Health Policy (Hansard, 30 January 1990)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, the Government's health policies are fully consistent with our objective, which is to improve the health of the nation while securing maximum effectiveness and efficiency from the resources made available to the caring services.

§ Lord Jenkins of Putney
My Lords, would the noble Baroness care to make her contribution to this day of action by clarifying the situation a little? Is she aware that the Secretary of State for Health is widely taken as having said on the BBC television programme "Panorama" that he wanted a two-tier ambulance serice within a two-tier National Health Service? Is she also aware that on the following Friday on Radio Nottingham he denied that he had made that statement? By clarifying the situation the noble Baroness would be making a most valuable contribution.

§ Baroness Hooper
My Lords, I am always delighted to try to help the noble Lord. I can tell him that my right honourable friend the Secretary of State assures me that he was referring to a two-tier ambulance service within the National Health Service as being the way forward. I see nothing in our National Health Service proposals to suggest otherwise.

§ Lord Molloy
My Lords, on the much broader question regarding the future of Britain's National Health Service, is the noble Baroness aware that the British Medical Association, the Royal College of Nursing, the Health Visitors' Association and the 161 Confederation of Health Service Employees are all gravely anixous about the future of the health service? Is she further aware that if things carry on as they are the health service created by Aneurin Bevan will ultimately be smashed by this Government?

§ Baroness Hooper
My Lords, we are all anxious about the future of our health service, which is why the Government are introducing the reforms.

§ Lord Stallard
My Lords, does the Minister agree that we would obtain a more efficient ambulance service if the Government were now to agree to send the claim to arbitration?

§ Baroness Hooper
My Lords, I regret to say that I cannot agree with the noble Lord on that point. There is no provision for independent arbitration in any NHS pay agreements. The NHS management must retain control of the amounts that it pays out in salaries and wages. It has to ensure that pay awards do not divert resources from patient care. Over 96 per cent. of the NHS staff have settled their pay question without recourse to industrial action.

§ Lord Auckland
My Lords, is my noble friend aware that while many people are critical of some aspects of the NHS under all governments, a record amount of money is now being put into it; and that more doctors and nurses are being recruited? While I and others are critical of some aspects of the NHS, recruitment must be considered in context.

§ Baroness Hooper
My Lords, my noble friend is of course correct. Spending on the NHS is now at an all-time high. It is up by 30 per cent. in real terms under this Government. Next year spending will be nearly 44 per cent. higher in real terms than it was in 1978–79. The proportion of GDP spent on the NHS and per capita spending are both higher than they were 10 years ago. As was made evident in a Question tabled by my noble friend Lord Orr-Ewing last week, the numbers of medical staff have also increased most encouragingly.

§ Lord Ennals
My Lords, there has been higher spending on the NHS every year for the past 42 years. Will the Minister report on the success or otherwise of the special cash initiative of 1987 which was designed to reduce the appalling length of waiting lists? Will she confirm a statement made by the general secretary of the National Association of Health Authorities that many health authorities are now using that money to prevent making the service cuts necessary due to funding problems? Secondly, will she confirm that the latest figures from her department show that in March last year there was an increase of 18,000 in the number of patients awaiting surgery compared with when the initiative was launched? The figures have gone up, not down.

§ Baroness Hooper
My Lords, the waiting list initiative, which was backed by the £119 million waiting list fund, has been successful in enabling hundreds of thousands of patients on the waiting 162 lists to be treated. In the first year of the fund, waiting lists and times fell in districts and specialties upon which the fund has been targeted compared to a rise elsewhere. The waiting lists are over 6 per cent. lower that the record high of March 1979. It is the time that people have to wait which is important, not the total number of people who are waiting. The latest provisional figures, which are for June 1989, show that the number of people who have been waiting for over a year has been reduced by 3 per cent. over the previous quarter; 22 per cent. more in patients and 69 per cent. more clay cases were treated in 1988–89 than in 1979.

§ Lord Ennals
My Lords, will the noble Baroness help me, because the figures that I have received from her department show that the number of people waiting for more than a year rose from 150,000 to 166,000 in the year ended March last, which are the latest figures that we have.

§ Baroness Hooper
My Lords, I am not sure to which figures the noble Lord is referring. Would they be the figures quoted in the Statistical Bulletin which was issued last week, which does not, so far as I am aware, deal with that point? What is clear is that some regions cope much better than others, so that there is an inconsistent national picture.

§ Lord Gisborough
My Lords, on the matter of the stated increase over the past 42 years, will my noble friend confirm that that was so except for the time when the Labour Party was in opposition, when capital expenditure decreased?

§ Baroness Hooper
My Lords, I should be grateful if my noble friend would repeat that question. I am not sure that I caught it.

§ Lord Cledwyn of Penrhos
My Lords, does the Minister agree that whatever arguments may have been advanced about the NHS, that service is in many ways suffering grievously at the moment as a result of the ambulance strike? Will she tell the House what initiatives she and her right honourable friend have to bring that dispute to an end?

§ Baroness Hooper
My Lords, as I understand it, we shall have an opportunity to debate the subject of the ambulancemen a little more thoroughly in the near future, because an Unstarred Question on the subject has been tabled. The Government's position is that the final pay offer —I do not understand why NUPE and its associated unions keep insisting that the final offer is still only 6.5 per cent. —is of at least 9 per cent. backdated to 1st April. That is the offer which is on the table, and the management side has always shown itself willing to meet to discuss that final offer.

§ Lord Cledwyn of Penrhos
My Lords, is the Minister aware that the British public are becoming confused, puzzled and frustrated by the continued reference to figures which are increasingly difficult for them to understand? Would it not be sensible for her right honourable friend the Secretary of State to ask NUPE representatives (Mr. Poole and his 163 colleagues) to meet him for a sensible discussion to bring the dispute to an end?

§ Baroness Hooper
My Lords, as I have said on previous occasions, it is not the custom for the Secretary of State to become involved in such disputes; it is for the management side to settle with the ambulancemen and their representatives. As I said previously, the management side has always been ready to meet on any occasion. A number of meetings have taken place.

§ Lord Cledwyn of Penrhos
My Lords, I apologise for getting up again, but it is not good enough for the Minister to say that her right honourable friend cannot be involved when he is involved every day in statements on that very issue in another place, on television and on radio. Will she convey to him the desire of the House —I believe on all sides —that he should, as a Member of the Cabinet and a representative of Her Majesty's Government, take an initiative now which would help to bring the dispute to an end, without waiting for an Unstarred Question in the House?

§ Baroness Hooper
My Lords, we believe that there is perfectly adequate negotiating machinery in place and that that machinery should be followed.

§ Lord Molloy
My Lords, is the Minister aware that the ambulance drivers' representatives have clearly said that the issue should go to ACAS, on the condition that the ambulancemen will agree to whatever ACAS decides, if the Government will? What is her answer to that?

§ Baroness Hooper
My Lords, my answer to that is a repetition of my previous answer. The Whitley Council is the machinery for that negotiation.

§ Lord Molloy
My Lords, why do we have ACAS? Is it the Government's intention to abolish ACAS? I note that there is no answer to that question?

§ Lord Jenkins of Putney
My Lords, is the Minister aware ——

Noble Lords
Next Question!

Noble Lords
No, No!

§ Lord Jenkins of Putney
My Lords, is the Minister aware that we are all anxious to help her as much as we can, especially if we can help her to persuade her right honourable friend the Secretary of State to settle the dispute? I believe that it is within her power to do so. Will she have a quiet word with him and ask him to be sensible?

§ Baroness Hooper
My Lords, we have always made it clear that we are anxious to see an end to this unfortunate dispute.