Ambulance Dispute

HC Deb 09 November 1989 vol 159 cc1189-223

5.2 pm

Mr. Robin Cook (Livingston)

I beg to move, That this House do now adjourn.

Leave having been given on Wednesday 8 November under Standing Order No. 20 to discuss: The current state of the ambulance dispute.

Mr. Cook

Every hon. Member in the Chamber must be aware of the gravity of the situation against which we debate the ambulance dispute. The dispute has continued for eight weeks, during which time it has affected every community in Britain. In London, it has arrived at a crisis as a result of the suspension of ambulance crews. I learned on my way to the Chamber that, in the course of today, throughout other parts of the country management have issued warnings of similar suspensions. The position in London today may be the position elsewhere in Britain by the end of the week.

In London, since yesterday, emergency cover is being provided by 50 Army vehicles and 53 police vehicles. I have no doubt that those who man those vehicles will give of their best. It is clear from their comments that they are in no doubt that their best will not be good enough to avoid the risk of tragedy. No hon. Member can have watched last night's television bulletins without concern when they saw shots of attempts to resuscitate a dying man with cardiac arrest in the back seat of a police car as it sped through central London, or of a woman with a spinal injury being manhandled in and out of the rear doors of a police car. The penalty for error in lifting a person with a spinal injury incorrectly can be paralysis for life.

The first question that the Secretary of State must answer when he responds to the debate is, why has he chosen to rely on these makeshift arrangements for emergency cover when there are trained ambulance staff at every ambulance station in London ready and eager to take emergency calls? Indeed, throughout last night they responded to emergency calls, because they continued to receive them from the Army, which called ambulance staff for the cases that they could not handle, from the fire brigade, which asked them to attend emergency incidents, and from hospitals, which asked them to attend for patients who needed to move urgently.

That was the situation throughout the night, but this morning there was a fresh development. The central control room of the London ambulance service started putting through selected emergency calls to ambulance stations and to the very staff suspended by the London ambulance service, who are not being paid by it but who on every occasion responded to them.

Those calls show how thinly stretched the temporary cover for emergencies is in London, and the response of ambulance staff exposes how unfair the Secretary of State was on Tuesday when he accused them of pretending and posturing in waiting for emergency calls.

The Secretary of State has justified suspending those staff on the basis of the 14 points of the work to rule. I have been through the 14 points and can advise the House that most of them have nothing to do with the emergency service. Some include matters such as a ban on paperwork.

The debate on whether it is possible to maintain emergency cover has focused on the point in the work to rule relating to the use of radiophones. There is no ban in the 14 points on radiophones for emergency use. The point at dispute is of such technicality that I find it breathtaking that grown men should have used it as the issue on which to suspend ambulance cover in London. Management are insisting that crews should press a button on radiophones to inform not the controller but the computer of their position so that control can select the ambulance to attend the emergency.

The staff side is offering to listen to every emergency case announced on open call, which would enable all ambulances to hear the emergency call and therefore enable the nearest one to radio in and respond to it. Mr. Spry, who is manager of one of the London regions, yesterday described this as a Mickey-Mouse service. That service is exactly the system that operated in London until eight months ago. That service, which Mr. Spry described as a Mickey-Mouse service, is precisely the system still used in almost every other ambulance service in Britain. Why, if that system is good enough for Manchester, Newcastle or Liverpool in normal times, would management rather call in the Army than see the system used in London?

There is a further dimension that makes it even more baffling and difficult to find a rational answer to that question. London ambulance staff have been suspended over a dispute aboout how they use their radiophones. They have been replaced by Army vehicles that cannot use their radiophones because they are on the wrong frequency for police control. There is no rational justification for suspending ambulance staff for using their radios in a manner that is the normal working method throughout the rest of Britain and replacing them with a system that has no radiophones.

Mr. Jonathan Sayeed (Bristol, East)

Will the hon. Gentleman give way?

Mr. Cook

I shall give way in a second.

The only possible explanation why management have taken that decision must be that they chose to escalate the dispute.

The second question that the Secretary of State must answer when he responds to the debate is, was that their decision, or was it his decision, to take this gamble with emergency cover in London?

Mr. Sayeed

On Tuesday's 6 o'clock news on television, Mr. Roger Poole said: Our members are prepared to operate 999 services with no qualification whatsoever. On the same programme yesterday, ambulanceman Chris Cosham admitted that London ambulance staff were not operating existing agreed radio procedures and informing the ambulance controllers when they completed an accident or emergency task.

Mr. Cook

rose——

Mr. Sayeed

No. That point was defended by Mr. Poole——

Mr. Cook

rose——

Mr. Speaker

Order. The hon. Member for Bristol, East (Mr. Sayeed) seems to be making a very long intervention.

Mr. Sayeed

If I am allowed to complete it, I shall not be much longer, Mr. Speaker. Will the hon. Member for Livingston (Mr. Cook) ask Mr. Roger Poole to keep to the commitment that he made on Tuesday night, or does the hon. Gentleman condone the attempt by the National Union of Public Employees to undermine and deceive the British public?

Mr. Cook

The House is in some difficulty, in that it has some two hours in which to crush a three-hour debate. If that is to be the length of intervention by Conservative Members, it will not be possible to give way again. There is no contradiction——

The Secretary of State for Health (Mr. Kenneth Clarke)

The hon. Gentleman——

Mr. Frank Cook (Stockton, North)

Shut up.

Mr. Robin Cook

If the Secretary of State will allow me, I cannot respond to—[Interruption]

Mr. Speaker

Order.

Mr. Bob Cryer (Bradford, South)

It is the Secretary of State——

Mr. Speaker

Order. I ask the House to settle down. Interventions of that kind do not help us.

Mr. Cook

There is no contradiction between the two statements produced by the hon. Member for Bristol, East (Mr. Sayeed). The ambulance staff are prepared to respond to every 999 call in precisely the way they responded up until eight months ago and in precisely the way that every other ambulance service in Britain responds to them.

This morning, the Secretary of State and I had a dummy run for this debate on radio. The right hon. and learned Gentleman justified the suspensions in London on the basis that the ambulance staff were now not moving non-emergency cases. The one example which he shared with the nation of such non-emergency cases was that of cancer patients going for radiotherapy. I have with me the union instructions on the restrictions on non-emergency cases. They list 12 separate exemptions from the ban. Exemption No. 7 is "all cancer-related patients".

Mr. Kenneth Clarke

rose——

Mr. Cook

It is explicit. All cancer-related patients are exempted. The Secretary of State has 10 minutes before he gets up to respond to the debate. He has all his officials in the Box. I challenge him when he gets up to name one ambulance station in London that has refused to move patients needing radiotherapy.

Hon. Members

Answer.

Mr. Jeremy Hayes (Harlow)

rose——

Mr. Cook

I am content to wait until the Secretary of State gets up to respond to the debate. That will give him 10 minutes to find the answer.

Mr. Hayes

rose——

Mr. Cook

No, I shall not give way again. I am anxious to proceed. The hon. Member for Bristol, East took up the time of three interventions.

I have no doubt that, when the Secretary of State gets up, he will wish to accuse me of taking my brief from the unions. He has done that in every previous debate, and it would be extraordinary if he put that gibe aside in this debate. I am not ashamed to inform the House that, over the past eight weeks, I have regularly met union officials. I am not ashamed to say also that I have listened to what they said to me about the dispute. I would have more respect for the way in which the Secretary of State has discharged his duties if in those eight weeks he had met the staff side just once. I ask the Secretary of State this third question: will he now meet the staff side? Is he prepared to sit down with the staff side to see whether they can find a solution to this crisis?

As well as meeting those union officials, I have met many serving ambulance men and women and ambulance officers. I have been struck by the commitment that those staff show to their job. Those people are perhaps sadly out of place in the brave new enterprise society that Conservative Members want to create. Overwhelmingly, they are people with intelligence and qualifications that would enable them to get better paid jobs, if that was what they were interested in. They have chosen the ambulance service because it gives them satisfaction and a reward for which money alone cannot be a substitute.

There have been plenty of occasions during the past three years when the nation has had the opportunity to observe the commitment of our ambulance staff and the risks that they take in pursuing that commitment. On Tuesday, the House received the report of the Clapham accident. Paragraph 5.19 states: The Court heard many tributes to the courage, dedication and professionalism of all the emergency services. Having heard the evidence and seen videos of their work at the scene, I wish to endorse the deep sense of appreciation which ran throughout the evidence of passengers on the trains for the outstanding work of the men and women who did so much to ensure a safe, swift and successful operation. When the Harrods bomb went off, ambulance crews were the only people to remain in the street tending to the wounded and dying when police closed the street because they expected a second bomb. When the aircraft crashed on the motorway, it was the ambulance crews who went into the fuselage at a time when aviation fuel poured from every fractured pipe.

Mr. Brian Murray, one of the ambulance men whom I have met recently and who attended the Brighton bombing in 1985, is observing this debate from a place that I cannot draw to your attention, Mr. Speaker. The question that he will want answered is, why is he now offered an increase of 6.5 per cent., which the right hon. Member for Chingford (Mr. Tebbit) today managed to describe as nearly 10 per cent.? There is no London weighting for Mr. Murray—he lives in Sussex. He has been offered less than the rate of inflation. He is being asked to take a cut in real pay. In truth, Mr. Murray is not seeking a rise just in line with inflation, and I would not pretend that he is. Mr. Murray wants an increase in line with earnings.

Mrs. Edwina Currie (Derbyshire, South)

rose——

Mr. Cook

I shall certainly give way to the hon. Lady.

Mrs. Currie

I am most grateful to the hon. Gentleman for his courtesy. Many Conservative Members share his belief that the ambulance service is a very good service and all of us owe it a great deal. Nevertheless, does the hon. Gentleman agree that this dispute is not about whether the ambulance service gives us a good service but about who runs the service, the management or the unions, and whether employees who are prepared to take industrial action which will damage patients should get paid more than those employees who will not?

Mr. Cook

This is a dispute about what is the proper rate of pay for the service that we demand of our ambulance staff. That is why it is proper to remind the House of the service and dedication that we require of them.

Since this dispute started, there has not been a major pay settlement as low as 6.5 per cent. In the week in which it started, the Treasury sanctioned a pay award to Inland Revenue staff that gave Inland Revenue typists 10 per cent. and inspectors 14.5 per cent. Since then, British Telecom has settled at 9 per cent. We are told that postmen may be offered 11 per cent. Firemen have settled at 8.6 per cent. The Secretary of State is much given to saying that National Health Service staff settled at 6.5 per cent.—doctors settled at 8 per cent., dentists at 8 per cent., professionals allied to medicine at 7.7 per cent. and administrators, managers and clerical staff for a deal worth 9.5 per cent.

Members of Parliament are to be awarded 10.7 per cent., and hon. Members will know that we are to receive that figure because it has already been granted to middle management in the Civil Service. I do not believe that Members of Parliament need to apologise for parity with the principal grade in the Civil Service, but I do not understand how hon. Members who benefited from that linkage could vote to deny linkage to ambulance staff. The ambulance staff seek linkage with the other two emergency services—the firemen and policemen. They work together daily with them, they share risks with them and they provide medical cover when the other services take those risks.

Mr. Richard Tracey (Surbiton)

rose——

Mr. Cook

That is why the fire brigade and the Police Federation fully support the demand of ambulance staff for linkage.

