§ 11.22 a.m.
§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Trefgarne)My Lords, with your Lordships' permission, I shall now repeat a Statement being made in the other place by my right honourable friend the Secretary of State for Health and Social Services:
§ "With permission, Mr. Speaker, I should like to make a statement on next week's threatened industrial action in the National Health Service. The health service unions affiliated to the TUC have called for a three-day national strike throughout the health service starting on Monday. This action is in support of their claim for pay increases of 12 per cent.
§ "Each health authority will do everything it can to maintain services and to minimise the effect of action on patients in accordance with the guidance we issued in 1979. The Government have made contingency arrangements to maintain emergency services where these are withdrawn. But I must warn the House that if industrial action is taken for three days patients will suffer. In the previous 24-hour stoppages the response was patchy but seriously disrupted services in some places. If the strike goes ahead out-patient appointments and non-emergency admissions will be cancelled and waiting lists for operations will grow longer. Past experience suggests that not even emergency services can be guaranteed in all areas.
§ "Mr. Speaker, I believe that in the light of this, the health unions should now urgently reconsider their case for taking industrial action. Their claim for a 12 per cent. increase in pay and improvements in holidays and hours of work, making a claim of 20 per cent. in all, is quite unjustified. Over £400 million has been provided for increases in pay this year. That is our final offer and there is no more money. The offers made by the Whitley Councils are for average increases ranging from 6 to 7½ per cent. This compares with settlements around 6 per cent. for civil servants, teachers and the armed forces. The money on the table, backdated to 1st April, is substantial. We estimate that average earnings would increase by £6.00 a week for a male full-time ancillary worker, £7.50 a week for a staff nurse, over £9.00 a week for a nursing sister and £11.00 a week for a leading ambulanceman.
§ "In addition, the Government have already started talks on permanent new arrangements for determining nurses' and midwives' pay, which we want in operation by next April. I have also offered to have talks with the health unions about improving arrangements for their pay in the future. Mr. Speaker, on pay for this year the right action for the unions would be to return to the Whitley Councils and begin discussions. On future arrangements for pay, talks between myself and the unions could start at once. I urge all those working in the health service not to take industrial action. Such action will only damage the health service and put patients at risk."
§ My Lords, that is the end of the Statement.
576§ Baroness JegerMy Lords I thank the noble Lord the Minister for repeating the Statement, though I am sure he will appreciate that we do not welcome it. Of course, we share the Government's anxiety and concern for the welfare of patients, and I am sure that that anxiety is felt by many of the staff concerned. But the Government cannot escape responsibility for the situation which has caused this terrible dilemma in our health services. This has been made worse by the information to regional health authorities that they will have to find one-third of the increase in pay, mean though it is, because the health authorities are not fundraising authorities and they can provide that money only by reductions in their services. This must be a Government responsibility.
Of course, we appreciate that there has been an increase in pay, but with an inflation rate of over 9 per cent. it really is unfair to expect some of the lowest paid workers in this country to accept a rise of from 6 to 7½ per cent. The Minister chose very carefully his examples of increases accepted by other public servants. He did not mention that judges have received 18 per cent. and that senior civil servants have received 14 per cent. Moreover, not only are these percentages higher, but the base line on which the percentages are worked out is infinitely higher than for these low paid workers.
I also have to ask the noble Lord about the figures he gave of the estimated increase in real terms. Is he disputing the facts given in a letter to The Times this morning by Mr. Geoffrey Drain, the General Secretary of NALGO, who says that when translated into money some of the increases will mean as little as £1.52 to £3.63? Those figures are quite different from those in the Statement. I also have to ask the noble Lord whether it is a fact that residential staff face large increases in their accommodation charges and that, therefore, there will be a net loss for many of the nurses and other workers in the health service?
Because I really want to be constructive, as I am sure we all do, could the Minister look again at the possibility of going to arbitration? This method was used earlier this year for a dispute in the teaching profession and it seems to me that we are in a desperate log jam of a situation. If the unions would agree to arbitration, as I believe they would, would the Government look again at this possibility?
§ Lord RochesterMy Lords, we on these Benches should like to join in thanking the noble Lord for having repeated the Statement. We join also in urging the health unions now urgently to reconsider their case for taking industrial action, as the Statement puts it. We hope, too, that they will now accept the Secretary of State's offer to have talks about improving arrangements for their pay in the future. As is well known, we have long considered that there is an urgent need to establish agreed long-term arrangements for pay determination covering not only nurses or even all those employed in the health service, but the public services as a whole. Is the noble Lord aware—I am sure he is—of our belief that it is only in this way that particular categories, such as health service workers who now feel unfairly treated, can be expected to renounce industrial action?
