Ambulance Dispute

HC Deb 19 February 1990 vol 167 cc665-717

Mr. Speaker

We now come to the debate on the dispute in the ambulance service in the name of the Scottish Nationalist party. I must announce to the House that I have selected the amendment in the name of the Prime Minister.

3.48 pm

Mr. Jim Sillars (Glasgow, Govan)

Before I start, I want to make one technical correction. We are not the Scottish Nationalist party but the Scottish National party, and there is more than just a semantic difference.

Mr. Speaker

I apologise.

Mr. Sillars

I was not looking for an apology.

I beg to move, That this House recognises public concern about the prolongation of the ambulance dispute; acknowledges strong public support for the ambulance staff; is aware of the Government's role in prolonging the dispute; and calls upon the Secretary of State for Health to renew negotiations with representatives of ambulance staff in order to seek an end to the dispute on the basis of a just award and a pay review mechanism that will recognise the place of ambulance staff in our emergency services. The motion is tabled in the names of my hon. Friend the Member for Moray (Mrs. Ewing), myself and others in the Scottish National party and Plaid Cymru. I acknowledge and recognise the co-operation of the hon. Member for Livingston (Mr. Cook) on behalf of the Labour party in ensuring that a single motion has been tabled by the Opposition today. Whatever political differences we may have in other areas, there are absolutely none in respect of this dispute.

I notice that the name of the organ grinder, the Secretary of State for Health, is missing from the Government amendment. It also appears that he is missing from this debate. I am sure that many members of the public, as well as ambulance staff, will think it an absolute disgrace that the right hon. and learned Gentleman does not reckon that this subject is important enough to present himself to the House to state his case.

Mr. Bill Walker (Tayside, North)

Will the hon. Gentleman give way?

Mr. Sillars

I shall not give way, even for a kiltie.

I shall refer to the Secretary of State for Health all afternoon because, with due respect to the other hon. Gentlemen, the organ grinder is far more important than the monkeys.

On page 2 of the right hon. and learned Gentleman's letter of 16 February, which was sent to hon. Members, he refers to the trade unions and says: They are still claiming 11.4 per cent. and are still insisting on a pay mechanism for ambulancemen"— I do not know why he fails to understand that women are also involved— which would link them to firemen or other staff". That statement from the Secretary of State was untrue. The position of the trade unions was made perfectly plain in a statement issued on 16 January. Paragraph 2 of that statement reads: The pay rate aspect of our claim is the other major demand. In April 1989 our claim was 11.14 per cent. on the hourly rate. However, the unions are prepared to negotiate on this and, if necessary, lower our sights. Paragraph 4 states: In November 1989, to facilitate negotiations, the ambulance unions dropped several key parts of the April 1989 claim. The parts of the claim dropped were:

1. 1. An increase in standby allowances
2. 2. An increase in annual leave
3. 3. The introduction of long service holidays
4. 4. A reduction in the working week
5. 5. The introduction of long service pay, after 5, 10 and 15 years' service."

Any of those five objectives is perfectly legitimate for a trade union involved in negotiations—the 11.14 per cent. pay claim is perfectly legitimate. It says a great deal for the flexibility of the trade unions that they were prepared to make that type of offer to the Government. They were prepared to lower their sights on a major part of their claim and to drop a series of important aspects of it. The Secretary of State's letter, which was sent to all hon. Members, is wholly inaccurate. Perhaps that is why he finds it extremely difficult to come here this afternoon to try to justify his unjustifiable position.

We have two reasons for tabling the motion. First, the ambulance staff have been in dispute for six months, and it is extremely important that the people that they elected, along with other concerned members of the public, appreciate that and do not forget those staff. In the past five weeks, momentous events have taken place in the Soviet Union, East Germany, other parts of eastern Europe and in South Africa with the freeing of Nelson Mandela. Various things have happened that have tended to push the ambulance dispute off the front pages and out of the media.

I have been involved in industrial disputes, and I appreciate that people can believe that they have been forgotten. As a result of this debate, an important signal will be sent to the ambulance staff and to the public to say that the dispute is at the top of the parliamentary agenda and of the public agenda. From my experience as a trade union official, I stress to ambulance staff that the combination of public support for them and their commitment to the public is unbeatable. If they maintain their commitment to the public, they will achieve their objectives as redefined by the trade unions.

The second reason for the motion is to produce a further critical examination of the issues, particularly against the changed political circumstances of the electoral prospects of the Tory party. That should make many Opposition Members consider their future carefully.

I have looked at all that has been said in the debates, and there seem to be six main pillars supporting the Government's case. I shall examine them in turn. First, the Government say that it is wrong for management to engage in arbitration, and therefore that solution is rejected. Secondly, they say that no more money is available because each penny spent comes off patient care funds. The third pillar is combined with the fourth: the Government reject a pay review mechanism, similar in its objectives to that applied to the fire service, to avoid further disputes. The Government justify that through their assertion that no true comparison can be drawn between the ambulance service and the police and fire service.

The fifth pillar of the Government's case is that it is immoral to take industrial action in an essential service. The sixth pillar is that the organ grinder—the Secretary of State—claims that he has no personal responsibility for direct intervention.

Mr. Tony Banks (Newham, North-West)

Does not the hon. Gentleman contrast the statements that the Secretary of State actually makes with the number of times that he goes on radio and television to argue the case, while trying to be Judas Iscariot and Pontius Pilate and wash his hands of the affair?

Mr. Sillars

Judas Iscariot at least got something. I take on board what the hon. Gentleman says, and I shall refer to the television stardom role that has been adopted by the Secretary of State.

The first pillar in the Government's case is arbitration. The Secretary of State's position is set out in Hansard, on 24 October last year. He said: Management cannot hand over the control of pay of large groups of people to third parties when it also has a responsibility to spend its money on the provision of patient service."—[Official Report, 24 October 1989; Vol. 158, c. 666.] I hope that everyone grasped the phrase. cannot hand over the control … of large groups". The ambulance men and women number about 22,000 out of 1 million people in the National Health Service—just over 2 per cent. of the total staff involved. They could not be defined, even by an idiot, as a very large group.

There are large groups, including the 100,000 doctors and the 490,000 nurses. Those are, by any definiton, very large groups. Their pay is not worked out by arbitration, but it is something near it, because there are pay review mechanisms that remove any possibility of industrial dispute.

I say to the Secretary of State, who is not here, that the job of management is to consider all the elements that make up an organisation's activity. They must consider its revenue, materials, equipment, fixed capital formation in hospitals, human capital and, last but by no means least, staff motivation, commitment and morale. Those are the elements that go to make a challenge to management.

There is now a distinct failure of management. For six months, they have failed to resolve a dispute that could easily be resolved by recourse to arbitration. To listen to the Secretary of State, one would think that arbitration was a completely new invention that had never been tried before and might lead to chaos and disaster.

Mr. Robert Hughes (Aberdeen, North)

Perhaps the hon. Gentleman may care to reflect on the Secretary of State's previous role as an Under-Secretary of State for Transport. Every time the railway unions sought an increase, he constantly said, "Go to the Railway Staff National Tribunal"—the arbitration organisation.

Mr. Sillars

Yes, that is the point I am making: there is nothing new about arbitration. It is a well-tried system employed to break down conflict and disputes or to resolve a dispute when that would be extremely difficult under normal circumstances.

Dame Jill Knight (Birmingham, Edgbaston)

I am following carefully what the hon. Gentleman is saying. Can he give some examples of arbitration used anywhere else in the Health Service instead of the Whitley council arrangements?

Mr. Sillars

I have heard and read this argument before, and it is not relevant. Once upon a time, in every industry and undertaking, there must have been a first time when arbitration was invoked—[HON. MEMBERS: "Oh."] That is a logical proposition that no one could confound.

I have personal experience of arbitration; I have served as a member of an arbitration panel which tried to solve a dispute between teachers and management in local government in the mid-1970s. Arbitration is not the handing over of management control to the arbiters. Arbitration does not take place in a vacuum. No one ignores the realities facing the management and the trade unions.

An arbitration panel is a tripartite body. The chairman is neutral; there is a nominee from the employers' side and another from the trade union side. They assess the award against the realities.

I was the trade union nominee on an arbitration panel, and it sat in private. No one on it could get away with loose intellectual or economic arguments, or with stupid social arguments, no matter which side he represented. There was genuine concern on the part of the whole tribunal, and that applied to every arbitration that I have ever experienced—

Mr. Bill Walker

Will the hon. Gentleman give way?

Mr. Sillars

No.

These panels tried to reach certain objectives. One was to resolve the dispute fairly; the second was to leave the structure of management-trade union relations intact; the third was to injure neither party. Arbitration is a civilised way of resolving disputes. The hon. Member for Aberdeen, North (Mr. Hughes) was right: it is ironic that the Government urge arbitration on a group of workers whose claim they do not like, but deny arbitration to another group whose claims they like in no circumstances—

Mr. Walker

rose—

Mr. Sillars

I shall not give way. I do not want to upset the hon. Gentleman; he will get in later, but he has to wait his turn.

The Select Committee examined arbitration. As I said before, somewhere along the line there must be a first time for arbitration. In the debate on 11 January this year, the hon. Member for Eastleigh (Sir D. Price) said: Last March, the Select Committee recommended that `the Government take the initiative in getting discussions started between the Management and Staff sides with the purpose of developing a mutually agreed arbitration procedure. We suggest that arbitration should be a last resort and that a strict timetable should be established and adhered to for issues referred to arbitration'."—[Official Report, 11 January 1990; Vol. 164, c. 1133.] The Select Committee foresaw difficulties of this kind, and put the idea forward. What a pity it was not accepted.

Mr. Walker

The hon. Gentleman has some knowledge of arbitration, but he is not the only Member with knowledge of it. These are complex and intricate matters. Will the hon. Gentleman tell the House from experience how Whitley works, and what impact arbitration for one group of workers would have on the standing of Whitley and on the Health Service?

Mr. Sillars

One of the great problems of Whitley was beautifully summed up by Lord McCarthy, who said that it was made up of employers who do not pay and paymasters who do not employ. I look forward to the day when I can stand here and claim to have piloted Concorde; I am sure that the hon. Member for Tayside, North (Mr. Walker) would get up and claim that he had done the same—

Mr. Walker

I have.

Mr. Sillars

I make no such claim.

I now come to the second pillar of the Government's case—that no more cash can be offered because none is available, and that if it is made available it can only come out of patient care. The hon. Member for Livingston (Mr. Cook) has said several times that the cost of prolonging the dispute is twice as much as it would have taken to settle it. No Conservative Member, and especially not the Secretary of State for Health, has answered the question posed by the hon. Member for Livingston about how the Secretary of State can find money to prolong a dispute when he denies his ability to find money to settle it.

There are other costs. It is said that the money must be taken from patient care, but there are other costs not inside the Health Service that are important to the community. What about police time? According to a parliamentary answer, the police in Scotland have turned out to 6,700 cases. Some 166,060 police man hours in England have been devoted to trying to tackle the problem in the ambulance service. What about the loss of police manpower in a society in which people are concerned about crime and security? Of course the loss is unquantifiable, but the citizen is entitled to ask why police are being sent to try to do the work of the ambulance staff when the work that they should be doing is securing the position of people in society.

Mr. Jeremy Corbyn (Islington, North)

Will the hon. Gentleman reflect on the quality of service given by the police, the Army, the Navy and the Royal Air Force in undertaking emergency duties that should be carried out by the ambulance service? That service is of a low standard simply because the people in those services are untrained and inexperienced in carrying it out. They are not qualified to do it, they do not want to do it and they should not have to do it. The issue could be resolved if the Government stopped being so awkward and understood the desire of the ambulance workers to carry out the service that they have been trained for and should be paid to do.

Mr. Sillars

I do not think that I have met anyone in the police who would argue for a moment that the police provide exactly the same standard of service. There is no question of that.

Mr. Ieuan Wyn Jones (Ynys Môn)

Is the hon. Gentleman aware that the Police Federation of England and Wales supports the claim of the ambulance men?

Mr. Sillars

I am aware of that. I am a former fireman, and all the firemen that I know take exactly the same position.

Pillars three and four of the Government's case are intertwined. They are a no-pay-review formula, linked to the assertion that, while ambulance crews are part of an emergency service, they are somehow or other, in the Secretary of State's eyes, of a lower status. Last year, the Secretary of State said: I do not accept that comparisons can be made with other emergency services, when only one tenth of the mileage of the ambulance service is taken up by emergencies."—[Official Report, 7 November 1989; Vol. 159, c. 855.] That is deeply insulting to ambulance crews.

I hope that that gibe was not aimed at the crew in Lockerbie, which turned out within three minutes of the call about that disaster. If we went to Lockerbie ambulance station and looked at the log book, we could probably prove that only one tenth of the mileage was for emergency services, but that is not the relevant point. The relevant point is that, when the emergency arose, the ambulance men had the commitment to fulfil their obligations to the community.

The Secretary of State's point of view shows a total incomprehension of how all our emergency services operate and the demands that they make upon the psychology, the physical condition, the bravery and the commitment of those engaged in them.

Mr. Richard Holt (Langbaurgh)

Will the hon. Gentleman give way.

Mr. Sillars

No. I have given way fairly generously.

I should like to compare the police, the fire service and the ambulance service. Some police officers undertake duties such as school crossing patrols. Those duties are important, but they do not constitute an emergency. Crime prevention is important, but it is not an immediate emergency. We can only guess at what special branch does, but I do not think that it engages in emergencies. The police have duties in community involvement and desk duties, and much time is taken up in court attendance. Those are all non-emergency activities, but no one would argue for a moment that the police are not an emergency service, because, when required, police officers have the ability to turn out.

Mr. Holt

Will the hon. Gentleman give way now?

Mr. Sillars

No. I am sorry, but the hon. Gentleman is not getting in.

I am a former fireman, and my brother recently retired as a fire officer. Over the years, I have kept in touch with my mates in the fire service. They are involved in non-emergency work such as equipment cleaning, maintenance and repairs. Fire prevention staff rarely turn out in emergencies, and the service also uses part-time and retained firemen in various parts of the country who, by their very definition, do not work mainly in the fire service. Nevertheless, they turn out for emergencies. Lockerbie has a part-time fire station, yet it turned out within six minutes the first appliance to attend the disaster there. In the case of the police and fire services, it is not necessary to prove that their staff are always engaged in emergency turnouts.

Ambulance staff are in exactly the same position. They undertake a great deal of routine work, but when there is a Clapham, a King's Cross, a Lockerbie or a Hillsborough, ambulance staff or whatever grade turn out to provide emergency services—and they all bring professionalism, skills, commitment and will power to the job in hand.

From my own experience as someone who has served in the fire brigade, I can tell the House that a great deal is required of men and women who respond to emergency calls. They are expected to go from dead stop to full ahead. One's heart is pounding and one's nerves are jangling, because one knows that one is about to encounter an horrific or potentially horrific situation. The police might find themselves confronted by an armed criminal. Firemen are expected to enter buildings full of flame and smoke from which other people are escaping. Ambulance staff must suppress the nausea they feel when dealing with injuries and burns that are horrible to contemplate and even worse to treat.

My brother, a former fire officer, made a very good point to me over the weekend. He pointed out that firemen save lives in the sense that they take people out of burning buildings and other difficult situations, but that their work is only potentially life-saving. If a life is saved, it is saved by the ambulance staff who take over and use the skills that firemen do not have, from the moment the firemen hand over a burned or devastated human being into the caring hands of the ambulance service.

The three services all have different characters, but they integrate in an emergency. When the Secretary of State says in a sarcastic voice that ambulance staff do not compare with firemen, we should remember that firemen acknowledge that ambulance crews turn out for more emergencies than they do. Also, every time that an ambulance crew is called out, it has to deal with a human being—which is not always the case in the fire service.

I turn to the fifth pillar—the Secretary of State's accusation about the morality of the dispute. In the debate on 11 January, he said: the industrial action organised and taken by the trade unions concerned is against patients and patient services, and it cannot be justified—as industrial action in any essential service cannot be justified."—[Official Report, 11 January 1990; Vol. 164, c.1115.] That is not a moral statement—it is moral blackmail. We as a society have no right to tell people that, because we need them, they must meet our demands, irrespective of the costs to themselves and to their families.

If one were to try to lift the Secretary of State's views out of the depths of moral blackmail and on to a plane of genuine morality, the wording of that statement would instead read, "As industrial action in any essential service cannot be justified, we have special review mechanisms to ensure that our emergency services are never taken advantage of."

If there is a moral equation between society and the emergency services, as in every other decent equation, morally there are two sides—there are rights on the public side but the public also have obligations to the people who serve them. The words that I read out are the moral equation; they are applied to the police and the fire service and they should be applied to ambulance staff.

Now I come to the issue raised by my hon. Friend the Member for Newham, North-West (Mr. Banks). He said that the Secretary of State had a personal responsibility to intervene. Hon. Members may have seen him on the Channel 4 programme. I thought at first that he was at a Nottingham Forest game, tossing the coin, but it turned out to be a commentary by him on the dispute. There is no question of his being a key player. He said on that programme that he is the man who provides the money, and how could he respond to ambulance staff demands? He has produced and presented radio programmes, and produced and presented the Channel 4 programme. I turned on the television set, and there he was in a helicopter above the north of England. The public want him to come down out of the air, and get to the negotiating chamber along with the trade unions.

Finally, there are the changed circumstances that I mentioned earlier—the Government's electoral prospects. My remarks bypass Conservative Members on the Front Bench, and are intended for Tory Back Benchers—an extremely anxious Conservative Party at present. The more that the hon. Member for Tayside, North (Mr. Walker) shakes his head, the more convinced I am about the accuracy of my statement.