Once upon a time, the demand for linkage had the full support of the Conservative party. In 1978, the present Prime Minister wrote to two ambulance men saying of the emergency services: All three deserve to have their pay negotiation put outside the arena of industrial dispute by being given firm and automatic linkage". That letter was written to Terry Wilton and Philip Rowe, two Conservative ambulance men in Somerset who were inspired by the letter to become founder members of the Association of Professional Ambulance Personnel, an association which is pledged not to take industrial action. Terry Wilton and Philip Rowe are now so incensed by the short memories of those in the Conservative party that they are supporting the industrial action by the ambulance service this month.

Mr. Hayes

Will the hon. Gentleman give way?

Mr. Cook

No, I will not.

The irony of the present dispute is that, in the confrontation between Ministers and unions, Ministers are trying to beat down staff who are clear that they want a formula that will take their pay out of the realm of annual disputes, so that the ambulance service will never again need to be disrupted.

We now come to the central mystery of the dispute. Every attempt that the Secretary of State makes to explain the mystery leaves it more baffling than before. When he responds to the debate, he must say why, if he is so confident in his case and if he is so convinced that 6.5 per cent. is the just, fair and final offer to ambulance staff, he is so frightened of putting it to arbitration.

Mr. Hayes

rose——

Mr. Cook

The whole country knows that the dispute would stop tonight if the Secretary of State only had the courage to go to arbitration. He does not demonstrate strength by sending in the Army; he demonstrates weakness by running away from arbitration.

Mr. Hayes

Will the hon. Gentleman give way?

Mr. Cook

I cannot resist the hon. Gentleman tonight.

Mr. Hayes

I am grateful to the hon. Gentleman. He has a unique opportunity today to behave in a statesmanlike manner. He has the opportunity because people who are frail, elderly and vulnerable, who may die tonight as a result of this dispute, would like to hear those who have influence with the trade union movement say that no wage dispute is worth the death of an old lady or a child. He has the opportunity to say, "Go back to the negotiating table and talk about structure." The hon. Gentleman is a decent, honourable and caring man. Why does he not go to the National Union of Public Employees and say, "You have peered over the abyss; don't let the inevitable happen."

Mr. Cook

The hon. Gentleman began with the perfectly fair point that lives are at risk and that this is an extremely grave situation. That is why we pressed for a debate today. If the hon. Gentleman believes that the situation is so grave and important that the House should consider it in a statesmanlike manner, I find it a pity that neither he nor any other Conservative Member supported our application for an emergency debate yesterday. The reason is simple: they know that their case cannot readily be defended.

Every time the Secretary of State is asked why he does not go to arbitration, he replies that he cannot because he decides how much money goes into the National Health Service and he is responsible for how that mony is carved up, so he cannot hand over decisions on that to an outside, independent body.

There is one obvious problem with that logic. Half the staff in the NHS already have access to an independent pay review body. Why should ambulance staff be so different that it is a point of principle that they cannot have access to an independent review? The real problem for the Secretary of State is that, every time he gives that answer to the question about arbitration into the microphone, every listener to the radio set knows that what he means is that he dare not go to arbitration because he knows that any form of arbitration will give the ambulance staff more money. The Secretary of State does not believe that he can convince any independent adjudicator that he is right. If he believes that his case cannot convince anyone else, he cannot really believe it himself.

Over the past three weeks, the Secretary of State has talked himself into a corner from which he cannot escape into arbitration. The House has the opportunity tonight to help him to make that escape. The House can decide tonight whether to prolong the dispute by calling in the Army, or whether to resolve it by calling in the arbitrators. I do not ask only my hon. Friends to join me in the Lobby for arbitration. I ask every hon. Member who wants to see full ambulance cover restored to his constituency to join us in the Lobby tonight.

5.26 pm

The Secretary of State for Health (Mr. Kenneth Clarke)

With the industrial action that we are facing now, especially in London, and with the seriousness of the issues involved. I should have thought that the whole House should be united by bonds of common humanity and concern for the plight of innocent members of the public who are being put at risk by industrial action in a key service. I shall begin by assuming that we are united in that. We should also be united by an overriding concern for the well-being of the National Health Service and all its staff, including those taking industrial action at present, and also for its patients, who look to us especially to guarantee the vital emergency parts of the service.

We all profess to agree on those points, but the massed ranks of Opposition Members are here for a debate about industrial action, which they always find especially attractive. Their attitude to the dispute, judged from what various hon. Members have said from a sedentary position and, by implication, from what the hon. Member for Livingston (Mr. Cook) said, is that if we and the people of London want the ambulance service back fully, we should give the ambulance men the money or whatever they want. That is an unattractive position.

We should consider the claim made by the Whitley council trade unions which are conducting the present dispute. They do not include the Association of Professional Ambulance Personnel, to which the hon. Member for Livingston referred. That is a moderate trade union which disapproves of industrial action. It represents about 20 per cent. of ambulance men, but because of its moderate stance the staff side has never admitted it to the Whitley council. Although some of the trade unions organising sanctions have fewer members, they monopolise the seats of the Whitley council and its negotiations.

The Whitley council trade unions have a claim for a pay increase of 11.1 per cent., with the establishment of a formula for determining future increases as well. The London men are seeking some London weighting above the over 11 per cent. claim that they are presently pursuing and I assume that they are looking for about 12 per cent. or 13 per cent. They have other claims, such as the reintroduction of premium rates for overtime—which they agreed to forgo in 1986—an increase in the standby allowances to bring them into line with those paid to ambulance officers, which management is minded to concede, an increase in annual leave and long service holidays, a reduction in the working week and the introduction of long service pay after five, 10 and 15 years of service. Those claims have not been withdrawn and they add up to more than 20 per cent. although it is the cash claim of more than 11 per cent. that is being pursued at the moment.

The unions are determined to get that claim or something like it by pursuing industrial action. Anyone who believes that in such a difficult situation it is easy for the management of the Health Service to get the service back by giving them a little bit more must reflect on the fact that I am quite confident, as is the management from its contacts with the trade union side, that they are not taking the action against the people of London to get a little bit more—they are looking for rather a lot more money.

Mr. Nigel Griffiths (Edinburgh, South)

Will the Secretary of State give way?

Mr. Clarke

No, I will not give way. This is a short debate. The hon. Member for Livingston (Mr. Cook) gave way only a couple of times. When I get on to the radiotelephones, people will want me to give way and there will be no Back-Bench debate if I give way too soon.

The fact that the ambulance men are pursuing their claim through industrial action of such an extreme nature is surprising when we recall that the trade unions were recommending the management's offer some months ago, and that offer was arrived at as a result of negotiation in the Whitley council. A few months ago the union leaders who now say that the offer of 6.5 per cent. is disgraceful, recommended their members to accept such an offer. No Labour Members referred to the inadequacy of a 6.5 per cent. offer then. No Labour Member said then that those vital men should be paid more.

Mr. Dennis Skinner (Bolsover)

rose——

Mr. Dave Nellist (Coventry, South-East)

rose——

Mr. Clarke

The reason for this noisy demonstration of support from Opposition Members now is that the ambulance men have taken industrial action having rejected the offer on a ballot. However, the trade union leaders who are now organising this action had recommended the 6.5 per cent.

Mr. Skinner

Will the Secretary of State give way?

Mr. Clarke

No.

Since the trade union leaders recommended 6.5 per cent., the offer has been improved. The men are being offered more money than their leaders recommended them to accept. The recommendation was not too surprising, nor was the fact that it emerged from the Whitely council. We are talking about a settlement which dates back to April this year.

The 6.5 per cent. offer must be set beside the 6.8 per cent. awards to the nurses and the Army. Most of the soldiers taking over ambulance men's duties today are less well paid than the ambulance men. Hon. Members accepted 6.7 per cent. and 160,000 National Health Service staff, including the ancillary workers represented by the same trade unions, also settled for 6.5 per cent. as a result of sensible negotiations.

After the 6.5 per cent. was rejected, the offer was improved—in particular, in London. The offer now, which has been rejected by the unions, is at least 9.3 per cent. for qualified personnel in London. At the moment the whole service in London is closed down because the ambulance men want more than 9.3 per cent. and they are taking industrial action to achieve that.

Mr. Skinner

Give way on that point.

Mr. Clarke

No.

The offer as it stands is worth about £13 a week for qualified staff outside London and about £20 a week for London staff. Back pay is accruing because the offer dates back to April 1989. Therefore, the ambulance men in London have at least £600 back pay waiting for them and the men outside have at least £400.

Labour Members say that that is not enough and that we should give them the money. However, they have not specified how much. They have not commented on the size of the claim—[Interruption.] We know why all these Opposition Members are in the Chamber now. Even the Leader of the Opposition is here. They are lured by the scent of a good strike—[Interruption.]

Mr. Speaker

Order. The hon. Member for Livingston (Mr. Cook) was heard in comparative silence. Throughout this debate there has been a background of commentary from a sedentary position. Hon. Members should listen to the Minister's speech.

Mr. Neil Kinnock (Islwyn)

The Secretary of State for Health mentioned me specifically. If the case that he is making convinces him so absolutely, why is he not willing to let the issue go to arbitration? The Labour party and the ambulance men and women have asked for nothing more.

Mr. Clarke

In the Health Service it is necessary to settle the pay of more than 1 million staff at a level which allows management to strike the right balance between staff pay and the growth of patient services. It is necessary to be fair to all staff in every grade because most of them do vital work in a dedicated way. It is also necessary to have an overall view of how much money will be allowed for pay because some money must be left for the expansion of patient services. It would be an abdication of management's responsibility for it to say that if a group of staff strikes or takes industrial action, it will hand over its responsibility, because of that action, to an outside body to decide how much more staff should get and how far patient services should expand.

Mr. Hugh Dykes (Harrow, East)

Will my right hon. and learned Friend give way?

Mr. Clarke

If any Government tried to run the National Health Service on the basis that a group which took industrial action against the patients would receive arbitration, they would reproduce the chaos that was produced in 1979 in the Health Service by giving way to every member of staff—[Interruption.] This is a noisy display by Labour Members because they have been drawn here by a strike. I have not seen the Labour Benches so crowded for a health debate for years—[Interruption.] Labour Members have not been drawn here by the National Health Service; they have been drawn here to back the National Union of Public Employees in its industrial action.

Mr. Dykes

Does my right hon. and learned Friend agree that the cumbersome suggestion of arbitration is very much the second option in comparison with the direct offer of immediate negotiations to be resumed right away?

Mr. Clarke

Exactly.

So far I have described the claim with which the Leader of the Opposition did not quite have the nerve to associate himself.

Mr. Harry Ewing (Falkirk, East)

On a point of order, Mr. Speaker. Is it in order for the Secretary of State for Health to use the fact that, as always, the Labour Benches are crowded to divert attention from the fact that, as always, the Tory Benches are empty?

Mr. Speaker

That is not a matter for me and it is taking up time.

Mr. David Clelland (Tyne Bridge)

Further to that point of order, Mr. Speaker. Is it in order for the Secretary of State, who has now twice mentioned the word strike, to mislead the House when no strike is taking place?

Mr. Speaker

The hon. Gentleman knows what this debate is about.

Mr. Clarke

In London absolutely no ambulance men are working at the moment, which by my definition is a strike.

