HC Deb 21 March 1989 vol 149 cc898-900
6. Mr. Ashley

To ask the Secretary of State for Health what estimate he has made of the effect on the National Health Service wage bill of allowing individual hospitals to set their own wage and salary rates.

Mr. Kenneth Clarke

None. In common with other White Paper proposals, the aim of freeing self-governing hospitals from central control over pay is to get the best value for money in terms of patient care from the resources that are made available.

Mr. Ashley

I am not surprised that the Secretary of State should try to dodge that question. Is he aware that these proposals are a recipe for chaos, because the BMA simply will not agree to doctors having variable rates, and because those other workers in the National Health Service who may be forced to accept them will be bitterly and deeply resentful? Why does the Secretary of State always allow ideology to override common sense?

Mr. Clarke

There is nothing ideological about it. There are many towns and cities in this country where the district general hospital is the largest single employer, and if it becomes self-governing and local people are put in charge of it, I can see no earthly reason why it should be said that they are not capable of settling the pay and conditions of their own staff if they want to. There would be advantages if they did, because the present national, centralised system is often too inflexible to enable local management to deal with local shortages of skilled staff.

I am sorry if the hon. Gentleman thinks that the BMA will automatically oppose the proposal. Sometimes I too am guilty of leaping to the conclusion that the BMA will always oppose things. Many doctors and other staff in the hospital concerned will feel loyalty to their own hospital and town, and will not be at all averse to the idea that pay and conditions should be settled more locally.

Dr. Glyn

Does my right hon. and learned Friend agree that this flexibility will allow us to adjust local conditions, which will probably result in a more efficient service and better pay?

Mr. Clarke

I agree with my hon. Friend, and many people in our great hospitals up and down the country will find this possibility one of the more attractive features of self-government.

Ms. Harman

Is the Minister aware that the Health Service Journal this week carries an advertisement for a finance director for a London teaching hospital, which it indicates is going to opt out? Will he please name that London teaching hospital or, if he does not know the name of it, will he find out and tell me by the end of today? Is it not reprehensible—[Interruption.]

Mr. Speaker


Ms. Harman

Is it not reprehensible that the process of opting out should be done in secrecy and by stealth?

Mr. Clarke

I know that the hon. Lady keeps picketing outside a certain hospital in case it becomes self-governing, but I am not going to help her by letting her know whether she is picketing outside the right one. She will have to find out for herself in due course. When proper applications are put in for self-government, of course they will be dealt with openly; we will publicise them all and discuss them fully with any interested members of the general public. I am not responsible for the advertisements, or even the copy that appear in The Health Service Journal.