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National Health Service (Industrial Dispute)

Volume 961: debated on Monday 22 January 1979

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(by Private Notice) asked the Secretary of State for Social Services if he will make a further statement on the ambulance service.

With your permission, Mr. Speaker, I should like to broaden my reply to deal with other industrial action in the National Health Service today. Today there has been widespread disruption and I regret to tell the House that there may be more in the days ahead.

It is not yet clear how many people have ignored their unions' advice to maintain cover for emergencies. But in some cases this emergency cover has not been provided today.

The London ambulance service is the most serious example. Yesterday I had talks with representatives of the London ambulance men. They agreed to provide an emergency service. But this morning many of the men themselves rejected that decision and refused to cover emergencies. I therefore authorised the use of Army ambulances.

I understand that the West Midlands is the only other area in England where ambulance men have refused to provide emergency services, and an emergency service is being provided by the police and voluntary organisations.

Any industrial action in the Health Service is likely to pose some risk to patients, but in the past the need to cover emergencies has been accepted by virtually everyone. Certainly, the unions have advised their members to provide an adequate emergency service. Some of their members have now chosen to reject that advice.

The issue is, in my view, extremely serious. Those concerned must face up to the consequences of their actions. Lives are at stake. Health Service workers must now think very seriously about that and its implications for the future of the Health Service and the confidence which people place in it.

The ambulance men have put their case to me. It will not be strengthened by some of them adopting what will be seen as a callous attitude to the lives and health of their fellow men. I do not believe that this is the kind of men that they are. I hope that they will now step back from the brink.

There is now a danger that industrial action by the ambulance men and other Health Service workers will continue in the days ahead. Enough is enough. Only the innocent will suffer if Health Service workers allow their anger to run out of control. They have made their point with today's day of industrial action and lobby of the House. There can be no point now in taking it out on the injured, the sick, the old and others who depend on the Health Service.

That is why today I have invited the general secretaries of the Confederation of Health Service Employees and the National Union of Public Employees to meet me urgently with a view to resuming an orderly approach to settling this pay dispute.

Many workers in the Health Service feel that their pay is too low and that they have fallen behind other workers. The Government have recognised these concerns. Last week the Prime Minister offered a better deal for the low-paid and a study of pay comparability.

These proposals should pave the way to sensible settlements. I am meeting representatives of both sides of the Whitley Councils dealing with ancillary workers and ambulance men later this week. There will also be further discussions about handling the nurses' pay claim.

But, Mr. Speaker, I must make it clear to the House that this Government cannot and will not abdicate their responsibility and let wages rip. That is the road to disaster. The only results would be a return to mounting inflation, balance of payments problems, cuts in public services, high taxes and rates and more on the dole. Those who will suffer most from all this will be the low-paid and those on fixed incomes, such as pensioners. This is the law of the pay jungle.

The whole House will join in condemning this appalling situation, which can only be terribly damaging to the standard of patient care in the country. We join the Secretary of State in condemning strikes of this kind within the Health Service. They are intolerable and a reflection on decent society.

We wish to congratulate the Red Cross, the St. John Ambulance, the police and the troops on the ready and willing way in which they have stepped in to reduce the tragedy that the strike must mean for many patients.

Is the Secretary of State aware that there has been intimidation by union branches of members who do not wish to strike? Is he aware that in addition to the many parts of London where people have refused to deal with emergencies, in Cardiff, Glasgow, Inverness, Strathclyde and Fife—in addition to Birmingham, Coventry and Solihull—there has been a complete ban on dealing with emergency cases?

It is clear that further strikes of this nature are being planned. We have a right to ask the Secretary of State what instructions he has given to the unions. What steps is he taking to avoid further strikes of this kind?

The hon. Member asked about voluntary organisations. We must make it clear that everywhere it is best that ambulance men, with their experience and training, should do the job. Only if they cannot do so—only if they are not prepared to do so—is it wise to use other services. Obviously, if an ambulance man does not provide an emergency service, it must be provided in other ways. I therefore agree with the hon. Member and welcome the enthusiastic way in which the voluntary organisations and the police have stepped in where that has proved to be necessary.

The hon. Member referred to intimidation. I hope that he will give some examples of it. So far I have had no reports on, for instance, pickets stopping supplies from reaching hospitals. If that did happen I should take a very serious view of it.

It is true that in Scotland there is a considerable problem. Together with the voluntary organisations, the police have made alternative arrangements. In Cardiff the Army has made available a small number of ambulances to help out there.

I must tell the hon. Member that I give no instructions to the unions. [HON. MEMBERS: "Why not?"] The union leaders are committed to supporting the provision of emergency services. When there were threats to the emergency services, I called in the union leaders to discuss these problems. As recently as last week they confirmed union policy. I believe that it is their wish to sustain that policy.