I have covered the claim and the offer. My hon. Friend the Member for Harrow, East (Mr. Dykes) has just referred to the efforts of the management to move on given that the original offer was rejected by the men in a ballot. As we can all see, the improved offer in London has not brought an end to the action in London.

Duncan Nichol, the chief executive of the National Health Service, has been making repeated efforts for several weeks to resume proper talks between his Whitley council negotiators and the trade unions. He has publicly offered to contemplate a two-year deal including bringing some money forward from the second year into the first year. He has offered a review of the overtime arrangements because the unions are not satisfied with the way in which their 1986 agreement is working on overtime. He has referred to the possibility of local flexibility to meet particular recruitment and retention shortages and the possibility of looking in particular at the paramedical staff and the emergency side of the service.

Mr. Skinner

How much does he earn?

Mr. Clarke

That was a public statement in advance of a resumption in negotiations. I see no way in which the chief executive of the NHS can possibly go any further in trying to get people back to work and sort the problem out where it should sensibly be sorted out—in the NHS negotiating machinery. He, I and the House have a duty to all the other staff in the service. Ninety-five per cent. of National Health Service staff have settled within the ordinary agreed procedures. They are all dedicated people as well. They have claims, some of which have been met in negotiations. The management has given over 10 per cent. to some of the low-paid staff whose jobs in the past have not been appreciated.

Any group of those staff could take industrial action and do great damage to the service if they thought that that was the way to get more than the others. I cannot help thinking that there are some in the trade union movement who have every intention that some of the others should do that if the ambulance men can establish that this sort of industrial action—if one is prepared to take it—gets more money.

Having set out the claim, the offer originally recommended by the trade unions and what has been done to try to get negotiations going again, let me consider the nature of the action now being taken and organised by the trade unions against an offer that they were once minded to accept and recommend.

Mr. Skinner

Will the right hon. and learned Gentleman give way?

Mr. Clarke

No, I will not give way.

First, we should look at the non-emergency work of the National Health Service. About nine out of 10 patients driven by ambulances are for non-emergency work such as taking patients to clinics. That is extremely important to patients especially when, as has already been described, it involves taking cancer patients to their radiotherapy sessions. That is not being provided, and in London it has stopped completely.

The Trades Union Congress has drawn up guidelines on non-emergency patients and said which categories, in the opinion of the trade unions, need to travel as non-emergency patients. In London they were offering to do about 2 per cent. of the ordinary patient journeys described as non-emergency work. The management has said that it will not pay ambulance men in full for doing about 2 per cent. of the work when many vehicles are travelling with no patients at all during the day. The reaction of the trade unions was to withdraw all that non-emergency work. They will not accept docking of pay while they are offering to do about 2 per cent. of the work. That is what brought things to a head earlier this week. The men doing little or no work were told that they would not be paid unless they did about half the work and that their pay would be docked unless they did full work. The response to that approach to non-emergency work was that the unions immediately moved to shut down the accident and emergency service in London again. They reverted to the 14 points.

We have heard much about the 14 points and the most extraordinary quotations are being made. Yesterday, when applying for this debate, the hon. Member for Livingston quoted something to do with the radiotelephones, but I still cannot find the document from which he took it. I did not recognise it as any part of the 14 points or discussions upon them. However, he may help us later.

I have a copy of the "London Ambulance Convenors News" upon which the badges of the trade unions are proudly displayed. It sets out the 14 points with which staff were to comply from Monday 23 October. That is the day on which the accident and emergency service first vanished from the streets of London. I readily accept that some of those points are far more important than others and some have nothing to do with the accident and emergency service. We are all getting bogged down with radiotelephones. Point three of the 14 points under the heading A ban on the use of the radio telephone states: Day crews to report at nearest hospital or ambulance station. A and E crews to assist with open-call system and to comply with blue calls, urgent assists and queries on calls. That was a deliberate decision to stop using the new semi-automatic call and recall system which was introduced because of the inadequacy, about which Labour Members have long complained, of the old system in London. We were not complying in London with the——

Several Hon. Members

rose——

Mr. Clarke

I promise that I will give way on the radiotelephone, but then we must move on.

That was the point put into practice when the accident and emergency service first vanished about two weeks ago. The management has expertise, and it does not wish to use the police and the Army in London. However, it rapidly came to the conclusion that it could not guarantee an accident and emergency service on those terms. The open-call system had long been inadequate in London. All that it requires—as could happen—is for one microphone to be left open accidentally, or accidentally on purpose, and the whole system is aborted. It also means that one loses control of the vehicle because the crew does not report back when it has finished work. It works in the rest of the country because it has not yet been computerised, but it was known not to work in London and it was abandoned because of its inadequacy. It was reintroduced by the trade unions because of that inadequacy and because they knew the management would lose control of the whereabouts of the vehicles.

The House must ask itself, what was the motive in introducing a rule which states: A ban on the use of the radio telephone"? The motive for setting out the 14 points was to ensure that the service did not work properly. That is what was achieved.

Mr. Robin Cook

The Secretary of State will acknowledge that the point explicitly said: A and E crews to assist with 'open-call system'". That means that they will respond to every 999 call over the open-call system. If that system is considered so appalling and unreliable that it was necessary to suspend the service and bring in the police and the Army, why was it that for 20 years until eight months ago that was the service covering London?

Mr. Clarke

It was becoming increasingly inadequate, and Labour Members were in the forefront of those complaining about its inadequacy. It cannot cope with the volume of traffic in London and certainly not when there is an industrial dispute, when microphones are being left open, nobody knows where vehicles are and they are not reporting back——

Mr. Nigel Spearing (Newham, South)

rose——

Mr. Clarke

Let me move on.

That was accepted by the trade unions. The House will recall that the police, St. John Ambulance and the Red Cross were used for only about 36 hours before normal service was resumed. The management said that it could not maintain an accident and emergency service in London without the police, Red Cross and St. John Ambulance. That was worrying and the trade unions sat down with the management and discussed what to do. On 24 October the 14 points were revised and an agreement was reached.

The media and half the House are suddenly becoming experts on radiotelephones, although that is not the only issue. Point five of the 24 October agreement states: All operational staff, including the frontline crews, will use the radiotelephone, in accordance with London Ambulance Service radio-telephone procedures". That is working normally and, as we all recall, the result was that the police left the streets of London and returned to their policing duties, the Red Cross and St. John Ambulance were stood down and we had a safe and reliable accident and emergency service again. That was the agreement between the trade unions and the management. The events of 48 hours ago occurred because of the rows over the non-emergency staff and because the management would not pay the men in full for offering to do 2 per cent. of the work. The trade unions broke their agreement and told their men to go back to the 14 paints knowing perfectly well that they were bringing back on to the streets the police, the Red Cross, St. John Ambulance and—as I told the House in my statement a fortnight ago—the Army to provide a service that they were refusing to maintain.

Mr. D. N. Campbell-Savours (Workington)

Is the Secretary of State aware of the letter sent by the five unions this morning to the London ambulance service, which says in its final sentence: Finally, the representatives of the trade unions in London will meet you to discuss any matters the moment you restore an accident and emergency service in London? Will he confirm that the accident and emergency service in London to which they are referring is the system that worked in London up to eight months ago? Is that not the truth? If it is, why will not the right hon. and learned Gentleman arrange for someone to meet them?

Mr. Clarke

On 24 October the trade unions agreed to restore accident and emergency services——

Mr. Campbell-Savours

Is it true?

Mr. Clarke

It is not true.

Mr. Campbell-Savours

Is this the truth? The trade unions are offering to meet if the right hon. and learned Gentleman arranges for the restoration of the service in London to what it was eight months ago.

Mr. Clarke

It was an inadequate service. It proved inadequate on 23 October and the unions—[Interruption.] On 24 October the trade unions accepted that they had gone too far with their 14 points. They agreed with the management that they would use the radiotelephones in accordance with London ambulance procedures. They broke that agreement to make an industrial point.

The management side offered to meet the trade unions again. My hon. Friend the Member for Bristol, East (Mr. Sayeed) was right to remind the House of my meeting with Roger Poole on television when he continued to assert that the men were prepared to operate normally. The London ambulance service management, which is desperate to get an ordinary service back, immediately contacted Chris Humphreys, the trade union leader in London, to see whether Roger Poole was confirming that the trade unions would comply with their agreement to use the radiotelephones in the ordinary way. Those London trade union leaders were pulled out of a meeting by their national leaders to avoid going back and confirming what Roger Poole had said. They are still refusing to honour the agreement that they reached on 24 October. That is the background to the dispute.

From my point of view—I believe that it should also be the view of the House—we require an effective accident and emergency service in London that can be guaranteed. People must decide who they believe can make the judgment on that service—[Interruption.]

Mr. Speaker

Order.

Mr. Clarke

The management of the London ambulance service has expertise, judgment and is not directly party to the dispute—[Interruption.]

Mr. Speaker

Order.

Mr. Clarke

In the past, the management has discovered, through experience forced upon it, that one cannot guarantee an effective service with the 14 points.

The Labour party prefers the judgment of the National Union of Public Employees on how to operate the accident and emergency service in London. The Opposition have asked me to overrule the local management because NUPE has gone back on its word by breaking the agreement of 24 October. NUPE wants to operate a system that it knows will not work.

Mr. Sydney Bidwell (Ealing, Southall)

rose——

Mr. Clarke

No.

My hon. Friend the Member for Harlow (Mr. Hayes) invited the hon. Member for Livingston to take a statesmanlike view. The speech of the shadow Secretary of State for Health was worthy of a shop steward in the middle of an industrial dispute—[Interruption.] He went over the point about the radiotelephones with all the accuracy of a barrack room lawyer trying to defend the difficult position created for him by a trade union—[Interruption.]

Mr. Speaker

Order.

Mr. Clarke

Let us address ourselves to what the shadow Secretary of State for Health said should be done as it gives us an idea of what a Labour Government would do faced with the present situation.

Mr. Frank Haynes (Ashfield)

rose——

Mr. Clarke

I am sorry, but I will not give way, even to the hon. Gentleman, or there will be no time for debate.

The hon. Member for Livingston has suggested that I should push the management out of the way and intervene as Secretary of State. He thinks that I should get in the trade unions, ask them what they want and make some arrangements to ensure that they get it. I did not appoint one of the best general managers in the National Health Service, Mr. Duncan Nichol, to treat him in that way. I do not believe that that is a sensible way in which to run the service.

The suggestions of the hon. Member for Livingston show the type of approach that the Labour party adopts to the management of great public services such as the NHS. The Opposition's idea is that if the unions demand something one should overrule and undermine the management, get the trade unions in and do a political deal which is acceptable to their trade union masters. That is exactly what they did in the late 1970s. All this is familiar to every hon. Member who was a Member during the Callaghan Government. The then Minister for Health—the post now held by my hon. Friend the Member for Surrey, South-West (Mrs. Bottomley)—was NUPE-sponsored. The Opposition gave so many concessions to everyone who took srike action that, by the winter of 1979, they had everyone in the services on strike. The only ones who suffered when Labour was in power were those, especially NHS employees, who would not take industrial action.

Mr. Campbell-Savours

rose——

Mr. Clarke

I shall not give way to the same hon. Gentleman.

Mr. Campbell-Savours

rose——

Mr. Speaker

Order. The hon. Gentleman must sit down.