I shall quote from Scotland on Sunday, published yesterday, 18 February. Under the headline "Thatcher set to ride out stormy spell", the article quotes a "Downing Street source"—there are no guesses or prizes for who that might be—who disclosed yesterday that Thatcher was reconciled to electoral setbacks as an inevitable consequence of mounting mortgage rates and high poll tax charges in England"— she is in the same boat in Scotland— 'The Prime Minister knows that the path of true love is never smooth'". It must come as a great surprise to all members of the public, racked by inflation, mortgage interest payments and high rents, that they are embraced in a passionate love affair with the Prime Minister, or that they are at least being propositioned by her. 'Of course it's all very painful. But it's painful because it's working'". Has it never struck the Tory Party that it is painful and that it is not working?

If this is Bernard Ingham speaking he must be losing his marbles completely, because the article continues: Medicine that works is always painful. That has never been my experience; it is sometimes true, but often it is not. But this attitude is certain to deepen despair among back-benchers who fear a bitter backlash in the Tory heartlands. The article goes on to comment on the mid-Staffordshire by-election and the local government elections in England, Wales and Scotland.

The quotation within a quotation from Scotland on Sunday demonstrates that the Tory Party's leader is now deep in the bunker, obsessed with a bunker mentality—a leader denying reality. She appears to have drawn into the bunker with her the Secretary of State for Health. Like first world war generals, they are driving their troops in front of them into the electoral slaughterhouse.

Does anyone think that it will be pleasant to be a Tory canvasser on the streets for the Mid-Staffordshire election or the local government elections in England, Wales and Scotland? Let us consider those elections. The Government must attend to this problem, because their vested interests are involved. Do they want to go canvassing on the poll tax, water charges, the current level of inflation, current interest rates or current mortgages and rents, or on the difficult Budget that we are all told is coming, or with the National Health Service Bill still in Committee, agitating the general population?

The Government cannot avoid campaigning on any of those issues. Do they really want to add to that poisonous cocktail their continuing dispute with the ambulance staff? Do their canvassers in the Mid-Staffordshire by-election campaign want to go down the pavements bumping into people who have just put money in the buckets of the ambulance staff, and asking them to vote Tory? It is absurd.

Any professional politician who wants to be in that position is in the bunker with the lady in Downing street—on the point of being medically unfit for leadership. The only conclusion that a Tory can draw from the present state of affairs—in his own interests, if not in the interests of the ambulance staff—is that he should seek to get genuine negotiations reopened to end the dispute. Tory Back Benchers can save themselves only by saving themselves from the folly of those on their own Front Bench.

4.20 pm

The Parliamentary Under-Secretary of State for Scotland (Mr. Michael Forsyth)

I beg to move, to leave out from "House" to the end of the Question and to add instead thereof: recognises the important contribution made by the skilled and dedicated service of ambulance staff; regrets that some have seen fit to prolong and intensify the action taken against patients in furtherance of the current pay dispute; appreciates the work of the police, the armed forces and the voluntary services in maintaining an adequate emergency service; supports the Government and National Health Service management on their handling of the dispute; calls on the trade union leaders to ensure that the undertakings they have given to maintain an adequate emergency service are met; believes that the dispute can only be resolved by the resumption of negotiations; and calls on the trade union leadership to recognise and act upon this.". Let me begin by saying to the hon. Member for Glasgow, Govan (Mr. Sillars) in respect of his latter remarks that, judging by the opinion polls in Scotland, we should not be taking any advice from him about how to maintain our position. After all, his party is sliding gracefully into third place behind the Scottish Conservative party.

When we face the electorate, we shall expect to be judged on our record of good management of the Health Service, which can be seen partly in the record number of patients being treated in Scotland. Our record of good management of the Health Service arises from the fact that this Government have always sought to do what is right by the Health Service—which is not, perhaps, to take the advice of Opposition Members.

No party represented in the House has a monopoly on admiration for the work of the ambulance service, and no party can claim that it alone supports the ambulance service and its workers. The Government support the ambulance workers and recognise their skill and dedication. It is interesting to note that, in a long speech, the hon. Member for Govan never once referred to the patient transport services arm of the ambulance service, but instead addressed all his remarks to the emergency services. The hon. Gentleman will be aware that the trade unions' claim is for recognition across the board for all sections of the ambulance service on an equal basis.

Having acknowledged the marvellous job done by the ambulance service, I must add that it is unfortunate that there should be industrial action in pursuit of a pay claim within that service, because there is no doubt that it is causing substantial disruption to the service and serious damage to patient care. The elderly are not being taken to their day centres. People are not getting to hospital for their courses of physiotherapy treatment, and waiting lists are being lengthened at a time when the Government are investing £7 million in reducing waiting lists in Scotland. Once again, the Opposition support those who take industrial action resulting in waiting lists being lengthened and in patient care being disrupted.

The admiration that we have for the ambulance service is perhaps reflected among those staff, of whom there are many thousands, who have continued to provide a full service and to carry out their duties, thus putting patients first. I should have thought that all Opposition Members would acknowledge and welcome their actions.

I want to put on record the strain placed on senior management and on officers working to maintain essential services. I am sorry that the hon. Gentleman for Glasgow, Rutherglen (Mr. McAvoy) should be shaking his head, because some people in the ambulance service have worked extremely hard to ensure that the 999 service has continued.

Mr. John McAllion (Dundee, East)

The Minister will be aware that, two weekends ago, three people died in Dundee who might have been saved if ambulance workers had been able to attend them. However, the management locked out the ambulance workers and denied them access to life-saving equipment.

Mr. Forsyth

If the hon. Gentleman wants to refer to examples in Dundee, I am sure that he saw the same BBC programme as I did, in which an ambulance man confessed that he had put attendance at a union meeting before answering an emergency call. To his credit, he has apologised. If the hon. Gentleman thinks that the dispute will be settled by engaging in that kind of argument, I have to disagree with him. There is a clear duty on the ambulance service management to ensure that the Scottish ambulance service procedures are followed. Management have made it perfectly clear that, when those procedures are followed, they will do everything in their power to ensure that the service continues.

Mr. Thomas McAvoy (Glasgow, Rutherglen)

I intervene only because the Minister referred to me earlier. He has referred to the senior management in the Scottish ambulance service. Does he not believe that morale in the ambulance service will be affected by Mr. James Wilby questioning the integrity of the people with whom he will have to work in future?

Mr. Forsyth

I am sure that the hon. Gentleman knows that his name is John, not James, Wilby. I believe that he is just as inaccurate in suggesting that Mr. Wilby has questioned the integrity of his staff. I know John Wilby, and his dedication to the ambulance service. He has spent most of his career in the service. It does not help to attack him in that way.

Senior management and officers have worked extremely hard to maintain essential services. If only for the benefit of the hon. Member for Islington, North (Mr. Corbyn), I want to place on record my thanks to the police, the voluntary services and the Army, who have had to step in when patients have been put at risk. They have done so because there has been no alternative, despite the fact that a clear undertaking had been given by trade union leaders that the emergency service would be maintained. That undertaking has not been met in a number of instances.

Dame Elaine Kellett-Bowman (Lancaster)

A very dear friend of mine had to be taken to hospital by the police because no ambulance was available. When I was at the West Kensington tube station the other day, some ambulance men were collecting money from the public in buckets. An ambulance came along. I thought that it was going about its normal duties, but it just picked up the ambulance men, complete with cash buckets—presumably to take them to their next cash collection point.

Mr. Forsyth

The House will have heard what my hon. Friend said. It is to be regretted that, despite the clear undertaking by trade union leaders that the emergency service would be maintained, that has not happened in a number of cases.

Mr. Corbyn

Will the Minister give way?

Mr. Forsyth

I shall give way to the hon. Gentleman in a moment.

I noted that, over the weekend, the hon. Member for Govan was quoted in the newspapers as describing the tactics that are being pursued as "brilliant and exemplary". If he thinks that there is anything brilliant or exemplary about Edinburgh being left with only two ambulances to cover the whole city, I could not disagree with him more. He has a responsibility to ask those men, who are not even following the advice of their trade union leaders, to ensure that a proper service is maintained.

Mr. Corbyn

Does the Minister accept that, all over the country, ambulance managements are standing down ambulance workers who are ready, able and willing to provide an emergency service, that they are asking the poice or the armed forces to deal with emergency cases instead, and that those who are sent in to carry out emergency work do not want to do it, are not qualified to do it and, furthermore, are not equipped to do it? Those whom they blame for having to do that work are the Conservative party and the Government. If he is genuine, why does the Minister not demonstrate his support for the ambulance workers by meeting the unions and coming to an agreement, so that a proper emergency service can be restored?

Mr. Forsyth

If the men in the Scottish ambulance service are prepared to work to the TUC guidelines and to provide an emergency service, they will be paid 100 per cent. on the emergency side. On the patient transport side, if the TUC guidelines are followed and if the ambulance men are prepared to take elderly people to their day hospitals, they will also be paid 100 per cent. There is absolutely no need for local authorities to set up alternative services at a cost to the community charge payer, and there is every opportunity for an emergency service to be maintained within TUC guidelines if that is what the trade unions wish to deliver. The public are entitled to that.

Mr. Siliars

Does not the Minister realise that, when a dispute involving an important public service continues for six months, there is at the heart of it a great struggle between the Government and the ambulance workers for public support, as that is a key element in any such dispute? Have not the public themselves passed judgment that the ambulance unions have conducted a brilliant campaign strategically and tactically, in that they have never withdrawn their services from the general public, who believe that, far from being brilliant, the Government's performance has been lamentable?

Mr. Forsyth

I am sure that every person in Glasgow will note that the hon. Member for Govan is completely unaware that a 999 service was withdrawn from his own constituency, and that he has described that as "brilliant and exemplary".

Mrs. Maria Fyfe (Glasgow, Maryhill)

I wonder whether the hon. Gentleman cares to respond to the point just made by the hon. Member for Glasgow, Govan (Mr. Sillars)—that the public support the ambulance workers and have made that very clear for six months?

Mr. Forsyth

The hon. Lady will have heard me say that the Government also support the ambulance workers. We support them for the service that they provide. But if we were to take the advice of the hon. Lady and the hon. Member for Govan, which seems to be the same, and if we were to allow some procedure for determining pay such as the hon. Gentleman suggests, pay in the Health Service would press upon resources and the hon. Lady would find that the public in her constituency would complain about the loss of the development of services in the Health Service.

Mr. Robert Hughes

Will the Minister give way?

Mr. Forsyth

I should like to make some progress. I shall give way to the hon. Gentleman later.

For the benefit of the hon. Member for East Lothian (Mr. Home Robertson), perhaps we should go back to 1986, as it is important to recognise the importance to the dispute of what has happened since then. Back in 1986, a new salary structure was agreed for the ambulance service, which included revised working practices and improved conditions. It was acknowledged by everyone on all sides that that represented a good deal for the ambulance service.

I have examined what had happened to prices and to wages in the ambulance service since that good deal was obtained. I discovered that prices to April 1989 have gone up by 23 per cent. and the pay of ambulance men, including the current offer which applies from April 1989, has gone up by 31 per cent. So there has been a real increase in ambulance men's pay of 8 per cent. over the 1986 settlement, which every ambulance man to whom I have spoken has acknowledged as a good settlement; they are on record as saying that it was a good deal.

Mr. Charles Kennedy (Ross, Cromarty and Skye)

The Minister is talking about the increase in ambulance men's pay since 1986, but he should compare it with that of firemen and policemen over the same period. Firemen's pay has gone from a 7.3 per cent. increase in 1986 to one of 8.6 per cent. for the current financial year; policemen's pay has gone from a 7.5 per cent. increase to 9.25 per cent. for the current financial year, and ambulance men's pay has gone from an increase of 6 per cent. to the current offer of between 6.5 per cent. and 9 per cent. over the past 18 months; but in the intervening two years, their pay increase dropped to between 5 and 6 per cent. They have consistently lost in comparison to other emergency services.

Dame Elaine Kellett-Bowman

It is not an emergency service: it is the emergency arm of the NHS, not the NHS arm of the emergency services. [Interruption.]

Mr. Forsyth

Perhaps I can answer the hon. Gentleman's point, as I did not hear what my hon. Friend said.

The hon. Member for Ross, Cromarty and Skye (Mr. Kennedy), is arguing a separate point. My point is that, in 1986, the ambulance service was completely restructured in terms of pay and conditions, and the ambulance men acknowledged that as a good deal. When we compare their position in 1986 to what it is now, we see that ambulance men's pay has increased 8 per cent. faster than prices. In real terms, their pay is better than it was in 1986.

The hon. Member for Ross, Cromarty and Skye asked me to make a comparison between ambulance men, fifth-year firefighters and other groups. I must be fair and say that the hon. Gentleman was right to say that, in terms of a comparison with firemen, the pay of ambulance men has not risen by as much, but in terms of the 1986 settlement, their pay has risen well ahead of inflation.

The management's final offer to the ambulance men is fair and reasonable. I am not sure whether everyone is aware of the nature of that offer, but I am certain that the hon. Member for Govan, judging by his speech, is completely unaware of it. I know that the hon. Member for Govan is aware that the offer is a 9 per cent. increase in pay, backdated to 1 April 1989.

Mr. Henry McLeish (Fife, Central)

It is over 18 months. Will the Minister give way?

Mr. Forsyth

I will give way to the hon. Gentleman later. I have already been very generous in giving way.

The nature of the offer is a 9 per cent. increase on all rates, backdated to 1 April last year. That is 9 per cent. over the current year, and that would run until the end of September this year. On 1 October, there will be an opportunity to negotiate a further increase. In addition to that, there is an extra £500 for all staff with paramedical skills.

Mr. Sillars

Will the Minister give way on that point?

Mr. Forsyth

If the hon. Gentleman will contain himself until I have explained the offer—

Mr. Sillars

There are only eight people in Scotland with paramedical skills.

Mr. Forsyth

There is an extra £500 for staff with paramedical skills. I acknowledge that the number of people in Scotland with those skills is small.

Mr. Sillars

Small? There are only eight.

Mr. Forsyth

Actually, there are 24.

Mr. Sillars

Only eight.

Mr. Forsyth

No, 24.

Mr. Dennis Skinner (Bolsover)

Anyway, there are not very many.

Mr. Forsyth

The hon. Member for Govan did not mention the most important part of the offer. There is an offer of a joint review of the 1986 salary structure, without the preconditions on the scope or timing of the outcome. The offer provides the ambulance men with an opportunity to accept a 9 per cent. pay rise—and the small number, admittedly, with paramedical skills would receive the extra £500—and the opportunity in October to get a further increase. They would also be able to consider the 1986 arrangement and the work carried out by the emergency services and the patient transport services. All that could be done without preconditions. The ambulance men have the opportunity to accept a good pay increase and have negotiations at the same time. That is a fair and generous offer.

Mr. McLeish

Is the Minister aware that the Government have tried to confuse the public? Will he tell the House and the listening public what the nature of the offer is over 12 months from April?

Mr. Forsyth

The hon. Gentleman did not really mean to ask me that. The nature of the offer over 12 months from 1 April 1989 is an increase of 9 per cent. That is a pretty reasonable offer.

Mr. McLeish

rose—

Mr. Forsyth

The hon. Gentleman wanted to know the nature of the offer from 1 April.

Mr. McLeish

The offer is over 18 months. What does that offer equate to over 12 months? How much cash, in percentage terms, will the ambulance men and women receive in the 12-month period from April to April, not over the 18 months?

Mr. Forsyth

The hon. Member for Fife, Central (Mr. McLeish) is an Opposition Front-Bench spokesman responsible, I believe, for industry, but he does not understand the nature of this offer. I will tell him again.

Over the 12 months from 1 April 1989 until 31 March 1990, the ambulance men will get a 9 per cent. pay increase that will be backdated to that date. Therefore, they will get a lump sum back payment. I hope that that is clear to the hon. Gentleman. From 1 April of this year until 30 September will also be 9 per cent., in so far as that 9 per cent. offer will extend over 18 months. On 1 October there will be an opportunity for a new arrangement to be reached.

Mr. Skinner

Will the Minister give way?

Mr. Forsyth

The hon. Member for Bolsover (Mr. Skinner), characteristically, understands that point only too well.

Mr. Skinner

Obviously, there is a gap between April and October, and that is the part that must be filled. We have 9 per cent. over 12 months and we have a gap of another six months. That makes 18 months. We have 9 per cent. They are paid over 18 months. That is roughly equivalent to 6.5 per cent. over 12 months.

Mr. Forsyth

The hon. Gentleman disappoints me. He will know that the original offer was 6.5 per cent. That offer was recommended to the ambulance men by their trade union negotiators.

Mr. Corbyn

They rejected it.

Mr. Forsyth

They rejected it. The trade union leaders believed that an offer of 6.5 per cent, was fair, and they recommended it to their members, but their members rejected it. Management, being reasonable and flexible, offered 9 per cent. over 12 months. The offer that is being made now is 9 per cent. until 30 September this year, with the opportunity then to discuss arrangements for the remainder of that year and also to review the structure of the 1986 settlement.

Mr. Robin Cook (Livingston)

Three times the Minister has said—I have been counting—that the offer is 9 per cent. over 12 months. It is important that we know whether the Minister is developing the Government's offer. I do not believe that I give away any secrets about this, but the Ministery will probably be aware that, the last time staff and management met Duncan Nichol before Christmas, it was made plain to Duncan Nichol that, if the offer was made at 9 per cent. for 12 months, the staff side could settle.

The Minister must be quite clear with the words that he is using. If he is prepared to say that it is a 9 per cent. offer over 12 months, this debate will have fulfilled a useful function and we can resolve the dispute this evening. The Minister must be quite honest and clear. Is that what he is saying? If he is not saying that, he should not mislead the House by using the very form of words that the staff side said that they would be willing to settle for.

