Nurses' Pay Award: Funding (Hansard, 20 July 1988)

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale)
My Lords, for the United Kingdom as a whole an extra £566 million has been provided from the reserve to meet the estimated cost of the award in excess of the provision in the relevant cash limits.

§ The Countess of Mar
My Lords, I thank the Minister for that Answer. Is he aware that because management guidelines for clinical regrading are unclear, and that in certain cases it is now apparent that some health authorities have not been allocated sufficient funds, many nurses are being under-graded? Does that not defeat the object of the exercise?

§ Lord Skelmersdale
My Lords, I do not know why the noble Countess regards the carrying out of the exercise as unclear when guidance to health authorities was issued on the subject by my department. I am well aware of suggestions that the funding may—and I stress the word "may"—be inadequate. I advise her that no region has given detailed consideration to even preliminary figures from all their districts so it is totally unprofitable to speculate. I know that the noble Countess has a particular interest in the West Midlands. This morning I was advised that no district in the West Midlands has yet submitted detailed regrading proposals.

§ Lord Molloy
My Lords, is the Minister aware that grave anxieties have been expressed by the Confederation of Health Service Employees and other representatives of nurses? Can he now give the House an assurance that their anxieties can he 1307 subdued completely because there will be no impediment and certainly no hiccup from any source in honouring the award which the Government have declared shall be given to Britain's nurses?

§ Lord Skelmersdale
My Lords, there is absolutely no question that the extra £566 million to which I referred in my initial Answer will be curtailed in any way.

§ Lord Molloy
My Lords, the Minister must realize—

Noble Lords
Order!

Lord Winstanley
My Lords, does that answer mean that the noble Lord cannot tell the House whether the estimated figure given by the Government will meet the needs? Will the Minister accept that, as a result of some of their recent actions, the Government have done a great deal to improve morale in the nursing profession and the relationship between nurses and the noble Lord's department? Will he also accept that to renege on certain promises, or to insist on nurses' pay being paid at the expense of patient care, will be a guaranteed prescription for undoing the good which has recently been done?

§ Lord Skelmersdale
My Lords, there is no intention to undermine the good that has been done and that is why I was absolutely firm in my answer to the noble Lord, Lord Molloy. We believe that the assumptions which underlie the review body's estimate of the costs of the award are reasonable. Clearly the review body thought so, otherwise it would not have recommended the award in the first place. It provides 15-3 per cent. extra in the total pay bill.

§ Lord Campbell of Alloway
My Lords, does my noble friend accept that there is an air of real urgency in the matter? For example, does he know of the situation at St. Peter's Hospital in Covent Garden? Does he accept that nurses are leaving their profession? Will he look into the matter to see what can be done in the immediate future to try to reassure some of the nurses?

§ Lord Skelmersdale
My Lords, yes, that is exactly the reason why the Government accepted the review body award. Of course, there are two problems: first, in certain specialities nurses are leaving the profession; secondly, for demographic reasons, they are not entering the profession.

§ Lord Ennals
My Lords, is the Minister saying that there will be no more money over and above that which has already been paid? Is he not aware that, according to the estimates from regional health authorities, over £100 million is under-provided in terms of fulfilling or covering the nurses' pay award? Does he accept the fact that the Secretary of State gave an absolute assurance in the other place and it was repeated in this place—that the Government would fully fund the nurses' pay award? Does he recognise the fact that if the additional money is not provided not only will there be cutbacks in patient 1308 care from health authority to health authority but, among nurses and indeed Members of your Lordships' House, there will be a great sense of anger because a parliamentary commitment will be breached?

§ Lord Skelmersdale
My Lords, there is absolutely no question of a parliamentary or any other commitment being breached. The full-year costs of the award will be £803 million in the United Kingdom. That money is already provided for and that money will be paid.

§ Lord Molloy
My Lords, is the Minister aware that the confident assurances that he has given to the House this afternoon cannot be obtained from regional health authorities? That is the aspect which worries the national associations when they receive reports from their regions. If when the issues were discussed with the regional health authorities all the regions gave the same answers as those given by the Minister this afternoon there would not be a great amount of anxiety. Will the Minister please be good enough to look into that aspect of the Question?

§ Lord Skelmersdale
My Lords, as I explained earlier, I have already done so. I came to the conclusion that it is too early to predict the outcome of the clinical grading review. As I said earlier, no region has given detailed consideration even to preliminary figures from all its districts. Therefore it must be totally unprofitable to speculate on the outcome.

§ Lord Ennals
My Lords, will the Minister look at the wording used by his right honourable friend the Prime Minister in answering Questions in another place when, as I understand it, she expressed herself clearly on the basis of the estimates but did not say that if there was a difference between the review body's estimates and the reality of covering the pay award that additional money would be found? Will the Minister look at that matter again?

§ Lord Skelmersdale
My Lords, yes, of course, I shall look at any authoritative source, including that of my right honourable friend the Prime Minister, in this or any other area. What she has said, she has said; what I have said to your Lordships this afternoon, I have said.

§ Lord Ennals
It would be nice if they matched up.