The House will thank my right hon. Friend for the frankness of his statement. Does he agree that union-bashing from the Opposition does not help? Nevertheless, will my right hon. Friend make it clear to the strikers that whether they are ambulance drivers or doctors, direct threats to life should not be tolerated? Will he indicate that that is how hon. Members on the Government Benches feel?

I agree with my hon. Friend. Sometimes, exaggerated attacks upon the unions serve to undermine the influence of moderate elements who wish in these situations to maintain control. Hon. Members on both sides of the House should use restraint. I agree that the withdrawal of emergency services—which can only threaten the lives and health of men, women and children—by family men, or whoever may do it, is not tolerable to society. I believe that it is not tolerable to people on both sides of this House.

Is it not true that the union made a great miscalculation in calling a strike which it manifestly cannot control? Have we not reached rock bottom with the suggestion that people could be left to die as a consequence? Is not a badly paid health worker at least in a better position than someone lying in the road waiting for an ambulance?

The policy of all four unions, which have given me a clear indication of where they stand, is to provide emergency services. What has happened is that some men have not taken that advice. I met representatives of the London ambulance service yesterday. As shop stewards, they took a decision unanimously to pull back from the brink and provide emergency services. In many parts of London, in the early hours of this morning, many of their men were not prepared to go along with the decision that had been taken. That was the reason why I felt that it was essential to act firmly in support of the health authority and make available not only police but, especially, Army vehicles.

My right hon. Friend will be aware that the London ambulance service has probably been one of the finest in the world. It is with deep regret that I and, I believe, all hon. Members view the action of some who have made the service unavailable for emergencies. May I pick up part of the Secretary of State's statement? The key to this matter is not just saying what one tells unions to do, or what one forces members to do—one cannot do that anyway in a democracy and a free country—but an immediate investigation of lower-paid workers in the National Health Service. When my right hon. Friend meets the general secretary of NUPE and others today, I hope that he will assure them that, in order to get the men back to work, this comparability study will take place immediately. We cannot go on tolerating a situation in which male nurses take home less than £40 a week. No one can justify that. It is part of the reason why there is so much trouble.

In relation to the London ambulance service and ambulance men generally, I would say that, today apart, they have been held in great respect throughout the country for the way in which they have worked, under great difficulties and often for difficult hours. They have served the people. I have joined in the condemnation today, but we should not forget the debt that we owe to the London ambulance service and to ambulance men throughout the country. On the question of pay, the Prime Minister last Tuesday described the Government's position in relation to additional support for the low-paid and made clear the position that we were taking on comparability. These matters are under discussion with those concerned. While they must be dealt with as an emergency, I do not believe that anything can justify the sort of action taken unofficially by those who withdraw emergency services.

Does not the Secretary of State's last reply clearly indicate the urgent necessity to arrive at democratic decisions within unions about action to be taken? Is it not abundantly clear that the suggestion of the Leader of the Opposition that there should be democratic decisions, and that a ballot should be taken, about the withdrawal of labour, particularly when lives are at stake, is so urgent that the Government must do something about it?

I am not going to respond to lectures by the hon. Gentleman and the Leader of the Opposition about the conduct of industrial relations with the unions.

Is my right hon. Friend aware that large numbers of hon. Members on the Government Benches believe that the ambulance men, the nurses and other low-paid ancillary workers in the Health Service and elsewhere are very badly paid but that this is the long-term result of free collective bargaining? Is it not the case that this problem cannot be solved overnight and that the sooner our trade union friends realise that, the better? Will he give two undertakings—first, that these problems will now be treated by the Government as a matter of urgency and, secondly, that no matter how justified the case, the Government will not allow, in any circumstances, emergency services of any kind to be jeopardised by the irresponsible action of an irresponsible minority?

I give an absolute assurance on my hon. Friend's last question. In addition, I believe that the cause for which people are demonstrating is deeply undermined, in the public's view, by those who act irresponsibly. In answer to my hon. Friend's first question, the Government are giving urgent consideration to these problems. It was for this reason that my right hon. Friend the Prime Minister made his statement in the House last Tuesday.

Is the Secretary of State aware that the ambulance men's branch in my constituency, which did not want to go on strike, has received a notice from the strike action committee that if the men do not strike, there will be "subsequent reprisals" taken against them and that any ambulance, for whatever reason, which passes the pickets will be "blacked for evermore"? Is that not intimidation? What does the Minister propose to do to stop that sort of bullying?