Mr. Forsyth

The role that I am performing is educating the hon. Gentleman's colleagues about the nature of the increase in wages that ambulance men would enjoy in the period from 1 April 1989 to 31 March 1990, which would be a 9 per cent. increase. It is certainly true that the 9 per cent. that was offered is over an 18-month period, and it is certainly true that, having had their 9 per cent. increase, that would hold good until 30 September, when there would be an opportunity for further discussion about any increases subsequent to that.

It is quite wrong for the hon. Member for Bolsover to imply that this is some kind of confidence trick. If it is a confidence trick, it is an expensive one, because it involved finding £6 million of new money to fund it. That is a very real movement on the part of management.

Mr. Sillars

Will the Minister give way?

Mr. Forsyth

I shall not give way. I must make some progress.

The improved offer that was made by management, which cost £6 million in 1989–90, was not even discussed by the main trade unions involved, but was rejected out of hand. The Government's position is that this dispute can be settled by negotiation and discussion. Management made an improved generous offer, which cost an extra £6 million, and it was not even discussed by the unions involved. Instead, they have persisted in taking industrial action that has caused untold misery to many elderly and sick people.

The hon. Member for Govan asked about the cost of the dispute. He asked how we can find the money to pay for the police, the Army and the voluntary services that are continuing to provide a service to the patient. The answer is simple: we have an obligation to try to maintain the emergency service, and that is what management have set out to do.

The hon. Gentleman suggested that simply allowing one group of workers in the Health Service to leapfrog the established arrangements for determining pay and conditions would incur no cost. I could not disagree with him more. Our package is fair and reasonable. It gives a 9 per cent. increase for the current year and offers scope for further discussion, and the trade unions should resume negotiations first.

The hon. Gentleman told us of his experience as a fireman and said that lives were saved by ambulance staff. He is right: lives often are saved by ambulance staff; but they are saved also by doctors, nurses, technicians and many thousands of other dedicated people in the Health Service. All those groups have long since settled. Administrative and clerical staff settled for 6.25 per cent. from 1 April 1989, and ancillary staff settled for 6.5 per cent. from April 1989. Fewer than 1 per cent. of NHS employees have yet to settle. The bulk of them—dedicated professional people—have taken 6.5 per cent., which was the original offer recommended by the trade unions to the ambulance men.

Mr. Robert Hughes

The Minister said that the difficulty was that any increased costs as a result of the increase in pay for ambulance personnel would have to come out of services, and that therefore other people within the Health Service would suffer. Is he saying that the cost of providing the police, for example, will come out of existing police budgets, that police budgets will have to suffer, and that those who depend on the police will suffer? Is he saying that the Government are providing new money to pay for the dispute and to pay for the police and other people involved? If that is what he is saying, is he not admitting that he is prepared to put dogma before the personal safety of patients, by finding extra money that could be paid to the ambulance personnel and get the dispute settled?

Mr. Forsyth

I take that as a plea by the hon. Gentleman that community charge payers in his constituency should meet the cost of the dispute. If the costs of the police were not to be met centrally by Government, they would be yet another charge on the community charge payer. I do not think that it would be right to expect the community charge payer to meet the costs of policing. Of course, Labour-controlled councils that are setting up alternative ambulance services will do so at the cost of the community charge payer.

The hon. Member for Aberdeen, North (Mr. Hughes) will remember that the previous Labour Government got into a mess over pay in the Health Service. That is why they had to cut the hospital building programme by one quarter. That is why they ended up cutting nurses' pay by one quarter in real terms. Inflation got out of hand. Because this Government have ensured good management within the Health Service, we have seen a development of the Service, more patients being treated and new services being provided—as in the hon. Gentleman's own constituency, where cardiac services have been expanded, which he has welcomed.

When the bulk of the dedicated staff in the National Health Service have settled for 6.5 per cent., it cannot possibly be right to agree to make some provision for ambulance men that is outwith the normal methods of determining pay and conditions, simply because some of their members are prepared to put patient care at risk.

The hon. Member for Govan said that we should try to move towards arbitration. My hon. Friend the Member for Birmingham, Edgbaston (Dame J. Knight) asked whether he could give an example of that tried and tested procedure inside the Health Service. He was unable to do so, because there is no agreed provision for arbitration within Whitley. If we were to say to the ambulance men, "You can have arbitration," what about the other groups in the Health Service? What about the other groups within Whitley? What is the point of having Whitley if every group can simply disagree and move to arbitration?

Mr. Sillars

Why not?

Mr. Forsyth

The hon. Gentleman says, "Why not?" The Health Service has well over 1 million employees, and 150,000 in Scotland. There would be chaos if every pay discussion went to arbitration. The system for determining ambulance pay and conditions within Whitley, which the hon. Gentleman repudiates, was satisfactory for several years when the settlements reached what was proposed by the ambulance men themselves.

Mr. Robert Hughes

Does the Under-Secretary not understand that the Whitley council provisions come from an age-old process that was established before we faced the tremendous difficulties of inflation that have persisted for 20 or 30 years? In my view, therefore, the whole Whitley council procedure should be rejigged to look at these matters—

Mr. Sillars

And the Select Committee on Social Services said so.

Mr. Forsyth

I am sure that the whole House will be impressed by the strong statement made by the hon. Member for Aberdeen, North against nationally organised bargaining through councils such as the Whitley councils. I hope that it will not embarrass the hon. Gentleman if I make common cause with him in a few moments.

Management must be responsible for pay. Pay in the National Health Service cannot be a matter for Government to determine, especially when 70 per cent. of its costs relate to pay. Management must determine the balance between service development and the amount that it can put forward for improving wages and salaries.

We are determined that there should be a better ambulance service in the future. We want to see more staff with paramedic skills. The hon. Member for Govan made great play of the fact that there are only 24 in Scotland. I should like to see a lot more—and our pay offer reflects that. It encourages people to acquire such skills. Although I approved a programme for increasing the numbers last November, it is now being held up by the dispute. We want the dispute to be resolved so that we can get on with establishing a service that has more paramedics.

We have increased spending on the Scottish ambulance service by 40 per cent. in real terms—that is even more than the amount by which we have increased expenditure on the Health Service overall, which has increased by one third.

Mr. Sillars

rose—

Mr. Forsyth

I have been very generous to the hon. Gentleman already—

Mr. Sillars

Will the Minister give way on this point?

Mr. Forsyth

Very well, I give way again to the hon. Gentleman.

Mr. Sillars

I thank the Minister for giving way. On Friday evening, I met a constituent who is a qualified ambulance man. On 16 August 1988, he received a letter congratulating him on his interest in undertaking extended training to become a paramedic. He then received a letter in February 1989, telling him how well he had done and that he had passed the pre-test examination. Then he got a letter on 3 July 1989, telling him: Unfortunately, at the very last minute, our Professional Advisory Group have come into conflict with the Scottish Home and Health Department. My constituent wants to become what is known as a paramedic, but cannot because of the Minister's Department. That is why we have only eight paramedics in Scotland.

Mr. Forsyth

I do not recall receiving any correspondence from the hon. Gentleman about that case. If it goes back to July 1989, he has taken a long time to raise the matter—

Mr. Sillars

I met the gentleman concerned on Friday.

Mr. Forsyth

If the gentleman came to see the hon. Gentleman on Friday and the correspondence goes back to July 1989, as I have just said, the fact remains that, in November last year, we decided to increase the training of paramedical staff, and that is now being held up. The hon. Gentleman is simply scoring points, when the real issue is whether there are opportunities for people to acquire paramedical skills. There are such opportunities, but they are being held up by the dispute, and the hon. Gentleman is not really helping to resolve it.

Mr. Dennis Turner (Wolverhampton, South-East)

rose—

Mr. Forsyth

I shall give way once more.

Mr. Turner

When will the Minister get round to telling us the cost of the dispute? The general public want to judge the Government on whether they have handled the dispute well or badly, as a result of the costs that the Government have incurred by continuing the dispute rather than settling it. Will the Minister please tell us the cost and set that against the pay increase that has been sought by the ambulance men?

Mr. Forsyth

If the hon. Gentleman had been here from the beginning of the debate, he might be more enlightened. He asks me about the cost of the dispute, but the cost is not measured only in money; it is measured in all those elderly people who are not getting to their day centres or to their out-patient appointments, and in increased waiting lists. If the hon. Gentleman had been here to listen to the debate from the beginning, he would know that there is the opportunity for the ambulance men to get a 9 per cent. increase in pay and for discussions on the future of the service to continue.

The point that I was seeking to convey when the hon. Gentleman intervened was that the management must be in a position to work out the balance between pay and service developments. If I can speak for the Scottish ambulance service—I am amazed that a Scottish nationalist Member should complain that the Secretary of State for Scotland should have responsibility for replying to the debate—

Mr. Sillars

Where is he?

Mr. Forsyth

The hon. Gentleman should know that I speak for and on behalf of my right hon. and learned Friend the Secretary of State for Scotland. My right hon. and learned Friend has responsibility for the ambulance service in Scotland. I thought it amazing that the hon. Member for Govan should complain about that and suggest that it should be the responsibility of my right hon. Friend the Secretary of State for Health, whose responsibilities are south of the border. That is an unworthy complaint.

I turn now to developments in the Scottish ambulance service, because I take it that the hon. Gentleman is interested in such developments in Scotland—

Mr. Sillars

And in the rest of the United Kingdom.

Mr. Forsyth

We plan to spend £6 million on a new radio communications system and £4.7 million on eight new communications centres. We are planning the computerisation of the ambulance service and are currently carrying out trials and pilot studies on the use of helicopters in Scotland. We are also planning a reduction in single manning.

Those developments are possible only if the management can judge what proportion of the resources should go into service development and what proportion into pay. If we were to listen to the hon. Member for Govan, all the resources would go on pay and there would be no service development. The first people to suffer would be the constituents of the hon. Member for Moray (Mrs. Ewing) and other people in rural areas, who will be the very ones to benefit from developments on single manning and from the use of helicopters to improve the emergency service.

Management must be able to judge the balance between pay and such developments. It would be wrong for Ministers to second-guess them or to force them to take decisions that are not in line with their view of the development of the service.

Mr. Turner

What about the cost of the police and the Army?

Mr. Forsyth

From a sedentary position, the hon. Member for Wolverhampton, South-East (Mr. Turner) is asking me about the police and the Army, and the hon. Member for Govan has already asked about parity for the ambulance service with the police and fire services. I advise the hon. Member for Livingston (Mr. Cook) that I do not recall the last Labour Government arguing the case for parity between the ambulance service and the police and fire services. I recall them setting up the Clegg commission, and I seem to remember that the Clegg commission rejected parity on the grounds that accident and emergency work was only a small proportion of the duties of ambulance staff. I must tell the hon. Member for Govan that the ambulance service is the emergency arm of the Health Service; it is not the health arm of the emergency service—the point that my hon. Friend the Member for Lancaster (Dame E. Kellett-Bowman) made earlier from a sedentary position.

It is right to say that the accident and emergency service accounts for only 10 per cent. of the journeys carried out by the ambulance service. Nothing has changed in the past 10 years to alter the arguments that were considered by the Clegg commission or the decision that was taken by the last Labour Government.

Mr. Holt

Will my hon. Friend reconsider what he has said about Clegg, and note that, when the Clegg commission investigated this matter, it did so at the fag end of the inquiry, and that no substantial evidence was brought to bear? There were anecdotal remarks by the management on that occasion, but neither side in the dispute has subsequently provided any statistical evidence to show how much time is spent on emergencies and how much is spent on routine matters.

Mr. Forsyth

My hon. Friend has been helpful in telling the House his view of what Clegg said. However, that does not alter the facts of the matter, the position of the previous Labour Government or the fact that, subsequent to Clegg, in 1986, when there was a reorganisation of the position of ambulance men, that argument was not deployed or found to be significant.

Mr. Robin Cook

Perhaps I could help the Minister to refresh his memory of exactly what Clegg said on the matter. His comment on whether ambulance staff spent more of their time on emergency services is in paragraph 32 of the report. He said: The employers also made clear to us their view that there was a distinction to be drawn between ambulancemen involved in emergency work (which occupied, in their view, only 10 per cent. of all activity) and the ambulancemen involved in the routine movements of patients. Is it not crystal clear from that statement that Clegg carried out no investigation and made no study of how much time was spent on emergency work? When the management quote Clegg, they merely quote back the echo of their own evidence to Clegg, which has never been substantiated.

Mr. Forsyth

The hon. Gentleman's party was in power and gave the terms of reference. If it was his party's policy that the ambulance men should have parity with the firemen and police, it was open to it to give them parity when it was in Government. If the hon. Gentleman seriously argues that Clegg would not have recommended parity if he thought that there was a case for it, I must take issue with him.

It is not a claim but a matter of fact that 10 per cent. of journeys are for accident and emergency purposes.

Mr. Cook

It is not a fact.

Mr. Forsyth

It is a matter of fact. If the hon. Gentleman argues that small acknowledgements should be made of the accident and emergency service and its activities, the final offer made by management provides for that. It provides for a complete review. Instead of fanning the flames of the dispute, the hon. Gentleman should urge the trade unions to go back to the negotiating table and seize the opportunity to put their arguments.

Mr. Cook

The Minister has made an important and interesting statement. He has just said that it is a fact that one in 10 calls are emergency work. He must he aware that, when we have attempted to find evidence for that fact, we have been told in parliamentary answers that the information is not centrally available. He must also be aware that his colleague, the Secretary of State for Health, referred me to figures collected by York district health authority on behalf of the whole of England. Those figures show that, far from one in 10 calls being emergencies, the figure is one in five. Will the Minister please give us the evidence for the fact that he declaims?

Mr. Forsyth

I am happy to write to the hon. Gentleman—[interruption.]—setting out the basis on which the figures have been compounded. [HON. MEMBERS: "Tell us now."]. If the hon. Member for Livingston seriously challenges the position that about one in 10 of ambulance journeys are for emergency purposes, he will find himself at odds even with the ambulance men themselves. I do not know how many ambulance men he has spoken to recently. I spend quite a lot of time speaking to them. They tend to be outside most of my meetings these days. The fact is not in dispute.

Even the hon. Gentleman must know that, in Scotland, the emergency service is organised on a separate basis for the non-emergency service in our urban areas. It is not a matter of great mystery how many patient journeys are emergency and how many non-emergency. If there is any variation in statistics, it is on the classification of journeys as either urgent or emergency journeys. The hon. Gentleman makes a non-point. If that is the best that he can do to undermine the Government's case that the trade unions should go back to the negotiating table, I look forward to his speech with interest.

I certainly believe that pay negotiations in future should allow—this is where I agree with the hon. Member for Aberdeen, North, who, alas, has now left the Chamber—for more local flexibility to cover recruitment, retention and local needs. The inflexible national pay bargaining process which exists in many parts of the Health Service is increasingly nonsense. The ambulance service is a clear case where local management must have more responsibility and discretion in the future.

We want a settlement of the current dispute. We want a better accident and emergency service, with more paramedical staff. We are interested in local productivity deals which will release resources for better pay. On the table now is a 9 per cent. increase in pay and the offer of talks without preconditions for the future. I urge the trade unions to take us at our word and to restore the service which the public are entitled to expect.

5.4 pm

Mr. Robin Cook (Livingston)

It is a sign of the desperation of the Minister's party in Scotland that he expressed satisfaction that it has managed to squeeze past the Scottish National party in the latest opinion poll by an amount which is the same as the margin of sampling error of the opinion poll. I warn the hon. Gentleman that it will take only another couple of speeches like the one that we have just heard to take his party back into third place.

It is extremely revealing that it took us so long during the Minister's speech to drag out of him the fact that the Government's current offer is in truth an offer of 9 per cent. over 18 months. If the hon. Gentleman and his colleagues really believe that that is a fair, decent and honest offer, why did he go to such lengths to pretend that it was not 9 per cent. over 18 months? Of course he knows the truth. That is why it was so difficult for him to utter the words "9 per cent. over 18 months". It is well below the rate at which any group outside the Health Service and many groups within the Health Service have settled.

It is entertaining that the Minister was caught out claiming as facts matters on which he did not have a brief. Let me amplify the point that I made to him in my intervention: during the previous debate on the ambulance service, the Secretary of State for Health referred me to the figures from York, claiming that one in 10 calls to the ambulance service were emergency calls. He went on helpfully to say that emergency calls in the Health Service are defined to include moving people who are seriously ill straight to hospital on the advice of a doctor.

I have consulted those figures. The figures collected in York show that the proportion of emergency patients as a proportion of all ambulance patients is 18.2 per cent. That is not one in 10, but almost one in five. The proportion of ambulance mileage spent on emergency calls is 28.6 per cent. of all ambulance calls. That is one in five of all patients and over one in four of ambulance miles. I ask again: where do the data come from to support the claim that one in 10 calls are to emergencies?

Mr. Forsyth

The hon. Gentleman will appreciate that my responsibilities extend only to north of the border. He asked me to justify the figure of 10 per cent. The figures are as follows: there were 156,770 accident and emergency journeys, 176,956 urgent journeys, and 1,664,020 passenger transport service journeys out of a total of 1,997,746. That substantiates my point that one in 10 journeys were for emergencies. I hope that the hon. Gentleman will not feel that I have wasted the time of the House. Rather than go through the figures for all the health boards, perhaps he will be content if I write to him.

Mr. Cook

We shall be interested to see those figures. If the Government are sitting on such figures, I find it perplexing that they decline to answer questions on them.

I remind the Minister that we are debating a British dispute and a British motion. Even if the figures that he quoted are thrown in as the Scottish contribution to the United Kingdom figures collected by York, it is perfectly plain that one in five of all patients are carried in an emergency and over one in four of all ambulance miles are for emergency calls.

Even if the figure were one in 10—the statistics do not support that contention—that exceeds the proportion of time spent by the police on emergency calls. It is probably broadly comparable with the amount of time that the fire brigade spends on emergency calls. No one would dream of contesting the fact that the police and fire brigade are emergency services because they spend only 10 per cent. of their time on emergency calls. Why, then, should Conservative Members make it such a point of principle to deny that for ambulance staff?

