REMUNERATION OF DOCTORS AND DENTISTS (Hansard, 20 February 1957)

§ THE MARQUESS OF SALISBURY
My Lords, with the permission of your Lordships, I rise to make a statement which is being made in another place by my right honourable friend the Prime Minister on the remuneration of doctors and dentists in the National Health Service and in the employment of local authorities. I will, if the House will allow me, give it in my right honourable friend's own words:
"The House will know that a claim has been submitted for an increase of not less than 24 per cent. in the remuneration of all doctors in the National Health Service. The extra cost to the country would be about £20 million a year. In present circumstances, the Government do not feel able to admit this claim, and representatives of the profession have been so informed.
"This does not mean that the Government have reached any conclusion as to the merits of the claim. Indeed, they have decided that the time is opportune for a full review of medical remuneration through an independent inquiry which would take into account the position of the medical profession in relation to other professional classes in the community, and would suggest how the matter could be kept under review. I have accordingly recommended to The Queen, and Her Majesty has been graciously pleased to approve, that a Royal Commission should be appointed for this purpose.
"Within the last few days a claim, similar to that of the doctors, has been received on behalf of the dental profession, and the dental profession will be included in the review to be conducted by the Royal Commission. The question whether the remuneration of doctors and dentists employed by local authorities should be included in the terms of reference is under consideration. I hope to announce at a later date the names of the Chairman and the members of the Royal Commission, together with the terms of reference."

§ VISCOUNT ALEXANDER OF HILLSBOROUGH
My Lords, I am much obliged to the noble Marquess the Leader 1088 of the House for making here on behalf of the Government the statement that is now being made by the Prime Minister in another place. I must say that the first impressions of this statement upon me are not very cheerful. Having regard to the long, outstanding application of the great profession of medical men and women to the State service, I feel it is extraordinary that, after this length of time, the question of their remuneration should be referred to a Royal Commission. That is a most extraordinary procedure to adopt. It was only last week that the noble Marquess, in that very difficult hour when he performed so brilliantly at the Box, said how much he deprecated the long delays and the odd form of inquiry which would be brought about by applying a Royal Commission to such a comparatively simple question as the roads in Oxford. Here we are dealing with something which is urgent, outstanding, and necessary to retain the good will of the medical profession in maintaining a great National Service to the people. To me, it seems like cowardice on the part of the Government for them not to deal with, and decide their policy upon, what is an urgent matter. Instead of that, they refer it to a Royal Commission.
There was no such reference to a Royal Commission, no such delay, before the Government made the statement in the other place the other day about the increased costs of welfare milk and the weekly contribution of the worker to the Health Service as there is going to be in regard to the remuneration of the doctors. There was no sort of cowardice or hesitation in referring that matter to a Royal Commission. Those are people of a different type. But here it looks as if the medical profession may be "got at" with a view to putting up with a Royal Commission. Having regard to his former association with the great medical profession, no doubt the Chancellor of the Duchy of Lancaster will be busy trying to spin the necessary story of glamour to his professional colleagues. I only hope that the country will take as strong and as sincere a view about this sort of thing as I do myself.

§ THE MARQUESS OF SALISBURY
My Lords, if the noble Viscount the Leader of the Opposition was asking a supplementary question, it is what I might call a rhetorical question. He referred—I rather expected he would refer to it— 1089 to a debate which took place last week on the Oxford roads, in which the Government rejected the idea of a Royal Commission. The noble Viscount must remember that the circumstances were entirely different in that case, as I explained—or, at least, I hoped I had explained—to the satisfaction of the House. There was in existence under the Town and Country Planning Act alternative machinery which was already in operation, and the fact that it was a very limited question—a limited problem, as the noble Viscount has said—made it easy to use that machinery. This is a very wide and complex question. I would remind the noble Viscount that I said in the statement I have just made … the time is opportune for a full review of medical remuneration through an independent inquiry which would take into account the position of the medical profession in relation to other professional classes in the community. That is, indeed, one of the great problems which has to be faced. It is no good the noble Viscount and others saying that the medical profession can be dealt with entirely in isolation; it cannot be done. This is one of the most complicated questions that exist, as I know from my connections with the research bodies in this country, and it is an eminently suitable question to be dealt with by a body of this kind.

§ VISCOUNT ALEXANDER OF HILLSBOROUGH
How long did it take the Government to discover that this was so complicated a question in comparison with others? For months and months this matter has been under discussion with the medical profession, and it has certainly been within the knowledge of the Ministry of Health from the moment that the State scheme was launched. Now, at this stage, when the doctors are in a very poor position—at least, some of them are—in relation to the increasing cost of living, that they should be dealt with by means of a Royal Commission seems to me almost unthinkable. Will the noble Marquess say whether, while the Royal Commission is sitting, any adjustment is going to be made to ease the position of the doctors?

§ THE MARQUESS OF SALISBURY
My Lords, I think I cart say something about that. I understand that my right honourable friends the Minister of Health and the Secretary of State for Scotland 1090 have told the doctors and dentists that they are willing to agree to the granting of an interim increase to the junior hospital medical and dental staff. This is on the basis that they can justifiably be regarded as underpaid at present. The offer will be negotiated through the established Whitley machinery. It will not be extended beyond this limited class to, for example, the lower-paid general practitioner doctors or dentists; it is meant to apply to those who are in most need at the present time.

§ LORD WILMOT OF SELMESTON
My Lords, in view of what the noble Marquess the Leader of the House says, and in my view rightly says, about the bearing on research workers, may I take it that consideration of those bearings will be included in the terms of reference of the Royal Commission?

§ THE MARQUESS OF SALISBURY
My Lords, the actual terms of reference I hope to be able to announce later. As I have said, anything which is done with regard to doctors and dentists has a bearing on these wider categories though, obviously, there is a limit even to the subjects with which a Royal Commission can concern itself. But there are categories outside the limits of such terms of reference which have a bearing on the recommendations which such a Commission could make.

§ LORD AMULREE
My Lords, I thank the noble Marquess for the statement he has made. I must agree that the questions raised by the medical profession have been going on for a long time and I hope that the Royal Commission will now settle them quickly. Secondly, I very much hope that the position of local authority doctors and dentists, which the noble Marquess states is under consideration, will come under the terms of reference of the Royal Commission. We were told during a debate on the Oxford roads that some Royal Commissions could report in six months while others might take six years. This is a matter of some urgency, and I trust that in this case the period will be one of six months and not a longer period.

§ THE MARQUESS OF SALISBURY
My Lords, the period which the Royal Commission will take is a matter for the Commission. Her Majesty's Government 1091 desire, as much as the noble Lord, that it shall be as rapid and efficient as possible in its work. With regard to the other question, perhaps the noble Lord will allow me to let him know exactly what will be included within the terms of reference when I am able to do so. I will certainly bear in mind the point that he has made.

§ LORD CONESFORD
My Lords, may I ask my noble friend whether, in settling the terms of reference of the Royal Commission, he will consider the advisability of making them wide enough to enable the Royal Commission to compare not only professional earnings as between different professions but professional earnings with non-professional earnings?

§ THE MARQUESS OF SALISBURY
My Lords. I have said that there must be some limitation of the terms of reference, even of a Royal Commission.

§ VISCOUNT ALEXANDER OF HILLSBOROUGH
My Lords, on this important matter we should be glad to know the date by which we may have the terms of reference and (although this is a question we may then ask) how long the Royal Commission will sit. This is such an extraordinary announcement that we should be informed of these terms of reference as soon as possible.

§ THE MARQUESS OF SALISBURY
My Lords, I can assure the noble Viscount that we will let him know as soon as we are in a position to do so.