HL Deb 01 February 1979 vol 398 cc350-61

4.10 p.m.


My Lords, with the leave of the House, I will now repeat a Statement which is being made in another place in answer to a Private Notice Question on the industrial action in the National Health Service. The Statement reads as follows:

"The impact of industrial action in the Health Service remains serious. The effects vary across the country, with very serious disruption in some places which is causing me grave concern; for example, the Westminster Hospital, the Great Ormond Street Hospital and the stores strike in Bolton. Most of the country has emergency-only ambulance cover; and between a third to a half of the hospital service is dealing with only emergency cases.

"The most serious disruption is in the Northern, North Western, London, Mersey and Trent Regions, but in most parts of the country services have been reduced.

"The trade unions involved in this dispute made it clear from the beginning that their members should maintain emergency and essential services. The fact remains that such action is now taking place; and it is therefore essential to take all possible steps to protect the safety and wellbeing of patients.

"In some cases local action has clearly gone well beyond the level approved by the unions. This has rightly caused great concern to the Government, the House and the whole country. The leaders of the trade unions have shared that concern, and while I deplore their policy of calling any form of industrial action in the National Health Service, I acknowledge the genuine efforts they have made to keep matters under control.

"They have co-operated fully in the "hot-line" arrangement between my Department and the union headquarters—an arrangement that has been helpful in solving a number of local difficulties that have been brought before this House. They have also produced more detailed guidance to their members on the need to preserve essential and emergency services.

"Last night I met General Secretaries and national officers of the four unions involved to impress upon them the seriousness of the position and the need to ensure that essential services are maintained. I welcomed the further advice they have given to their members and sought clarification on a number of points—for example, the impact of industrial action on highly dependent long-stay patients and the need to have adequate warning of local industrial action.

"They have agreed to consider the points I put to them. In the meantime they believe the more detailed guidance will be of real help in keeping the action within tolerable limits.

"It is essential that Health Service staff taking industrial action should, at the very minimum, stay within the bounds set in the more detailed advice agreed by the unions on Tuesday night. Even this may pose risks to patients. But anyone ignoring that guidance would be acting in a reckless and irresponsible manner.

"This must be avoided, and effective communication between the National Health Service management and unions can help to avert it. That is why I am today taking steps to ensure that health authorities are fully aware of the need to bring in full-time officials of the trade unions concerned immediately when industrial action goes beyond tolerable levels.

"Mr. Speaker, the position is serious, but it would be a great deal more serious if so many nurses, doctors, administrators and other staff—as well as ordinary members of the public—had not rallied in this difficult situation. The House and the country will want me to express our thanks to them."

My Lords, that concludes the Statement.

4.15 p.m.


My Lords, I should like to thank the Minister for repeating the Statement made by his right honourable friend in another place. It is welcome at least to hear that the Government are acknowledging the very serious situation, which, as we have been reminding the Government for some days, has been growing. As the noble Lord the Minister has told us, one-third to one-half of the hospitals are on emergency admissions only, and it is patently clear to many of us that the position is today deteriorating. We believe that the emergency powers—they are small but effective powers—could have been invoked at a much earlier stage.

We also believe that the co-operation of the other services would be very important indeed, and for that reason I should like to ask the Minister one specific question. He has mentioned the Westminster Hospital and I mentioned it yesterday: it is on the front pages of the evening papers. I believe there is a very serious point of law here. Your Lord-ships will be aware that two vans blocked the main service road between Page Street and Horseferry Road, and were placed in such a position that it was impossible to bring in supplies. The question I should like to ask the Minister is this: have the police been instructed to perform something other than their duty, which is, of course, to ensure that obstructions to highways are removed?

We are glad of and we support the actions of the Secretary of State in all he is doing to communicate with the unions so far as it benefits patients. But it is quite apparent to us that the "hot line" has not operated effectively in a number of specific instances. For several days now, as I said from the Despatch Box yesterday, sterile dressings and other vital supplies have not reached a large number of hospitals throughout the country. Our information is necessarily sketchy, and we are grateful to the Secretary of State for providing as much information as he has done. However, we are deeply worried about the position and we hope that the Government will further consider the invocation of emergency powers.