Mr. Clarke

In the six years of the previous Labour Government the real-terms pay of nurses sank every year for six years. During that time, doctors' pay was below inflation——

Mr. Campbell-Savours

rose

Mr. Speaker

Order. The hon. Gentleman must not continually rise.

Mr. Campbell-Savours

Let us get back to parity.

Mr. Clarke

The BMA does not take the kind of industrial action that brings Opposition Members flocking to the Floor of the House to say that Ministers should intervene to give them the money to get the service back working.

This debate is not the way in which to resolve this dispute. The dispute will be resolved by common sense and by the responsible action of those outside. Meanwhile, everyone should discharge their duty to the NHS.

Mr. Dennis Turner (Wolverhampton, South-East)

rose——

Mr. Clarke

I shall not give way.

It is the duty of the London ambulance service management to make its best judgment about whether it can guarantee an effective service to the public and to seek to get its trade unions to honour the agreement that the unions made with it on 24 October. It is the duty of Duncan Nichol and his colleagues on the NHS management executive to continue to make valiant efforts——

Mr. Campbell-Savours

rose——

Mr. Turner

rose——

Mr. Speaker

Order.

Mr. Clarke

It is Duncan Nichol's duty to continue with his efforts to get the unions back to the negotiating table.

It is the Government's responsibility to look after the interests of innocent people whose welfare, when injured or seriously ill, is put at risk by the irresponsible action taken by the unions in parts of the ambulance service, in particular, in the capital.

Mr. Campbell-Savours

rose——

Mr. Clarke

What we are hearing from the Labour party is a din. What we should be hearing from it is an appeal for common sense and an appeal for negotiations to be resumed.

I believe that the trade unions should show some compassion and concern for the people of London. They should honour their commitment to maintain the accident and emergency service. The Labour party and NUPE should tell the trade unions to get back to the negotiating table and to follow the procedures of the NHS. In that way, the dispute could be settled for those staff as it was for 95 per cent. of NHS staff.

Hon. Members

Resign!

Mr. Speaker

Order.

Mr. Tony Baldry (Banbury)

On a point of order, Mr. Speaker. It must be the right of every hon. Member to be able to listen to debates. I was sitting near my right hon. and learned Friend the Secretary of State, but, because of the barracking from the Labour Benches, it was almost impossible to hear what he said. Will you please remind——

Mr. Speaker

Order. The hon. Gentleman was here and he saw me rise on numerous occasions.

I must tell the House that a great many hon. Members want to participate——

Mr. George Galloway (Glasgow, Hillhead)

rose——

Mr. Speaker

Order. So that as many hon. Members as possible can be called I ask for brief speeches—speeches of five minutes even, if that can be achieved.

5.59 pm

Mrs. Gwyneth Dunwoody (Crewe and Nantwich)

I have listened carefully to the Secretary of State, and find it difficult to express my anger and contempt in adequate terms. I have sat in this House for 22 years. Today, I speak freely as someone who has been closely involved with the work of the London ambulance service for the past 14 years. I hold the view which I shall express today because a member of my family who has been closely involved in the issue has been driven out of the ambulance service to which he gave total commitment by the appalling pay and conditions.

When I listen to the Secretary of State, I find it impossible to believe that any serious politician can come to the House and make such scurrilous and totally unacceptable attacks on the London ambulance service or any other service. We are talking about a pay dispute which has been forced upon men and women who, day after day, give a commitment to the people of London of whom the Secretary of State spoke. Day after day, shift after shift, those men and women face increasing personal violence and great risk from increasingly hazardous diseases. They are constantly prepared to do so for wages which the Secretary of State would not accept for someone who devilled for him.

In this dispute, the Government have deliberately sought to provoke the ambulance men and women. Since cash limiting has taken over in the Health Service, the Government have deliberately sought to split those who work in what the Secretary of State constantly refers to as the emergency services from other men and women. His suggestion, somehow or other——

Mr. Dykes

rose——

Hon. Members

Sit down!

Mrs. Dunwoody

The Secretary of State's suggestion is that this is a service in which less than 10 per cent. of the calls involve emergency work and for the rest of the time the staff do no more than taxi drivers. That was the implication of everything that the Secretary of State said.

The service is so stretched and ambulance workers are so tired because they are constantly working—some of them seven days a week. They include people who one day drive old ladies to hospital on coaches and the next day kneel into a battered car to give mouth-to-mouth resuscitation to save someone's life. The Secretary of State's constant assertion that these people are not ordinary ambulance men and women is not only despicable but unworthy of comment.

Mr. Dykes

rose——

Hon. Members

Sit down!

Mrs. Dunwoody

I have watched the deterioration of the service, the inability of managers to manage and the imposition of management services which do not operate.

The Secretary of State talked about the open-call system. Why is it so essential? It is essential because, when all the other systems do not work, the ambulance workers can hear one another and respond. I have known children with steel bolts in their heads saved because the open-call system was used to relay urgent messages from one ambulance to another. Time and again I have seen men and women take risks that the Secretary of State would never take. He talks about bandages and blankets. He would not care to see his family wrapped in dirty blankets, yet he dares to suggest that the ambulance men and women are wrong to refuse to co-operate without properly equipped and cleaned ambulances. What he is doing is beneath contempt.

The Secretary of State is removing the dignity and the right to a decent standard of living from the men and women who provide a vital service which saves lives every day and night—not just when it suits him. I cannot tell him how much I despise that action from someone who is paid a reasonable wage and, supposedly, comes to this House as a responsible Secretary of State. He is becoming the Erich Honecker of the Government, riding his Wartburg round and round the M25, looking for a way out. Let him do the decent thing and resign with grace.

6.5 pm

Dame Jill Knight (Birmingham, Edgbaston)

The speech of the hon. Member for Livingston (Mr. Cook) was rather odd in some particulars. He finished with a throb in his throat and begged the House to vote for his motion to bring back full cover for the people of this country. The odd thing was that he had spent a considerable amount of time earlier in his speech telling us that people were receiving full ambulance cover and all the 999 calls were being answered. I was listening extremely carefully, and the fact is that we were told that 999 calls were being answered and then told to vote for the motion so that all 999 calls would be answered.

I am getting a little sick of the parrot cry for arbitration, arbitration, arbitration. I wonder why Opposition Members do not bother to find out the facts and recall history. The NHS pay and conditions have never ever been settled by arbitration. Pay and terms of service for ambulance staff and others in the NHS have always—this was so when the Labour party was in government—been settled by the Whitley council. Therefore, to suppose that this is a magic formula which the Labour party never used when it was in office is quite extraordinary.

Many misapprehensions are going round this House tonight. One is that hon. Members from one side of the House have bleeding hearts and the others have stony ones. That is completely untrue. No hon. Member has anything but admiration for the way that the ambulance personnel normally respond to emergency and more run-of-the-mill calls. Between 80 per cent. and 90 per cent. of the duties which ambulance personnel carry out are not actually emergency calls, but important calls to take people to treatment.

Mrs. Dunwoody

The same people carry them out.

Dame Jill Knight

The hon. Lady must not pretend to have the only bleeding heart in the House, because she is totally inaccurate. We all want the ambulance staff to get a fairer wage.

Mr. Nellist

Will the hon. Lady give way?

Dame Jill Knight

No, I am trying to be quick.

The second misapprehension is that what is on offer is so unreasonable that it calls for an industrial dispute. Virtually all other staff in the NHS have settled pay claims—some of which have not produced a settlement as favourable as the one on offer. As we know, the London ambulance men are being offered 9.3 per cent. Many settlements have been made that are far below that figure. An increase of 20 per cent. in overtime pay has been offered, which does not seem unreasonable.

I believe that, during the past three years, ambulance men have been given a 28 per cent. increase. My right hon. and learned Friend the Secretary of State will correct me if I am wrong but I believe that during those three years the retail price index has risen by considerably less—I think that the figure is 9.4 per cent. Therefore, it is hardly the case that the offer is so unreasonable and—with all the discussions that can take place in the Whitley council—it seems incredible that the ambulance staff feel that they must continue with this dispute.

The fourth misapprehension is that ambulance staff should be linked with firefighters—fifth-year firefighters at that. What about first, second or third-year firefighters?

The Minister for Health (Mrs. Virginia Bottomley)

They are not paid so much.

Dame Jill Knight

My hon. Friend is correct. I sometimes think that Opposition Members will never be satisfied with any decision of a court or other body outside this House unless the decision goes their way.

Professor Clegg looked at this very point of comparability between ambulance men and firefighters. I refer hon. Members to Command Paper 7641—the standing commission on pay comparability—a most thorough document. Hon. Members may be interested to know the yardsticks examined by the professor and his commission. He looked at the degree to which the job is made disagreeable and/or difficult by dust, fumes, wet, noise, extremes of temperature, lack of freedom of movement, lighting or unpleasant movement—and at the degree of physical endurance involved. He also considered work performed under unfavourable environmental conditions such as those that I have already Mentioned——

Mrs. Dunwoody

When was that study done?

Dame Jill Knight

In 1978. The hon. Lady would do well to have a look at what Professor Clegg had to say. He considered the danger of falling from height and of incurring cuts and burns. Things have not changed—[Interruption.] Why does not the hon. Member for Bradford, South (Mr. Cryer), who makes a fetish of involving himself in every debate from a sedentary position, not have the guts to stand up and make his own speech instead of trying to spoil someone else's?

Mr. Cryer (Bradford, South)

rose——

Madam Deputy Speaker (Miss Betty Boothroyd)

Order. I think that the hon. Lady is indicating that she is not giving way.

Mr. Cryer

rose——

Madam Deputy Speaker

Order. The hon. Gentleman has not been called and he is wasting valuable time.

Dame Jill Knight

I should like to draw attention to a statement made by the right hon. Member for Morley and Leeds, South (Mr. Rees) when he was Home Secretary: People talk about special cases. But the point is that a number of people in industry in general can also put forward a special case. I must make it clear…that we cannot move outside our guidelines". If that was a fair comment to make when the Opposition were in power, it is fair comment to make today.

My right hon. and learned Friend has two clear overriding duties to this country. First, he cannot allow the message to go out that failing to care for emergency patients or for those who have met with accidents or heart attacks will put extra money into people's pockets. It would be monstrous if one had only to threaten to withhold medical care to obtain an increase in salary. That is what my right hon. and learned Friend would be saying if he allowed himself to be blackmailed into meeting the Opposition's demands.

The second duty——

Mr. Geoffrey Lofthouse (Pontefract and Castleford)

rose——

Dame Jill Knight

I am anxious to be quick.

Mr. Lofthouse

rose——

Madam Deputy Speaker

Order. The hon. Lady has made it clear that she will not give way.

Mr. Cryer

I should be quite happy to make my own speech——

Madam Deputy Speaker

Order. The hon. Lady has made it very clear that she is not giving way.

Dame Jill Knight

I have never known the hon. Member for Bradford, South to need the pity of the rest of the House.

The second duty on my right hon. and learned Friend's shoulders——

Mr. Lofthouse

rose——

Madam Deputy Speaker

Order. The hon. Gentleman should not persist once the hon. Lady has said that she will not give way.

Dame Jill Knight

Many hon. Members want to speak, as I know you are aware, Madam Deputy Speaker.

