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Ambulance Service (West Midlands)

Volume 958: debated on Monday 20 November 1978

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( by Private Notice)

asked the Secretary of State for Social Services if he will make a statement on the breakdown of ambulance services in Birmingham and the West Midlands.

I should like at the outset to allay understandable public concern by saying that, according to information we have received this morning from the West Midlands regional ambulance service, an emergency ambulance service is being maintained throughout the West Midlands area. The dispute, which affects Birmingham, Coventry, Solihull, Sandwell, Dudley, Wolverhampton and Walsall, has, however, worsened over the weekend.

Normally there are about 200 ambulances available of which between 38 and 43 are on emergency standby. I understand that there are 52 vehicles on station today and that, as I have said, this is sufficient to maintain an emergency service.

No out-patients are being conveyed by ambulance but all 999 calls are being answered, although in some circumstances patients may be asked to make their own way to hospital. I also understand that the number of 999 calls this morning was considerably lower than usual because of the help being given by the police and the commendable restraint being shown by GPs and the general public.

Officers of the regional health authority are currently discussing with their counterparts in the area health authority ways of increasing the service to provide some facilities for out-patients.

This complex dispute centres on the issue of anomalies and bonuses payable following the transfer of the service from local authorities in 1974. Since that time, ambulance men on routine calls have refused to cross local authority boundaries. In the last few weeks the West Midlands men have stepped up their action by refusing to cross boundaries even on 999 calls, by refusing to use radios when on the road and finally, last Thursday, by refusing to refuel their ambulances. Instances were reported of ambulances running out of fuel while on the road.

On Friday, the regional administrator, following consultations with the chairman of the RHA, decided that the ambulance service could not continue under such conditions and he therefore required each man to give an undertaking to work normally or be suspended. By this morning, 400 men out of a total of 650 had been suspended.

I undertand that the ambulance men who have been suspended are to hold a mass meeting today. Hon. Members may be assured that we shall keep very closely in touch with the developing situation.

I point out, without disrespect to my hon. Friend the Under-Secretary of State, that I asked this Question of my right hon. Friend the Secretary of State.

Will my hon. Friend tell us whether any consultation took place with the Department on Friday before these men were suspended? He has confirmed that discussion and consultation took place in the West Midlands. Will he confirm that normal working for these ambulance men means working as they did before April 1974, four and half years ago? Will he tell us why no action has been taken by any of the Ministers in the Department in four and a half years to get this matter solved? The answer that my hon. Friend has given today is not good enough.

I answered my hon. Friend's Question, which was about emergency services. I hope that I did my best. I must make clear to my hon. Friend and the House—and I am getting tired of having to make it clear—that I am responsible for this aspect of industrial relations in the National Health Service. If my hon. Friend feels that I am not up to the job, fair enough—he can make his own representations. As long as I am responsible, however, I shall continue to come to the Dispatch Box and answer Questions for which I have ministerial responsibility. My right hon. Friend knows the contents of the answer.

My hon. Friend asked about consultation with the Department. We were notified on Friday of the intention of the regional health authority to undertake the action that it has taken. I remind my hon. Friend and the House that arrangements for the provision of ambulance services are the responsibility of the regional health authority and not of Ministers, who are in close touch, of course, with members of that authority.

This is a complex dispute. My hon. Friend is right in saying that it has been continued since 1974. It is not a dispute that will be easily resolved. I do not wish to take up the time of the House by giving a very long supplementary answer on the ins and outs of the dispute, but I think that the point could be well met in a Written Answer for the benefit of the hon. Members concerned.

Is the hon. Gentleman aware that great credit is due to the police and the St. John Ambulance Brigade and Red Cross volunteers who are striving to deal with crisis cases? But does he realise that the dispute about pay anomalies has lasted for more than four years? It cannot be allowed to drag on, or there could be serious loss of life. Would it not help if the TUC intervened to try to bring some quicker solution to the problem?

I appreciate what the hon. Gentleman has said about the services being given by voluntary organisations. We are much indebted to them for their efforts during this difficult period. I must make clear that this is not a national dispute. There is a Whitley Council agreement on incentive schemes for ambulance men, and ambulance authorities throughout the country are trying to ensure that ambulance men who have transfer conditions from local government under the Health Service reorganisation in 1974 are transferred on to the new incentive scheme. However, the dispute is about the fact that many of the men, particularly in the West Midlands, do not want to be transferred to the new incentive scheme until the anomalies to which I have referred have been brought out. That is what the dispute is about.

Order. As far as I can see, every hon. Member who has got up, except those on the Front Benches, has a constituency interest. If the questions are brief, I hope to call them all.

My hon. Friend has drawn attention pointedly to the fact that he is responsible for industrial relations in the Department. That being the case, although this matter is one for the regional health authority, would he not agree that in exercising his responsibility, and since I raised this matter some two years ago on an individual case, he might well have taken an initiative himself before now? Will he now consider taking such an initiative?

My hon. Friend is right. This is a matter primarily for the West Midlands regional health authority and the regional ambulance service. My Department is now fully involved with discussions going on with officials of the authority, and I hope that we shall come to terms with them shortly about a means of solving this very difficult dispute.

Does the hon. Gentleman understand that his statement will not allay fears in the West Midlands? Does he further understand that in a constituency like mine the ambulance service is totally dependent now on volunteers and the police? Does he also understand that, even now, strenuous new efforts are being made to widen the dispute and that Mr. Adamson, of the National Union of Public Employees, has said this morning that the dispute is essentially about the right to take this kind of industrial action? Will the hon. Gentleman say, therefore, that it is not justifiable to take this kind of industrial action, which places at risk the lives of patients?