§ Lord TrefgarneMy Lords, I am obliged to the noble Lord, Lord Rochester, for his response to this Statement, but less obliged to the noble Baroness, Lady Jeger, for her response. The position of the Opposition now contrasts very sharply with the position that pertained in February, 1979, when there was industrial action in the health service at that time. On those occasions, Mr. Ennals, who was then the Secretary of State for Social Services, said:
I believe we should condemn industrial action that does damage to the health service, whether it comes from doctors, nurses or anyone else who works in the service".The Opposition of that day, now consisting of my honourable and right honourable friends, supported the Government on that occasion in their opposition to industrial action in the health service. But now, in the face of the very generous offer which has been made to the health service workers, in the face of the very substantial increases which have been made in the pay of health service workers since we came into office, we find that the Opposition are attacking us and supporting, it seems, the industrial action which is being taken. This is quite disgraceful.It is not possible to say that action can be taken in the health service without affecting patient care. That is what the unions allege and it simply is not true. In the face of these difficulties—and they are likely to be very serious in the face of the three day industrial action which will take place next week if the unions do not change their minds in the meantime—the effect on patients will be very grave indeed. I hope that the Opposition will reflect very carefully on the effects of the action which they are supporting.
§ Lord KilmarnockMy Lords, we on this Bench thank the noble Lord for repeating the Statement which has been made in another place. We single out in the Statement the reference to permanent new arrangements which we welcome in principle, but we very much doubt whether permanent new arrangements can be successful outside the framework of a sensible national incomes policy. We regret the disruption and the suffering which will be caused. I should like to ask the Government whether at this stage they have washed their hands of the matter. Is there not possibly a case for arbitration which the Government have, rather consistently, set their face against?
§ Lord TrefgarneMy Lords, perhaps I may deal with the question of arbitration which was also raised by the noble Baroness, Lady Jeger. It is for the Government to decide how much money is available for the purpose of salaries and other wage payments in the health service. The individual allocation of those moneys is for the Whitley Councils. So arbitration, of a kind at least, takes place within the Whitley Councils. The only possible result of arbitration would be increased salary awards, and I regret to have to tell your Lordships that the money is not available for any increased salary payments. For that reason, the Government have felt it right not to agree that arbitration should take place. The noble Baroness, if I may revert to her remarks—I am sorry that I did not deal more fully with what she said earlier—also referred to the TSRB salary awards, particularly to judges, which were announced a few 578 months ago. The fact of the matter is that nurses are, in percentage terms, better off now in relation to 1979 than even judges are.
§ Lord TrefgarneYes, they are. Nurses are something like 20 per cent. better off now in real terms than they were in 1979, whereas judges now are only 14 per cent. better off than they were at that particular time. So the TSRB award had a very considerable element of catching up involved in it—and not all the catching up has yet taken place—while nurses within the health service have more than caught up with any arrears which may have existed at that time. As for the letter in The Times to which the noble Baroness referred, I have not seen it, but it is perhaps worth saying that in producing their figures for increases the trade unions have consistently referred to basic pay and not to average earnings. Basic pay of course is very much less than average earnings, because it does not include things like overtime and shift payments.
§ Lord Campbell of AllowayMy Lords, would my noble friend the Minister agree in the context of this Statement that a limit should be set on so-called sympathetic action, especially in the state-controlled sector where there is no identity of interest with the trade dispute and where the apparent purpose of such action is to bring pressure to bear on the Government? May I ask my noble friend whether it is the legitimate business of the miners' union to support this strike, or the ASLEF strike, by picketing and the provision of substantial donations? And is this support lawful under the existing law, or even constitutional within the rule books?
§ Lord TrefgarneThe position, my Lords, on secondary action, as I understand it—it is of course a comparatively complex legal matter—is that where an employer believes that he has suffered damage by way of secondary action he has the right to take civil action against those who conduct the secondary picketing, for example for the recovery of damages. It is not a criminal act but it is clearly a civil offence. It is therefore for the health authorities to consider in any particular case whether they think they have suffered damage and, if so, to seek to get appropriate redress.
§ Lord MishconMy Lords, the Minister used, I think rather tactlessly, the word "disgraceful". Would the Minister care to suggest to this House what action is available to a group of lowly paid workers who are refused arbitration and whose verbal protests go unheeded? Is there anything other than industrial action which he can suggest they can take? And would the noble Lord the Minister, when referring to precedents in recent administrations, tell the House whether there is any precedent for interviewing nurses and offering them an increase in pay which is higher than that for another group of workers represented by the same unions and for leaving the other representatives of the unions in another room and allowing them to read in the newspapers about the offer made to the nurses? Would he not describe that sort of conduct as not only foolish but also disgraceful?
§ Lord TrefgarneMy Lords, the noble Lord asked what action was open to those who felt aggrieved in circumstances such as those in which the health service workers now find themselves. I would answer that that would depend literally upon the circumstances in which they found themselves. I think they have been made—indeed, I am certain that they have been made—a very fair and reasonable offer. The right course of action for them, therefore, is to desist from the threat of industrial action and to remain at their posts and at the same time for their representatives to go back to the Whitley Councils to begin discussions on the distribution of the very substantial funds—£400 million, no less—which are now available for distribution through the Whitley Councils. As for the second matter which the noble Lord raised, it is the case that the funds which we have made available to the nurses' Whitley Council is slightly higher in percentage terms than the funds which are available for the other groups of workers. But it is right, I believe, that the workers who are specially concerned with patient care, and who in the distant past, at least, have had a very unsatisfactory deal, should be recognised in this way, and I am quite convinced that the Government have made the right move in that direction.