The second duty that lies heavy on the shoulders of my right hon. and learned Friend is that of ensuring that all emergency calls are met. If the only way to do that is to call in the Army and the police, so be it. I do not believe that ambulance staff generally are militant people. Most of them must detest putting sick people in jeopardy. I hope that in future we can arrive at a no-strike agreement so that never again will our people have to face the trauma, worry and fear that are now in their hearts.

6.17 pm

Mr. Charles Kennedy (Ross, Cromarty and Skye)

The placing of troops on the streets of the capital by the Health Department is a reflection of the gravity of the situation, but some of the Secretary of State's characteristic comments on it did not measure up to that gravity. There have been reports during the afternoon of some staff being suspended without pay in Manchester, Surrey and Essex, so the problem is unequivocally a national one. The dispute should never have been allowed to reach this stage. The Secretary of State could have used his office long ago to prevent that.

I want to offer one reflection on the post-Griffiths NHS management which has become visible through this sad dispute. At the time of the Griffiths report and the debates in the House on the new management structure that was envisaged—I believe that the Secretary of State was then a Minister of State at the Department of Health—we were offered an assurance of the Minister's continuing political accountability to Parliament for the NHS. Yet in this dispute the Secretary of State appears to be willing to regard the NHS from his office as a spectator sport.

This contrasts dramatically with the position that the right hon. and learned Gentleman adopted in the House only two weeks ago on GPs' contracts. He did not spectate on that occasion: he dictated. As a result of the belligerence that he has shown in this dispute and in other matters he has inflamed an already vexed problem.

The Secretary of State defended Mr. Duncan Nichol. In what The Guardian yesterday described as a frank interview, Mr. Nichol acknowledged that he and his colleagues were failing to convince NHS staff, let alone the wider public, of the merits of the Government's health shake-up. There was, he said, a long way to go. I suspect that the Secretary of State's comments this afternoon have not got him much further down the road towards displaying concern or sensitivity about the attitudes expressed in the dispute.

Elsewhere we are told that advisers advise and Ministers decide. In the Department of Health it appears that managers decide and Ministers do little more than provoke. The Secretary of State should face up to his responsibility for that.

What of the remuneration of the ambulance men and their comparability with other emergency services? The Secretary of State has made it clear on several occasions, and confirmed this afternoon, that he sets the parameters within which pay bargaining is conducted at Whitley council level, but he and the Prime Minister earlier today were disingenuous to suggest that progress can be achieved at Whitley council level, given that he has made it categorically clear that more resources will not be available. That knocks on the head any room for meaningful manoeuvre or further negotiations to try to resolve the dispute.

As the Secretary of State will not speak to them directly, it is worth letting the ambulance men speak for themselves. A constituent of my hon. Friend the Member for Berwick-upon-Tweed (Mr. Beith), a Mr. Black, who has almost 12 years of service with the Northumbria ambulance service, wrote to my hon. Friend as follows: Over recent years we have in this service put up with a great deal of changes, cutbacks, and streamlining, but nevertheless 'weathered the storm' and picked ourselves up again … Mr. Duncan Nichol makes a statement that we do not compare with the Police and Fire services. It is totally demoralising and upsetting. As you well know we have the notorious A.1 road running through our area, and often get calls to accidents on it. On some occasions the fire service are in attendance with the police and ourselves, and sometimes there is only Police and ambulance. After Mr. Nichol's comments I feel that whenever in future I am involved with other emergency services I am going to feel inferior to them. It is ridiculous to think that we work for a service that is not classed as an emergency service. I quote his letter in full as he gives a clear representation of how the ambulance men feel. He continued: Whenever we leave an incident, we leave behind us the traffic police trying to take statements, and speak with witnesses, the Fire service hosing the road, and sweeping up broken glass, and the main responsibility for the major part of the incident is left with us, which is the lives of the injured who are in our hands only, until we reach the hospital. I am not decrying another service because one service can not work without the other, but it certainly makes me think that I am part of the 'Cinderella Service' … I have been proud to be an ambulance man and thoroughly enjoy my work, but since Mr. Nichol's remarks I have felt demoralised and sickened … The opinion I am portraying is my own, but I feel that this will be the same throughout the ambulance service nationally. When, as he must, the Secretary of State defends Mr. Nichol, will he bear in mind that that is the effect of Mr. Nichol's attitude in this dispute?

Mr. Kenneth Clarke

The Northumberland ambulance service is one of the best in the country. It has gone through considerable reorganisation and it almost solely performs accident and emergency work. It does hardly any non-emergency work. A high proportion of its staff are trained as paramedical staff. Duncan Nichol openly talked about looking particularly at paramedical staff, people with high qualifications and those who concentrate on accident and emergency services. Unfortunately, that view is rejected by the trade unions, the Labour party, and the hon. Member for Crewe and Nantwich (Mrs. Dunwoody). They do not believe in distinguishing between the tenth of the mileage for emergency work and the other nine tenths for the rest. Duncan Nichol has freely spoken about the need to consider high-quality paramedically trained staff of the kind now concentrated in Northumberland.

Mr. Kennedy

I can only state the hallowed phrase that is used when things go badly for the Government—the message somehow does not seem to be getting across to the ambulance men.

I now quote another ambulance man in my constituency, Mr. Moore. He lives in Wester Ross, a typical profoundly rural area. He writes with a sense of frustration about the conditions in which he and his colleagues find themselves. He says: In addition to the 40 hours which I am on duty I also do 'on call' duty which amounts to a further 40 hours each week. For this I receive in the region of 50p per hour. Due to economic factors many rural areas are run on a wing and a prayer. Some are still served by contractors … where untrained staff are paid per mile for driving an ambulance. Fortunately, the 'prayer' seems to work, so far. The current dispute is a call for fair treatment—not to get rich but to stop getting poorer. As many hon. Members will know from their constituency work, many ambulance men are in receipt of housing benefit and family credit. That shows the inadequacy of their pay, particularly for those with young families. It cannot be good for much of their income to be derived from the state benefit system. Surely the Secretary of State can recognise the inadequacies. More skill training and more paramedics are needed, but resources and political will are at the heart of the dispute. The Secretary of State's speech lacked conviction.

I now refer to the longer-term implications. There should be an independent pay review board for this sector to avoid leap-frogging between the Whitley arrangement and the independent pay review bodies for certain sectors. It should take into account public and private sector comparisons, market factors and conditions in local labour markets. If we have an independent arbitration service, it, too, should consider no-strike agreements and pendulum arbitration as a way of resolving future disputes.

Clearly, the existing management structure has failed by letting the dispute reach this stage. The remuneration on offer is unfair and the denial of comparability is equally unjust. As Lord McCarthy, when he looked at the Whitley set-up, said, it consisted of employers who do not pay and paymasters who do not employ. The dispute is presided over by a Minister who does not seem sufficiently to care. The Army should be put back into barracks and ambulance crews should be put back on our streets.

6.25 pm

Mr. John Marshall (Hendon, South)

There has been more than a whiff of hypocrisy in the debate. It is well to remember the tactics that have been employed by the ambulance men in London this week. They were to maximise public inconvenience and minimise the cost to their own pay packets. Those are the tactics of the blackmailer and the bully-boy in the 1980s. [Interruption.] They are quite disgraceful tactics, and I thank the Opposition for their support. Faced with those tactics, any responsible Government would have done the same as the present Government have done. After all, the Labour Government put the green goddesses on to the streets in 1978–79.

Mr. Merlyn Rees (Morley and Leeds, South)

On that occasion, the fire service was shut down completely. Obviously, in that situation, any Government had to save lives. If the hon. Gentleman thinks that this is on all fours with the firemen's dispute, he is looking back 10 years to when he was not a Member of Parliament.

Mr. Marshall

As a former Home Secretary, the right hon. Gentleman knows that 90 per cent. of cases in London are not emergency cases, and those are the cases with which the ambulance men are not dealing. Surely, when 90 per cent. of cases are not being dealt with, it is the Government's duty to take some action. Labour Members' lectures on Health Service staff wages are like Satan rebuking sin. The last Labour Government were responsible for a massive decline in the living standards of nurses and others in the Health Service.

This afternoon, we heard the Labour party's first commandment—"Thou shalt not annoy thy union paymasters." The House has heard from the hon. Member for Linlithgow (Mr. Dalyell) that he had been meeting ambulance workers for the past eight weeks. He did not say that he condemned their action or that he asked them to go back to their normal work. Labour party leaders will never condemn union action that creates hardship for others or is responsible for job losses.

Some people say that the Government should pay whatever is necessary to end the dispute, but they do not consider the consequences. If people are paid a certain sum to stop an irresponsible strike, the result will be a rash of irresponsible public sector strikes. If the Government pay huge sums for every irresponsible strike, the result will be rip-roaring inflation. Opposition Members know all about that, because they were responsible for it before. Those who suffer most from rip-roaring inflation are those for whom the Labour party claims to stand—the elderly, the sick, and the poorest paid. The weakest members of the community suffer from rip-roaring inflation. That is why the Government are right to stand firm rather than to pay up and give in to blackmail, which is what they are being asked to do.

6.29 pm

Mrs. Audrey Wise (Preston)

The ambulance workers of Lancashire are as keen as the ambulance workers in the rest of the country to achieve a proper wage structure. They are just as determined in their action, but there is a significant difference between the position of the people of Lancashire and that of the people of London and other parts of the country: the people of Lancashire have their emergency ambulance service secured, because the chief ambulance officer has decided that he will not have the Army, the police or any other organisation running ambulances in Lancashire. He talked to the trade unions and, as could be the position everywhere else, there is in Lancashire an emergency service covering 999 calls, maternity calls, the terminally ill, renal dialysis calls, radiotherapy and special categories of people at risk. There has been an agreement with the trade unions, the organisations that Conservative Members are castigating and slandering this evening.

The ambulance workers of Lancashire have shown determination to win their proper pay. In common with their colleagues throughout the country, they have also shown their devotion to the service. All ambulance workers would gladly sign the sort of agreement which was signed in Lancashire this morning.

Mr. Dykes

Will the hon. Lady give way?

Mrs. Wise

As the hon. Gentleman has already intervened in the debate and as there is a little time available to us, my answer is no.

I recommend that the Secretary of State consults the chief ambulance officer of Lancashire and follows his example. As it is supposed to be the trade unions alone who are making certain claims, I recommend that the right hon. and learned Gentleman reads yesterday's editorial comment in the Lancashire Evening Post, which states: It is a sad fact of life that too many people take too much for granted and that applies particularly to the three emergency services. The only time we really take note of ambulancemen and women is either when we need the service personally or when its personnel are involved in saving life during the aftermath of a national disaster. The article continues: Backed by public support and sympathy, the ambulance-men's case is a sound one. That is right.

The Government are making a tremendous error in thinking that they can distinguish between patient care and the work of the ambulance service. That is their excuse for refusing arbitration. In the terms of the Government's reply to the Select Committee on Social Services, they are afraid that money will be "diverted from patient care", but the ambulance service and ambulance workers are patient care. There is no patient care unless these workers do their job as they want to do. The population is behind them, as the Secretary of State will learn to his cost. Come to Lancashire, Secretary of State, and learn from those who have saved the emergency service in the county without the ambulance workers having to lose pay——

Mr. Kenneth Clarke

Does the hon. Lady appreciate that the management in London entered into an agreement with the unions on 24 October which put ambulances back on the street? Earlier this week, with the approval of her party, the unions cynically broke that agreement and returned to the old operation of their 14-point plan.

