§ 6. Mr. CummingsTo ask the Secretary of State for Health what is the average pay of senior managers in the NHS in 1989, 1993 and 1994. [17576]
§ Mr. MaloneSenior managers are paid at a particular point on a scale which in 1989 went from £12,560 to £39,170 per annum. By 1993 those rates had been increased by 20.8 per cent. and in 1994 by a further 2.2 per cent., making the range £15,490 to£48,340 per annum.
§ Mr. CummingsCan the Minister justify to the House why national health service executives are receiving wage rises more than twice the rate of inflation, while nurses are subject to a guaranteed 1 per cent. wage rise, which would give a midwife a rise of 43p a day? Will the Minister for once recognise the value of our nursing staff and ensure that their rises equate to those of senior health service staff?
§ Mr. MaloneOf course the Government recognise the worth of all clinicians, nurses, midwives and health visitors who work in the health service. They make a fantastic contribution, which has been recognised by the independent review body, the recommendations of which the Government have accepted in full. Trusts are now coming forward with pay proposals, 75 per cent. of which are in the area of 3 per cent. The Government and I fully expect that trend to continue. I hope that, instead of demonstrating, staff will go to their trusts and pick up the offers which are increasingly on the table.
§ Mr. SimsSince the national health service owns a large number of properties, spends more than £100 million a day, has the largest labour force in the country and treats thousands of patients, is it not essential that those vast resources are competently and efficiently managed and that those managers are appropriately rewarded? Does my hon. Friend also accept that some of the rather well publicised recent incidents, in respect of which the standard of service in the health service was below what we might reasonably expect, could be ascribed not to structural faults in the NHS, but to management error and shortcomings? Will my hon. Friend ensure that those who are responsible are brought to account?
§ Mr. MaloneMy hon. Friend is right to point out that, in aservice as complex as the NHS, delivering increased in-patient activity, day care activity and out-patient activity across the board needs to be properlymanaged. I 8 remind him that, compared with 12 years ago when 60 per cent. of those who worked within the NHS were involved in direct patient care, the figure is now 66 per cent. That is an increase. On the specific point that my hon. Friend made, I remind him that most health service management is subject to performance-related pay. If performance does not come through and if there are shortcomings, that will be taken into account when determining remuneration.
§ Mr. Nicholas BrownWhat estimates does the Minister have of the administrative costs of introducing local pay bargaining into the NHS? To which groups in the NHS does he intend that to apply?
§ Mr. MaloneAs the hon. Gentleman well knows, it is the Government's policy that local pay be introduced for health service clinicians in the long term, and in the short and more immediate term, to nursing staff and midwives. The reason for that is important. It is to give them the benefits of local pay, so that trusts can configure pay and conditions packages appropriately in respect of local conditions. It is far more appropriate that that is done on a local rather than a national basis. A large number of trusts already have in place extremely well developed and refined systems; others will be making across-the-board packages, which they have already been doing. It is in the long-term interests of nursing staff that they pick up the offers which are on the table and ensure that they get fair pay and local pay and conditions.
§ Mr. FormanHow many of the senior managers referred to in the original question are experienced former nursing and clinical staff? Is it not rather important to recognise that many people are promoted from the wards into managerial positions?
§ Mr. MaloneMy hon. Friend makes an extremely important point. That is one of the strengths of the new NHS. There are far more clinicians and people with qualifications in nursing involved at senior levels in NHS trust management. That is highly significant, and there has been a large amount of reclassification of those who were previously solely involved in clinical duties who are now involved in management as well. That is broadly welcomed by the professions, and I never understand why it is constantly sneered at by the Labour party.