth, Alan (Strat'd-on-A) | Paice, James |
| Howarth, G. (Cannock & B'wd) | Patnick, Irvine |
| Howell, Ralph (North Norfolk) | Patten, Chris (Bath) |
| Hughes, Robert G. (Harrow W) | Patten, John (Oxford W) |
| Hunt, David (Wirral W) | Pattie, Rt Hon Sir Geoffrey |
| Hunt, John (Ravensbourne) | Pawsey, James |
| Hurd, Rt Hon Douglas | Peacock, Mrs Elizabeth |
| Irvine, Michael | Porter, Barry (Wirral S) |
| Irving, Charles | Porter, David (Waveney) |
| Jack, Michael | Portillo, Michael |
| Jackson, Robert | Powell, William (Corby) |
| Price, Sir David | Taylor, Ian (Esher) |
| Raffan, Keith | Taylor, John M (Solihull) |
| Rathbone, Tim | Temple-Morris, Peter |
| Redwood, John | Thompson, D. (Calder Valley) |
| Rhodes James, Robert | Thompson, Patrick (Norwich N) |
| Riddick, Graham | Thurnham, Peter |
| Ridley, Rt Hon Nicholas | Townsend, Cyril D. (B'heath) |
| Rifkind, Rt Hon Malcolm | Tracey, Richard |
| Roberts, Wyn (Conwy) | Tredinnick, David |
| Roe, Mrs Marion | Trippier, David |
| Rossi, Sir Hugh | Trotter, Neville |
| Rost, Peter | Twinn, Dr Ian |
| Rowe, Andrew | Vaughan, Sir Gerard |
| Ryder, Richard | Waddington, Rt Hon David |
| Sackville, Hon Tom | Wakeham, Rt Hon John |
| Sainsbury, Hon Tim | Waldegrave, Hon William |
| Sayeed, Jonathan | Walden, George |
| Scott, Nicholas | Walker, Bill (T'side North) |
| Shaw, David (Dover) | Waller, Gary |
| Shaw, Sir Giles (Pudsey) | Ward, John |
| Shaw, Sir Michael Scarb') | Wardle, Charles (Bexhill) |
| Shephard, Mrs G. (Norfolk SW) | Warren, Kenneth |
| Shepherd, Richard (Aldridge) | Wells, Bowen |
| Sims, Roger | Wheeler, John |
| Skeet, Sir Trevor | Whitney, Ray |
| Smith, Sir Dudley (Warwick) | Widdecombe, Ann |
| Smith, Tim (Beaconsfield) | Wiggin, Jerry |
| Soames, Hon Nicholas | Wilshire, David |
| Spicer, Sir Jim (Dorset W) | Winterton, Mrs Ann |
| Spicer, Michael (S Worcs) | Winterton, Nicholas |
| Squire, Robin | Wolfson, Mark |
| Stanbrook, Ivor | Wood, Timothy |
| Stanley, Rt Hon John | Woodcock, Mike |
| Stern, Michael | Yeo, Tim |
| Stevens, Lewis | Young, Sir George (Acton) |
| Stewart, Allan (Eastwood) | Younger, Rt Hon George |
| Stewart, Ian (Hertfordshire N) | |
| Stokes, John | Tellers for the Noes: |
| Sumberg, David | Mr. Robert Boscawen and |
| Summerson, Hugo | Mr. Mark Lennox-Boyd. |
| Tapsell, Sir Peter |
§ Question accordingly negatived