Mrs. Wise

Like the Secretary of State, I have had the privilege of listening to my hon. Friend the Member for Livingston (Mr. Cook). Consequently, I am fully seized of the situation in London. The London ambulance workers are willing to run an ambulance service which would be entirely adequate. As my hon. Friend the Member for Crewe and Nantwich (Mrs. Dunwoody) has said, that service may even have advantages. The right hon. and learned Gentleman's argument will not wash.

The ambulance and emergency services for Lancashire have been saved. If the Secretary of State would give way and cease his provocation, the emergency service for the rest of the country could be saved as well.

6.35 pm

Mr. Richard Holt (Langbaurgh)

We all know the story about the man who asked the yokel where he was and the route that he should take, whereupon the yokel told him that he had come from the wrong place. Where are we in this dispute? We are in a mess. In fact, we are in a hell of a mess. Why are we in it? I suggest that there are many historical reasons, which have not all surfaced today.

The first roots of the dispute were established in 1978, and they were part and parcel of what led to the Clegg report of 1979. If ayone wants to dispute that, let me make it clear that I have the report with me and can quote from it if necessary.

I am a practising personnel man who has been involved in industrial relations for over 20 years, but I could not find my way around, or understand, what is going on. There are far too many negotiators. There are far too many people who have their fingers in the pie. There is the Whitley council. What is that body and where is it? How are the members of the council appointed and where are they appointed? There are unions with leaders who clearly do not have the trust of their members; if they did, they would be able to strike a deal and adhere to it. Management is not negotiating because it does not have control of the finances. A financial limit is imposed upon it. No self-respecting management that is in that position can enter negotiations and strike a deal.

What is the role of the Secretary of State? He is player No. 5 in this game. No one knows what his role is, but we all have suspicions. Finally, there is the Treasury, which is player No. 6. We are still not sure about the nature of the Treasury's role.

Much is said about comparability and the Clegg report. Hon. Members talk about the report as if it came down from the mountains. They suggest that it is inviolate and right for all time, and never could have been wrong in the first place. We must recall the days when the Clegg commission was established. What was the climate of that time? How many people were in dispute at that time? When we read the Clegg report and everything that is related to it, we find that it is one, two or three, and then the ambulance men. The report states that it had to make assumptions when it came to determining comparability because it did not have time to discover the facts. The Clegg commission was given too great a brief and too little time. As a result, the ambulance men's case came last. The commission did not do its job properly. If there were a re-examination now of the ambulance men alone, we might come to different conclusions.

Who can put his hand on his heart and say that in his opinion ambulance men are dealing with emergency cases all the time? The figure of 10 per cent. refers to time and not to cases. How many firemen are dealing with emergencies for more than 10 per cent. of their working day? I would back the firemen's snooker, darts and other teams in my area against the teams formed by the ambulance men in the area, even though the firemen do not have quite so much free and down time as the ambulance men. However, we are told that the ambulance men must have more. The Clegg commission made a mistake and did not do its job properly. It considered the issues in hindsight and as a consequence the argument that is advanced on the basis of the Clegg report is unsound.

Mr. Eddie Loyden (Liverpool, Garston)

Does the hon. Gentleman realise that firemen are always ready to respond to calls? The only way in which we could oblige the hon. Gentleman would be to set fire to our cities so that the firemen could work 24 hours a day. Is that not ridiculous?

Mr Holt

A great deal of what we are discussing is ridiculous. The ambulance men's dispute should never have reached its present stage. That is ridiculous. To some extent, it is ridiculous to talk about the events of 10 years ago. To talk about 6.5 per cent. when everyone else, including ourselves, is getting more is also ridiculous. We are told that there is a man who has the freedom to negotiate when he has not, and he is saying silly things about the ambulance men having £600 to come, for example, when that is their money, money which has been withheld for the past few months. It is said that they can have some of next year's money, but that is not the way for anyone to negotiate this year's agreement. That is entirely the wrong approach.

The Clegg report states: We have no direct information relating to comparable conditions of service, but ambulancemen's conditions of service are broadly the same as for NHS ancillaries. That is how out of touch Clegg was in his report. He actually equated ambulance men, who deal with emergencies, with cooks and porters in hospitals.

I am a little closer to this issue than some of my colleagues because I am one of the few Conservative Members who have actually met Roger Poole and the others concerned with the dispute. Far too many unions are involved—we are trying to deal with five unions, and we should be trying to do something about that. Roger Poole, in a letter to me, states that the unions are looking for a pay formula that would ensure that never again would ambulance staff have to take industrial action over a national wage claim.

One of the comments in the Clegg report is that these people do not feel that society gives them the status that they should be given. It suggests that they should be monthly salaried—but 10 years on, no one has actually thought about it. That is something that the Government could be doing now. The pay review body should be thinking about the status of ambulance staff, and we should be considering no-strike agreements similar to those with the police and others in the public sector. The Government Front Bench are snared, but they can get themselves off the hook if they listren to their friends on the Conservative Benches.

6.41 pm

Mr. Nigel Spearing (Newham, South)

The hon. Member for Langbaurgh (Mr. Holt) has properly pinpointed some of the anomalies as they are perceived by a Conservative Member. There is a powerful case for those anomalies to be referred to the Arbitration, Conciliation and Advisory Service. I hope that he agrees with that, and that he will condemn the disgraceful speech of the Secretary of State. The right hon. and learned Gentleman's speech demeaned the occasion and, indeed, demeaned him.

I do not enter this debate with a National Union of Public Employees briefing or with a briefing from any union. My interest lies in the death of Mrs. Margaret Lander, a constituent of mine, and the suffering of a Mr. Lambert, both of Canning Town. More than a fortnight ago, they waited an hour for an ambulance when, only five minutes away at the Plaistow ambulance station, ambulance crews were willing and waiting to take them to hospital. Last Tuesday, the Secretary of State had the effrontery to say that ambulance people were only pretending to be available. I can tell him that since 9 am yesterday, more than 100 calls to the London ambulance service have been answered by ambulance personnel, most in voluntary time and through the radiotelephone system.

The Secretary of State's conduct has been very bad, and I criticise him on two main grounds. However, before doing so I want to comment on the points made by the hon. Member for Brmingham, Edgbastoin (Dame J. Knight), who referred to pay. If she believes in market forces, as do most Conservative Members, she should pay attention to the haemorrhage in the personnel of the London ambulance service. Of the 2,700 staff, 680 left during the two years to June and of those, 380 left before normal retirement age and 200 because they were unfit.

Dame Jill Knight

rose——

Mr. Spearing

I am sorry, but I cannot give way. I am responding to points made by the hon. Lady. She knows, as do all those who referred to the 10 per cent. time factor, that it is misleading because those who deal with non-emergency cases are still dealing with sick people who are in distress. Those who care for those who are in distress are necessarily under stress themselves. All ambulance crews are under stress all the time.

The Secretary of State says that Mr. Nichol is concerned with the highly skilled. He may not realise, and neither may Mr. Spry—who is not the administrator of the ambulance service, but the general manager of South-West Thames regional health authority—that before one can become skilled at dealing with accidents on the A1 one must do an apprenticeship in dealing with the less difficult cases. I challenge the Secretary of State to say that he and the South-West Thames regional health authority are not putting out feelers for privatising the non-emergency services—for hiving off the so-called non-emergency service. Are they not in contact with such organisations as Securicor, London Regional Transport and even borough transport authorities? I have asked the right hon. and learned Gentleman about that, but he appears not to know the answer. As Secretary of State, he should know the answer. Will he get up and tell me whether that is the case?

Mr. Kenneth Clarke

Currently, the non-emergency staff in London are offering to do about 2 per cent. of their work, but want to be paid in full. The management will not accept that. That led to the trade unions breaking their agreement on the accident and emergency services and coming out in sympathy. The money that was previously being spent on non-emergency crews is, of course, now required to pay for the hospital car service, the taxis and the other vehicles that are being used to carry non-emergency patients. There are already parts of the country where the non-emergency service has been adequately replaced by other forms of transport. The strike is accelerating that day throughout the country.

Mr. Spearing

The right hon. and learned Gentleman did not deny my main charge. He has destabilised public service after public service—in which Conservative Members appear to have no interest—by threatening the integrity of those services and calling them into question. I challenge him to say that he is not doing that, but he has already confirmed my fears in his intervention. How can we extend the hospital ambulance service by expenditure on a minicab or a black taxi to take an elderly lady to hospital? That is what the Government are doing, and it undermines the morale and the cohesion of the ambulance service. The dispute is not simply about the immediate matter of pay.

On 31 October 1986, I had a debate with the hon. Member for Derbyshire, South (Mrs. Currie). I am sorry that she is not in her place today. She said: About 10,500 fewer walking patients were being transported—a reduction of 44 per cent. I am more than happy at that development."—[Official Report, 31 October 1986; Vol. 103, c. 666.] It was absolute sauce and a scandal for the hon. Lady to say that. She is no longer a Minister, but the Secretary of State and his colleagues are responsible for that policy. They are responsible for capping the funds of the ambulance service in London, when, in fact, it should be demand-led.

The right hon. and learned Gentleman mentioned the radio service. That service was introduced a few months ago, but it is an electronic computer system that does not always work properly. It sometimes jams. The Poplar ambulance station sent a detailed memorandum to the so-called administrators of the London ambulance service asking them to put it right. They have not even received a reply—[Interruption.] I ask the Secretary of State to pay attention to what I am saying. I hope that he will stop talking to his right hon. Friend the Member for Mole Valley (Mr. Baker) and attend to the detail of the shocking maladministration of the ambulance service in London. That is the background to the dispute.

My constituents in Canning Town were waiting for an ambulance from the local ambulance station. The administrators of the London ambulance service decreed that they should not receive their ambulance calls, and the Secretary of State must take responsibility for that decision because it was made by one man, whom I will riot name, with the Secretary of State's connivance. It is he and he alone who is responsible.

6.49 pm

Ms. Harriet Harman (Peckham)

The Secretary of State commented on how many Labour Members were in the House when he spoke tonight. They are here because they had hoped to hear something from him tonight which showed that we could look forward to the resolution of the dispute. We have heard nothing of that tonight. Those Labour Members who are present tonight are reflecting the high level of public concern in their constituencies that there should be an urgent resolution to the dispute.

The situation is serious. The Army and police vehicles and the voluntary ambulances cannot cope adequately with accidents and emergencies. To expect them to do so is unfair on ambulance crews who want to work and who have been prevented from doing so, and it is unfair on the police and the Army, who are put in the front line of a situation which is not of their making and with which they know that they cannot cope.

The Government have been right in the past to praise the ambulance service, particularly when ambulance officers and crews have risked their lives to save others. But when it comes to a pay award, they are offered less than the rate of inflation. They are offered a pay award that would let them see their standard of living slide, and that is wrong; that would see a widening gap between their pay and the pay of the other emergency services—the police and the fire service—with whom they have to work as a team.

The dispute need never have happened. It should never have happened. Having created the dispute, the Government are now making things worse every day and every hour.

