§ Baroness EMMET of AMBERLEYMy Lords, I beg leave to ask the Question which stands in my name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government whether the unoccupied beds and closure of wards in many hospitals are due to the lack of medical and nursing staff; and if so, whether this is due to their dissatisfaction over pay.
§ Lord WELLS-PESTELLMy Lords, beds in National Health Service hospitals may be temporarily unavailable for use for a variety of reasons. It is not possible to identify any particular factor to which local staff shortages may generally be attributed, but I have no evidence that it may be due to dissatisfaction with pay among those referred to in the noble Baroness's Question.
§ Baroness EMMET of AMBERLEYMy Lords, while thanking the Minister for that Answer, which does not really get me very much further, may I ask whether he is aware that at present a very large number of hospitals are relying on agency nurses because their own staff is inadequate? Agency nurses must, of course, cost more than ordinary staff. Is this a wise way of going on?
§ Lord WELLS-PESTELLMy Lords, I am not aware that a very large number of hospitals are dependent on agency nurses. It may be that many hospitals are, but the total number is not very great. The latest available figures show that the number of whole-time equivalent nursing staff—both qualified and unqualified—employed in hospitals continues to rise. At September 1976 the number stood at 528 something like 286,000 nurses. This represents—and I want to emphasise this—an increase of about 30,000 nurses since September 1974. and I am happy to say that the number of qualified nurses in that period rose by 18,000. That may not be enough. My right honourable friend has made it perfectly clear that, in the money that he has recently allowed for an increase of activities in the National Health Service, something over 9,000 jobs will be provided. More than half of those jobs will be for additional nurses and midwives.
§ Lord SANDYSMy Lords, arising out of the noble Lord's reply, I wonder whether the Government can tell us whether a review body is looking into the question of nurses' pay and, if that body is sitting, when it will report?
§ Lord WELLS-PESTELLNo, my Lords, I cannot say when it will report; but on the question of nurses' pay I think one must bear in mind that we have no evidence—and we have been at some pains to try to ascertain this—that there is any real dissatisfaction among nurses so far as their pay is concerned. Since the independent Halsbury Committee of Inquiry brought nurses' pay to levels comparable with other groups in 1974, they have had, along with the rest of the community, the various increases which have been available under the Government's pay policy. I do not think I can say more than that to the noble Lord, other than the fact that we do not think pay is a problem at this stage.
§ Lord HARMAR-NICHOLLSMy Lords, since the noble Lord's reply concedes to some extent that there are unoccupied beds and closed wards, does not that confirm the mistake of phasing out pay-beds? Would it not be better if they were allowed to be used by people prepared to pay, and this at the same time would bring the consultants to make an even greater contribution to the good health of the country? Is not the Answer some confirmation that, even at this late hour, it would be a good thing to reverse that policy'?
§ Lord WELLS-PESTELLMy Lords, I do not know how many times I have to go over this point in your Lordships' House. Now that we are running up towards an Election. I can understand that 529 noble Lords perhaps want to make some capital out of this. But I have said time and time again that a very considerable percentage of the pay-beds were never in use, and getting rid of a thousand of them in one fell swoop did not affect the situation at all. It was taking away beds that were not in use.
As the noble Lord wants to know something about bed occupancy, may I say that the average daily number of available beds in the National Health Service hospitals in England for all specialities during 1976—that is the latest year for which we have information—was 383,100 beds, of which there was a daily occupancy of 310,800 beds. This means that 81 per cent. of the total beds were in daily occupancy. Noble Lords may ask: why is it that 19 per cent. are not? I think the reason is that, when one patient goes out, another patient cannot be put in immediately. There is an interval sometimes of one, two or more days' delay.
The Earl of HALSBURYMy Lords, would the noble Lord agree that the nursing profession can earn more outside than it can inside its professional sphere? There has been a very bad drift away from the situation from which I rescued them four years ago.
§ Lord WELLS-PESTELLMy Lords, that may well be; but I did indicate a short time ago that, since 1974, we have been able to recruit 30,000 nurses.
Baroness WARD of NORTH TYNESIDEMy Lords, could the Minister say whether there are any outstanding recommendations made by the Royal College of Nursing to him or to his Department which have not yet been met? Does he have regular meetings with them?
§ Lord WELLS-PESTELLMy Lords, I am not in a position to answer the noble Baroness without notice. I just do not know.
§ Lord CARR of HADLEYMy Lords, in view of the interesting figures which the noble Lord gave about the closure of private beds, to the effect that those closed so far had virtually been those which were not occupied, can the Government assure us that they will not in the future close beds which are occupied?
§ Lord WELLS-PESTELLMy Lords, as the noble Lord knows, the whole question of the pay-beds is in the hands of the Health Service Board, and the Government are guided by the Health Service Board recommendation before taking any action at all.
§ Lord DRUMALBYNMy Lords, is what the noble Lord has said not fallacy, because it was always possible for pay-beds to be occupied by National Health Service patients when they were empty?
§ Lord WELLS-PESTELLMy Lords, I have nothing further to add. The whole question of pay-beds is far wide of the Question I have been asked to answer, and your Lordships do not like Ministers departing from Questions.