My right hon. Friend the Secretary of State has already, on industrial disputes, deplored the taking of action which places people's lives at risk or in peril in any way, and I have nothing to add to what he has said. I agree with the hon. Gentleman's comments about the use of voluntary services, and I hope that we shall not be relying on them for very long.

Would not my hon. Friend agree that this is virtually a re-run of the firemen's dispute, which was settled in a remarkably short time once the firemen had taken direct action? He has bravely taken responsibility for the conduct of industrial relations in the National Health Service. The fact that direct action has had to be taken after such a very long time in which this dispute has festered surely indicates very significant managerial incompetence in the conduct of industrial relations in the National Health Service.

I think the fact is that this has been an intractable problem. I must correct my hon. Friend on one thing. This is not direct action. This has been indirect action, since the men, by taking their indirect action, were still at work and getting full pay.

Is the hon. Gentleman aware that the matters about which he has been speaking have not been the only things to cause anger to ambulance men in the West Midlands over a long period? Is he aware that they are also angry at continually being treated as the poor relations of the emergency services in relation to pension rights, long-service awards and their liability to prosecution for traffic infringements? Will he also take those matters into consideration with a great deal more vigour than he has done hitherto?

I am well aware of the points that the hon. Gentleman has made, but they are not pertinent to this dispute.

My hon. Friend said in reply to my hon. Friend the Member for Birmingham, Perry Barr (Mr. Rooker) that he did not wish to take up the time of the House by reading a long supplementary answer. Is he aware that in the opinion of many of us that was tantamount to declining to give any facts about the situation to the House of Commons? Will he accept that the action which has been taken in suspending these men simply escalates the difficulty and does nothing to secure an ambulance service for our constituents? Will he accept the responsibility of resolving this difficulty or ensuring that it is resolved?

My hon. Friend has asked for information, and she shall have it. I hope that she will pay note to what I have to say.

The transferred ambulance men—we are talking about people transferred from the local authorities to the health authorities in 1974—had certain protected rights to retain ex-local authority conditions of service. They also retained earnings from inherited working practices. This has led to different rates of pay for the same work. The ambulance men's Whitley Council agreed a national incentive scheme under which it was intended that a common level of bonus would be achieved to replace the differences in earnings. Pay policy prevented this until 1977.

Phase 3 of the Government's pay policy gave us the opportunity to make progress by implementing the Department's bonus scheme. Accordingly, we have been attempting to negotiate with the ambulance men's trade union since April 1978. The main union concerned is adamant that the buying out of anomalies must be treated as a separate issue from the bonus scheme, on which it will negotiate only after the anomalies have been removed. The management's latest offer, in October of this year, was a generous interim payment, to be absorbed by the phased introduction of the Department's bonus scheme, commencing within six months. That was rejected by the men.

After this strike is settled, may I ask the Minister to give careful consideration to the contracts of employment that are entered into with those who carry out essential services within the Health Service? Will he consider requiring all those who carry out those essential services within the Health Service to agree to a "no strike" clause being inserted in their contracts of employment?

We already have sufficient trouble in the National Health Service without going into the suggestion contained in the latter part of the hon. Gentleman's supplementary question as an attempted solution to our problem. I take note of what he said in the first part of his supplementary question. Terms and conditions of employment are obviously something about which management must always be concerned.

Does not my hon. Friend accept that, however complex the issue may be, four years-plus is too long? Would he not agree that he seems to be taking a far too complacent attitude to the situation? Is he aware that today a meeting is taking place which could result in this dispute being spread to the whole of the West Midlands regional health authority? Is he further aware that there is a possibility of nationwide support action in a matter of days?

I said that I understood there was to be a mass meeting today. I hope that the outcome of the meeting will be favourable. Even if it is not, my officials are closely in touch with the regional health authority. It is in the interests of all of us, not only hon. Members but the general public, that this dispute —it is a complex one—should be resolved as satisfactorily and as speedily as possible.

Is the Minister aware that, in spite of the intricacies of the dispute, the main responsibility of the Government and this House must be towards the patients? Is he satisfied that the ambulance services can be kept going? If they cannot be kept going, will he consider using the facilities of Her Majesty's Forces?

I do not want to say anything on that point or to answer hypothetical questions. At the moment the emergency service, which is the important service, is being kept going and steps are being taken to see whether the out-patient service, which, as the hon. Gentleman will understand, is very sketchy at the moment, can be improved.

The Minister must be aware of the appalling damage that was done recently by the strike of maintenance supervisors working in the National Health Service. Is he aware that this strike which we are now discussing has similar features? Is he further aware that undoubtedly the care of patients will suffer? Can he assure the House that there is adequate local negotiating machinery? For instance, is he aware that, as of last night, there were no arrangements for any meeting between NUPE and the regional health authority? Will he see that local negotiations are started immediately?

To answer the hon. Gentleman's latter point, the negotiations will obviously have to depend now on the outcome of the mass meeting this afternoon. Even if that proves to be unsuccessful—that is, if the men decide to convert the action into an official strike—the regional health authority will have to get together with representatives of the men—the regional officials—to resolve the dispute. There is adequate negotiating machinery on pay and conditions of service within the service. There is the Whitley Council machinery. The Whitley Council has provided for the possibility of a solution to this dispute, but so far it has not been a solution satisfactory to the men.