The Secretary of State has insulted the ambulance crews that have been praised in the past by accusing them of posturing and pretending. He has twisted the facts, saying that the unions first accepted the pay offer when it is clear that the pay offer was twice refused on a ballot of all the membership. He said again and again in the House tonight that the union is on strike. The ambulance crews are not on strike; they have been suspended. Is he so out of touch with what is happening outside the House that he has not seen today the London ambulance service vehicles taking ambulance calls with signs on the side saying, "Suspended but still working"? Those ambulance crews want to work, but they are being prevented from doing so. The ambulance crews are rightly concerned about the pay offer, not just as a matter of justice for themselves, but because they rightly have long-term fears for the future of the service.

As my hon. Friend the Member for Newham, South (Mr. Spearing) said, ambulance crews are voting with their feet and leaving the ambulance service. The fact that the London ambulance service, like other ambulance services, is understaffed contributes to the fact that only half our ambulance services meet the Government guidelines for getting to accidents and emergencies on time. The Surrey ambulance service, which serves the constituency of the Minister for Health, does not meet the Government target for getting to accidents and emergencies on time.

The Secretary of State talked of bonds of common humanity. I hope that he will listen to the case of Mavis Thomas, whose sister came to see me in my surgery. Mavis Thomas, aged 17, had an asthma attack and an ambulance was called. The London ambulance service told me that no vehicles were available at the nearest three ambulance stations. It took half an hour for the nearest ambulance to arrive, and by the time Mavis Thomas reached hospital it was too late to resuscitate her and she died. Understaffing has contributed to the situation where the service cannot provide the ambulance service that we all want to see.

If the Secretary of State had talked to ambulance crews, he would know, as we do, that they do not want to be prevented from working. He would know, as we do, that they do not want to be in an industrial dispute. They do not want to be in political controversy. They want to do their job, and it is that job that the public want them to do. The Government are gambling with people's lives, both currently and in the future. They must agree to arbitration.

The Secretary of State has offered no hope of a solution tonight. The House must vote for arbitration to replace confrontation. If we do, the dispute could be ended tonight.

6.54 pm

The Minister for Health (Mrs. Virginia Bottomley)

All of us in the House feel strongly about the important contribution made by the skilled and dedicated service of ambulance staff. None of us wants to underestimate the important part that they play in caring for the sick and the injured, often in stressful and difficult circumstances.

I want to pay a special tribute to the chief ambulance officers and all their staff who are struggling to maintain services to the public. Many have refused to turn their backs on their responsibilities. Members of the Association of Professional Ambulance Personnel have declared themselves unwilling to countenance action that would hurt patients.

But having said that, I want to make it clear that today we have seen the Opposition in their true colours. It sends a shudder down one's back to think that, were the country ever so unfortunate as to have the Labour party in power again, once again it would be beer and sandwiches and, "Let's sort this out. Let's pay up. Who cares?" The frail and the vulnerable cannot speak. They do not have the strong arm of the trade unions. What they need is the long arm of the Government.

It is an interesting contrast that a week ago, when we were discussing the fundamental element of our primary health care proposals, the contract for the general practitioners, the Opposition Benches were almost empty. But today, with the whiff of industrial action, they come out of their lairs. With the prospect of a picket line, they stir from their lethargy.

Once again, we are reminded of the winter of discontent. Health care is to be decided not by those with the skills to decide on how best to meet patients' needs, not by medical and other practitioners, but by trade union guidelines, by the COHSE and NUPE convenors, who take it upon themselves to decide whether a case is urgent or needy.

Mr. Nellist

rose——

Mr. Jeremy Corbyn (Islington, North)

rose——

Mrs. Bottomley

When we see the Opposition Benches crowded in this way, all of us know full well what the Opposition are really considering.

Mr. Corbyn

On a point of order, Mr. Speaker.

Mr. Speaker

I hope that it is a point of order and not a point of argument.

Mr. Corbyn

It is a point of order, Mr. Speaker. The Secretary of State and the Minister of State have, throughout their speeches, vilified the National Union of Public Employees, which is my union, and at no stage have they been prepared——

Mr. Speaker

Order. It must be a point of order for me.

Mr. Corbyn

It would be common courtesy to allow a representative of that union to respond on behalf of its members. In those circumstances, is it in order for the Minister to refuse to give way?

Mr. Speaker

I am sorry that it has not been possible to call the hon. Gentleman and many other hon. Members, but unless the Minister gives way, I cannot do anything about it.

Mrs. Bottomley

Much has also been said about those who are not involved in emergency work. All of us agree that the nine out of 10 miles that the ambulance crews ride looking after those who are not accident or emergency cases are equally important. They are vulnerable and frail people who need the services that the ambulance crews should properly and rightly provide. Nor will the people of London think much of the argument that ambulance crews who are not carrying out a full day's work should receive their full pay.

The facts speak for themselves. This year the Government have provided the largest ever increase in NHS funds, far in excess of anything that the Labour party would ever have been able to provide. Within those generous resources, it must be right that the NHS management should decide how the resources are to be allocated, which are the cases that should be dealt with and how the rewards should be paid to those who work.

If patients are to experience the high standards of health care that we are determined to provide, Health Service employees must know that we shall protect them from the reckless and excessive claims of trade unions. Patients—the frail and the vulnerable; those who cannot speak, and who have not the strong arm of the unions behind them—must know that they can have confidence in our running of the National Health Service.

We want a speedy resolution of the dispute. We want to see service personnel return to their barracks, and not to be forced to man the ambulance service. And, of course, we want the unions to return to the Whitley council so that we can discuss in detail many of the aspects that have already been raised.

In London, where the thrust of this appalling action is taking place, this year's settlement would ensure that the pay of ambulance staff was well ahead of inflation. I ask the House to reject the outrageous claims of the Opposition, and to reject the motion. The Government believe in the National Health Service; we believe in those who work for it; and, above all, we believe in the patients. We do not believe that the National Health Service should be run by the excessive claims of irresponsible trade unionists.

Question put:—

The House divided: Ayes 204, Noes 297.

Division No. 386]	[7pm
AYES
Abbott, Ms Diane	Flannery, Martin
Adams, Allen (Paisley N)	Flynn, Paul
Allen, Graham	Foster, Derek
Archer, Rt Hon Peter	Fraser, John
Armstrong, Hilary	Fyfe, Maria
Ashdown, Rt Hon Paddy	Galloway, George
Ashley, Rt Hon Jack	Garrett, John (Norwich South)
Ashton, Joe	George, Bruce
Barnes, Harry (Derbyshire NE)	Godman, Dr Norman A.
Barnes, Mrs Rosie (Greenwich)	Golding, Mrs Llin
Barron, Kevin	Gordon, Mildred
Battle, John	Gould, Bryan
Beckett, Margaret	Griffiths, Nigel (Edinburgh S)
Bell, Stuart	Griffiths, Win (Bridgend)
Benn, Rt Hon Tony	Grocott, Bruce
Bennett, A. F. (D'nt'n & R'dish)	Harman, Ms Harriet
Bermingham, Gerald	Healey, Rt Hon Denis
Bidwell, Sydney	Heffer, Eric S.
Blair, Tony	Henderson, Doug
Boyes, Roland	Hoey, Ms Kate (Vauxhall)
Bradley, Keith	Hogg, N. (C'nauld & Kilsyth)
Bray, Dr Jeremy	Home Robertson, John
Brown, Gordon (D'mline E)	Howarth, George (Knowsley N)
Brown, Nicholas (Newcastle E)	Howell, Rt Hon D. (S'heath)
Bruce, Malcolm (Gordon)	Howells, Dr. Kim (Pontypridd)
Buchan, Norman	Hoyle, Doug
Buckley, George J.	Hughes, John (Coventry NE)
Caborn, Richard	Hughes, Robert (Aberdeen N)
Callaghan, Jim	Hughes, Roy (Newport E)
Campbell, Menzies (File NE)	Hughes, Simon (Southwark)
Campbell, Ron (Blyth Valley)	Hume, John
Campbell-Savours, D. N.	Illsley, Eric
Canavan, Dennis	Ingram, Adam
Carlile, Alex (Mont'g)	Janner, Greville
Cartwright, John	Jones, Barry (Alyn & Deeside)
Clark, Dr David (S Shields)	Jones, Ieuan (Ynys Môn)
Clarke, Tom (Monklands W)	Jones, Martyn (Clwyd S W)
Clelland, David	Kennedy, Charles
Clwyd, Mrs Ann	Kirkwood, Archy
Cohen, Harry	Lambie, David
Coleman, Donald	Lamond, James
Cook, Robin (Livingston)	Leadbitter, Ted
Corbyn, Jeremy	Leighton, Ron
Cousins, Jim	Litherland, Robert
Crowther, Stan	Livingstone, Ken
Cryer, Bob	Lofthouse, Geoffrey
Cummings, John	Loyden, Eddie
Cunliffe, Lawrence	McAllion, John
Dalyell, Tam	McAvoy, Thomas
Darling, Alistair	McCartney, Ian
Davies, Rt Hon Denzil (Llanelli)	Macdonald, Calum A.
Davies, Ron (Caerphilly)	McFall, John
Davis, Terry (B'ham Hodge H'l)	McKay, Allen (Barnsley West)
Dewar, Donald	McKelvey, William
Dixon, Don	Maclennan, Robert
Dobson, Frank	McNamara, Kevin
Doran, Frank	McWilliam, John
Duffy, A. E. P.	Madden, Max
Dunwoody, Hon Mrs Gwyneth	Mahon, Mrs Alice
Eastham, Ken	Mallon, Seamus
Evans, John (St Helens N)	Marek, Dr John
Ewing, Harry (Falkirk E)	Marshall, David (Shettleston)
Ewing, Mrs Margaret (Moray)	Marshall, Jim (Leicester S)
Fatchett, Derek	Martin, Michael J. (Springburn)
Fields, Terry (L'pool B G'n)	Martlew, Eric
Fisher, Mark	Maxton, John

Meacher, Michael	Short, Clare
Meale, Alan	Sillars, Jim
Michael, Alun	Skinner, Dennis
Michie, Bill (Sheffield Heeley)	Smith, Andrew (Oxford E)
Michie, Mrs Ray (Arg'l & Bute)	Smith, C. (Isl'ton & F'bury)
Mitchell, Austin (G't Grimsby)	Smith, Rt Hon J. (Monk'ds E)
Morgan, Rhodri	Smith, J. P. (Vale of Glam)
Morley, Elliot	Snape, Peter
Morris, Rt Hon A. (W'shawe)	Soley, Clive
Morris, Rt Hon J. (Aberavon)	Spearing, Nigel
Mowlam, Marjorie	Steinberg, Gerry
Mullin, Chris	Stott, Roger
Murphy, Paul	Strang, Gavin
Nellist, Dave	Straw, Jack
O'Brien, William	Taylor, Mrs Ann (Dewsbury)
O'Neill, Martin	Taylor, Matthew (Truro)
Orme, Rt Hon Stanley	Thompson, Jack (Wansbeck)
Patchett, Terry	Turner, Dennis
Pendry, Tom	Vaz, Keith
Pike, Peter L.	Wall, Pat
Powell, Ray (Ogmore)	Wallace, James
Prescott, John	Walley, Joan
Quin, Ms Joyce	Wardell, Gareth (Gower)
Radice, Giles	Wareing, Robert N.
Randall, Stuart	Watson, Mike (Glasgow, C)
Redmond, Martin	Welsh, Andrew (Angus E)
Rees, Rt Hon Merlyn	Welsh, Michael (Doncaster N)
Reid, Dr John	Wigley, Dafydd
Richardson, Jo	Williams, Rt Hon Alan
Roberts, Allan (Bootle)	Williams, Alan W. (Carm'then)
Robinson, Geoffrey	Wilson, Brian
Ross, Ernie (Dundee W)	Winnick, David
Rowlands, Ted	Wise, Mrs Audrey
Ruddock, Joan	Worthington, Tony
Sedgemore, Brian
Sheerman, Barry	Tellers for the Ayes:
Sheldon, Rt Hon Robert	Mr. Frank Haynes and
Shore, Rt Hon Peter	Mr. Frank Cook.