What should cause most concern to the House, and undoubtedly will cause most concern and disappointment to the world outside, is that, during what was not a brief contribution to the debate, the Minister did not produce a single idea on how the stalemate would be broken. Not one new avenue of negotiation was opened up, not one new channel by which a second opinion might be taken. The only basis on which he held out the hope of settlement was if the staff side surrendered and accepted what has been on the table for the past three months. That was the Minister's sole contribution.

This is the sixth occasion when I have addressed the House on this issue. If, on the first occasion, at the end of November, I had been asked whether I would expect to address the House on the same matter at the end of February, I would have had difficulty crediting it. I still have difficulty in believing that even this Government have proved so stubborn, so dogmatic and so indifferent to public opinion that they have stonewalled the dispute for almost six months and not even met the staff side for more than two months.

My thoughts were unusually well expressed by the hon. Member for Harlow (Mr. Hayes), who, a fortnight ago in the London Evening Standard, was quoted as saying: That a settlement is not even remotely within sight is remarkable, that the two sides are not even talking is obscene. Most of my hon. Friends and, I suspect, some Conservative Members would agree with the hon. Gentleman.

Mr. Michael Forsyth

The hon. Gentleman can have him, if he likes.

Mr. Cook

I rather suspect that, instead of having the hon. Member for Harlow, we shall have his seat at the next general election.

Since that article, written only three weeks ago, three attempts have been made to bring the two sides together: by Church leaders, by an all-party group of Members of the other place and last week by the promptings of the chief ambulance officers—the very people whom Ministers keep telling us are the management of the ambulance service and should be allowed to get on with the process of negotiation themselves. Each of those three bids failed to bring about talks, because each time the management and the ministerial side refused to talk.

Mr. Sydney Bidwell (Ealing, Southall)

Does my hon. Friend agree that the great British public see this as the Government seeking to grind the ambulance workers into dust while they, by their generosity and widespread support for the ambulance workers' case, refuse to allow the Government to do so?

Mr. Cook

I will have comments to make about the degree of public support for the ambulance service later in my speech. It was notable that the Minister, although claiming to pay attention to opinion polls when they allowed the Tory party in Scotland to sneak into second place, ignored the opinion polls that related to the merits of the dispute.

My hon. Friend leads me to question why the public support the ambulance workers. We have all had opportunities to see ambulance staff at work, and over the past six months many of us have found ourselves in circumstances when we have witnessed their absence and the cost in human terms of that absence. It occurred to me a fortnight ago when I appeared on "Question Time". Ironically, shortly after we began discussing the ambulance dispute, a member of the audience took a severe heart attack and we had to interrupt the recording to accommodate the incident.

Hon. Members who have taken part in that programme will know that it is recorded in the Greenwood theatre, which is part of Guy's hospital. Although we were on the periphery of a major hospital complex, it was some time before a police ambulance arrived. When it did, it had no oxygen for the patient, who was breathless and in severe distress. The police had no training in resuscitation techniques—nor, to be fair to them, would it have been much value to them, because they had no resuscitation equipment. The only stretcher equipment that they had was an ambulance trolley, which was unsuitable for manoeuvring the patient up and down the steps. I am sorry to say that, when the patient reached Guy's hospital immediately round the corner, he was dead on arrival.

Many cases have involved a patient having to wait for much longer periods than usual. Only last week, there was an inquest into the death of an 86-year-old man who fell down the stairs at home and broke his pelvis and seven ribs in the fall. He waited eight hours before an Army ambulance came to collect him. His wife was quoted at the inquest as saying: The waiting was really awful, sitting there thinking every car coming by was going to be an ambulance. I agree with the Minister that the public focus is caught by such cases. The public imagination is captured by emergency cases. I agree that those who depend on the non-emergency services are reminded of the dispute not just once in a while when they require emergency attention, but every week when they cannot attend their day hospital or get the treatment that they require. Many of their medical conditions will undoubtedly have deteriorated in the past six months, because there is no way that one can backdate physiotherapy treatments at the end of the dispute.

Mr. Michael Forsyth

The hon. Gentleman gave the House a moving account of two incidents from his own experience. Will he join us in condemning those people who withdraw the 999 service and a service within TUC guidelines, and call upon all ambulance men to accept the advice which has been given and to maintain a 999 emergency service within TUC guidelines?

Mr. Cook

Every time I have been asked, I have condemned those few ambulance crews that have not operated within the TUC guidelines. On every occasion, my advice to ambulance staff has been to adhere to them. One of the main reasons why those guidelines are not being fulfilled by ambulance staff is that the management have put every possible impediment and difficulty in the way of the crews fulfilling those guidelines.

Ministers cannot avoid the fact that they have the responsibility that the dispute has continued for so long. Never once in those six months have Ministers sat down with the staff side to find a solution. No meeting, whether initiated by management or Ministers, has taken place within the past two months. Yet, while Ministers have been willing to tolerate the human cost, they have also been willing to shell out a large financial cost. That financial cost can be measured accurately, as human costs cannot.

The Secretary of State for Health and the Minister are given to advocating that we should seek to privatise parts of the ambulance service, on the basis that it would cost less. It is rather perverse that they have both prolonged the dispute by contracting the service out to the police, who cost more. The cost of the police and Army cover for the ambulance service certainly exceeds £20 million, and has probably cost about £25 million. That is not counting the £5 million paid to hill farmers in order to provide a statement so as to postpone the debate on the ambulance service three weeks ago.

Mr. Nigel Spearing (Newham, South)

Is my hon. Friend aware that, on Friday, I received a written answer from the Secretary of State for Health which informed me that the London ambulance service did not yet know how much it had spent on military support, but that it had spent £7 million on additional support, of which £6.5 million went to the police up to the end of January?

Is my hon. Friend aware that the London public resent their money being spent against their interests? Furthermore, for the second time in two months, they resent the fact that the Secretary of State for Health is not here to speak for himself.

Mr. Cook

My hon. Friend quotes some helpful figures from London, which are part of the £25 million in my global total. To put my hon. Friend's figures in the best and most relevant perspective, it is necessary to look at how much is would cost to settle the dispute.

To meet the entire cost of the claim from the staff side would be £10 million only. That is equivalent to less than half the amount that the Government have been willing to pay the police and the Army to provide substitute services. I do not believe that it would even take £10 million to settle the dispute. If the Government met the unions halfway, they could get a settlement for £5 million—one fifth of what they have paid the police and the Army.

Mr. Nicholas Bennett (Pembroke)

Surely the hon. Gentleman appreciates the implications for the National Health Service of giving in to such an industrial dispute. Why were the hon. Gentleman's arguments not pertinent to the Labour Government in 1978 during the fire service's dispute? The Labour Government, of which the hon. Gentlemen was a supporter, brought in the green goddess fire engines and actively fought that dispute.

Mr. Cook

I would not want the hon. Gentleman to overstate my support for the Labour Government on that occasion. For what it is worth, it was that dispute which resulted in the agreement, negotiated by my colleagues in the previous Labour Government, which has provided a pay mechanism in the fire brigade service and which has guaranteed 13 years of industrial peace. That is precisely why we find it incomprehensible that Conservative Members should resist the same deal for the ambulance staff.

Although I understand that the personal experience of the hon. Member for Pembroke (Mr. Bennett) will not necessarily change how he will vote on this occasion, or persuade him to speak in a different way, I had hoped, given his personal debt to the ambulance service, that the least he could have done about the dispute was to stay silent.

Mr. Corbyn

I do not know whether my hon. Friend noticed, but when he was explaining that to settle the ambulance dispute would cost £10 million, the Minister shook his head vigorously. We know that the Minister does not want to settle that dispute, and that he would rather break it. Has my hon. Friend speculated on how much money the Government are prepared to spend to destroy the dispute rather than to settle it and return a proper ambulance service to the people?

Mr. Cook

I shall happily give way if Conservative Members want to tell us how deep those coffers are. It is interesting to note that the Government can always find enough contingency funds to raid when it suits their political prejudices.

It is, of course, no criticism of the policemen or the Army personnel who have provided the service in the past four months to say that the money that has gone on that substitute service has, inevitably, purchased an inferior one. The police and Army personnel do not have the training or the experience to be exposed to the difficult and stressful circumstances in which they now find themselves.

I note that, for once, the Government amendment recognises the skills and dedication of the ambulance staff. Although that does not persuade me to vote for their amendment, that recognition of those skills, albeit belated, is welcome. One of the most unpleasant parts of the Government's response to the dispute has been the way in which they have sought repeatedly to under-value the skill and competence of ambulance staff or the stressful circumstances in which those skills are used.

There has been much welcome talk of the skills of the paramedics. The Minister referred to those personnel, and was good enough to admit that the number of paramedics to whom he has offered the £500 is necessarily few. One of the main reasons why there are few paramedics is the pathetic provision made by the Government to provide the training necessary to acquire those paramedic skills.

The great majority of the 24 paramedics in Scotland mentioned—I should add the seven qualified in the London area—are people who have acquired their paramedical qualification in their own time because they were not allowed time off to train. It is a sign of their motivation that, despite the fact that they had to study in their own time, they have done so and qualified. Many more want to train, and there are now parts of Britain in which there is a six-year waiting list for training as a paramedic, so great is the motivation of ambulance staff to acquire those skills.

It also says much about the commitment of the ambulance staff and not just of those who have acquired the skills of a paramedic that, in just about every station in Britain, staff have given freely of their time and energy to raise the funds to purchase the equipment that those paramedics need.

The Minister has responsibility for the Health Service in Scotland, and he will be aware that the Scottish ambulance service has 325 defibrillators. Every one of those has been bought by charitable money and from fund raising by the ambulance service—not one has been paid for out of Health Service funds. Every month, 800 people in Scotland are assisted by those defibrillators and resuscitated by them. If the Minister is serious about wanting more paramedics, he must accept that there must be more paramedical training throughout Britain, funded by the Government, and that, once trained, they will require the equipment necessary to do their job.

Although the skills of paramedics are first-class, what makes me rather uneasy about Ministers' constantly focusing on those skills is the sub-text—the skills of the paramedics are being praised to play down the skills of qualified ambulance staff. Four out of five ambulance staff are fully qualified and they are trained in life-saving skills, which they use daily. Every day in Scotland, there are likely to be 1,000 emergency cases, which will require those skills. In London, as well as in parts of Scotland, there are ambulance staff who spend their entire time responding to emergency calls.

The other week, I read an account of one of the ambulance crews called to the Clapham junction disaster. That crew spent three hours at Clapham junction, and on their way back to the station they were diverted to deal with a traffic accident caused by a motorist who had had a heart attack. Having taken the motorist to hospital, the crew were then sent from the hospital to deal with a woman in an advanced state of labour. When the crew arrived at her house, they were unable to move her and had to deliver her baby at home.

In a single shift of some five hours, without a break, those ambulance staff demonstrated skills in coping with patients who were haemorrhaging severely, they applied splints to those with broken limbs, they lifted patients with multiple fractures, they applied resuscitation techniques to a person with a severe heart attack and, finally, they demonstrated skills in obstetrics by delivering, unaided and without proper theatre equipment, a child at home. Many doctors could not span those skills, and few would expect to do so within a single shift.

One of the consequences of the exacting demands on ambulance staff and the varied role that they must play in emergencies is stress. The mortality rate among ambulance staff is 10 per cent. higher than the average for manual workers. Few ambulance staff survive in work until the statutory age of retirement. Those who do so have an average period of survival in retirement of two and a half years only.

The hon. Member for Glasgow, Govan (Mr. Sillars) referred to one of the contributing factors. The pulse and blood pressure of an ambulance crew on emergency duty will alternate rapidly several times in one shift—they will move from a resting mode to one of severe excitement. It has been measured and quantified by doctors who have accompanied ambulance staff throughout entire shifts on emergency calls. The Government know that, because, as I reminded Ministers in the last debate, they received a report in 1985 on stress among ambulance staff.

Mr. Bill Walker

Under a Labour Government.

Mr. Cook

No, there was not a Labour Government in 1985. I wish that there had been, but I am sorry to say that the Labour Government has receded further into history than 1985.

I reminded the Secretary of State of that report in our last debate in January. I was not prepared for his response, which appeared in a parliamentary answer on 2 February. He said: Consideration of the final report of the working party on the problems of long-serving ambulance men and women has not yet been completed. I shall consider the question of publication when it has been."—[Official Report, 2 February 1990: Vol. 166 c. 420.] That was a parliamentary answer from the same Secretary of State who, since he arrived at the Department of Health 18 months ago, has turned his madcap ideas about the Health Service into a White Paper, turned that White Paper into a Bill and now insists that the Bill will be implemented by April of next year. He has turned the entire Health Service upside down within three years, but, five years after getting a report of stress among ambulance staff, he has yet to decide whether to publish it.

One of the key recommendations in the report, which is widely known if not widely published, is that the age of retirement for ambulance staff should be reduced to the age of retirement of the other emergency services—above 55. I offer this free advice and consultation—I would not dream of charging for my consultation, unlike Conservative Members—that it would be a useful gesture of conciliation if the Government were to say that they were prepared to look sympathetically at reducing the retirement age of ambulance men. That would not be a concession to the dispute; it would not be inflationary or have knock-on effects on other Health Service workers. If the Government were to make that gesture, it would create a mood of conciliation in which negotiations would be more fruitful.

That gesture would show some of the flexibility that the Government keep demanding of the union side, but of which they have demonstrated precious little themselves. However, it is partly because the staff have shown that flexibility and the public know the stress under which the staff work and the skills that they demonstrate when they work, that the public have given the ambulance staff, throughout the dispute, magnificent and unprecedented support.

The public have given them support, not just in the opinion polls, in which the ambulance staff are scoring better than Conservative Members, but tangible support, in cash. It is estimated that £4 million has been paid in individual donations during the past five months to the ambulance service. That is more than any party in this House could hope to raise with buckets in the streets. Perhaps the most depressing lesson of this dispute has been that that massive evidence of public support counts for nothing under the Government.

I presented a petition in the House on behalf of ambulance staff just before Christmas. It was signed by 4.5 million people—a record number of signatures on any petition presented to Parliament in its entire history. It was longer even that the petition represented by the Chartists in the 1830s. Since our last debate, I have received the official Government response to that petition. The Under-Secretary of State for Scotland assured us that the Government support the ambulance staff.

The official Government response to the petition of 4.5 million people consists of a dozen lines that are a stale re-hash of the Government's position. The Secretary of State for Health sends longer letters than this to 15-year-old constituents who have written to him on the matter. The response contains not a word that the Government are in the least bit troubled about the evidence in the petition that they have not a shred of public support for their position.

What I find perplexing about the Government's attitude in response to this dispute is that, in fairness to them, the dispute demonstrates a new trade unionism for which the Government can claim a large part of the credit. The political victory of the Conservative party in 1979 confirmed for many in the trade union movement that errors had been made in the winter of discontent.

That is why, when the union leaders set out on this dispute, they set as their objective winning and retaining public support. It is the Conservative laws that have obliged trade unions to consult their members by ballot. In this dispute the unions have consulted the ambulance staff three separate times in individual ballots and on every occasion there has been a margin for action of 4:1.

The tragedy is that the new unionism and the aproach on the part of the trade union leaders has turned out to make no difference to Government's response. Confronted by trade unions, their response has proved as reliable and boringly predictable as Pavlov's dogs. The clearest contradiction is that they have repeatedly urged unions to contemplate no-strike agreements. For the past six months, they have held out against a negotiating bid by the staff side which, if one strips away the rhetoric, is effectively an offer to negotiate a no-strike pay formula. It is Ministers, not unions, who are resisting that opportunity.

The greatest damage that will be done by this dispute will not be the damage done to the emergency cases who should have been assisted earlier than they were, or even to those who have been unable to attend day centres in the past six months. The greatest damage that this dispute is likely to do is to kill that new trade unionism stone dead.

I can tell Ministers, if they have not worked it out for themselves, that the next time National Union of Public Employees finds itself in dispute with them, and its leaders turn to the members and say that the important thing is to win and retain public support, those leaders are likely to be reminded by their members that much good has it done the ambulance staff and that public support is an impotent weapon under a Goverment who understand only the arithmetic of power.

There is still time to stop this message going out, show that massive public opinion counts for something and settle this dispute in a way that is fair to ambulance staff and gives patients the formula that they need to prevent the service from being disrupted again. If Ministers and Conservative Members are unwise enough to ignore that opportunity, they may find that public opinion will take its revenge the very next time that it is confronted with a ballot box.

Mr. Robert Hughes

On a point of order, Madam Deputy Speaker. I understand that, during my enforced absence, when I was dealing with constituency telephone calls, the Under-Secretary of State for Scotland said that I was in favour of local bargaining. That was certainly not the intention of my intervention. I intended to say that a look at the Whitley council system should at least consider arbitration.

5.38 pm

Dame Jill Knight (Birmingham, Edgbaston)

In opening this debate, the hon. Member for Glasgow, Govan (Mr. Sillars) gave a good knockabout parliamentary performance. Although I listened carefully, I do not think that there were more than a couple of points on which I should like to take him up.

Mrs. Margaret Ewing (Moray)

The introduction to this debate was serious and constructive, and my hon. Friends and I deeply resent the suggestion that it was knockabout.

Dame Jill Knight

The hon. Lady is perfectly entitled to her opinion and I am entitled to mine. I am elected to this House to give my opinion from time to time and that is what I have every intention of doing this afternoon.

Only a couple of points in the speech of the hon. Member for Govan require comment. First, he made great play of the Prime Minister being, as he described it, in the bunker. I suppose that he meant that she was being assailed and attacked from every side. I can inform the hon. Gentleman that my right hon. Friend the Prime Minister was freely and democratically elected the Woman of the Year for the fourth year running by a poll on the "Today" programme. That shows the opinion of the public on the competence and admirable qualities of my right hon. Friend.