4.18 p.m.


My Lords, we on these Benches would wish to join in thanking the Minister for having repeated this Statement, and we, too, welcome such steps as have been taken to limit industrial action in conjuntion with the trade unions concerned. The part of the Statement which we most welcome is that which comes right at the end, where the Secretary of State says that the positions would be a great deal more serious if, among others, ordinary members of the public had not rallied in this difficult situation.

This leads me to say one thing in relation to one of the hospitals mentioned by the noble Lord, namely, the Great Ormond Street Hospital for Sick Children. The action taken yesterday by the devoted ladies who voluntarily carried out cleaning and other duties in that hospital is greatly to be admired, as is the work of bodies such as the Women's Royal Voluntary Service and the Red Cross in places such as Liverpool, most seriously affected by these disputes in the public services generally.

Faced with these practical examples of what can be done, I should like to ask the noble Lord one specific question. Will the Government positively encourage further action by volunteers in engaging in activities which might in some quarters be regarded as strike breaking, but which in the case of occupations vital to the support of life, as in the National Health Service, may well more generally be regarded as praiseworthy public service?

4.21 p.m.


My Lords, I am most grateful to both noble Lords for what they have said. So far as Westminster Hospital is concerned, this is a somewhat new matter. The noble Lord, Lord Sandys, will understand me when I say that this is a matter that we have been considering this afternoon before the House sat, and it is one which will receive further consideration. It is a serious matter and we are not unmindful of that. I should like to say, in case it is not understood, that the "hot line" is between my Department's headquarters and the union offices of the four trade unions involved, and it is manned 24 hours a day. We share the view put by the noble Lord, Lord Rochester. When my right honourable friend went so far as to draw attention to the contribution that ordinary members of the public have made, he was, of course, referring to the voluntary people and their efforts. The running of hospitals is not the responsibility of the Secretary of State; that is the responsibility of hospitals. But we would certainly foster and encourage anything that they may well be able to do to improve the services.


My Lords, is the noble Lord aware that there are dangers of victimisation in keeping the emergency services going? Is he aware that the case was reported yesterday in the newspaper of an ambulance man at Swinton, Manchester—a Mr. Hornby—who, at the request of a doctor, conducted a grievously ill patient to hospital? He has had his membership of his union, the Confederation of Health Service Employees, terminated, and has been sent to Coventry by his colleagues. What can the noble Lord do to protect men in this service, who are trying to keep the National Health Service going in the interests of the whole community, and to carry out the Government's own policy?


My Lords, these are difficult situations. We must face the fact that, at the present moment, temperatures and tempers are running very high in various parts of the country. This kind of thing is something that, however unacceptable many of us, if not all of us, find it, and however much we would deplore it, can perhaps be best dealt with through the trade union involved, and we hope that when tempers have cooled a different kind of attitude will prevail.


My Lords, can my noble friend say what are the guidelines which the Government have submitted to the unions involved, to bring a speedy end to the appalling incidents which have occurred all over the country?


My Lords, the first point I would make is that the guidelines do not emanate from the Government. I am happy to say that the guidelines were drawn up by the four trade unions involved. As regards the National Health Service ambulance staffs, the guidelines which the trade unions concerned have agreed are that all 999 calls will be answered, all maternity admissions will be carried, all patients requiring radiotherapy and renal dialysis will be carried and terminal discharge will also be carried. So far as ancillary staffs within the National Health Service are concerned, services in relation to cardiac, dialysis, cancer, intensive care, accidents, emergency patients and children must be fully maintained at all times. No services should be reduced to a level where satisfactory cover cannot be maintained in respect of emergency and high dependency patients, in particular. Delivery and distribution of drugs, oxygen and fuel must not be impeded.

I want to stress that these guidelines have been drawn up by the four trade unions concerned. I know that some noble Lords will say that there is very little evidence of their being in effect at the moment. In point of fact, they are being effected in a large part of the country, but we recognise that there are pockets of resistance where they are not being operated at the moment. But my right honourable friend is seeking to do something through the usual channels, which in this case are the trade unions.

