NHS: Junior Doctors (Hansard, 29 June 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, my right honourable friend the Minister for Health has been in correspondence with the Hospital Junior Staff Committee of the British Medical Association about their concern over National Health Service finance and manpower. The evidence cited by the committee was investigated by the department and did not support their claims.

§ Lord Molloy
My Lords, in thanking the Minister for his reply, I should like to ask him whether he is aware that at their conference the junior doctors passed resolutions expressing grave apprehension about what they consider to be the deteriorating effect of cuts in the National Health Service—for example, bed closures, ward closures, long waiting lists, and, in particular, cuts in the medical and nursing staffs. Their apprehensions are entirely genuine. They are not involved with regard to their pay; their concern is for the patients. We understand the Government share that concern, and, therefore, they should take cognisance of the doctors' views.

§ Lord Glenarthur
My Lords, I am aware of the views expressed by the committee. but, on the other hand, as I said, there has been considerable correspondence between my right honourable friend the Minister of State for Health and the committee, and the fact is that the claims they make are not substantiated.

§ Lord Ennals
My Lords, who can know better than the junior hospital doctors, working as hard as they do, right across the country? The committee represents 25,000 junior hospital doctors. Who better than they can know the situation in the National Health Service? Has the Minister read their report and has he seen the resolution, from which I should like to quote two sentences only? One is: The quality of patient care is deteriorating as a result of worsening financial crisis in the National Health Service". The second is: that Government expenditure plans will lead to a decreasing proportion of gross national product being spent on health care over the next three years". 1144 In the light of this, how can the Minister simply lightly say that the evidence they have produced is not substantiated?

§ Lord Glenarthur
My Lords, the fact is that they make a series of different claims. Another of their claims is that there are many doctors out of work. On many occasions at the Dispatch Box I have answered questions about exactly that, and there is not the evidence to support the claims they make. Certainly I am very happy to let the noble Lord have a copy of the correspondence, which deals very effectively with the claims that they make. Perhaps I ought to say also that I am aware of the fact that yesterday my right honourable friend met the junior hospital doctors committee. I do not know what was the outcome of that, but no doubt they made their claims then, and they would have been dealt with by my right honourable friend.

§ Baroness Gaitskell
My Lords, is the Minister aware of what the Government are doing in relation to this Question? Have they had experience, as I have had, several times, of the National Health Service and of the people who have been treated by it, as well as those who work in it? They will be doing a really wicked thing if they make cuts in the National Health Service, which looks after patients who do not have a great deal of money. and who, indeed, might not have any money. The NHS looks after patients very well; those working in it are not over-paid. One of the most wicked things that the Government could do would be to attack them and to take action which would harm the hospitals and. indeed, the National Health Service.

§ Lord Glenarthur
My Lords, I share entirely the noble Baroness's views of the importance of the health service and those who work within it. The fact is that there are improvements that can be made within the health service—there always are—and I am glad to see that the noble Baroness agrees with me. The fact is that the Hospital Junior Staff Committee's claims have not been substantiated, but my right honourable friend the Minister of State for Health has been in consultation with them and has explained the facts to them.

§ Lord Molloy
My Lords, is the Minister aware that, as has been said, there are throughout Britain 25,000 junior doctors? The resolutions in the report refer to their views of their experiences throughout the country. They work, on average, an 88-hour week. They are not asking for even a halfpenny more. They have joined with the National Association of Health Authorities in stating quite clearly that the £100 million last year had a devastating effect; that over the next three years nothing whatever has been taken into consideration in regard to inflation; and that all this constitutes the biggest threat to the NHS and the patients. The situation can be helped only if all of us believe in our National Health Service and enable it to serve the patients. That is what it was designed for and, a the doctors and health authorities say, we have got to put a stop to the staff losses and under-funding.

§ Lord Glenarthur
My Lords, if the committee are able to produce any clear evidence, then, of course, my right honourable friend will look into it; but so far they have not been able to do so. So far as excessive hours are concerned, the problem is recognised, and it is being tackled. First of all, the Government have banned on-call rotas requiring junior doctors to be on duty more than one night and one weekend in two. Any such rotas are subject to strict central control, as the noble Lord will be aware. Secondly, last year we asked health authorities to conduct a major review of the continuing need for rotas which were worse than a one-in-three basis, and over the past 18 months they succeeded in reducing these by 20 per cent.—from approximately 5,000 to 4,000. Finally, we expect authorities to keep their rotas under close scrutiny, especially where the doctors concerned spend a high proportion of their on-duty time working, rather than just standing by.

§ Lord Ennals
My Lords, sometimes one wonders whether Ministers who answer from the Dispatch Box see very much of doctors, nurses and hospitals around the country. I am grateful to the Minister for saying that he will supply a copy of the correspondence which he has had. In return, I shall supply a copy of the correspondence which I have had, which involves not only the Hospital Junior Staff Committee but the British Medical Association itself, in support of them.

§ Lord Glenarthur
My Lords, if I may respond to the noble Lord, I should like to say that on the question of unemployment among doctors, the BMA distanced itself from what the junior hospital doctors claimed when they made their report last time. As we know, they are about to produce another report, and certainly we shall be very interested to see what it says.

§ Lord Strabolgi
My Lords, in view of what the noble Lord has said, has anything been done to reduce the very long waiting time that so many patients are having to undergo when waiting for vital operations?

§ Lord Glenarthur
My Lords, certainly work is being done on that, but of course—

§ Lord Strabolgi
My Lords, what work?

§ Lord Glenarthur
—it is strictly another question; but I would be delighted to answer it if the noble Lord would care to table a Question on it.

§ Lord Molloy
My Lords, is the noble Minister aware that I very much appreciate the detail into which he goes? He does not in any way skimp his replies to any Questions concerning the National Health Service and that is very much appreciated. In so far as the noble Lord has said that correspondence has passed between the BMA's junior doctors and his honourable friend in another place, I should have thought that that was a sufficient basis, after a written exchange of views, to examine matters in detail, which I am sure that both will then find to their mutual advantage on behalf of our National Health Service.