The hon. Member for Govan mentioned the Clegg report. Whatever one may say about that report there is no doubt that Professor Clegg gave far more attention to comparability than did the hon. Member for Govan. It is true that ambulance men were tacked on to NHS ancillary staff, but the hon. Member for Govan should not be allowed to get away with the accusation that the professor, given the important job of producing a report on behalf of the Standing Commission on Pay Comparability, did a sloppy job.

A few moments ago I hurried out to get a copy of the report and read it once more. I understand that, during my absence, the hon. Member for Livingston (Mr. Cook) mentioned paragraph 32, which states that the employers believed that there was inadequate comparability. However, he missed the point that the next paragraph gives evidence from the unions. Information was taken from unions, and it was considered. As with all such reports, the important element of the Clegg report was its conclusion, reached after careful consideration: ambulancemen's conditions of service are broadly the same as for NHS ancillaries. I am entitled, and it is my duty, to remind the House that, whatever the hon. Member for Livingston may say about his views having changed, when he was a member of the Labour Government, they set up the Clegg commission and accepted its report. Although I was in the House at the time, I cannot recall the hon. Gentleman strongly objecting to its conclusions.

Opposition Members and large numbers of members of the public have been informed about the actual offer for the ambulance men. Roger Poole's continual claim that ambulance men have been offered only 6.4 per cent. was repeated this afternoon. I felt almost as though I were in "Alice in Wonderland": Alice was listening to the Red Queen saying that 6.4 per cent. is exactly the same as 9 per cent. I shall not carry the analogy any further, but it is extraordinary to pretend that 6.4 per cent. is the same as 9 per cent. It could be so only if salaries were to increase over an 18-month period to 9 per cent. but the period was chopped off after one year. In that case, something funny might begin to happen. But it is not happening: the 9 per cent. is on offer and has been since April last year, and the public do not know that. Even some ambulance men do not know it.

Not only is the 9 per cent. backdated to 10 months ago, but 14 per cent. and 16.3 per cent. increases are on offer for paramedics, the latter figure being for those who work in London. By no stretch of the imagination can those figures be called 6.4 per cent. The hon. Member for Bolsover (Mr. Skinner), who has left the Chamber—I did not think that he would stay long—tried to maintain that the sums were the same. They are not. This is a generous offer to people who deserve it.

Mrs. Fyfe

The hon. Lady is attempting to persuade the public that this is all a misunderstanding that has nothing to do with Government intransigence. If she is convinced that this is a fair offer, misunderstood by the public and ambulance men alike, why is she so reluctant to support the ambulance workers' demand for arbitration?

Dame Jill Knight

I am trying to remind ambulance workers what the figures are. The hon. Lady must understand that public opinion, to which great attention has recently been drawn, is based on wrong information. The public believe that the offer is 6.4 per cent.; it would be good if they realised that the true figures were 9 per cent., rising to 16.3 per cent.—a generous offer to people who deserve one.

Of course the ambulance workers do a good job and the public appreciate that—

Mr. Nigel Griffiths (Edinburgh, South)

rose—

Dame Jill Knight

I must get on; many hon. Members want to speak.

Nevertheless, it must be said that the service could be a great deal better. We should stop using ambulances to ferry round people for treatment, for instance. It has often appalled me to think of these expensive pieces of equipment hourly and daily doing a job that minibuses could do.

I believe that the Government are right to encourage staff to obtain higher medical qualifications by paying them more. It beats me why there should be such solid opposition from the unions when the Government want to pay highly qualified people more money. That happens with teachers, doctors, accountants and even British Rail staff—everyone gets more money if better qualified. It is as simple as that; there is nothing wrong with it. Opposition Members, who have supported the unions which have fought this principle all the way, seem to think it wrong to improve the ambulance service and to pay more money to those who are more highly qualified.

We all want the dispute settled; sick people and accident victims are in danger, and it is no use Opposition Members pretending otherwise. We know that people have been in danger and have not been attended to when they should have been taken to hospital. Whatever is said about public support, people are getting a little tired of collecting buckets. It upsets me that they are putting in money because they support the ambulance men but do not understand how much is on offer. It is rather sad to see old-age pensioners, perhaps living only on a pension, putting in money for people who earn much more than they do.

Salaries are rising. A leading ambulance man or woman now on £10,888 a year will receive £11,868. Paramedics' pay will rise to £12,368. Those finding it difficult to spare money for the collecting buckets may not know how much money is on offer. The wages of qualified, as distinct from leading, ambulance men earning more than £10,000 a year will rise to more than £11,000.

Are the collections quite honest? Who gives people permission to collect on the streets every day? If one wants to collect for the People's Dispensary for Sick Animals, for children's charities, for the blind or for any other charity one must obtain a permit. There must be an agreement about places where collections are taken up, and details of the money must be audited. Opposition Members may think that this is funny, but it is not funny to con the public, and there is an element of conning in the collections. It is wrong that, day after day, collections should be taken up when, as far as I know, no permission has been given for them. There is certainly no supervision of the collection of the money or of how it is dished out. I am beginning to get letters about the matter, and I think other hon. Members will get letters, too.

It is nonsense to suppose that the Government can grant all the union demands. At one stage, the union agreed and recommended the 6.5 per cent. offer, but now it is asking for 11.4 per cent. That would have disastrous results everywhere and there would certainly be cuts in service. There would be an immediate public outcry if cuts had to be made to pay the 11 per cent. that the ambulance unions seek. It would also be an awful blow to the morale of people in the other parts of the National Health Service, nearly all of whom have settled at 6.4 to 6.8 per cent. What will they think if they see people receiving more money as a result of a dispute and a great deal of trouble? I can imagine the demands that the Government would have to face.

It would be wrong to take the ambulance service out of the National Health Service. It would send out a dangerous signal if the House and the Government gave in to the demands, because it would be tantamount to saying that people who care for sick people or accident victims can have more money in their pockets by refusing that care. That is the terrible message that would go from here if we gave in.

We all want this worrying strike settled. Could a way ahead be sought by making training more quickly available? The hon. Member for Govan cited a case which purported to show that a man had waited a long time for training. If that is true, the man had a genuine grievance, which should be examined. I do not know whether it is true, but I am told that ambulance men have to pay for their courses. Perhaps there is a way ahead along that avenue, which may lead to negotiation. I should like training to be made available much more quickly and cheaply for ambulance men who are striving to better themselves.

What about opening a gate to local deals? We have seen the worth of the Northumbria experiment. There is no time to give details of it, but any hon. Member who has studied it knows that local effort in Northumbria has resulted in an excellent and much better service for patients. That is what we all want. Is there any possibility of agreeing a no-strike deal? Some of us would like to see the kind of deal that was worked out for the nurses because we never want to see another dispute like this one.

I warmly welcome the statement by my right hon. and learned Friend the Secretary of State that by, 1 October, the unions will be able to negotiate again, having had their 9 per cent. increase and back pay to April 1989. Perhaps, if people in the ambulance service looked at all the points that I have made, they could negotiate an even better deal in October. I urge the Government to stand firm but to make their case more widely known. They should also make quite clear what is on offer and the amount that the ambulance men currently receive. We must recognise that there are some things that we can do to smooth the progress of the negotiations so that the whole matter can be settled amicably and quickly.

5.55 pm

Mr. Michael J. Martin (Glasgow, Springburn)

I have been a shop steward and a full-time union officer, and have been involved in many disputes, most of which the public did not even hear about. Some went on for a long time, while others were settled quickly. The ambulance dispute reminds me of a problem in the highlands some years ago. Cleaners there had their hours cut by the Highland regional council, whose members thought they were being smart and were dealing with a bunch of part-time ladies who could do without jobs.

Cleaners throughout the highlands went on strike a few months before the regional council elections. The councillors did not realise that the cleaners would get public sympathy, because they were from small villages and women took on those jobs because no one else would do them. In other areas of high unemployment, the women were doing such jobs not for pin money, but to keep body and soul together.

I was the union officer there at the time, and I saw a change in the attitude of the council members as soon as support for the cleaners started to appear. The councillors ran for cover and began to settle the dispute. However, it was too late; in the elections, many of them lost their seats on the council.

The Minister says that management are there to manage. If a general election was pending in the next six months I guarantee that the Government would lean on management and tell them to settle the dispute. We are not dealing with industrial management who have private resources at their disposal but with a management who depend on Government for the resources to pay the staff. It is nonsense for the Minister to sit back and say that it is up to management to manage. He knows quite well that, if he telephoned the managers, they would jump and settle the dispute if they knew that that was the will of the Government. Convervative Members suddenly think that the Whitley council is marvellous. The hon. Member for Birmingham, Edgbaston (Dame J. Knight) let the cat out of the bag.

Mr. John Maxton (Glasgow, Cathcart)

The hon. Lady has gone.

Mr. Martin

No, the hon. Lady is still in the Chamber; I give her credit for that. She let the cat out of the bag when she talked about local negotiations. In some highland areas, when someone is asked to work overtime, he is told, "Your overtime will be a fish supper, so that you will not go without a meal." That is the attitude in some rural areas. The worst thing that could happen is a return to local negotiations. Rural areas would suffer, while urban areas would have some bargaining power.

The Whitley council appeal procedure is cumbersome. Although there is nothing to take its place at present, that does not mean that the procedure should not come under scrutiny. The Minister misled the House when he said that the ambulance workers could easily use the Whitley council appeal procedure. He knows, even if other right hon. and hon. Members do not, that that procedure is so cumbersome that people sometimes have to wait two or three years for a hearing.

The first stage of such an appeal is that the full-time union officer representing the appellant must find three nominees from the union side, at least one of whom must not be a member of his union. Management must also nominate three persons to sit on the appeal panel. There is usually failure to agree at the first stage, because it is eachy-peachy on both sides. Further stages of the appeal follow, and at each, written evidence must be submitted before there can be another hearing. Let us not kid ourselves that a dispute that has already lasted six months will be quickly resolved using the Whitley appeal procedure. It could take another two years.

Right hon. and hon. Members may recall that the upgrading of nurses was argued about in the House 18 months ago, when nurses were told that any among them who were dissatisfied with their grading could use the Whitley appeal procedure. Only last week, I received a letter from a nurse telling me that she was involved in an appeal. Who are we conning?

Mrs. Margaret Ewing

There are hundreds more nurses in the same situation.

Mr. Martin

I take the hon. Lady's word for that. I am highlighting the fact that putting more disputes in the pipeline will only aggravate the situation.

Mr. Bill Walker

rose—

Mr. Martin

I will not give way to the hon. Gentleman, because many other hon. and right hon. Members wish to speak, and it would be unfair of me to give way now.

Earlier, I mentioned a cleaners' dispute in which I was involved as a full-time union officer, and the support that it received from the public. When the hon. Member for Birmingham, Edgbaston (Dame J. Knight) mentioned the bucket collections that are made by ambulance workers, she used, I believe, the word "con". I do not think that she really meant that. In any event, I can tell the hon. Lady that any collection that is taken by trade union members is well scrutinised and well recorded. No one gets away with any kind of con. It is dishonourable for any Member of Parliament to say that men and women wearing the uniform of one of the finest services in this country would try to con the public.

In Glasgow, men and women, and even young boys and girls, do not walk past collection buckets without making a donation. My own daughter is not a political activist, but she tells me that, if she passes such a collection twice during her lunch hour, she will make a donation on both occasions. It is not so much the amount of money that is given as the gesture of public support that matters.

There are those who argue that the public are uneducated or ill-informed, but if their hearts are behind the ambulance workers, as they are, the Government will have a tough job of resolving the matter—particularly if they take the attitude, "We'll leave it to management"; or, with a nod, and a wink to management, "Let them sit it out. They'll not get a ha'penny. Your job will be on the line if you settle this dispute."

In London, many minicab drivers receive radio calls to turn up at St. Thomas's hospital and at other hospitals. Because they are paid only a set fee, they do not respond, saying, "We don't want to know." That is because the fare will be an elderly patient whom they will have to help into their cab—which is not designed for a person suffering from arthritis or some other severe ailment. On arriving at the patient's destination, he or she must be taken to the door of their home, the key found, and the door unlocked. I would hope that nine out of 10 cab drivers are decent enough to help an elderly person to and from hospital—but the fact remains that, if minicab drivers can avoid taking such fares, they gladly do so.

It is shameful that a Government who claim to care for the people allow the elderly to be humiliated by making them use minicabs to travel to and from therapy. The same Government would not allow the Army to do such a bad job as to put our nation at peril from an intruder. The Government have a duty to settle the dispute. The Minister may think that it will be only a couple of months before ambulance staff are back at work, but as a former trade union officer, I can tell him that I have known of disputes on the records of the Trades Union Congress disputes committee that lasted for one and a half or two years.

Dame Jill Knight

The miners went back in the end.

Mr. Martin

The trouble with the hon. Member for Edgbaston is that she knows nothing about industrial relations. The miners might have gone back, but they brought about the downfall of the Tory Government. She had better remember that.

Mrs. Teresa Gorman (Billericay)

The miners also brought down the Labour Government.

Mr. Martin

I do not recall the miners bringing about the downfall of the Labour Government. I can recall the right hon. Member for Old Bexley and Sidcup (Mr. Heath) saying in this House, "It's me or the miners." The people of this country chose the miners. In any event, I do not intend to be sidetracked by the hon. Member for Edgbaston. I was merely emphasising that, if the Government intend to take the same attitude as the hon. Member for Edgbaston—that, as the miners went back to work, so will the ambulance workers—I remind them that there are on record disputes that lasted years. Given the Government's attitude, the ambulance dispute also will last years. The Government owe it to the country to get the ambulance men back to work.

6.8 pm

Mr. Bill Walker (Tayside, North)

The speech to which we have just listened can be succinctly summed up by the words, "Scrap Whitley." I am sure that that is what the hon. Member for Glasgow, Springburn (Mr. Martin) was telling the House. That may be what he and others want; it is certainly the cornerstone of the dispute.

The hon. Member for Livingston (Mr. Cook)—who is not in his place, but I understand why—has dissociated himself from the previous Labour Government. That come as no surprise, because I remember how he disagreed with the previous Labour Government over devolution. But now, in the hope of getting a seat on the Treasury Bench, the hon. Gentleman is prepared to support their policy.

In his introduction, which I thought flippant and frivolous, the hon. Member for Glasgow, Govan (Mr. Sillars) indulged in all sorts of sideswipes about people whom he described as "organ grinders". The hon. Member for Moray (Mrs. Ewing) is in her place to represent the Scottish National party. I remind her that members of the SNP came to the House and said categorically that they would not take part in or assist with any matters affecting England. But now we have the Govan edict—that the SNP will do what the hon. Member for Govan wants to do, any time, anywhere. That is no surprise, because the SNP has been described by its own supporters as a party with no policies, or policies for everything, and different policies for everywhere. We have seen an example of that today.

The hon. Member for Govan complained that the Minister opening the debate was a Scottish Minister. I can just hear the same fellow complaining that the Minister was English. All Opposition Members, other than the nationalists, know and understand that.

I shall now deal with the essence of the debate. The hon. Member for Govan—[HON. MEMBERS: "Look at him."] Have a good look, because it is a good kilt. I am proud to wear it because it is the Air Force kilt, and it is the 50th anniversary of the Battle of Britain this year. On Wednesday there will be Royal Air Force airmen in the House and that is why I am wearing it. Madam Deputy Speaker, I am responding to some of the uninformed comments of the Opposition.

The essence of this dispute is that the ambulance men have said that they do not accept Whitley rules. In the previous speech we heard one of the reasons why. I have news for the hon. Member for Springburn. I have some years' experience as a Whitley negotiator—[HON. MEMBERS: "You?"] Yes. I spent six and a half years as a Whitley negotiator, so I know something of the problems. I certainly endorse the comments of the hon. Member for Springburn about the delays in the appeal procedure. That is clearly part of the problem. But although the appeals procedure is slow—that has been proven down the years—it is often effective and it has produced good answers in the end. So should we scrap Whitley?

Opposition Members cannot call for one group which is covered by the Whitley umbrella to have separate arbitration. One group cannot operate differently from the rest, and the hon. Member for Springburn knows that as well as I do. If we allow one group of workers to go to arbitration because they have gone on strike, we must allow all groups to go to arbitration. There is no way in between. I see the hon. Member for Aberdeen, North (Mr. Hughes) asserting that there is a way in between. That may be, but the proposal that has been put forward is, "We want arbitration." We must consider whether all the Whitley procedures—the way that negotiations are conducted and carried out—should be changed.

My hon. Friend the Under-Secretary of State for Health, will correct me if I am wrong, but I think that the ambulance men have been given an offer that would take them through until the end of September. They have been told that, on 1 October 1990, they can negotiate for new structures and conditions—they have been told that the 1986 agreement is up for alteration.

The Government have said that they are agreeable to the management's offer. If that is so, all the other groups that have negotiated under the Whitley rules—more than 90 per cent., or the bulk, of the people in the Health Service have agreed—could properly say, "If there is going to be a change of structure for one group, perhaps it should be considered for all groups."

Clegg studied the problems in the light of the terrible industrial difficulties during the closing stages of the previous Labour government. A number of hon. Members have commented on the Clegg report. The important thing that was highlighted by Clegg, who was acting as the referee—one can criticise the referee, as a certain heavyweight boxer has recently—was that the ambulance service should not be considered part of the emergency services. If things have changed—there is a possibility that they have—and we are in a new era, with different arguments being put forward, perhaps there is a need for a complete review and an in-depth study of the issues. That could be a way to resolve the problem.

I have never been in favour of trying to erect imaginary structures that are expected to produce answers with which we can all live, because usually a solution will present more problems the next time there is negotiation. That has been my experience, and I am sure it is true for many other people who have worked in industrial relations on both sides of the negotiating fence.