Obviously, I condemn totally that sort of action. If the hon. Gentleman gives me the information, I will make an inquiry. It cannot be other than against the interests of the ambulance men themselves.

Can the Secretary of State recollect the problems that confronted the police and the firemen? At that time, a long time ago, it was put to him that the three life-saving services, which includes ambulance men, should be dealt with. My right hon. Friend mentioned comparability. Will he give, or publish in the Official Report, figures showing the extent to which ambulance men have fallen behind the police and firemen in comparability? Why did he not deal with the matter two or three years ago? Then we might not have had the problem now.

Following the Prime Minister's statement about the way in which we intend to carry out studies of investigation on comparability, these are precisely the questions that will be looked at. Those questions include the extent to which people's pay is different from that in the private sector, and to what extent one can make a comparison between what they are doing and what people are doing elsewhere. These matters are being looked at very urgently. They are under discussion with those concerned and it would not be helpful for me to make a further statement in the House this afternoon.

Order. I propose to call two more hon. Members from each side, apart from the Front Bench. I also have an application under Standing Order No. 9 in connection with this matter.

Is the Secretary of State aware that when the ambulance men settled last year for 10 per cent. it was agreed that there should be further discussion about shift pay and holiday allowances? Will he confirm that in the last 12 months no progress has been made on those fronts? If not, why not?

It is not helpful in relation to today's action for me to deal across the Floor of the House with questions of percentages and wage negotiations. These are matters that should be dealt with through the proper channel. That is where they are being dealt with.

However competent it may be, the cover given by the police and voluntary services in the Greater Birmingham area is likely to be insufficient. Will my right hon. Friend say if and when steps can be taken to draft troops and vehicles into that area?

It is too early to say. I shall watch carefully to see how effective are the actions of the police and voluntary organisations. It is for the health authorities to indicate to me whether or not they can fulfil their statutory obligations to provide emergency services. If they cannot, the Government must decide the best way they can do it, because the Government have a responsibility to ensure that emergency services are provided.

I see the whole of the Government Front Bench in front of me. Is the Secretary of State aware that what we are seeing with all these strikes is not merely disputes about pay but the start of revolution, and that unless the Government decide to govern and are prepared in certain circumstances to remove pickets by force. England will dissolve into anarchy and chaos?

It is not revolution, but if I were to follow the course suggested by the hon. Member and others of his hon. Friends, that is where it might lead us. It is for the Government to decide the best way in which we can develop our relationship with the trade union movement in dealing with these difficult issues.

We must all be concerned about the dangers of the present situation, but is it not a fact that the lower-paid workers who are here today have an unanswerable case for an early substantial rise in their rates of remuneration? Are they not the victims of the disgraceful cuts in public expenditure that were forced on us by the IMF to some extent? Are we not in those circumstances right to reject out of hand the demand for further cuts in public expenditure called for by hon. Members on the Opposition Benches?

When the Government announced on Wednesday their public expenditure plan for the next few years, part of it was a significant increase in resources available for the development of the National Health Service. Those who are making their demands today should understand that if they seek wage settlements that have no other result than to push up taxes, rates and inflation, not only will that not mean that people have more money in their pockets to spend; it will also put in peril the Government's plans for expanding the resources available to the NHS. That is a lesson that must be learned by those who are involved in wage bargaining today.

Will the right hon. Gentleman recognise that in all parts of the House the deepest disquiet has been expressed not only about the withdrawal of emergency services today but about the threats for the days and perhaps weeks ahead? He said that he was meeting the general secretaries of the unions concerned. Will he bear in mind the fact that the official instruction from NUPE today and for the weeks ahead was to cause "the maximum possible disruption" of services? Will he impress upon them that, bearing in mind the nature of many of their members, that is a green light for the maximum disruption of services, and that, whatever they may say in their instructions about emergency services, that is bound to lead to the sort of action that we are seeing in the London ambulance service and in other ambulance services today? Will he try to persuade Mr. Fisher and Mr. Spanswick and the others that he will meet that they should withdraw that sort of damaging instruction and that if they must persist with their action, which we all deplore, they must ensure that it safeguards the health and lives of patients, which must be the primary responsibility of all in the Health Service?

I shall speak frankly, but I shall speak in confidence, to the general secretaries of the unions when I see them later today. But the right hon. Gentleman and his colleagues should think carefully about the position that they themselves have taken. They themselves have given constant encouragement to free collective bargaining, and we are now reaping some of the consequences of their absolute irresponsibility.

On a point of order, Mr. Speaker. Can you advise the House whether you have had a request from the Secretary of State for Education and Science to make a statement about why so many of this country's schoolchildren are being deprived of education today? Is it not quite unacceptable?