§ 3.41 p.m.
§ Lord Trefgarne
My Lords, with the permission of the House, I will now repeat a Statement being made by my right honourable friend the Secretary of State for Health in the other place. The Statement is as follows:
"With permission, Mr. Speaker, I should like to make a Statement about the pay dispute in the National Health Service.
"As I have reported to the House, revised proposals on health service pay were put to all the staff organisations on September 16th as a basis for discussion. They envisaged discussions about improved pay determination arrangements for all non-medical National Health Service staff groups, together with a two-year pay agreement to cover the period until 31st March 1984. I proposed that the financial basis of the two-year agreement should be the offer for this year of 7½ per cent. to nurses and midwives and professions allied to medicine, and 6 or 6½ per cent. for other groups, together with an additional 4 per cent. for next year. The proposals made it clear that there could be no more money for this year.
"As a result of this initiative, there have been lengthy exploratory discussions with the professional organisations representing nurses, midwives and health visitors. There have also been discussions with representatives of the professions allied to medicine. I am glad to say that in the last few days talks have been taking place with the health service unions affiliated to the TUC.
"Following the Government's consideration of the outcome of the discussions with the professional nursing bodies and the TUC Health Services Committee, I have authorised the management sides of the Whitley Councils which negotiate the pay of nurses and midwives, and of the professions allied to medicine, to make revised pay offers covering the period until 31st March 1984. The financial resources which I have made available to them are on the basis envisaged in the proposals put forward on 16th September, but the Government have agreed that, in formulating pay offers, these management sides may proceed on the basis that the money available for 1983–84 will be increased to allow average pay increases for that year of 4½ per cent. The distribution of the pay offers within the cash limits set by Government is for negotiation within the Whitley Councils.
"If this revised pay offer is accepted, then the Government believe that better permanent pay arrangements should be established for nurses and the other professions. As the House is aware, the Government are firmly committed to seeking improvements in the arrangements for determining nurses pay. We put proposals forward as a basis of discussion as long ago as August 1980. Talks began in March this year, but these discussions have not shown the progress we would want.
"Mr. Speaker, we should remember that we are dealing here with a group of dedicated and skilled staff who do not take strike action because of the consequences of such action on patients. The Government believe that it is time that we settled 115 upon more satisfactory arrangements. We have therefore decided to propose the establishment of a review body, which will have the task of making recommendations to Government about the pay of nurses, midwives and health visitors. We propose that it should have the further remit of making recommendations about the pay of the professions allied to medicine, such as physiotherapists and radiographers.
"I shall shortly be launching consultations relating to the composition, terms of reference, coverage and method of work of the new review-body. Like other review bodies, it would, in looking at levels of pay, need to take account of all relevant factors, including, for example, economic and financial considerations and service needs. It is intended that its first report should relate to the period beginning 1st April 1984, at the end of the two-year pay agreement now proposed.
"I believe that this decision will give the professions concerned a much better basis for determining their pay and that it will be warmly welcomed by them. The Government regard their position as wholly exceptional. There can be no general extension of the review body principle to other staff groups.
"This is an important step forward for the nurses and the other professional groups and, therefore, for the health service. The proposals we have made offer a fair settlement for pay over two years followed by the establishment of a review body. They provide an opportunity for stability in the National Health Service to make the service improvements we all want and to recover from the damaging effect of the industrial action which has taken place this year.
"On the pay of other health service staff, discussions with the Health Services Committee are continuing. The aim must be to secure a resumption of negotiations in the relevant Whitley Councils. That is the way forward and the proposals I have announced today are a significant step in that direction."
My Lords, that is the Statement.
Lord Wallace of Coslany
My Lords, I wish, on behalf of the House, to thank the noble Lord, Lord Trefgarne, for repeating that Statement, a lengthy one. May I first ask him to confirm—my attention was diverted momentarily—that he used the sentence:There can be no general extension of the review body principle to other staff groups".
Lord Wallace of Coslany
My Lords, the timing of this Statement is significant, in fact suspiciously so; I understand that the Royal College of Nursing is meeting today to decide on Government offers, and at the same time, as we know, delicate negotiations are going on in another direction. Of course, this is an offer only to nurses, midwives and health visitors and not to ancillary staff. Indeed, no mention is made of other groups of workers—namely, ancillary workers—and I should like to know why not. As for the offer, one assumes that negotiations will continue for both sections, and it is obvious that they will continue on 116 the points mentioned in the Statement. The Statement underlines the fact that ACAS should have been brought in much earlier. Frankly, it seems obvious that ACAS has been largely responsible for this move in getting the Government to change their attitude.