I place on record my gratitude and thanks to the ambulance men in Scotland who have worked to the rules. I particularly thank those ambulance staff from north Tayside who have been carrying out normal duties, as that is much appreciated by my constituents.

Mr. McAllion

Does the hon. Gentleman support the Tory councillors in Tayside who voted unanimously with councillors from other parties to set up an emergency service through the regional council?

Mr. Walker

The hon. Gentleman is wrong. It was not voted on. The position—[Laughter.] It did not get voted on. There was no division. The hon. Member for Dundee, East (Mr. McAllion) must understand that Tayside region Conservative councillors took the view that the ambulance service has nothing whatever to do with local government, and I agree with them. They do not think that they have any accountability; it is not their locus, so they should not debate or vote on it. My answer is yes, I support them.

One must understand that the question to be resolved is whether employers should succumb to one group because they are working to rule and carrying out industrial action, or whether they should support the more than 90 per cent. of workers who have settled. Any sensible employer would support workers who have settled.

My advice to the ambulance men is not to listen to voices from the Opposition Benches. Since 1979, they have been looking for a union or any cause that could somehow discomfort the Government, or put them in a bad light. They tried it with the miners and with other workers. The fact of the matter is—[Laughter.] The hon. Member for Moray may find this funny, but it is too serious a matter for joking. It is too important for the future of the ambulance men, the ambulance service and for patients, who are suffering at present. This is not a flippant or frivolous matter. Nothing to do with wages is ever flippant or frivolous to the people involved, whether they are the people who have to pay or those who hope to be paid.

We are discussing whether Whitley has a future. I warn management very seriously that, if they succumb to blackmail—that is what industrial action is—they will put everything else that works at risk. Whitley is at risk. There are proposals to change Whitley and to say—as I understand the hon. Member for Aberdeen, North does—that there should be some form of arbitration service, and not necessarily the present appeals procedure. I accept that that procedure is slow and cumbersome, but in my experience it has worked.

When I negotiated for people, they were always delighted when we appealed and were successful, even though it took some time. The pay was always backdated, which is a big advantage of working in the public service as opposed to outside it, where that system does not normally apply. That is why one can afford to be a little slower in reaching decisions in the public service.

This is a serious matter of principle, and the principle is whether Whitley, and the interests of the 90 per cent. of Health Service workers who have settled, are worth defending. If we succumb to blackmail supported by Opposition Members, who are engaged in political opportunism—

Mr. Ernie Ross (Dundee, West)

The hon. Gentleman seems to think that the dispute is the result of a plot by Opposition Members. Every Saturday, I stand with the ambulance men in the city square in Dundee, and there is no lack of people going about their business—not people wearing Labour party, SNP or SLD stickers but ordinary people, from the very young to the very old—who put money into the ambulance men's buckets. Why does the hon. Gentleman think that is?

Mr. Walker

The hon. Gentleman is old enough to remember other similar disputes, in which—

Mr. Ross

I do not.

Mr. Walker

In that case, I apologise to the hon. Gentleman, who cannot be as old as I thought he was. As soon as a dispute is settled, feelings evaporate and views and attitudes change.

The conspiracy is not one by the ambulance men, some of whom are trying to deal with a genuine grievance. They are going about it wrongly, but that is a different matter. In a number of instances they have a case for saying that conditions should be altered. That is not unusual; very few groups could not make such a case. The important point is that the Opposition regard the dispute as an opportunity. They are engaged in political opportunism. It is among Opposition Members that we find the intrigue and political machinations. I am not blaming the ambulance men, although they are mistaken in their methods and although they will live to regret the scrapping of Whitley. That is the important point and I want it on record.

Mr. Robert Hughes

The hon. Gentleman should be extremely careful not to put words into other people's mouths. By saying that there is a case for looking at the Whitley council procedures and possibly bringing in arbitration as an alternative to a review procedure, we are not saying that Whitley should be scrapped. Let us be perfectly clear about that. No one says, "Scrap Whitley." We are merely saying that the Government should look at Whitley and improve it rather than allow it to fall into disrepute.

Mr. Walker

The captain of the Titanic probably did not want to sink the Titanic, but people's actions have an effect—[Laughter.] Hon. Members should listen carefully. The other 90-odd per cent. of staff who settled under Whitley take the view that the system works, but Whitley may be killed off by the very people who should be making it work. Hon. Members know that the machinery depends on the active involvement of both sides to make it work. If one group—the ambulance men—says no to Whitley and decides to pursue its claim in a different way, the other 96 per cent. of staff may be tempted to do the same, and that would amount to scrapping Whitley.

6.23 pm

Mr. Dafydd Wigley (Caernarfon)

In recent months, Wales has faced similar problems to those confronting Scotland and England. We are grateful to the Scottish National party for introducing the debate and to the hon. Member for Glasgow, Govan (Mr. Sillars) for his introductory remarks. I take issue with the hon. Member for Tayside, North (Mr. Walker) about the need for the Opposition to rattle round looking for causes to do in the Government. The Government are quite capable of doing incredible damage to themselves, as the poll tax and the ambulance dispute has proved.

I thank ambulance workers in my constituency, in Wales and in general for the tremendous work that they do and for the dignity and restraint with which they have conducted themselves in the recent most difficult weeks. As hon. Members have said, they command overwhelming support in the community. A BBC poll undertaken in Wales showed that 100 per cent. of those asked supported the ambulance workers. Only two people who were asked to sign a petition in my constituency, which carried 3,000 signatures, refused to do so.

It is disgraceful that the dispute should have been drawn out for so long, when the Government could easily have found a way of reaching a settlement. The size of the ambulance workers' claim is quite reasonable. If hon. Members are happy to accept an annual salary increase in excess of 10 per cent., how can we say that the ambulance workers do not deserve a similar increase? What measuring rod can we use?

The method of pursuing the claim has also been reasonable by and large, although today is a sad day in Wales because, in South Glamorgan, we have seen what amounts to a lockout; that represents a serious aggravation of the dispute, which the ambulance workers did not want. It is interesting to note that, this weekend, in the neighbouring county of Gwent, the ambulance manager passed control of the service to the ambulance workers themselves. That was an intriguing step forward, and reflects the sense of responsibility that the management felt the ambulance workers showed towards their work. I believe that that is generally so.

I have taken the trouble to go round all three ambulance stations in my constituency—in Caernarfon, Pwllheli and Porth-madog—and I am deeply impressed by the sense of responsibility shown by the men and by the Transport and General Workers Union and its leadership. They have tried to stick to the rules laid down centrally by the unions, to ensure that those who could be adversely affected by industrial action are protected, and that the dispute does not endanger life and limb.

I have noted the long hours that the ambulance workers often have to work. I have known some to work an all-day shift and then go on to all-night standby, at a rate of pay of £4 per full standby shift. That rate of remuneration compares badly with those of electricity and gas workers on standby work. Ambulance men may work as long as 24 hours on the trot; and one can well imagine the strain that that places on them.

What can be the Government's motive for prolonging the dispute? It cannot be to establish 9 per cent. over 18 months as the norm, given what is happening in industry—at Ford and elsewhere. It is widely believed among ambulance workers that there is an attempt to use the dispute to split their work into two, with a professional upgraded staff for the paramedical part of the work and a taxi-driver-type service for the other part, which is eventually to be privatised. It would be a woeful state of affairs if the Government used the dispute to pursue their own dogma and to make one more stride towards privatisation.

Perhaps some of the services in inner-city areas can be undertaken by something less than the full crew, and I understand that such a system has been experimented with in some cities. But in rural areas such as mine, it is not practical or possible to downgrade the service into a taxi-type service. Those areas need full-time professionals, because some parts of my constituency are 50 miles from the hospital to which the ambulance workers must take emergency cases. In my county, the average time for taking people to hospital is one hour, compared with seven minutes in some city areas. One cannot have a blanket approach, which I fear the Government have.

Ambulance workers and emergency workers, who turn out to all sorts of emergencies—not just medical emergencies. When the fire engines are called out, the ambulances are also called out, and the ambulance workers are often there first. They are often called out in police emergencies, too. If the fire service is entitled to index-linked pay, it is ridiculous that the pay of ambulance workers should not be index-linked. There should at least be parity of approach, if not parity in pay scales.

It is important that training should be adequate. It would not be right to pay a higher rate to only a limited number of highly trained staff if training is not made available to the overwhelming majority. As the dispute seems to be escalating, I am also worried about ambulance cover in rural counties, especially if we have to rely on the Army. I understand that six Army ambulances would be available to cover the whole of Gwynedd. That would be impossible.

I believe that there is a solution to the problem. 'We should lay on one side for a moment the percentage increase for this year and consider other aspects. The Government ought to say that they are prepared to allow next year's pay award to go to arbitration. They ought to accept that decision and be prepared to index-link it to average industrial wages. The Government should not use such a settlement as a basis for privatisation. The Government ought to agree to review the equipment that is available to ambulance workers—a subject that causes them considerable worry.

If the Government adopted such an approach, I believe that there could be a settlement, based on a figure for this year which the Government could accept. We must find a way out of this dispute. An old constituent of mine, Wil Napoleon, who is dead now, had a very good dictum: "Never start a fight in a pub without a back door." I suspect that the Government have started a fight in a pub without a back door, and that they will have to pay the price.

6.31 pm

Sir Hector Monro (Dumfries)

I listened with interest to the speech of the hon. Member for Caernarfon (Mr. Wigley), and to his suggestions about how to resolve the dispute. It is important to hold negotiations as soon as possible without preconditions. I was a Health Minister in the early 1970s. There was a similar strike to this one in 1972–73, when we had to introduce civilian volunteer drivers. Fortunately, that dispute was resolved far more quickly than this one.

I pay tribute,as did the hon. Member for Glasgow, Govan (Mr. Sillars), to the ambulance men in my constituency, who provided such effective help at the time of the Lockerbie disaster. They have to deal with many serious accidents on the A74. They turn out rapidly in such emergencies. I pay great tribute to them.

The National Health Service and the unions agreed a negotiating structure in 1986. They decided to proceed under the Whitley procedure by means of freely agreed negotiations. There was no place for arbitration in the 1986 agreement. Furthermore, arbitration is not an option in other parts of the National Health Service. We cannot change the rules of the game.

In May 1989, management and unions reached agreement on 6.5 per cent. The unions put that agreement to their members on 20 June, but it was rejected. After that, the dispute began. On 4 December 1989, the National Health Service offered 9 per cent., backdated to 1 April 1989 and running through to September 1990. Leading ambulance men would have an increase of about £1,000 over 12 months and ambulance men and women would receive an additional £650, while those who are trained as paramedics would receive an additional £500. The unions responded with an 11 per cent. demand, with pay to be linked to police and fire service pay.

The Labour party set out the terms of reference of the Clegg inquiry. The unions' demand was linked to the Clegg report, but Clegg said that there should be no link between the fire service, the police and the National Health Service.

The 1986 agreement ought to be reviewed. There should be no preconditions. I do not understand why the unions insist on preconditions and will not return to the negotiating table. A 9 per cent. offer is on the table. To offer to renegotiate the structure without preconditions seems to me to be reasonable. A restructuring of the pay system, including Whitley and arbitration, would be on the table. Whether agreement would eventually be reached about that is another matter.

The ambulance men and the unions would, if they were wise, start afresh and try to resolve the problem during the next few months. They have already been offered 9 per cent., backdated to April 1989. That is a reasonable offer. The unions ought to get round the table with the National Health Service and resolve the problem between now and September 1990. Between now and September, 9 per cent. would be paid to the ambulance men. If the unions took that course, it could lead to much happier times for ambulance men and women.

6.37 pm

Mr. Thomas McAvoy (Glasgow, Rutherglen)

The main reason for this claim is to retain the value of ambulance men's earnings. The unions have said that a pay mechanism, such as a pay review body, would be given serious and constructive consideration. Alternatively, the Government could propose a new pay mechanism. The unions have been flexible.

The hon. Member for Glasgow, Govan (Mr. Sillars) referred to five key parts of the union's case. They have said that they are willing to drop those demands if that would help to solve the dispute. The unions are ready to negotiate on both the pay claim of 11.14 per cent. and the nature of the pay formula. Flexibility is there. The Government ought to respond.

The emergency work of ambulance crews has been well illustrated. During the last few days, newspaper articles have suggested that the unions are almost defeated. I do not know whether those articles have been influenced by Government sources. If this dispute ends in defeat for the ambulance workers, working practices will be seriously affected.

A disgraceful attack on Scottish ambulance staff was instigated by Mr. Wilby, the director of the Scottish ambulance service. He called into question the ambulance workers' commitment to the service and to their professional duties. How he thinks that that will contribute to future harmony in the Scottish ambulance service I do not know. Perhaps he got carried away by conducting the Government's political fight on their behalf. No doubt he will be rewarded with a mention in either the new year's or the birthday honours list. When that happens, clearly it will be a reward for political service.

The position in Scotland contrasts with that in Gwent, where common sense prevails and obviously the priority of the management in charge of the ambulance service is public service instead of defending the Government's battle ramparts. There should be no totem poles, as the Government have sufficient strength. To their credit, many Conservative Members, particularly the hon. Members for Macclesfield (Mr. Winterton) and for Harlow (Mr. Hayes), have tried to get the Government to move, but the Government's position seems to echo the miners' strike. They are trying to show their strength and be macho, but true strength is the ability to be flexible and to negotiate. The Government should show their strength by negotiating with the ambulance workers.

6.40 pm

Mrs. Margaret Ewing (Moray)

I intend to be brief in summing up, first because the case is self-evident and has already been put more than adequately by my hon. Friend the Member for Glasgow, Govan (Mr. Sillars), the hon. Member for Caernarfon (Mr. Wigley) and hon. Members from other Opposition parties. Secondly, I should not like to give the Minister the excuse that he could not reply to all the points that have been raised because he ran out of time before we forced the issue to a Division. Therefore, I shall ask the Minister some basic questions.

Throughout the debate, we have heard that it is costing £20 million-plus to subsidise alternative forms of support to replace the ambulance crews. Will the Minister give us a straight answer as to who is paying that money? Exactly where is it coming from? It has been mentioned that, were we to spend £10 million, which is all that it would take to settle the dispute, we should open the floodgates. I should be interested if the Minister could name any individual group that has ever used the emergency services as leverage to argue its own case in industrial discussions about wages. The entire industrial community recognises that the emergency services are different, and there is widespread support from all working people for the settlement of the dispute. I suspect that no one would try to use it as a lever.

As we are referring to the emergency services, perhaps the Minister will be more forthcoming about dealing with the letter of 22 August 1978 from the private office of the then Leader of the Opposition than the Under-Secretary of State for Scotland was on "Left, Right and Centre" on Friday night, when his subdued and humble demeanour made me wonder how many charm schools he had visited recently. That letter was signed by Matthew Parris on behalf of the then Leader of the Opposition. It stated: In all the comments she made during the Firemen's strike, Mrs. Thatcher linked her remarks not just to the firemen but to what she, and you, call Emergency Services. All three deserve to have their pay negotiations put outside the arena of industrial dispute by being given firm and automatic linkage to national price or wage rises. Will the Minister comment on that and tell us why the Conservative party seems to have changed its mind about the Clegg report? Conservative Members use it in their defence when we call for arbitration, but I was in the House in the 1970s when the Clegg report was published and the Conservative Opposition were very much against it. What has made the Conservatives change their minds in the intervening 10 years? Does the Minister accept that the report has been discredited in so far as it affects the ambulance men, because it is quite clear that there was no real analysis of their situation then, and there is now a strong argument for a much better analysis?

I should like to know exactly what the Under-Secretary of State for Scotland meant when he said that the current offer would hold good until October. He led us a merry dance round various statistics, mentioning 9 per cent., 6 per cent., 6.4 per cent., 6.5 per cent., 18 months, 12 months and the rest. But when he said that the offer would hold good until October, it was not clear whether it would hold good after October, and that seems a strange way of offering the ambulance workers a negotiating base. If the Government are not guaranteeing the ambulance men the continuation of their wage increase after October, surely there is little point in them even considering negotiation.

The hon. Member for Dumfries (Sir H. Monro) said that negotiations should be reopened without preconditions, but the Government have placed preconditions on the ambulance staff in their negotiations because they are saying that there will be no pay review and no further increase forthcoming. Those are very tight preconditions for the Government to place on the ambulance staff, and I ask the Government to rescind them.

The Minister referred to investment. According to a press release from the Scottish Office this month, it amounts to some £4.7 million in Scotland. Of course, everyone welcomes investment in the ambulance service. It was disingenuous of the Minister to say that those of us who support the ambulance staff do not want such investment in the ambulance service. No one knows better than the ambulance staff how desperately that investment is needed. In my constituency, and I am sure in the constituencies of many other hon. Members representing rural areas, there is not a single fete, show or bazaar during the summer months where the ambulance men do not have an ambulance on display—and available for use in the event of an emergency—to raise funds to provide equipment to improve the service to the local community. When we talk about improving health provision and the need for investment, the Minister should note that the ambulance men have done a great deal to improve the service through their own voluntary efforts to buy vital equipment such as defibrillators.

I studied history, and one of my favourite books is "1066 and All That". Others who have studied history will know it well. One part of that book mentioned the arrival of what was known as "the face" and its implications for historical developments. Wars were fought over the face and deaths were caused by the face. It seems to me that the Government are more intent on saving their face than on resolving the ambulance dispute.

If ambulance staff are at the point of ceasing to observe the TUC guidelines, that must mean that they are being forced into total despair, anger and frustration at Government action. No Opposition Member wants the TUC guidelines to be broken, nor do the vast majority of the ambulance staff, but the frustration is being caused by the growing chasm between the Government, and the ambulance staff and the public. If the Government were to accept our motion, they would show a genuine commitment to resolving the dispute, which we all want to be resolved.