Baroness SEEAR

My Lords, I am glad that the guidelines have been issued, but can the Minister tell us that in issuing the guidelines the trade unions have undertaken to take action against members who do not conform with them? Guidelines have no force of law, and guidelines issued by trade unions who are not prepared to enforce them in individual cases, when they are in breach, are not worth the paper that they are written on.


That is perfectly true, my Lords, but I was at some pains to point out that they are working in a large number of areas. We are just as disturbed as anybody else to feel that there is a resistance to these guidelines coming from some members of trade unions, when they have, in fact, been drawn up by their own trade unions, and my right honourable friend the Secretary of State has made his feelings very clearly known.


My Lords, will the noble Lord confirm that, when a member of one of these trade unions fails to comply with the guidelines, the trade union in question will withdraw his membership?


My Lords, I do not think that in the present climate it will serve any useful purpose at this time to suggest action of that kind. I think that we must wait and let the trade unions deal with this in their own way.


My Lords, the Minister spoke of tempers running high, and I understand that. But does he realise that the general public is quite horrified at the talk of a tolerable level of industrial action in these matters? Would he feel able to accept that people who know patients and have friends, who are suffering from this, really wonder when something will be done? Finally, may I ask the Minister whether, if the guidelines do not take effect within the immediate future, we may hope that the public will no longer be asked to put up with this kind of thing?


My Lords, my right honourable friend and everybody associated with him would welcome an opportunity to bring all this to a speedy conclusion, and we are working towards that almost to the complete exclusion of everything else. I do not like to feel, when we are faced with the kind of situation that we are faced with at the present moment, when there is so much chaos and confusion, that we can accept anything that can be considered tolerable. But we must remember that at the present moment the vast majority of members of the National Health Service are, in fact, working and are not taking strike action, either for a short period or for a long period.


But, my Lords, may I revert to the question of the Westminster Hospital? Is it the case, as reported, that two vehicles had their tyres slashed and had to be removed by the Army? Has the noble Lord seen the reports on television of the action at Great Ormond Street Hospital for Sick Children, and is it not the fact that the children at Westminster Hospital are having to be looked after by their own parents? The noble Lord has said that tempers are rising; but will he bear in mind that the temper of the public is a temper to be taken into account, too, and will he use his "hot line" to tell the unions that the whole credibility of their union membership and of their union organisation is now in question?


My Lords, I think that the unions concerned are under no misapprehension as to how we feel; it has been made perfectly clear to them. If I may revert to the question of the Westminster Hospital, the position there was that these two vans were found to have their tyres down. The police endeavoured, so I understand, to pump them up again, but their pump was not strong enough, by virtue of the size of the tyres. Apparently, an individual went around the corner, off his own bat, and got hold of some Territorials who came round with special pump. When they found that they got no response they examined the tyres and found that they were slashed. As I have said, this is a matter which we are still looking into.


My Lords, would the Minister urge upon his colleagues that it would be widely regarded as a sign of strength and not of weakness if the Government were at once to initiate discussions with the other political Parties so that there might be a national approach to these problems?


My Lords, I do not think that I ought to commit my right honourable friend the Sercetary of State other than to say that I will certainly pass on to him what the noble Lord has said.


My Lords, can the noble Lord say why the Government will not have discussions with the other Parties?


My Lords, I am not sure that it is for me to reply to that question. If I were to reply as an individual, all I would say is that at this stage I cannot see that any more could have been done than has been done already.


My Lords, the Minister will have noticed that the spokesman for the Conservative Party twice made the suggestion that the Government had erred in some way in not seeking emergency powers. If this is so, it is quite a serious charge which ought to be faced. Will the Minister be kind enough to tell us what else the Government can or cannot do because they lack the power to do it? Is there anything that the Government can do, or is this just hocus pocus—the ordinary Tory line of making a difficult situation more difficult?


