§ 3.45 p.m.
§ THE LORD PRIVY SEAL (THE EARL OF LONGFORD)My Lords, with permission, I should like to repeat a Statement which my right honourable friend the Prime Minister has just made in another place, about doctors' and dentists' pay. His words were:
"I should like to make a Statement about the latest Report of the Review Body on Doctors' and Dentists' Remuneration, covering the next two years, which is being published to-day. I should like to express the Government's gratitude to the Review Body for the sustained and intensive work they have put into the conduct of this particularly difficult review.
"The Government accept all the Review Body's recommendations in principle and are at once making arrangements to implement those for hospital doctors and dentists, and for general dental practitioners, in full 425 with effect from April 1, 1966, at an estimated cost in the current financial year of about £ 12 million. The average percentage increases in net remuneration are 13.4 for hospital doctors and dentists and 10.6 for general dental practitioners.
"For general medical practitioners it is estimated that full implementation of the recommendations would cost some £ 28 million this year and would involve an increase of about a third in aggregate net income. The Government agree with the Review Body that special considerations of workload and manpower in general practice justify an exceptionally large increase in remuneration for general practitioners. In the light however both of current economic difficulties and of their general policy for prices and incomes, the Government have decided that they would not be justified in implementing an increase of this magnitude in a single immediate step. They accordingly propose that the Review Body's recommendations should be implemented in two stages. The first stage would apply retrospectively from April 1, 1966, and would be designed to increase net income by about half the full amount, or rather more than 15 per cent. The second stage, completing the implementation of the Review Body's recommendations, would take effect from April 1, 1967. The Government are willing to discuss with the profession how this can best be achieved and are putting forward their own proposals.
"A third and final Report on the negotiations between the Health Departments and the profession about the proposed new contract for family doctors is also being published to-day, and the Minister of Health is to-day writing to the Chairman of the General Medical Services Committee to convey the Government's proposals as regards both the contract and remuneration."
§ LORD NEWTONMy Lords, I am sure we are all very grateful to the noble Earl for repeating the Prime Minister's Statement to the House. It is a very important Statement and it deals with what is going to be a very expensive matter. I have no doubt that the medical profession as a whole is, and has been, of the opinion that the Gov- 426 ernment were morally obliged to accept the recommendations, whatever they were, of the Review Body without referring them to the Prices and Incomes Board. Whether other wage and salary earners will think so is another matter, because the increases recommended by the Review Body are obviously far in excess of anything that could be reconciled with the Government's incomes policy as a whole.
May I ask the noble Earl just two general questions? First, what effect do the Government think their decision to accept in principle the Review Body's recommendations will have on the incomes policy as a whole? Secondly, I should like to ask whether the Government expect that the medical profession will accept that general medical practitioners alone of the doctors concerned should not get the whole of the recommended increase in one step?
§ THE EARL OF LONGFORDMy Lords, I am very grateful for the careful tone of the noble Lord, Lord Newton. I think that I can only give him a personal answer to the questions he has put. I feel that I cannot avoid them, but equally, I cannot commit the Government to my view of these rather speculative matters. I would hope that the line taken by the Government here is the one best calculated to assist the incomes policy. It shows that the Government pay great attention to the advice of very well qualified bodies of this kind. Moreover, it shows that they make tremendous efforts, as on this occasion, to soften any impact that might appear undesirable. As regards the attitude of the medical profession, there are distinguished members of that profession in this House whose opinions might be more valuable than my own, but I hope for the best.
§ LORD WADEMy Lords, may I join in expressing gratitude to the Review Body for the work which they have done? Would the noble Earl agree that general medical practitioners, as well as hospital doctors, have been leaving the country not only because of offers of better remuneration but often because of offers of far better working conditions? Therefore, may I ask whether the first stage to which reference has been made in the Statement applies only to net income; or whether it will also deal with requests for help 427 for better treatment over ancillary assistance for doctors, and the improvement of premises, and other matters affecting working conditions? I should be obliged if the noble Earl could say to what extent that is covered in this first stage.
§ THE EARL OF LONGFORDMy Lords, I would rather have a little more notice of that question. As the noble Lord is aware, the arrangements being reached with the medical profession refer to a new system of remuneration as well as to the actual pricing within that system, and I would hope that, apart from the actual pricing, the new system, which certainly one hopes would be accepted, would itself be beneficial along the lines which the noble Lord has in mind.
§ LORD BLYTONMy Lords, can my noble friend say whether he expects the trade unions who represent the £ 9-a-week man to accept the 3½ per cent. norm in the light of this enormous increase?
§ THE EARL OF LONGFORDMy Lords, I appreciate the gravity of the point raised by the noble Lord, Lord Blyton. He will be aware that this extremely well qualified Review Body has taken that factor into account. They point to the special circumstances in the case of the medical profession. The incomes policy was never supposed to apply across the board without any qualification at all, but I recognise the gravity of what the noble Lord has in mind. If it were not for that kind of consideration I have no doubt there would not have been this delay in the implementation.
§ LORD STRATHCLYDEMy Lords, can the noble Earl say when the medical profession last received an increase in remuneration?
§ THE EARL OF LONGFORDA large part of the profession received it last year.
§ BARONESS SUMMERSKILLMy Lords, may I anticipate for the noble Earl the criticisms of members of the medical profession? They will wonder why the general practitioner has been discriminated against for this reason. This Review Body has been sitting for some years, and during that time large numbers of young general practitioners have left the country. The result has been that the older general practitioners have been holding the fort. Postponing full 428 implementation for the older men—for that is what it means—in this country will make them feel that they are being called upon to bear a hardship which perhaps the Government never considered.
§ THE EARL OF LONGFORDMy Lords, I should be much surprised if the present Minister of Health, who I think is perhaps as good a Minister of Health as we have had in this country, has not considered all these aspects. I feel quite certain that he has.