I welcome the establishment of a review body, but why not a similar set-up for other staff? Why say:There can be no general extension of the review body principle to other staff"?And may I ask the Government why they have not made such an extension? After all, we must face the fact—mention has been made, most appropriately, of the dedicated attitude of nurses and other medical staff in the health service—and the Government must remember that the success of hospital work is decided by teamwork at all levels. Even the most first-class consultant is dependent on the teamwork of nurses and supporting staff; the ancillary staff who assist in feeding patients and helping to look after them play their part, too.
May we be given some information—I appreciate that we are at a delicate stage—about the position of the present talks with the health service unions affiliated to the TUC? I ask that because speeches by Ministers in recent days have not been helpful in what has been a delicate negotiating stage. Indeed, it is regrettable that the dispute has gone on for so long. Arbitration would have been sensible and fair to all sides and would have ended the dispute many weeks or months ago. I should like to conclude by saying to the Minister and to the Government in general that Government Ministers involved in the dispute should be sent by the Prime Minister for a crash course on industrial relations. So far they have acted like a bull in a china shop and have not helped the situation.
§ 3.50 p.m.
My Lords, on behalf of my noble friends on these Benches and, in addition—I hope here that I establish a welcome precedent—on behalf of, and at the request of, my noble friends in your Lordships' House in the Social Democratic Party, I should like to join the noble Lord, Lord Wallace of Coslany, in thanking the noble Lord, Lord Trefgarne, for repeating this important Statement. In so far as the Statement suggests that there is a glimmer of light at the end of a long, dark and, frankly, unnecessary tunnel, we welcome it. We would ask the noble Lord to bear in mind that noble Lords on these Benches, while fully understanding the reasons for the health workers' industrial action, have never supported that action, though we have supported, and still support, their claim that many, if not all, health workers are in fact seriously underpaid, as evidenced by the large number of full-time workers who are at present in receipt of family income supplement.
We welcome the hesitant steps which the Government appear to be taking towards the evolution of a new system of pay determination for workers in this vital, essential, public service—a course of action which has been urged from these Benches and indeed from the Social Democratic Party for a very long time—but we regret the apparent intention of the Government to try to drive a wedge between groups of workers who ought, ideally, to be working harmoniously together in partnership. We believe that some essential workers in this vital public service are 117 indeed more essential than others, but we nevertheless believe that all those workers are essential if the health service is to function satisfactorily. I ask the noble Lord whether the Government will keep an open mind on the wisdom of the course of action of trying to divide groups of workers in a vital, essential service, who ought to be working very closely in partnership.
§ Lord Trefgarne
My Lords, I am grateful to both noble Lords for the welcome that they have given to the Statement. I should first like to deal with the points made by the noble Lord, Lord Wallace of Coslany. The noble Lord asked, why was it just now that we were making an offer in respect of the nurses and midwives and related professions, and not to the other members represented by the TUC Health Services Committee? The fact is that we made a revised offer on 16th September, and have had discussions with the nurses' representatives more or less continuously since that time. It was only last Friday, I think, that the representatives of the TUC Health Services Committee actually came to have a discussion at all. Previously they had rejected out of hand the proposals which my right honourable friend had put forward.
As for the question of a review body for other grades of workers within the health service, the Government feel very strongly indeed that over the last few months, during a period of great difficulty in the health service, those who have kept the service going have been the nurses and the midwives and the professions related to them. It is they who have spurned industrial action and, as I say, it is they who have kept the treatment services available within the health service. We think it right to take recognition of that fact in formulating our new proposals.
The noble Lord referred to a team effort in the health service. It has not been much of a team just lately. A number of the players have been remaining on the sidelines or in the pavilion.
As for the TUC talks, I hope that your Lordships will forgive me if I do not expand on what is happening in the talks. They have only just begun. They are at a critical stage. The Government—and I trust the others taking part—are not without hope that some way forward will emerge from the talks. But I hope that your Lordships will forgive me if I do not expand in detail on what is happening. Certainly no conclusion had been reached when I left my department a few moments ago.