§ Baroness JegerMy Lords, why does the Minister seem to criticise trade union leaders who quote the increases available in terms of basic pay? Surely it is basic pay which we are arguing about. If the Minister is basing his figures on overtime earnings, surely it means that the Government's policy is one of compulsory overtime in order for these people to earn a decent living.
§ Lord TrefgarneMy Lords, the Government's policy is no such thing. However, I have been asked to give an accurate indication of the money which workers take home in their pay packets at the end of the week. Surely that is the right figure to offer to your Lordships, not some other figure which appears only on a piece of paper. As I said in the Statement, a male, full-time ancillary worker only working three or four hours a week of overtine—which is not very significant in total working terms—gets an increase of something like £6 a week.
§ Lord GisboroughMy Lords, would my noble friend accept that most of his noble friends on this side accepted and agreed with most of the statements made by members of the party opposite at the time they were in Government and were in the same situation, with the only exception that it seems that we have been much more generous?
§ Lord TrefgarneMy Lords, as I indicated in answer to an earlier question—to the dismay, apparently, of the noble Lord, Lord Mishcon—it is indeed the case that the Opposition at the time of the last serious dispute in the health service did stand by the Government, and it is a pity that we do not have the same support now.
§ Lord MolloyMy Lords, is the noble Lord, Lord Trefgarne, aware that the analogy he drew with the situation in 1979 is not going to help this current situation in any way whatsoever but only damage it, 580 because much of that action was totally unofficial and was condemned by the general secretaries of quite a number of the trade unions involved? I believe he ought to withdraw that statement. Is the noble Lord also aware that the figures he read out—for which I gather he is not responsible—which were produced in another place, are wholly inaccurate, are connived at, and will bring great bitterness into this dispute and make no contribution to resolving it? Is he further aware that even the Secretary of State tried to improve the situation but that he is second to the diktat of the Treasury? Although at the time of the general election the Government said that there would be free negotiation between employers and trade unions in this country, they have completely reneged on that. They have made the promises of Dr. Jekyll and implemented those of Mr. Hyde.
§ Lord TrefgarneMy Lords, I doubt whether the patients will be able to detect the difference between unofficial action and official action which the noble Lord, Lord Molloy, asked us to observe. The fact of the matter is that if one is a patient in hospital and the services of the staff are withdrawn, it makes no difference at all whether that is official or unofficial action. As to the figures I adduced in the Statement and which my right honourable friend has prepared, and to which the noble Baroness, Lady Jeger, also referred, these are, as I said before, the figures reflected in the wage packet at the end of the week, and I would have said that they are the most helpful ones.
§ Lord Harmar-NichollsMy Lords, is my noble friend Lord Trefgarne aware that most observers would have to suspect the protests coming from the Benches opposite, when one compares the attitude they adopted when they had the responsibility of Government, with what they are saying now—particularly in light of the fact that they have never moved from their claim for 12 per cent.—which is above the figure of inflation and twice that given to the Armed Forces?
§ Lord MolloyLike the Top Salaries Review Body.
§ Lord TrefgarneMy Lords, my noble friend is quite right in drawing comparisons. Since 1979, the total pay bill in the National Health Service has increased from £4 billion to £8 billion, which is precisely a 100 per cent. increase. The total costs in the health service at the same time, and the total money made available to the health service by the Government since 1979, has increased from £7.7 billion in 1979 to £14.5 billion for the current year. These are very substantial sums. They surely indicate our total commitment to a flourishing health service. At the same time, the staff has significantly increased, too. I do not believe that we can be accused of neglecting the health service. We are making enormous resources available and yet, at the same time, we are not supported by the workers.
Lord OramMy Lords, is it not absurd to continue to argue in percentage terms, as the noble Lord the 581 Minister did, in making comparisons between the needs of a judge and the needs of a nurse? Is not the appropriate cost of living index in the case of a judge a very different thing from the appropriate cost of living index in the case of a nurse?
§ Lord TrefgarneMy Lords, I am not aware of the standard or cost of living of individual judges, or for that matter of individual nurses. The fact is that there was a substantial element of "catching up" involved in the pay award made to judges, and it applies to only a very small number of people. It might be worth saying in that same context that the total number of nurses has increased in the same period by some 10 per cent. and now stands at something approaching half a million.
§ Baroness JegerMy Lords, I apologise for intervening again, but the noble Lord the Minister did not, I believe, answer one of my questions; I know I asked several. Is it not a fact that many nurses and other residential staff will be faced with considerable increases in charges for their meals and accommodation, which may more than absorb this modest increase?
§ Lord TrefgarneMy Lords, I understand that the accommodation charges are still under discussion with the Whitley Council and it is too early to draw the comparison which the noble Baroness wishes me to draw.
§ Baroness Gardner of ParkesMy Lords, in relation to the last question, is my noble friend the Minister aware that although superb accommodation is provided in some places, the amount charged, even after the proposed increase, will still be far below anything that could be available to anyone in London?
§ Lord TrefgarneMy Lords, I believe that is the case. It is also the case that student nurses and nurses asked to live in sub-standard accommodation enjoy substantial discounts.