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Hospital Workers (Disputes)

Volume 957: debated on Tuesday 7 November 1978

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asked the Secretary of State for Social Services what steps he intends to take to avoid the possibility of lives being lost as a result of any future industrial dispute among hospital workers.


asked the Secretary of State for Social Services what proposals he has to improve industrial relations in the health services.


asked the Secretary of State for Social Services whether he will enter into discussions with all trade unions involved in the National Health Service with the object of agreeing basic ground rules for industrial action by National Health Service workers so as to reduce the danger to patients resulting from industrial action.

My aim is to improve NHS industrial relations so as to avoid industrial action that can harm patients. I put forward proposals recently for a new local disputes machinery designed to resolve problems speedily where they arise; consultations are proceeding on the reforms to the Whitley system recommended by Lord McCarthy; and greater emphasis is being put on industrial relations training and the importance of the personnel function in the NHS. I hope shortly to explore with leaders of the professions and unions what scope there is for resolving national pay disputes without resort to action that puts patients at risk.

Is it not tragic that members of a Service which is dedicated to preserving and saving life should themselves have been responsible for endangering lives, and all for the sake of some marginal improvement in conditions of service? Surely this sort of thing must not happen again.

I hope very much that it will not happen again. Naturally, I deplore any action which puts patients' health at risk, whether the action is taken by supervisors, ancillary workers or doctors. I hope that we shall never again have action similar to the events of the past few weeks, when issues which should properly be resolved in the Whitley Council become the cause of an unnecessary and damaging dispute. That is why I believe that the leaders of organisations within the Health Service must try to find, on national as well as on local disputes, a way through to minimise industrial action.

Order. I must call first those hon. Members whose Questions are being answered.

Does the Secretary of State agree that one way to improve industrial relations in the Health Service is to build up the links between hospitals and their local communities? In this connection, does he agree that the press statement dated 23rd October, which advocated the setting up of a national complaints scheme, will seriously undermine local autonomy and the authority of local hospital managers?

The document that was presented does not deal with the question of a national complaints procedure. It says that the procedures for dealing with disputes should be agreed between management and union representatives and should be brought to the knowledge of all concerned. Disputes that are not resolved by officers of the authority should be considered quickly by the authority itself or by a group of members appointed for this purpose or, in the event of the authority being unable to resolve the dispute, be referred to an informed but independent body. This is, of course, at regional level, not national level.

The other main advantage is that, pending the outcome of the processes, management and unions would accept that the status quo applies and that normal working should continue.

Does the Secretary of State agree that until more authority is delegated on the management side it will be most difficult to settle disputes where they arise, which is in the hospital or on the job? Given that we shall continue to have disputes no matter how well the system is improved, will the Secretary of State try to negotiate with the union some form of Geneva Convention that industrial action is not open-ended but restricted so that patients do not suffer in the way that they have done in recent industrial disputes within the NHS?

There are two different questions here with regard to the delegation of authority to the management side. It is important that both the management and staff side behave with the maximum responsibility, especially because they are concerned with the Health Service. As for a "Geneva Convention", nothing would please me more than a declaration from the representatives of Health Service workers, including doctors, that they were prepared to refrain from the use of industrial action.

However, I do not believe that we could impose such a requirement upon them. Most organisations—including, I suspect, the BMA—would not accept the requirement, but we must have some acceptable ground rules. We must ensure the co-operation of all in protecting patients' interests.

I welcome my right hon. Friend's recent initiatives, but do not the events of the last two years show that it is no good just tinkering with the Whitley machinery, even under the McCarthy recommendations? Until the basic problem of low-paid workers within the Health Service is tackled on a massive scale, we shall continue to have industrial disputes.

It is not just a question of low paid workers in the National Health Service. Some of those involved in industrial disputes have been at the higher end of the pay scale, including consultants and others with extremely responsible positions. There is no reason to suggest that it is just pay policy that causes industrial disputes. We must work to achieve better disputes machinery, which is the aim of this initiative, with the support of the leaders both of the professions and the unions.

Because of the many low-paid workers in our hospitals, their importance despite their low pay, the difficulty that they have in taking industrial action, and the fact that they cannot have productivity deals, does my right hon. Friend agree that the only equitable way to deal with their wages is to link them to average industrial earnings?

I shall not be drawn into how, during the course of the next few months, we should deal with the succession of pay claims that will come in from different groups within the National Health Service. We have to deal with them carefully and sympathically. Some will undoubtedly fall within the category of low-paid workers defined by the Government in the White Paper.

The Secretary of State must now be aware of the deep anxiety not only in the House but in the country about the use of industrial action within the National Health Service where it creates dangers for patients. Will he now take a firm initiative to try to bring the parties together to get a declaration, a patients charter as it were, to protect the interests of patients—

All those who are involved with patients—in order to give meaning and effect to the sentiment that the Secretary of State included in his annual report, which is that the interests of the people who serve must come first?

Terms such as "patients charter" are easy to mouth. The arrangements are much more difficult to establish. Instead of continually criticising, the right hon. Gentleman might respect the fact that, for the first time since the Health Service was created, the Secretary of State brought together the leaders of the professions and of the trade union movement and reached an agreement putting forward proposals to deal with non-Whitley Council issues. As I have already said, it is now my intention to consult with that same group to see whether we can work out some ground rules that will ensure that disputes about pay can be dealt with without industrial action.