Nurses' Morale (Hansard, 18 May 1995)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, it is always possible to do more for the morale of valued, professional staff. I am confident that giving individual nurses greater responsibilities and involving them more in the decisions that affect their work will continue to do much to raise morale.

§ Lord Molloy
My Lords, I thank the Minister for that Answer. Is she aware that only this month nurses at the various conferences pledged themselves wholeheartedly to the National Health Service? Is she further aware that UNISON conducted a survey among its members and the Royal College of Nursing and found that there was concern that nurses were not getting a fair crack of the whip over pay increases? Could that matter at least be examined?

§ Baroness Cumberlege
My Lords, as regards nurses' pay, we follow the recommendations of the pay review body. That body, which is independent, has reported for 12 years running and we have always accepted its recommendations. This year it recommended that nurses' pay should be 1 per cent, across the board, with additions of up to 2 per cent, locally determined. We are recommending that. Two-thirds of the trusts have now put their offers on the table and three-quarters of those are at 3 per cent, or more.

§ Baroness Gardner of Parkes
My Lords, does the Minister agree that press reports indicating that 1 percent, is the norm are causing unnecessary anxiety and loss of morale among nurses? Is she aware that in the case of most trusts the offer of 3 per cent, has been on the table for a long time but that local union negotiators have been restricted by their national bodies over even discussing those long-standing offers?

§ Baroness Cumberlege
My Lords, my noble friend Lady Gardner is right. Many trusts have had local pay for some time—for instance, Derby, Heatherwood, Southend, Nottingham Community Health and many others. There local pay has been negotiated and agreed with staff, and in many cases the staff have been involved in the new scheme. Indeed, they are benefiting and choosing to join the scheme because they know that local pay makes sense and means that their decisions and their excellence can be rewarded, whereas national negotiation does not allow for that.

§ Baroness Jeger
My Lords, will the Minister explain why it is important that nurses' pay should be locally negotiated? Why does that not apply to doctors who are employed by the same hospital trusts? Part of the trouble is that nurses believe that they are being treated differently from doctors in the same hospitals.

§ Baroness Cumberlege
My Lords, since the National Health Service began, and certainly since the new contract for GPs was introduced in the mid-1960s, GPs 666 have been on performance-related pay, which is very local indeed. Consultants have always had merit awards which reflect their performance. Doctors who were offered local pay by their independent review body—an additional 2.5 per cent.—chose not to pick it up. I believe that the nurses are very wise indeed to take up the offer that they have received. In fact, in the end their percentage increase will be greater than that of doctors.

§ Lord Dean of Harptree
My Lords, bearing in mind the long tradition of strike-free service by members of the Royal College of Nursing, will my noble friend assure the House that Her Majesty's Government will do all in their power to bring home to nurses the fact that strike action would inevitably harm patients, as it did during the winter of discontent, and that it would also harm the well-deserved good reputation that nurses have with the public?

§ Baroness Cumberlege
My Lords, my noble friend Lord Dean is absolutely right that if nurses try to withdraw any of the work that they are doing it will affect patient care. Indeed, if they want to be disruptive to the National Health Service that will affect patients in that many will have to wait longer for treatment. That would really be a tragedy because we have made such progress in reducing the time that people wait for treatment. It would be a tragedy if the Royal College of Nursing's members voted for industrial action. It would cause me personal sadness and sorrow because I believe that in the long term it would erode the professionalism of the Royal College of Nursing, which would be a very great pity indeed.

§ Baroness Masham of Ilton
My Lords, is the Minister aware that many of the nurses who trained at the Nightingale School of Nursing at St. Thomas' Hospital are saddened at its closure, which will take place this October? It has been in existence since Florence Nightingale herself. Is the Minister aware that sometimes change is not good for morale?

§ Baroness Cumberlege
My Lords, I should like to pay tribute to the training which nurses receive. In the past four years we have invested £400 million in the new nurse training scheme. I believe that we have the best trained and most committed nurses in the world.
The Nightingale School of Nursing is not closing. It is transferring to Guy's Hospital, which will become a centre for all sorts of teaching, research and development. We recognise increasingly in the National Health Service that there are many different professions and disciplines. The more general training that can be provided for all those different professions, the better will be the teams that we have in the future, which in turn will give a better quality of care.

§ Lord Ashley of Stoke
My Lords, if, as is probable, the vote goes in favour of industrial action, do the Government really intend to go to war with the nurses?

§ Baroness Cumberlege
My Lords, we value nurses: one has only to see the enormous investment that has gone into not only their training but also their general professional development now in post-registration training. The last thing that we want is war. Perhaps I may say to the noble Lord that it is not a vote for industrial 667 action. Nurses will vote as to whether they will change their rules so that in the future they can take industrial action. That is an important, significant point.

§ The Earl of Onslow
My Lords, how is it that the Government have managed to lose the argument and get themselves blamed for what an independent review body has recommended when there have been occasions in the past that an independent review body has made awards which are deeply offensive to the financial strategy of the Government? How is it that the Government are blamed for this when for once it is not their fault?

§ Baroness Cumberlege
My Lords, there is a term for that but perhaps this is not the appropriate place to use it. Some of the difficulty is that the pay review body made the recommendation but it was the nursing unions and health unions generally which promoted the idea that it was only 1 per cent. Indeed, I know that some nurses still believe that they will receive only 1 per cent. The Government cannot say that every nurse will receive 3 per cent, because 2 per cent, is to be determined locally. That was a difficult message to get across. I believe that once local pay is established, we shall not face those problems in the future. It will be a matter for local negotiation. I believe that that is the way forward. If one looks at the survey carried out recently by the LSE, one can see that only one-quarter of workers throughout the country are covered by national pay deals compared with nearly a half 10 years ago.

§ Baroness Jay of Paddington
My Lords, will the Minister tell us how many of the local pay deals have conditions attached to them which mean that, in effect, most of those who are to receive the pay award will not receive the full 3 per cent.?

§ Baroness Cumberlege
My Lords, half of the offers that have been put on the table have some qualification. But in many cases that will mean that overall nurses receive higher levels of pay. In fact, we now know of trusts which are offering between 3 per cent, and 9 per cent. In all the examples which I gave nurses will receive more than they would have done if they had stuck to national agreements.

§ Lord Laing of Dunphail
My Lords, does my noble friend agree that any pay system which gives the same reward to those who work less effectively and with less commitment than their colleagues, and with no regard to local conditions, must be flawed?

§ Baroness Cumberlege
My Lords, my noble friend is absolutely right. As someone who has built up one of the most successful British companies and employed large numbers of staff, he will know the ingredients of success. Centrally negotiated wage agreements are fast becoming irrelevant and inappropriate in today's world. We must move away from that. No organisation can run its business when it has no control over 70 per cent, of its costs.