Mrs. Fyfe

On a point of order, Mr. Deputy Speaker. Does the House have the right to demand to know whether the Secretary of State for Health and the Secretary of State for Scotland have a reasonable excuse for absenting themselves for the entire debate?

6.48 pm

The Parliamentary Under-Secretary of State for Health (Mr. Roger Freeman)

As the hon. Member for Livingston (Mr. Cook) rightly reminded the House, we have debated the subject a number of times. The best contribution that I can make to this short debate is to shed further light on Government policy on five particular points. I approach those five issues in a constructive and, I hope, enlightening fashion that will help to carry the debate further. I appreciate that a number of hon. Gentlemen have spoken with great passion and a sense of loyalty to their union colleagues and to the issues involved, but it seems to me that I can best serve the debate by answering the five key points that have arisen.

First, the hon. Member for Livingston implied that in some way we undervalued the contribution of ambulance men and women. That is not the case. As my hon. Friend the Member for Stirling (Mr. Forsyth), who has responsibility for health in Scotland, said, we all value greatly the role of ambulance men and women. Although I accept the very strong public sympathy for ambulance men and women and the understanding of their role, there is a difference between accepting that public sympathy and stressing that the Government have responsibility for settling public sector pay, however important a particular sector may be. It is not inconsistent for me to say that although the Government understand that public sympathy, we have a sense of responsibility.

The hon. Member for Livingston asked me specifically about retirement and stress. He was right to make that point. Unquestionably some ambulance men and women suffer great stress, particularly when they leave a horrific road traffic accident to deal with another rostered duty. In due course we will consider the reports on this issue. Although it is true that policemen retire earlier than ambulance men, I must stress that the police pay twice as much superannuation contributions as ambulance men and women to achieve earlier retirement. Nevertheless, the hon. Member for Livingston was right to raise the issue, and we shall consider it in due course.

The second of the five main topics to arise in the debate was cost. The hon. Member for Livingston said that we could have settled the dispute some months ago, and that the dispute is inconsequential. He said that the cost of the police and Army services helping to provide emergency cover in certain areas has amounted to about £20 million. I do not dissociate myself from that figure, although it is an estimate and not all the bills have come in yet. In response to the hon. Member for Moray (Mrs. Ewing), I can state that those costs will be paid by the National Health Service—by the appropriate ambulance authorities.

We are considering an additional cost because, although there may be some savings from staff who have absented themselves or are on lower pay, there will still be a burden. We cannot set the costs of the services provided by the police and the Army against the cost of increasing the pay of ambulance men and women in one year, because the cost recurs. The implications of agreeing to the union's demands for a pay review body or, failing that, binding arbitration, would be much more expensive for the ambulance service. We must remember that the ambulance service costs about £200 million a year.

My hon. Friend the Member for Tayside, North (Mr. Walker) referred to the 390,000 Whitley staff who would wish to share in any pay review body, mechanism or binding arbitration. The NHS pay bill is about £13 billion. In the debate before Christmas, the hon. Member for Livingston said that it was Labour party policy to agree to a pay formula. I hope that he has cleared that with his right hon. Friends the shadow Chancellor and the shadow Chief Secretary to the Treasury, because such a pay formula would have significant financial implications for the Health Service and for public sector pay.

My hon. Friend the Member for Lancaster (Dame E. Kellett-Bowman) asked a specific question about the offer that is on the table. That offer is backdated to 1 April, to increase the rate of pay by 9 per cent. per annum over an 18-month period. From 1 October this year, fresh negotiations on the further increase in pay will have to take place. My hon. Friend the Member for Lancaster reminded the House, rightly, that the increase is more than 9 per cent. in London—12 per cent.—and that we are putting on the table £500 per annum to increase pay for trained paramedics. That represents an extra £900 in cash for ambulance men and women over the 12 months beginning 1 April.

The third main point to arise from the debate relates to emergency and non-emergency work about which the hon. Member for Livingston asked specific questions. All hon. Members would agree that some parts of the ambulance service are non-emergency in nature; there can be no dispute about that. I can give the hon. Member for Livingston the figures. In terms of the number of patients carried, 10 per cent. of the activity of the ambulance service is emergency work, to which should be added another 5 per cent. for doctors' urgent cases. That means that 15 per cent. of ambulance service activities involves emergency work. That figure is not dissimilar to the one that the hon. Member for Livingston quoted for York.

We are in danger of confusing functions with the argument that we must have a full roster of ambulance men and women on which to draw in the event of an emergency. I suggest that some functions of the ambulance service are not of an emergency nature and can be contracted out. The experience in Northumbria and Wiltshire supports that contention.

Mrs. Gorman

Will my hon. Friend confirm now or later the figures that I heard in a BBC broadcast to the effect that the average cost of a non-emergency journey is £40 per person? If that is correct, it must be cheaper to contract such work out.

Mr. Freeman

My hon. Friend is right to draw attention to the fact that non-emergency functions, when contracted out, can be cheaper. We are not being prescriptive, and it is for the various ambulance authorities to decide which part of the service to contract out and when. However, my hon. Friend was correct—

Mr. Wigley

Will the Minister give way?

Mr. Freeman

No. I have only three minutes left and two points with which to deal, and one of those points was made by the hon. Gentleman himself.

The fourth point to arise from the debate concerns training and equipment to which my hon. Friend the Member for Birmingham, Edgbaston (Dame J. Knight) referred. The hon. Member for Livingston mentioned 14,000 qualified ambulance men. Of those, only 2,000 are fully qualified paramedics. My hon. Friend the Member for Edgbaston wanted to know whether those 2,000 qualified staff have to pay for that additional training. They do not.

We need to increase the proportion of ambulance men and women who are qualified paramedics. We want one paramedic in each emergency ambulance. Paramedics are qualified to provide drips, to unblock airways and to control heartbeats. We have only 2,000 ambulance men and women who are so qualified. I agree with the hon. Member for Livingston that we need to devote additional resources to training and equipment in the ambulance service. My hon. Friend the Under-Secretary of State for Scotland referred to steps that have already been taken to that end in Scotland. I confirm that my right hon. and learned Friend the Secretary of State for Health takes that issue very seriously. Over the coming months, we will be concentrating on how to improve training and the resources devoted to equipment in the Health Service.

On national pay, we want greater local flexibility which, in some cases, means higher pay, paid for by productivity in the ambulance service. That should be possible. That is the correct route further to reward ambulance men and women.

Mr. Poole knows that this dispute, including the pay review body, cannot be won on his terms. Surely both sides should sit down, without rancour or loss of face, but with common sense and good grace, and solve the dispute.

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

The House divided: Ayes 207, Noes 276.

Division No. 83]	[6.59 pm
AYES
Abbott, Ms Diane	Campbell, Menzies (Fife NE)
Allen, Graham	Campbell, Ron (Blyth Valley)
Anderson, Donald	Campbell-Savours, D. N.
Archer, Rt Hon Peter	Canavan, Dennis
Ashdown, Rt Hon Paddy	Cartwright, John
Ashley, Rt Hon Jack	Clark, Dr David (S Shields)
Ashton, Joe	Clarke, Tom (Monklands W)
Banks, Tony (Newham NW)	Clay, Bob
Barnes, Harry (Derbyshire NE)	Clelland, David
Barnes, Mrs Rosie (Greenwich)	Clwyd, Mrs Ann
Barron, Kevin	Cohen, Harry
Battle, John	Cook, Robin (Livingston)
Beckett, Margaret	Corbett, Robin
Beith, A. J.	Corbyn, Jeremy
Bennett, A. F. (D'nt'n & R'dish)	Cox, Tom
Bermingham, Gerald	Cryer, Bob
Bidwell, Sydney	Cummings, John
Blair, Tony	Cunliffe, Lawrence
Blunkett, David	Dalyell, Tam
Boateng, Paul	Darling, Alistair
Boyes, Roland	Davies, Rt Hon Denzil (Llanelli)
Bradley, Keith	Davies, Ron (Caerphilly)
Bray, Dr Jeremy	Davis, Terry (B'ham Hodge H'l)
Brown, Ron (Edinburgh Leith)	Dewar, Donald
Bruce, Malcolm (Gordon)	Dixon, Don
Buchan, Norman	Dobson, Frank
Buckley, George J.	Doran, Frank
Caborn, Richard	Douglas, Dick
Callaghan, Jim	Duffy, A. E. P.

Dunnachie, Jimmy	Marshall, Jim (Leicester S)
Dunwoody, Hon Mrs Gwyneth	Martin, Michael J. (Springburn)
Eastham, Ken	Martlew, Eric
Evans, John (St Helens N)	Maxton, John
Ewing, Harry (Falkirk E)	Meacher, Michael
Ewing, Mrs Margaret (Moray)	Meale, Alan
Fatchett, Derek	Michael, Alun
Faulds, Andrew	Michie, Bill (Sheffield Heeley)
Fearn, Ronald	Mitchell, Austin (G't Grimsby)
Field, Frank (Birkenhead)	Moonie, Dr Lewis
Fields, Terry (L'pool B G'n)	Morgan, Rhodri
Fisher, Mark	Morley, Elliot
Flannery, Martin	Morris, Rt Hon A. (W'shawe)
Flynn, Paul	Morris, Rt Hon J. (Aberavon)
Foot, Rt Hon Michael	Mullin, Chris
Foster, Derek	Murphy, Paul
Fraser, John	Oakes, Rt Hon Gordon
Fyfe, Maria	O'Neill, Martin
Garrett, John (Norwich South)	Orme, Rt Hon Stanley
Garrett, Ted (Wallsend)	Patchett, Terry
George, Bruce	Pendry, Tom
Godman, Dr Norman A.	Pike, Peter L.
Golding, Mrs Llin	Powell, Ray (Ogmore)
Gordon, Mildred	Prescott, John
Gould, Bryan	Primarolo, Dawn
Graham, Thomas	Quin, Ms Joyce
Griffiths, Nigel (Edinburgh S)	Radice, Giles
Griffiths, Win (Bridgend)	Randall, Stuart
Hardy, Peter	Rees, Rt Hon Merlyn
Harman, Ms Harriet	Richardson, Jo
Haynes, Frank	Robertson, George
Healey, Rt Hon Denis	Robinson, Geoffrey
Heffer, Eric S.	Rogers, Allan
Henderson, Doug	Ross, Ernie (Dundee W)
Hinchliffe, David	Rowlands, Ted
Hogg, N. (C'nauld & Kilsyth)	Ruddock, Joan
Home Robertson, John	Salmond, Alex
Hood, Jimmy	Sedgemore, Brian
Howarth, George (Knowsley N)	Sheerman, Barry
Howells, Geraint	Sheldon, Rt Hon Robert
Howells, Dr. Kim (Pontypridd)	Shore, Rt Hon Peter
Hughes, John (Coventry NE)	Short, Clare
Hughes, Robert (Aberdeen N)	Sillars, Jim
Hughes, Roy (Newport E)	Skinner, Dennis
Hughes, Simon (Southwark)	Smith, Andrew (Oxford E)
Illsley, Eric	Smith, C. (Isl'ton & F'bury)
Ingram, Adam	Smith, Rt Hon J. (Monk'ds E)
Janner, Greville	Smith, J. P. (Vale of Glam)
Jones, Barry (Alyn & Deeside)	Soley, Clive
Jones, leuan (Ynys Môn)	Spearing, Nigel
Jones, Martyn (Clwyd S W)	Steel, Rt Hon Sir David
Kaufman, Rt Hon Gerald	Steinberg, Gerry
Kennedy, Charles	Stott, Roger
Kilfedder, James	Strang, Gavin
Kinnock, Rt Hon Neil	Straw, Jack
Kirkwood, Archy	Taylor, Mrs Ann (Dewsbury)
Lambie, David	Thomas, Dr Dafydd Elis
Lamond, James	Thompson, Jack (Wansbeck)
Leadbitter, Ted	Turner, Dennis
Leighton, Ron	Vaz, Keith
Lestor, Joan (Eccles)	Wallace, James
Lewis, Terry	Walley, Joan
Litherland, Robert	Warden, Gareth (Gower)
Livsey, Richard	Wareing, Robert N.
Lloyd, Tony (Stretford)	Welsh, Michael (Doncaster N)
Lofthouse, Geoffrey	Williams, Rt Hon Alan
McAllion, John	Williams, Alan W. (Carm'then)
McAvoy, Thomas	Wilson, Brian
McFall, John	Winnick, David
McKay, Allen (Barnsley West)	Wise, Mrs Audrey
McLeish, Henry	Worthington, Tony
Maclennan, Robert	Young, David (Bolton SE)
McNamara, Kevin
McWilliam, John	Tellers for the Ayes:
Madden, Max	Mr. Andrew Welsh and Mr. Daffydd Wigley.
Marek, Dr John
Marshall, David (Shettleston)

NOES
Adley, Robert	Gale, Roger
Aitken, Jonathan	Gardiner, George
Alexander, Richard	Garel-Jones, Tristan
Alison, Rt Hon Michael	Gill, Christopher
Amess, David	Glyn, Dr Sir Alan
Arbuthnot, James	Goodhart, Sir Philip
Arnold, Jacques (Gravesham)	Goodlad, Alastair
Arnold, Tom (Hazel Grove)	Goodson-Wickes, Dr Charles
Atkins, Robert	Gorman, Mrs Teresa
Baker, Nicholas (Dorset N)	Gow, Ian
Banks, Robert (Harrogate)	Greenway, Harry (Ealing N)
Beaumont-Dark, Anthony	Greenway, John (Ryedale)
Bellingham, Henry	Gregory, Conal
Bendall, Vivian	Griffiths, Sir Eldon (Bury St E')
Bennett, Nicholas (Pembroke)	Grist, Ian
Benyon, W.	Ground, Patrick
Biffen, Rt Hon John	Gummer, Rt Hon John Selwyn
Bonsor, Sir Nicholas	Hague, William
Boscawen, Hon Robert	Hamilton, Hon Archie (Epsom)
Boswell, Tim	Hanley, Jeremy
Bottomley, Peter	Hannam, John
Bowden, Gerald (Dulwich)	Hargreaves, A. (B'ham H'll Gr')
Bowis, John	Harris, David
Brandon-Bravo, Martin	Haselhurst, Alan
Brazier, Julian	Hayes, Jerry
Bright, Graham	Hayhoe, Rt Hon Sir Barney
Brown, Michael (Brigg & Cl't's)	Hayward, Robert
Browne, John (Winchester)	Heathcoat-Amory, David
Bruce, Ian (Dorset South)	Heseltine, Rt Hon Michael
Buck, Sir Antony	Hicks, Mrs Maureen (Wolv' NE)
Burns, Simon	Hicks, Robert (Cornwall SE)
Burt, Alistair	Higgins, Rt Hon Terence L.
Butcher, John	Hill, James
Butler, Chris	Hogg, Hon Douglas (Gr'th'm)
Butterfill, John	Hordern, Sir Peter
Carlisle, John, (Luton N)	Howard, Rt Hon Michael
Carlisle, Kenneth (Lincoln)	Howarth, Alan (Strat'd-on-A)
Carrington, Matthew	Howe, Rt Hon Sir Geoffrey
Carttiss, Michael	Howell, Rt Hon David (G'dford)
Chalker, Rt Hon Mrs Lynda	Howell, Ralph (North Norfolk)
Chapman, Sydney	Hughes, Robert G. (Harrow W)
Churchill, Mr	Hunt, Sir John (Ravensbourne)
Clark, Hon Alan (Plym'th S'n)	Hunter, Andrew
Clark, Dr Michael (Rochford)	Irvine, Michael
Clark, Sir W. (Croydon S)	Jack, Michael
Clarke, Rt Hon K. (Rushcliffe)	Janman, Tim
Colvin, Michael	Jessel, Toby
Conway, Derek	Johnson Smith, Sir Geoffrey
Coombs, Anthony (Wyre F'rest)	Jones, Robert B (Herts W)
Coombs, Simon (Swindon)	Jopling, Rt Hon Michael
Couchman, James	Kellett-Bowman, Dame Elaine
Critchley, Julian	Key, Robert
Currie, Mrs Edwina	King, Roger (B'ham N'thfield)
Davies, Q. (Stamf'd & Spald'g)	King, Rt Hon Tom (Bridgwatar)
Day, Stephen	Kirkhope, Timothy
Devlin, Tim	Knapman, Roger
Dorrell, Stephen	Knight, Dame Jill (Edgbaston)
Douglas-Hamilton, Lord James	Knowles, Michael
Durant, Tony	Knox, David
Dykes, Hugh	Lamont, Rt Hon Norman
Eggar, Tim	Lang, Ian
Emery, Sir Peter	Latham, Michael
Evans, David (Welwyn Hatf'd)	Lawrence, Ivan
Evennett, David	Lee, John (Pendle)
Fairbairn, Sir Nicholas	Leigh, Edward (Gainsbor'gh)
Fallon, Michael	Lennox-Boyd, Hon Mark
Favell, Tony	Lester, Jim (Broxtowe)
Fenner, Dame Peggy	Lilley, Peter
Finsberg, Sir Geoffrey	Lloyd, Sir Ian (Havant)
Fookes, Dame Janet	Lloyd, Peter (Fareham)
Forman, Nigel	Lord, Michael
Forsyth, Michael (Stirling)	Luce, Rt Hon Richard
Forth, Eric	Lyell, Rt Hon Sir Nicholas
Fowler, Rt Hon Sir Norman	MacKay, Andrew (E Berkshire)
Fox, Sir Marcus	Maclean, David
Franks, Cecil	McLoughlin, Patrick
Freeman, Roger	McNair-Wilson, Sir Michael
French, Douglas	McNair-Wilson, Sir Patrick
Fry, Peter	Madel, David

