§ 1. Mr. Wareing
To ask the Secretary of State for Health what representations have been made to him by trade unions with members employed in the National Health Service about the pay and conditions of their members.
§ The Secretary of State for Health (Mr. Kenneth Clarke)
Recent representations that I have received have been concerned with the implementation of the clinical grading structure for nurses and the grading review for the professions allied to medicine. Pay settlements have now been concluded for 1988 covering more than 90 per cent. of all National Health Service staff.
§ Mr. Wareing
In view of the most recent leak—about the Autumn Statement—by this leakiest of Governments, will the Secretary of State tell us how he will ensure the full funding of the pay award to the National Health Service ancillary staff? The AHAs say that £2 billion is necessary even now. Will that necessitate the media going to another Spanish beach before the people in the Health Service are told by the Government that they will receive a real reward for the hard efforts that they have put into the service?
§ Mr. Clarke
The hon. Gentleman will have to contain himself and wait for the Autumn Statement, which I believe he will find contains quite good news. Meanwhile, I can only remind him that 90 per cent. of our staff have reached satisfactory settlements, and these settlements have now been put into effect for the staff concerned.
§ Mr. Soames
Will my right hon. and learned Friend accept that his Department's successful achievement in the pay settlement has been received with considerable pleasure? Is he aware that nurses find it difficult to move, especially to the south-east of England, because of the very high cost of housing and living expenses? Does my right hon. and learned Friend agree that the time is fast approaching when we must move to regional pay? What hope can he give that the Government will take that step?
§ Mr. Clarke
I agree with my hon. Friend, because obviously it is necessary that we recruit and retain people of the required quality in every part of the country. We all know that the costs incurred for staff vary from place to place, as do difficulties in recruitment. We have put in our evidence to the nurses review body the suggestion that we should now move to greater geographical variation and local flexibility, and similar discussions are taking place in the Whitley council about management and administrative staff. I believe that common sense dictates that we should start to reflect local variations in conditions in future pay negotiations for a giant service such as this.
§ Mr. Clarke
When the new G grade posts are created in the new year, about three quarters of all sisters will be on the higher grades. If the right hon. Gentleman has found discontented sisters, he has no doubt looked hard and had the assistance of COHSE, which is trying to make difficulties over the minority of sisters who find themselves on the lower grade. The unions agreed to this grading structure, and it is preposterous now to claim that everyone should have gone on the higher of the grades available to sisters. Sisters have been graded according to their skill and the responsibility of the post.
§ Sir Peter Emery
Will my right hon. and learned Friend make it clear that the fear expressed by a number of health authorities that they could meet the pay award only by reducing services is unjustified? The Government have made extra funds available so that the whole of the award to nurses can be made without any reduction in services within the National Health Service.
§ Mr. Clarke
Yes, Sir. I am glad that I can give my hon. Friend that assurance. We had to adjust the estimates of the cost as the grading exercise went on and as it became obvious that our first estimate was too low. We have honoured our commitment to fund the cost of the grading exercise in full. We used the regional health authorities' own figures as the basis for doing so, and the authorities have all confirmed that they are satisfied that that funding has been made available in full. That means that there is no reason why patient services should be affected in any way by this desirable improvement in the career structure of nurses.
§ Mr. Robin Cook
As this is the Secretary of State's first appearance at the Dispatch Box since his appointment, may I welcome him back to Health and express the hope that he will be with us for rather longer than his predecessor? May I invite the Secretary of State to 805 reconsider his decision of two weeks ago not to meet the trade union side? Is he aware that, in the recollection of the Royal College of Nursing, he is the first Secretary of State who has declined to meet it when requested, which appears all the more odd as his predecessors were doing double the job? Does he agree that most of the 20,000 appeals which are now going through the system could have been avoided if he had agreed to the trade union offer to go to binding arbitration? If he is so confident of his case on regrading, why did he intervene personally to veto arbitration?
§ Mr. Clarke
First, I thank the hon. Gentleman for his kind words. I look forward to his contribution to our discussions on the Health Service.
I declined to meet the staff side of the Whitley council because it is quite improper for the Secretary of State to put himself in the place of the management side in a negotiating body of that kind. We had plainly reached the stage where continued negotiations were getting us nowhere and where, in my opinion, the trade unions were trying to reopen the basis on which everybody had accepted the grading structure earlier in the year. I concluded that we should get on and implement the Government's declared intention in the new grading structure and provide the funds to meet it.
Of course, I look forward to meeting the staff side of the NHS at some time in the future when we have a sensible agenda and when we are not trying to supplant proper negotiations within the Whitley council.