The noble Lord, Lord Wallace, said the Government had acted like a bull in a china shop during the progress of the dispute. During the progress of the dispute the Government have moved their position three times. They have twice made additional resources available for pay purposes within the health service. During the same time we have been confronted by a total refusal of the unions to negotiate within the Whitley Councils. There has been industrial action on a wide scale, which has caused very serious difficulty—that I do not for a moment deny—and they have not budged one centimetre from the original claim of 12 per cent. which they lodged some months ago. Twelve per cent. was what they said it was, but if one took into account the extra holidays and reduced working hours that they wanted at the same time, it was something nearer 20 per cent., which clearly could 118 not have been countenanced in present circumstances. As I say, during the same time the Government have made a number of moves to meet the aspirations of the workers. That is why we have made the new proposals that we have made, which I hope will commend themselves to your Lordships.
The noble Lord, Lord Winstanley—if I may pick up a point that he made—said that he thought that many, if not all, the health service workers were underpaid. I do not deny that in the health service there are some workers who are comparatively lowly paid, but, as I have previously said to your Lordships, they are not, I believe, more lowly paid than others outside the health service doing similar work. I should like to solve right across the board the problem of low pay in our economy, but I fear that I could not start by solving it in the health service, except at unacceptable cost to the public purse.
The Earl of Halsbury
My Lords, before I come to my question I should like to assure the noble Lord that my speech last Thursday was not based on any leak from his department. I am delighted that, after a lapse of eight years, it is taking the advice that I gave it that number of years ago. However, the fact that it is taking only half the advice that I gave it indicates to me that it still does not understand why I gave the advice.
That brings me to my question. Does the noble Lord really think that he can adhere to his intention to confine the review body practice to the nurses and midwives without extending it to the radiographers, the physiotherapists, and the other trained grades? Outside the trained grades there is a market rate for unskilled labour, and assistants, floor cleaners, and so on, have a basis for saying whether they are overpaid or underpaid by comparison with unskilled labour outside. But where the Government control recruitment to training for a skilled profession, and then to all intents and purposes act as the monopoly employer of that profession, there can be no independent standard of what people ought to be paid except the judgment of independents who must not be parties or self-interested in the sense that the Government are. That is the basis of the advice that I gave, and if the noble Lord is going to accept only half of it, it means that he has not understood the reason for the advice.
§ Lord Trefgarne
My Lords, I am not sure that I made myself clear in either the Statement or the subsequent response to noble Lords opposite. I emphasise that we intend to consult on the proposals, and therefore maybe to change them in the light of the consultation. We have certainly not reached a final view as to which of the professions on the margins of the ones that the noble Lords are describing ought, or ought not, to be included within the ambit of the new review board. But at present we have in mind that it should include nurses, midwives, health visitors, physiotherapists, radiographers, remedial gymnasts, occupational therapists, orthoptists, chiropodists, dieticians, and speech therapists, which I believe cover most of the professions that the noble Earl had in mind.
§ Baroness Jeger
My Lords, I fear that some of the noble Lord's rather intemperate words this afternoon will have further entrenched the apparently invidious divisions that are being made within the National Health Service. I should like to ask the noble Lord: on which side of the line are the very skilled, essential, and highly trained theatre and laboratory technicians to fall? Surely it is quite wrong for the Government to propose a divide-and-rule basis for settling claims in the National Health Service, in which everyone must work together. In view of the length of training of the laboratory and theatre technicians, I should like in particular to ask the noble Lord where he puts them.
§ Lord Trefgarne
My Lords, we do not at present have in mind to include within the ambit of the review body the grades to which the noble Baroness refers, but I make it clear that we have no closed view on the question. We intend to consult on the proposals that we have made, and maybe to adjust them in the light of the consultation. It was not we who divided, as the noble Baroness suggests, the various groups of workers within the health service. Even after September 16th (if you leave aside what happened before that time) it was the nurses who came in response to the proposal that we had made for discussions with us, and not the other groups, who spurned the offer of discussions that we made at that time.