Malins, Humfrey	Smith, Sir Dudley (Warwick)
Maples, John	Soames, Hon Nicholas
Marland, Paul	Speller, Tony
Marshall, John (Hendon S)	Spicer, Sir Jim (Dorset W)
Martin, David (Portsmouth S)	Spicer, Michael (S Worcs)
Mayhew, Rt Hon Sir Patrick	Squire, Robin
Meyer, Sir Anthony	Stanbrook, Ivor
Miller, Sir Hal	Stanley, Rt Hon Sir John
Mills, lain	Steen, Anthony
Miscampbell, Norman	Stern, Michael
Mitchell, Andrew (Gedling)	Stevens, Lewis
Mitchell, Sir David	Stewart, Allan (Eastwood)
Moate, Roger	Stewart, Andy (Sherwood)
Monro, Sir Hector	Stewart, Rt Hon Ian (Herts N)
Montgomery, Sir Fergus	Stokes, Sir John
Moore, Rt Hon John	Stradling Thomas, Sir John
Morris, M (N'hampton S)	Sumberg, David
Morrison, Rt Hon P (Chester)	Summerson, Hugo
Moss, Malcolm	Tapsell, Sir Peter
Moynihan, Hon Colin	Taylor, Ian (Esher)
Neale, Gerrard	Taylor, John M (Solihull)
Needham, Richard	Taylor, Teddy (S'end E)
Nelson, Anthony	Tebbit, Rt Hon Norman
Neubert, Michael	Temple-Morris, Peter
Newton, Rt Hon Tony	Thompson, D. (Calder Valley)
Nicholls, Patrick	Thompson, Patrick (Norwich N)
Nicholson, David (Taunton)	Thorne, Neil
Norris, Steve	Thornton, Malcolm
Onslow, Rt Hon Cranley	Thurnham, Peter
Oppenheim, Phillip	Townsend, Cyril D. (B'heath)
Page, Richard	Tracey, Richard
Paice, James	Tredinnick, David
Parkinson, Rt Hon Cecil	Trippier, David
Patnick, Irvine	Trotter, Neville
Patten, Rt Hon John	Twinn, Dr Ian
Pawsey, James	Vaughan, Sir Gerard
Peacock, Mrs Elizabeth	Viggers, Peter
Porter, David (Waveney)	Waddington, Rt Hon David
Powell, William (Corby)	Walden, George
Raison, Rt Hon Timothy	Walker, Bill (T'side North)
Redwood, John	Waller, Gary
Renton, Rt Hon Tim	Walters, Sir Dennis
Rhodes James, Robert	Ward, John
Ridley, Rt Hon Nicholas	Wardle, Charles (Bexhill)
Ridsdale, Sir Julian	Watts, John
Roberts, Wyn (Conwy)	Wells, Bowen
Roe, Mrs Marion	Wheeler, Sir John
Rossi, Sir Hugh	Whitney, Ray
Rost, Peter	Wiggin, Jerry
Rowe, Andrew	Winterton, Mrs Ann
Ryder, Richard	Winterton, Nicholas
Sackville, Hon Tom	Wolfson, Mark
Sainsbury, Hon Tim	Wood, Timothy
Shaw, David (Dover)	Woodcock, Dr. Mike
Shaw, Sir Giles (Pudsey)	Young, Sir George (Acton)
Shaw, Sir Michael (Scarb')	Younger, Rt Hon George
Shephard, Mrs G. (Norfolk SW)
Shepherd, Richard (Aldridge)	Tellers for the Noes:
Shersby, Michael	Mr. Greg Knight and Mr. David Lightbown.
Sims, Roger
Skeet, Sir Trevor

Question accordingly negatived.

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

The House divided: Ayes 255, Noes 199.

Division No. 84]	[7.12 pm
AYES
Adley, Robert	Beaumont-Dark, Anthony
Aitken, Jonathan	Bellingham, Henry
Alexander, Richard	Bendall, Vivian
Amess, David	Bennett, Nicholas (Pembroke)
Arbuthnot, James	Biffen, Rt Hon John
Arnold, Jacques (Gravesham)	Bonsor, Sir Nicholas
Atkins, Robert	Boscawen, Hon Robert
Baker, Nicholas (Dorset N)	Boswell, Tim
Banks, Robert (Harrogate)	Bowden, Gerald (Dulwich)

Bowis, John	Heseltine, Rt Hon Michael
Brandon-Bravo, Martin	Hicks, Mrs Maureen (Wolv' NE)
Brazier, Julian	Hicks, Robert (Cornwall SE)
Bright, Graham	Higgins, Rt Hon Terence L.
Brown, Michael (Brigg & Cl't's)	Hill, James
Browne, John (Winchester)	Hogg, Hon Douglas (Gr'th'm)
Bruce, Ian (Dorset South)	Hordern, Sir Peter
Burns, Simon	Howard, Rt Hon Michael
Burt, Alistair	Howarth, G. (Cannock & B'wd)
Butcher, John	Howell, Rt Hon David (G'dford)
Butler, Chris	Howell, Ralph (North Norfolk)
Butterfill, John	Hughes, Robert G. (Harrow W)
Carlisle, John, (Luton N)	Hunt, Sir John (Ravensbourne)
Carlisle, Kenneth (Lincoln)	Hunter, Andrew
Carrington, Matthew	Irvine, Michael
Carttiss, Michael	Jack, Michael
Chalker, Rt Hon Mrs Lynda	Janman, Tim
Chapman, Sydney	Jessel, Toby
Churchill, Mr	Johnson Smith, Sir Geoffrey
Clark, Hon Alan (Plym'th S'n)	Jones, Robert B (Herts W)
Clark, Dr Michael (Rochford)	Jopling, Rt Hon Michael
Clark, Sir W. (Croydon S)	Kellett-Bowman, Dame Elaine
Clarke, Rt Hon K. (Rushcliffe)	Key, Robert
Colvin, Michael	King, Roger (B'ham N'thfield)
Conway, Derek	King, Rt Hon Tom (Bridgwater)
Coombs, Anthony (Wyre F'rest)	Kirkhope, Timothy
Coombs, Simon (Swindon)	Knapman, Roger
Couchman, James	Knight, Dame Jill (Edgbaston)
Currie, Mrs Edwina	Knowles, Michael
Davies, Q. (Stamf'd & Spald'g)	Knox, David
Day, Stephen	Lamont, Rt Hon Norman
Devlin, Tim	Lang, Ian
Dorrell, Stephen	Latham, Michael
Douglas-Hamilton, Lord James	Lawrence, Ivan
Durant, Tony	Lee, John (Pendle)
Dykes, Hugh	Leigh, Edward (Gainsbor'gh)
Eggar, Tim	Lennox-Boyd, Hon Mark
Emery, Sir Peter	Lester, Jim (Broxtowe)
Evans, David (Welwyn Hatf'd)	Lilley, Peter
Evennett, David	Lloyd, Sir Ian (Havant)
Fallon, Michael	Lloyd, Peter (Fareham)
Favell, Tony	Lord, Michael
Fenner, Dame Peggy	Luce, Rt Hon Richard
Finsberg, Sir Geoffrey	Lyell, Rt Hon Sir Nicholas
Fishburn, John Dudley	MacKay, Andrew (E Berkshire)
Fookes, Dame Janet	Maclean, David
Forman, Nigel	McLoughlin, Patrick
Forsyth, Michael (Stirling)	McNair-Wilson, Sir Michael
Forth, Eric	McNair-Wilson, Sir Patrick
Fowler, Rt Hon Sir Norman	Madel, David
Fox, Sir Marcus	Malins, Humfrey
Franks, Cecil	Maples, John
Freeman, Roger	Marland, Paul
French, Douglas	Marshall, John (Hendon S)
Fry, Peter	Martin, David (Portsmouth S)
Gale, Roger	Mayhew, Rt Hon Sir Patrick
Gardiner, George	Miller, Sir Hal
Garel-Jones, Tristan	Mills, lain
Gill, Christopher	Miscampbell, Norman
Glyn, Dr Sir Alan	Mitchell, Andrew (Gedling)
Goodhart, Sir Philip	Mitchell, Sir David
Goodlad, Alastair	Moate, Roger
Goodson-Wickes, Dr Charles	Monro, Sir Hector
Gow, Ian	Montgomery, Sir Fergus
Greenway, Harry (Ealing N)	Morrison, Rt Hon P (Chester)
Greenway, John (Ryedale)	Moss, Malcolm
Gregory, Conal	Moynihan, Hon Colin
Griffiths, Sir Eldon (Bury St E')	Neale, Gerrard
Grist, Ian	Needham, Richard
Ground, Patrick	Nelson, Anthony
Hague, William	Neubert, Michael
Hamilton, Hon Archie (Epsom)	Newton, Rt Hon Tony
Hanley, Jeremy	Nicholls, Patrick
Hannam, John	Nicholson, David (Taunton)
Hargreaves, A. (B'ham H'll Gr')	Norris, Steve
Harris, David	Onslow, Rt Hon Cranley
Haselhurst, Alan	Oppenheim, Phillip
Hayes, Jerry	Page, Richard
Hayward, Robert	Paice, James
Heathcoat-Amory, David	Parkinson, Rt Hon Cecil

Patten, Rt Hon John	Summerson, Hugo
Pawsey, James	Tapsell, Sir Peter
Peacock, Mrs Elizabeth	Taylor, Ian (Esher)
Porter, David (Waveney)	Taylor, John M (Solihull)
Raison, Rt Hon Timothy	Taylor, Teddy (S'end E)
Redwood, John	Tebbit, Rt Hon Norman
Renton, Rt Hon Tim	Temple-Morris, Peter
Rhodes James, Robert	Thompson, D. (Calder Valley)
Ridley, Rt Hon Nicholas	Thompson, Patrick (Norwich N)
Ridsdale, Sir Julian	Thorne, Neil
Roberts, Wyn (Conwy)	Thornton, Malcolm
Roe, Mrs Marion	Thurnham, Peter
Rost, Peter	Townsend, Cyril D. (B'heath)
Rowe, Andrew	Tracey, Richard
Ryder, Richard	Tredinnick, David
Sackville, Hon Tom	Trippier, David
Sainsbury, Hon Tim	Trotter, Neville
Shaw, David (Dover)	Twinn, Dr Ian
Shaw, Sir Giles (Pudsey)	Vaughan, Sir Gerard
Shaw, Sir Michael (Scarb')	Waddington, Rt Hon David
Shephard, Mrs G. (Norfolk SW)	Walker, Bill (T'side North)
Shersby, Michael	Waller, Gary
Sims, Roger	Ward, John
Skeet, Sir Trevor	Wardle, Charles (Bexhill)
Smith, Sir Dudley (Warwick)	Watts, John
Soames, Hon Nicholas	Wells, Bowen
Speller, Tony	Wheeler, Sir John
Spicer, Sir Jim (Dorset W)	Whitney, Ray
Spicer, Michael (S Worcs)	Wiggin, Jerry
Squire, Robin	Winterton, Mrs Ann
Stanbrook, Ivor	Winterton, Nicholas
Stanley, Rt Hon Sir John	Wolfson, Mark
Steen, Anthony	Wood, Timothy
Stern, Michael	Woodcock, Dr. Mike
Stevens, Lewis	Young, Sir George (Acton)
Stewart, Allan (Eastwood)	Younger, Rt Hon George
Stewart, Andy (Sherwood)
Stewart, Rt Hon Ian (Herts N)	Tellers for the Ayes:
Stokes, Sir John	Mr. David Lightbown and Mr. Greg Knight.
Stradling Thomas, Sir John
Sumberg, David

NOES
Abbott, Ms Diane	Clwyd, Mrs Ann
Allen, Graham	Cohen, Harry
Anderson, Donald	Cook, Robin (Livingston)
Archer, Rt Hon Peter	Corbett, Robin
Ashdown, Rt Hon Paddy	Corbyn, Jeremy
Ashley, Rt Hon Jack	Cox, Tom
Ashton, Joe	Cryer, Bob
Banks, Tony (Newham NW)	Cummings, John
Barnes, Harry (Derbyshire NE)	Cunliffe, Lawrence
Barnes, Mrs Rosie (Greenwich)	Dalyell, Tarn
Barron, Kevin	Darling, Alistair
Battle, John	Davies, Rt Hon Denzil (Llanelli)
Beckett, Margaret	Davies, Ron (Caerphilly)
Bennett, A. F. (D'nt'n & R'dish)	Davis, Terry (B'ham Hodge H'l)
Bermingham, Gerald	Dewar, Donald
Bidwell, Sydney	Dixon, Don
Blair, Tony	Dobson, Frank
Blunkett, David	Doran, Frank
Boateng, Paul	Douglas, Dick
Boyes, Roland	Duffy, A. E. P.
Bradley, Keith	Dunnachie, Jimmy
Bray, Dr Jeremy	Dun woody, Hon Mrs Gwyneth
Brown, Ron (Edinburgh Leith)	Eastham, Ken
Bruce, Malcolm (Gordon)	Evans, John (St Helens N)
Buchan, Norman	Ewing, Harry (Falkirk E)
Buckley, George J.	Fatchett, Derek
Caborn, Richard	Faulds, Andrew
Callaghan, Jim	Fearn, Ronald
Campbell, Menzies (Fife NE)	Field, Frank (Birkenhead)
Campbell, Ron (Blyth Valley)	Fields, Terry (L'pool B G'n)
Campbell-Savours, D. N.	Fisher, Mark
Canavan, Dennis	Flannery, Martin
Cartwright, John	Flynn, Paul
Clark, Dr David (S Shields)	Foot, Rt Hon Michael
Clarke, Tom (Monklands W)	Foster, Derek
Clay, Bob	Fraser, John
Clelland, David	Fyfe, Maria

Garrett, John (Norwich South)	Morley, Elliot
Garrett, Ted (Wallsend)	Morris, Rt Hon A. (W'shawe)
George, Bruce	Morris, Rt Hon J. (Aberavon)
Godman, Dr Norman A.	Mullin, Chris
Golding, Mrs Llin	Murphy, Paul
Gordon, Mildred	Oakes, Rt Hon Gordon
Graham, Thomas	O'Neill, Martin
Griffiths, Nigel (Edinburgh S)	Orme, Rt Hon Stanley
Griffiths, Win (Bridgend)	Patchett, Terry
Hardy, Peter	Pendry, Tom
Harman, Ms Harriet	Pike, Peter L.
Haynes, Frank	Powell, Ray (Ogmore)
Healey, Rt Hon Denis	Prescott, John
Heffer, Eric S.	Primarolo, Dawn
Henderson, Doug	Quin, Ms Joyce
Hinchliffe, David	Radice, Giles
Hogg, N. (C'nauld & Kilsyth)	Randall, Stuart
Home Robertson, John	Rees, Rt Hon Merlyn
Hood, Jimmy	Richardson, Jo
Howarth, George (Knowsley N)	Robertson, George
Howells, Geraint	Robinson, Geoffrey
Howells, Dr. Kim (Pontypridd)	Rogers, Allan
Hughes, John (Coventry NE)	Ross, Ernie (Dundee W)
Hughes, Robert (Aberdeen N)	Rowlands, Ted
Hughes, Roy (Newport E)	Ruddock, Joan
Hughes, Simon (Southwark)	Salmond, Alex
Illsley, Eric	Sedgemore, Brian
Ingram, Adam	Sheerman, Barry
Jones, Barry (Alyn & Deeside)	Sheldon, Rt Hon Robert
Jones, leuan (Ynys Môn)	Shore, Rt Hon Peter
Jones, Martyn (Clwyd S W)	Short, Clare
Kennedy, Charles	Sillars, Jim
Kilfedder, James	Skinner, Dennis
Kinnock, Rt Hon Neil	Smith, Andrew (Oxford E)
Kirkwood, Archy	Smith, C. (Isl'ton & F'bury)
Lambie, David	Smith, J. P. (Vale of Glam)
Lamond, James	Soley, Clive
Leadbitter, Ted	Spearing, Nigel
Leighton, Ron	Steel, Rt Hon Sir David
Lestor, Joan (Eccles)	Steinberg, Gerry
Lewis, Terry	Stott, Roger
Litherland, Robert	Strang, Gavin
Livsey, Richard	Straw, Jack
Lloyd, Tony (Stretford)	Taylor, Mrs Ann (Dewsbury)
Lofthouse, Geoffrey	Thomas, Dr Dafydd Elis
McAllion, John	Turner, Dennis
McAvoy, Thomas	Vaz, Keith
McFall, John	Wallace, James
McKay, Allen (Barnsley West)	Walley, Joan
McLeish, Henry	Wardell, Gareth (Gower)
McNamara, Kevin	Wareing, Robert N.
McWilliam, John	Welsh, Michael (Doncaster N)
Madden, Max	Wigley, Dafydd
Marek, Dr John	Williams, Rt Hon Alan
Marshall, David (Shettleston)	Williams, Alan W. (Carm'then)
Marshall, Jim (Leicester S)	Wilson, Brian
Martin, Michael J. (Springburn)	Winnick, David
Martlew, Eric	Wise, Mrs Audrey
Maxton, John	Worthington, Tony
Meacher, Michael	Young, David (Bolton SE)
Meale, Alan
Michael, Alun	Tellers for the Noes:
Michie, Bill (Sheffield Heeley)	Mr. Andrew Welsh and Mrs. Margaret Ewing.
Moonie, Dr Lewis
Morgan, Rhodri

Question accordingly agreed to.

MR. DEPUTY SPEAKER forthwith declared the main Question, as amended, to be agreed to.

Resolved, That this House recognises the important contribution made by the skilled and dedicated service of ambulance staff; regrets that some have seen fit to prolong and intensify the action taken against patients in furtherance of the current pay dispute; appreciates the work of the police, the armed forces and the voluntary services in maintaining an adequate emergency service; supports the Government and National Health Service management on their handling of the dispute; calls on the trade union leaders to ensure that the undertakings they have given to maintain an adequate

emergency service are met; believes that the dispute can only be resolved by the resumption of negotiations; and calls on the trade union leadership to recognise and act upon this.'.