My Lords, those of us who are in close touch with the situation find it very difficult at this stage to see what else the Government or, for that matter, any other Government which might be in power could do.


My Lords, where union members will not follow their leadership, what the Government could do would be to instruct the police, when volunteers are prepared to do the work, to escort volunteers through the picket lines and protect them.


My Lords, the noble Viscount must know only too well that there is no evidence at all at the present moment that volunteers who wanted to do something have in any way been seriously impeded.


My Lords, my noble friend must understand that wherever there is action which is regarded as criminal, the right action should be taken against it. Obviously, we must be sure that that action is criminal in character and that we are not imagining things. In his answer, my noble friend made it as clear as the noonday sun that the health authorities have a certain responsibility in this matter. But they have no power. The only people who have got the power are the Government, plus the Leaders of the two Oppositions, the CBI if necessary, and the TUC, if necessary. They have the power to get them together as quickly as possible and say to them, "This is a national problem and no individual action or voluntary action will suffice". That is the only way to tackle the problem and it should have been tackled in this way two weeks ago. We should not have had to wait until now.

Several noble Lords: Answer!


My Lords, I thought that that was a statement, not a question.


My Lords, first may I associate myself with those noble Lords who have expressed appreciation of the more active approach to this matter which is being made by the Government to the trade unions. This at least is limited good news. Obviously, in the present situation there have to be difficult negotiations between the Government, the trade unions and those people who are, I shall now allow myself to call them, striking against the sick. That is what is happening. For that reason, I wonder whether the noble Lord could assure me that the Government are practically aware, not just theoretically aware, that it would be very dangerous in these negotiations to give any countenance to the idea that this kind of action is something that this country can tolerate indefinitely? In other words, it is important to give no point away on this particular thesis. I hope that the noble Lord can assure one that the Government are conscious of this and are putting it into practice.


My Lords, my right honourable friend is on record time and time again as condemning what is taking place today in the strongest possible language—in language which could not be stronger. As I have said, he is consulting various people in order to see whether anything more can be done at this juncture, and I can assure your Lordships that he will do it, if it is possible.


My Lords, will the Minister bear in mind, despite what has been said by the noble Lord, Lord Shinwell, that the Government, the CBI, the Opposition, the TUC, the Archbishop of Canterbury are powerless for one simple reason: that a high proportion of the strikers are part-time workers? If there is any attempt whatever to take action which the strikers do not like, or which even the unions do not like, it will be followed by unofficial action. The thing to do here, as with the lorry drivers, is to get this strike settled. When it is settled, you can table all the grievances and then collaboration can take place between the parties in a sensible, sane atmosphere. But to talk the sort of nonsense at the present time that is being talked is ridiculous.


My Lords, does the noble Lord recall the quotation from the poem which says that so long as you go on paying danegeld you will never get rid of the Dane?


My Lords, I happened to listen to the one o'clock news—I do not know whether the noble Lord did—in which there was an interview between Robin Day and some of the strikers. I am not very much in favour of broadcasting all these things, but I listened with some interest to a member of NUPE being interviewed. He said that he had never had any instructions from NUPE headquarters and that he had never been told what the code of practice was. When Robin Day said to him, "Are you quite sure?" he said, "Yes". The arrangements for communications are, as the noble Lord has told us, satisfactory, but the information does not get through to the people. As I say, this was put out on the one o'clock news. Whether anything has been done about that, I do not know.


My Lords, I would not claim that everybody knows, because I could not prove it. I do not know how the communications are made, but my right honourable friend the Secretary of State was given an assurance by the four unions concerned that all their representatives in the districts and the regions who are handling these situations would in fact be informed of the guide- lines; and included in that information would be the various matters which I read out earlier to your Lordships.


My Lords, may I ask my noble friend a specific question?

several noble Lords: Order, order!

The LORD PRIVY SEAL (Lord Peart)

My Lords, I detect from noble Lords that we ought to proceed. We are having an important debate and noble Lords have ventilated their strong feelings.


My Lords, I think that the Minister ought to answer this question.


My Lords, I know, but I think that we should proceed.