§ Lord Molloy
My Lords, is the noble Lord aware that what he has just said is not entirely correct? He has just said that they "spurned" the offer; that is, turned it down absolutely and said they would have no discussion, no negotiations. When the noble Lord looks at the record I think he will find that that is not wholly true. May I also put this to him: Will the review body cover the ancillary staffs and the ambulance crews? Will those very important people be included? Also, will the noble Lord not reconsider the offensive statement he made when he suggested to any neutral person listening to this discussion this afternoon that Great Britain's nurses had been on total strike for the past seven months? What happened is that because of the obdurate behaviour of this Government they were driven to hold some small token strike. That is the reality; and this Government then dived in, with all the venom they possess, to attack Britain's nurses.
My final question is this. It may well be, as has been the case in the past with the results of other review bodies, that when they are examined both by the employers (in this instance the Government) and by the staff involved, neither side can agree. If that is so, will the Government then be prepared to do what is done throughout British industry but what has been spurned by this Government; that is, indulge in the sensible tradition of British negotiation and then see that a totally independent arbitrator is assigned to attempt to resolve the situation?
§ Lord Trefgarne
My Lords, I have on a number of occasions explained to your Lordships why the Government cannot proceed along the line that the noble Lord suggests; namely, to appoint an arbitrator to determine these matters. As I have said many times, it is for the Government to decide what is the total sum of money available for this purpose, and then to allow the Whitley Councils to formulate and make the 120 necessary offers having regard to the sum of money that we can make available.
The noble Lord earlier said that I had suggested that the nurses had been on total strike for seven months. I said quite the reverse. The position is, of course, that by and large the nurses have not been on strike over recent months. It is the other grades of workers who have been on strike—the ancillary workers, for example, to whom the noble Lord refers. If the noble Lord thinks that that is not true, he should have been with me on some of the visits that I have made to hospitals around the country in recent months, as indeed have my honourable and right honourable friends in the department. There has been widespread industrial action in the health service in recent months. I exclude the nurses from that because, of course, the nurses, with a few exceptions, do not take industrial action. That is why we think it right to move forward with the creation of the review body to which the Statement refers.
The Earl of Halsbury
My Lords, I think I owe the noble Lord an apology, if I may, with the indulgence of the House, deliver one. I heard the beginning of his remarks from the other end of the Chamber, hurried back here to take part in the questioning and missed the critical portion, to which I referred.
§ Lord Nugent of Guildford
My Lords, while my noble friend is being accused of obdurate behaviour in the Government's unwillingness to concede the very large increase sought by the unions on the other side, is he aware that the Government have been seen as representing the general interest of the nation as a whole, and especially of the taxpayer, and indeed the whole of industry, in settling a level for the increase which had some relationship to the general level of increase which could be paid in industry, which has to earn the living of the community and provide for these funds in the first place? The representation that the Government have been obdurate and unreasonable does not fit the picture at all.
§ Lord Trefgarne
My Lords, I am obliged to my noble friend for that information. Not for the first time he puts his finger on the nub of the matter.
Lord Wallace of Coslany
My Lords, there is one point on which I should like to correct the noble Lord the Minister, if I may. He referred to the fact that the only people who had gone on strike were the ancillary workers, and he categorised the whole situation as involving ancillary workers only. He has visited hospitals, and so have I. It is a fact that, in the case of the great majority of ancillary workers, what they have done has been done with extreme reluctance, and in many cases on only a token basis. There are a few places where there has been industrial action and the media have emphasised those, but not those cases where the staff have done their best to keep going.
§ Lord Trefgarne
My Lords, if the noble Lord thinks that the effects of the industrial action have been anything other than serious, he is, I assure him, deluding himself. It is of course true that not all the ancillary workers have been on strike. Indeed, in some areas very small numbers indeed have been on strike. But they have been carefully selected so that they have 121 in some cases managed to bring their hospials to a halt, or nearly so.
§ Lord Molloy
But, my Lords, this is terribly important. I think the noble Lord might have acknowledged the TUC's code and the call of the Confederation of Health Service Employees to their members to see that there was adequate cover particularly for emergencies. I confess that in some instances that call was disregarded, but that was the plea of the trade unions. The noble Lord knows it and that the TUC backed it, and he might have had a word to say in acknowledgement of that fact.
§ Lord Denham
My Lords, I hope that the noble Lord, when he intervenes, will ask a question eliciting information, because that is the purpose of questions after Statements.
§ Lord Trefgarne
My Lords, it is true that the TUC and the main unions involved in the dispute issued some guidelines with regard to the maintenance of emergency services, but I have to tell your Lordships that those guidelines were not adhered to and there were cases where emergency services were not maintained.