NOES
Adley, Robert	Butler, Chris
Alexander, Richard	Butterfill, John
Alison, Rt Hon Michael	Carlisle, John, (Luton N)
Amery, Rt Hon Julian	Carlisle, Kenneth (Lincoln)
Amess, David	Carrington, Matthew
Amos, Alan	Carttiss, Michael
Arbuthnot, James	Cash, William
Arnold, Jacques (Gravesham)	Channon, Rt Hon Paul
Arnold, Tom (Hazel Grove)	Chapman, Sydney
Ashby, David	Chope, Christopher
Aspinwall, Jack	Clark, Hon Alan (Plym'th S'n)
Baker, Rt Hon K. (Mole Valley)	Clark, Dr Michael (Rochford)
Baker, Nicholas (Dorset N)	Clark, Sir W. (Croydon S)
Baldry, Tony	Clarke, Rt Hon K. (Rushcliffe)
Batiste, Spencer	Colvin, Michael
Bellingham, Henry	Conway, Derek
Bendall, Vivian	Coombs, Simon (Swindon)
Benyon, W.	Cormack, Patrick
Bevan, David Gilroy	Couchman, James
Biffen, Rt Hon John	Cran, James
Blackburn, Dr John G.	Critchley, Julian
Blaker, Rt Hon Sir Peter	Currie, Mrs Edwina
Body, Sir Richard	Curry, David
Boscawen, Hon Robert	Davis, David (Boothferry)
Boswell, Tim	Day, Stephen
Bottomley, Peter	Devlin, Tim
Bottomley, Mrs Virginia	Dorrell, Stephen
Bowis, John	Dover, Den
Boyson, Rt Hon Dr Sir Rhodes	Dunn, Bob
Braine, Rt Hon Sir Bernard	Durant, Tony
Brandon-Bravo, Martin	Dykes, Hugh
Brazier, Julian	Eggar, Tim
Bright, Graham	Emery, Sir Peter
Brooke, Rt Hon Peter	Evans, David (Welwyn Hatf'd)
Browne, John (Winchester)	Fallon, Michael
Bruce, Ian (Dorset South)	Farr, Sir John
Buck, Sir Antony	Favell, Tony
Budgen, Nicholas	Fenner, Dame Peggy
Burns, Simon	Field, Barry (Isle of Wight)
Burt, Alistair	Finsberg, Sir Geoffrey

Fishburn, John Dudley	Leigh, Edward (Gainsbor'gh)
Fookes, Dame Janet	Lennox-Boyd, Hon Mark
Forman, Nigel	Lester, Jim (Broxtowe)
Forsyth, Michael (Stirling)	Lilley, Peter
Fowler, Rt Hon Norman	Lloyd, Peter (Fareham)
Fox, Sir Marcus	Lord, Michael
Franks, Cecil	Lyell, Sir Nicholas
Freeman, Roger	MacGregor, Rt Hon John
French, Douglas	MacKay, Andrew (E Berkshire)
Gale, Roger	Maclean, David
Garel-Jones, Tristan	McLoughlin, Patrick
Gill, Christopher	McNair-Wilson, Sir Michael
Gilmour, Rt Hon Sir Ian	McNair-Wilson, Sir Patrick
Glyn, Dr Alan	Madel, David
Goodhart, Sir Philip	Major, Rt Hon John
Goodson-Wickes, Dr Charles	Malins, Humfrey
Gorman, Mrs Teresa	Mans, Keith
Gorst, John	Maples, John
Gow, Ian	Marland, Paul
Grant, Sir Anthony (Cambs SW)	Marlow, Tony
Greenway, Harry (Ealing N)	Marshall, John (Hendon S)
Greenway, John (Ryedale)	Martin, David (Portsmouth S)
Gregory, Conal	Mates, Michael
Griffiths, Sir Eldon (Bury St E')	Maude, Hon Francis
Griffiths, Peter (Portsmouth N)	Mawhinney, Dr Brian
Grist, Ian	Maxwell-Hyslop, Robin
Ground, Patrick	Mellor, David
Grylls, Michael	Meyer, Sir Anthony
Gummer, Rt Hon John Selwyn	Miller, Sir Hal
Hague, William	Miscampbell, Norman
Hamilton, Hon Archie (Epsom)	Mitchell, Andrew (Gedling)
Hamilton, Neil (Tatton)	Mitchell, Sir David
Hampson, Dr Keith	Monro, Sir Hector
Hanley, Jeremy	Montgomery, Sir Fergus
Hannam, John	Moore, Rt Hon John
Hargreaves, A. (B'ham H'll Gr')	Morrison, Sir Charles
Hargreaves, Ken (Hyndburn)	Moss, Malcolm
Harris, David	Moynihan, Hon Colin
Haselhurst, Alan	Mudd, David
Hayes, Jerry	Neale, Gerrard
Hayhoe, Rt Hon Sir Barney	Needham, Richard
Hayward, Robert	Nelson, Anthony
Heathcoat-Amory, David	Neubert, Michael
Heddle, John	Newton, Rt Hon Tony
Heseltine, Rt Hon Michael	Nicholls, Patrick
Hicks, Mrs Maureen (Wolv' NE)	Nicholson, David (Taunton)
Hicks, Robert (Cornwall SE)	Nicholson, Emma (Devon West)
Higgins, Rt Hon Terence L.	Onslow, Rt Hon Cranley
Hill, James	Oppenheim, Phillip
Hind, Kenneth	Paice, James
Holt, Richard	Patnick, Irvine
Hordern, Sir Peter	Patten, Rt Hon Chris (Bath)
Howarth, Alan (Strat'd-on-A)	Patten, John (Oxford W)
Howarth, G. (Cannock & B'wd)	Pattie, Rt Hon Sir Geoffrey
Howe, Rt Hon Sir Geoffrey	Pawsey, James
Howell, Ralph (North Norfolk)	Porter, David (Waveney)
Hughes, Robert G. (Harrow W)	Portillo, Michael
Hunt, David (Wirral W)	Powell, William (Corby)
Hunter, Andrew	Price, Sir David
Irvine, Michael	Raison, Rt Hon Timothy
Irving, Charles	Redwood, John
Jack, Michael	Renton, Tim
Jackson, Robert	Rhodes James, Robert
Janman, Tim	Ridley, Rt Hon Nicholas
Jessel, Toby	Roberts, Wyn (Conwy)
Jones, Gwilym (Cardiff N)	Roe, Mrs Marion
Jopling, Rt Hon Michael	Rossi, Sir Hugh
Kellett-Bowman, Dame Elaine	Rowe, Andrew
Key, Robert	Rumbold, Mrs Angela
King, Roger (B'ham N'thfield)	Ryder, Richard
King, Rt Hon Tom (Bridgwater)	Sackville, Hon Tom
Knapman, Roger	Sayeed, Jonathan
Knight, Greg (Derby North)	Scott, Rt Hon Nicholas
Knight, Dame Jill (Edgbaston)	Shaw, David (Dover)
Knox, David	Shaw, Sir Giles (Pudsey)
Lamont, Rt Hon Norman	Shaw, Sir Michael (Scarb')
Lang, Ian	Shelton, Sir William
Latham, Michael	Shephard, Mrs G. (Norfolk SW)
Lawrence, Ivan	Shepherd, Colin (Hereford)
Lee, John (Pendle)	Shepherd, Richard (Aldridge)

Shersby, Michael	Tredinnick, David
Sims, Roger	Trippier, David
Skeet, Sir Trevor	Twinn, Dr Ian
Smith, Tim (Beaconsfield)	Vaughan, Sir Gerard
Soames, Hon Nicholas	Viggers, Peter
Spicer, Sir Jim (Dorset W)	Waddington, Rt Hon David
Spicer, Michael (S Worcs)	Wakeham, Rt Hon John
Squire, Robin	Walden, George
Stanbrook, Ivor	Walker, Bill (T'side North)
Stanley, Rt Hon Sir John	Walker, Rt Hon P. (W'cester)
Stern, Michael	Waller, Gary
Stevens, Lewis	Ward, John
Stewart, Allan (Eastwood)	Wardle, Charles (Bexhill)
Stewart, Andy (Sherwood)	Watts, John
Stewart, Rt Hon Ian (Herts N)	Wheeler, John
Stradling Thomas, Sir John	Whitney, Ray
Sumberg, David	Widdecombe, Ann
Summerson, Hugo	Wiggin, Jerry
Tapsell, Sir Peter	Wilkinson, John
Taylor, Ian (Esher)	Wilshire, David
Taylor, John M (Solihull)	Winterton, Mrs Ann
Tebbit, Rt Hon Norman	Wolfson, Mark
Temple-Morris, Peter	Wood, Timothy
Thatcher, Rt Hon Margaret	Yeo, Tim
Thompson, D. (Calder Valley)	Young, Sir George (Acton)
Thompson, Patrick (Norwich N)	Younger, Rt Hon George
Thorne, Neil
Thurnham, Peter	Tellers for the Noes:
Townend, John (Bridlington)	Mr. Alastair Goodlad and
Townsend, Cyril D. (B'heath)	Mr. David Lightbown
Tracey, Richard

Question accordingly negatived.

Mr. Corbyn

On a point of order, Mr. Speaker. During the debate that has just ended, the Minister—due either to shortage of time or lack of inclination—was unable to give the House any idea of what is now going to happen in the ambulance dispute, or of whether the intention is to withdraw the troops and negotiate properly with the unions who wish to undertake the emergency services. Is the Minister able to say when the House will be able to return to this important matter so that representatives of the unions concerned—the National Union of Public Employees, the Transport and General Workers Union, the Confederation of Health Service Employees and the General, Municipal, and Allied Trades Boilermakers Union—will be able to put their concerns directly to Ministers?

Mr. Speaker

I cannot advise hon. Members on tactics, but there may be opportunities next week, no doubt, to do that.

Several Hon. Members

rose——

Mr. Speaker

Order. It was a short debate. Those hon. Members who were called spoke very briefly. Nevertheless, I am sorry that more hon. Members could not be called.

Mrs. Alice Mahon (Halifax)

Further to that point of order, Mr. Speaker. I withdrew my name from the list of those who wished to speak in the debate because time was short. However, to elaborate on the point made by my hon. Friend the Member for Islington, North (Mr. Corbyn), people could die tonight on the streets of London. The Secretary of State has said nothing whatever about what is going to happen——

Mr. Speaker

Order. I am sorry, but we cannot continue the debate now.

Mr. Cryer

On a point of order, Mr. Speaker. The International Westminster Bank Bill is to be considered during private business at 7 o'clock and

Mr. Speaker

Order. I suggest that the hon. Member ought to raise that point when we reach private business.