Hospital Closures: Unemployed Doctors and Nurses (Hansard, 18 July 1984)

§ Lord Molloy
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Glenarthur)
My Lords, in 1982 and 1983, 70 hospitals, involving 4,571 beds, were approved for closure, and 19 major schemes involving 5,302 beds were completed, in addition to many smaller schemes providing a further substantial number of new beds and other facilities. Occupational information is not now collected on claimants at unemployment benefit offices. We have no evidence that any significant number of doctors or nurses are unable to find posts if they are moblile and prepared to move to units with vacancies.

§ Lord Molloy
My Lords, is the noble Lord the Minister aware—the country is—that the Government changed the rules to hide the figures? Doctors want to be recognised as doctors when they are unemployed, but they can no longer—I hope the House will note this—register as unemployed doctors; nor can nurses similarly register. The fact of the matter is that the National Health Service has made its contribution to the unemployed total through Government policies which were referred to on the last Question. Would not the Minister agree that the British Medical Association, the consultants, junior doctors and representatives of the nurses are concerned that patient care is deteriorating? The National Health Service is in danger, and there ought to be a national conference involving all these responsible bodies to try to make certain that this health service of ours is saved and does not go into the dustbin of unemployment which this Government have created.

§ Lord Glenarthur
My Lords, the facts do not support what the noble Lord says—and there are plenty of facts. If the noble Lord wants me to rehearse a whole list of improvements that have been made to the health service since this Government came to office I could do so; but I do not think that it would necessarily benefit the rest of the House. To turn to the unemployment of doctors, the fact is that if there is significant unemployment—and there are no indications to say that there is—it is probably in those parts of the country where doctors do not want to work, and the unemployment is also probably temporary.

§ Lord Kilmarnock
My Lords, is it not the case that the number of unemployed doctors rose from 431 in 1979 to 1,418 in 1982, and that the number of unemployed female nurses rose from 3,696 in 1979 to 8,086 in 1982? Is it not likely that this upward trend has been continuing? Would it not be helpful to revert to the practice of breaking down unemployment figures by occupation? If we do not know the facts, how can we possibly seek to reverse them?

§ Lord Glenarthur
My Lords, as the noble Lord knows, the fact is that the system for recording these vacancies was changed to a voluntary one and that is the reason why those figures are not now available. But the fact also is that the number of staff unemployed is not what the noble Lord says it is. I could certainly give the noble Lord a long list of figures but I would rather give them to him in writing than quote them to him now over the Dispatch Box.

§ Lord Nugent of Guildford
My Lords, is my noble friend aware that the figures for the numbers of doctors employed in the health service in the four years from 1978 to 1982 have gone up by 3,500, and the numbers of nurses have gone up by 46,000? Do these figures really look as if the Government are dismantling the health service? Should not the Government be congratulated on adding to the strength of the health service in this way?

§ Lord Glenarthur
My Lords, I am very grateful for my noble friend's remarks. The fact is that a total of nearly 65 million cases are dealt with at hospitals as 1483 in-patient, out-patient or day cases. There were over half a million more in-patient and day cases in 1982 than in 1978. I could go on at length, but I think that my noble friend has made the point for me.

§ Lord Ennals
My Lords, the Question basically is about the number of doctors and nurses who are unemployed. Is it not very disturbing that the Minister cannot give those figures? Is it not the case that his right honourable friend the Secretary of State is responsible to Parliament for the provision of the National Health Service and surely the figures should be available? Has the noble Lord read the BMA's claim that there are now 2,000 doctors unemployed—and that is a current figure—and the claim of the Royal College of Nurses that there are roughly 10,000 nurses who are unemployed? Is it not grossly unsatisfactory that the noble Lord cannot give the actual figures to the House when the professional bodies themselves are giving figures which are deeply disturbing to the health service and to the nation?

§ Lord Glenarthur
My Lords, there are various estimates floating around, one of which has been, as the noble Lord says, that the BMA suggested that there were 2,000 people unemployed. It was the BMA junior doctors who completed that survey. It is also interesting to note that the BMA distanced itself from those figures.

§ Lord Ennals
No, my Lords.

§ Lord Glenarthur
Yes, my Lords, they did. There has been no evidence to suggest that those figures are correct.

§ Lord Sandys
My Lords, reverting to an earlier question, is it not the case that more than 5,302 beds have been created in hospitals, and does that not show a surplus of new beds being created and therefore employment in the health service? Is not this most satisfactory?

§ Lord Glenarthur
My Lords, I am very grateful for my noble friend's intervention. Whereas capital spending under the Labour Government was slashed—and that is not too strong a word—by 33 per cent., it is now up by over 23 per cent. since 1978–79.

§ Lord Cledwyn of Penrhos
My Lords, I am not quite sure how helpful the bandying of figures is. In connection with the question asked by the noble Lord, Lord Sandys, is it not the case that, since 1979, 160 hospitals have been totally or partially closed with a loss of 8,000 beds? Is not that the case and would not that result in a decline in the employment of doctors and nurses?

§ Lord Glenarthur
No, my Lords. The fact is that I shall now have to start swapping further statistics with the noble Lord, Lord Cledwyn. The facts do not support the allegations at all. The fact is that employment has gone up; and the fact is, too, that the number of patients who have been treated in hospital and in other ways has also increased. If there have been cuts, they have been in waste and not in anything else.

§ Lord Molloy
My Lords, is the noble Minister aware that I do not expect him or even ask him to accept my version of the facts which I have given this afternoon? There must be a referee. I am submitting, and I hope that this House will agree—

Noble Lords
Question!

§ Lord Molloy
My Lords, I am asking this question. Would the noble Lord be prepared to see representatives of the consultants of Great Britain, the British Medical Association, the junior doctors, the Confederation of Health Service Employees and the Royal College of Nursing who all say that it is absolutely disgraceful that the number of nurses, doctors and consultants is falling, that hospitals are being closed and that patient care is in danger? None of them is asking for increases in pay—they just want to make certain that their dedication is put to full use and that patient care will not suffer because of the unemployment which is creeping among every grade and rank of the medical services of our nation.

§ Lord Glenarthur
My Lords, as I have told the noble Lord, Lord Molloy, on numerous occasions, there are continual contacts between the Department of Health and Social Security and all the representatives that he has just named. That will continue.

§ Lord Mackie of Benshie
My Lords, will the Minister or the Leader of the House give a ruling on the use of the term, "noble Minister"? It is my understanding that noble Lords are always noble, whereas the nobility of Ministers is a matter of opinion.

§ The Lord President of the Council (Viscount Whitelaw)
My Lords, that is a very interesting point; but after the time that has been taken on this Question I think that we should answer it on another day.