§ 3.50 p.m.
§ Lord WELLS-PESTELLMy Lords, with your Lordships' permission, it might be convenient if I were now to repeat a Statement being made in another place by my right honourable friend the Secretary of State for Social Services about consultants in National Health Service hospitals. The Statement reads as follows:
"In my Statement on 13th January I told the House of the events leading up to the consultants' rejection of the Government's proposals of 20th December for a new consultant contract and their decision to start industrial action. I indicated that while two principles were not negotiable, that is the maintenance of the existing differential between whole-time and parttime consultants, and the introduction of a system of payment by item of service, there were other aspects of the proposals which could and should be further discussed. I proposed a return to the negotiating table as quickly as possible.
" The consultants responded by asking for clarification of certain points, and although sanctions were continuing, I agreed exceptionally to meetings between their representatives and health departments' officials on 23rd January and 5th February. The clarification talks have been useful, I think, for both sides, but by their very nature they cannot reach the detailed agreement which must come as a result of negotiation. Following those meetings I wrote to the professions on 11th February explaining my position on the points the consultants' representatives put to me. I have placed a copy of my letter in the Library."—
There will be also a copy in the House of Lords Library—
" First, let it be quite clear that a new contract is not being foisted on consultants against their will. They came to me when this Government took Office and told me of their longstanding dissatisfaction with their contract. At their request I set up a Working Party to deal with their complaints. I was not then, and I am not 32 now, forcing—or even urging—them to take a new contract.
" In common with the majority of contracts of employment for senior professional people the present contracted commitment for whole-time and maximum part-time consultants is open-ended. It is not limited to 38½ or 31½ hours. The purpose of my proposals of 20th December was to meet the consultants' complaint that this system did not adequately reward the very long hours many of them do. Their representatives in the JWP had themselves asked that the consultant's present open-ended commitment should be replaced by a closed contract which would clearly define his basic commitment and ensure that additional work could be contracted and paid for separately. The Government have accepted this principle and I believe that negotiations should be resumed in order to discuss how it should be implemented. As I told the House on 13th January, and as my honourable friend the Minister of State spelt out again in the debate on 23rd January, we arc not insisting on a precise ' nine till five' formulation of the new standard contract and accept the need for flexibility provided the basic commitment is specific enough for a system of extra payments to be built upon it and provided the whole-time differential is maintained.
" I also attach great importance to replacing future payments of distinction awards by a new system of financial supplements which would be more widely available to all consultants. The aim would be to provide financial recognition for special contributions to the National Health Service, particularly in those specialities or in geographical areas where understaffing has created difficulties. I believe there is considerable support in the profession itself for this kind of change though here again I am willing to negotiate criteria and methods of payments which would be right for the National Health Service and fair to consultants and which would protect those who have benefited under the old scheme.
" Because I recognise that many of these concepts are novel and require considerable discussion I am anxious 33 that our discussion of them should not hold up the Review Body's repricing of the existing contract which we want to see completed if at all possible by 1st April. The Government recognise that consultants have had to wait twelve months for their substantive review and that they are due for an increase in pay and are ready to give the consultants the same assurances that I gave to the GPs. My Department has already submitted its evidence explicitly recognising the need for pay increases and I have now supplemented this with new figures on the present state of recruitment and the manning of hospitals in the NHS which reinforce the case. I am also today submitting evidence to the Review Body supporting important improvements in the consultants' incremental scale which would considerably shorten the scale and particularly help the younger consultants by removing the present danger of overlap between the senior registrars' and the consultants' earnings. In addition I have told the consultants that I am willing to submit joint evidence with them on other matters to which they attach importance, such as the introduction of a London allowance for medical and dental hospital staffs and the financial recognition of family planning work. It would, of course, be necessary for negotiations to be resumed for joint evidence to be possible.
" Since agreement on more fundamental changes in the existing contract will necessarily take some time I have, as I have already told the House, offered to invite the Review Body to price the new arrangements without commitment and at a later stage. I am also prepared to ask them to do this within the context of the present review so that the arrangements could enter into effect within the same twelve months period. But it will clearly only be possible to do this if the Review Body has some indication of the lines of the new arrangements before it reports in April on the existing contract. This is another reason why the negotiations should be resumed immediately.
" Any decision to lift sanctions and resume negotiations rests with the professions' committees and I understand 34 they are to meet on Thursday to consider my letter and the replies I have received. I regret to inform the House that in these replies the professions' negotiators, while recognising that there is common ground between us on a number of points, conclude that a recommendation for the immediate lifting of sanctions is unlikely. I can only hope that after considering my letter and Statement today the profession at their meetings on Thursday will decide to resume negotiations and to lift their sanctions which are damaging the Health Service and causing hardship to thousands of patients. I will, of course, inform the House of the outcome."
My Lords, that is the end of the Statement.
§ 3.58 p.m.
§ Lord ABERDAREMy Lords, the House will be grateful to the noble Lord, Lord Wells-Pestell, for having repeated that Statement. I find it a rather lengthy apologia for the failure of the Secretary of State to reach agreement with the consultants. A new contract is important, and there is no doubt at all that many consultants are doing a great deal more work than is called for by the present contract; it does not do them justice. However, it takes two to make a contract, and the Government will have to await the outcome of the meeting of the professions on Thursday before they know whether negotiations can be resumed. I would only ask them to show much greater understanding than they have done hitherto of the needs of the consultants. The consultants place very high in their priorities their own independence and freedom to practise medicine. They are united in their opposition to the recent Government proposals. No agreement will be possible if the Government insist on proposals which are too heavily biased in favour of full-time salaried service. I am sure all of us hope that an agreement will be reached on a new contract. I am sure it is possible, but only if the Government show greater flexibility and understanding.
§ Lord AMULREEMy Lords, I too would like to thank the noble Lord, Lord Wells-Pestell, for repeating the Statement. It is a long Statement, and 35 it includes a large number of points. All I consider to be really important is that negotiations should be resumed as soon as possible, and I very much hope that, in the light of the Statement given and the letter written to them, the consultants will see fit to lift their sanctions when they meet together on Thursday. To apply sanctions is rather alien to professional people as a rule, and one would very much like to see them revert to a more normal practice.
§ Lord WELLS-PESTELLMy Lords, I am most grateful to the two noble Lords who have spoken. I do not think this is a time to engage in argument and I will make no comment on what the noble Lord, Lord Aberdare said, except to say that in the last analysis it is desirable that both sides in any dispute should get round the table, and the sooner this can be done the more likely is it that the problems will be resolved.