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Social Services

Volume 25: debated on Tuesday 15 June 1982

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National Health Service (Dispute)

1.

asked the Secretary of State for Social Services if he will make a statement on the effect on the National Health Service of the Confederation of Health Service Employees and National Union of Public Employees dispute.

The response to the three national 24-hour stoppages varied across the country. Overall, the effect on hospitals has been that, while doctors and the majority of nurses have maintained patient care, admissions in many districts were restricted to accident and emergencies only and patients were subjected to inconvenience and discomfort. In some instances, emergency cover was not provided.

In addition to those one-day stoppages local action has disrupted administrative and hospital support services in some districts. All of that will have had an adverse effect on patients, which is why we strongly deplore the industrial action being taken.

I thank my right hon. Friend for his reply. Is he aware that I have recently had a meeting at Christchurch hospital with nurses and ancilliary workers who are angry and unhappy with the present position? Is my right hon. Friend aware that they are equally angry and unhappy about being unwillingly enrolled as some sort of stormtroopers in Arthur Scargill's anti-Government campaign? Will my right hon. Friend take note of that and also of the fact that one of the pleas put to me by the majority of those present was that the Government should start to look at alternative ways of funding the National Health Service?

We are not only looking at my hon. Friend's point about raising additional funds for the National Health Service, but taking action by selling surplus land.

My hon. Friend's first point is of fundamental importance. The National Health Service should be warned that its pay dispute is being used for wider political purposes by people who have no interest in the Health Service. That will be deplored by the service and by the public, because patient care is suffering as a result.

How long will the Minister continue to deny that there is real justice in the health workers' claim? How long will the Government continue to believe that people should be paid between 7 and 14 per cent. more if they have industrial muscle, regardless of the merit of their case, while the nurses and health workers, whose cases have great merit, should be screwed down by the Government simply because they are believed not to have industrial muscle?

I am not sure whether it is part of the SDP's extraordinary incomes policy that Health Service workers should be paid 7 or 14 per cent. more. However, in the next few days I shall be having talks with the Royal College of Nursing. As I announced in the debate last week, Mr. Pat Lowry is opening communications between the unions and the Government. Talks on that are continuing.

Does the Secretary of State agree that this problem has been caused by his pig-headed attitude towards the Health Service? When will he recognise that there is not only a legitimate case, but that finances should be made available to meet the just claim that has been put forward by the Health Service workers?

Before the hon. Gentleman comes out with such generalisations, I hope that he will recognise that the Health Service unions' claim would cost about £750 million. I do not believe that that is realistic.

Does my right hon. Friend agree that there is, unfortunately, an appalling difference in the standard of service set by some employees in the National Health Service compared with the example and dedication of the British people in the South Atlantic?

We should not generalise on that. I should like to pay tribute to the nurses and the other staff who have remained at work in the Health Service while the industrial dispute has taken place.

Instead of deliberately trying to divide one set of Health Service workers from another, will the Secretary of State give a proper mandate to Mr. Pat Lowry and ask him to open negotiations with extra money on the table? If he were really interested in the patients, he would be prepared to do that now.

Because I do not believe for one moment that we can sub-contract the decision about how much the Government can afford to pay in this connection, I have asked for Mr. Lowry's help. Those talks are proceeding, and I hope that the hon. Lady will leave it at that.

Private Patients (Greenwich And Bexley)

3.

asked the Secretary of State for Social Services how much money was not collected from private patients using beds or out-patient services such as pathology and X-ray services in National Health Service hospitals of the Greenwich and Bexley area health authority during the financial year 1980–81; and what action has been taken by the Greenwich and Bexley area health authority to recover this money from the consultants who failed to identify these private patients.

It is not possible to say what charges for accommodation and services may not have been recovered from private patients by the former Greenwich and Bexley area health authority, but I agree with the implied criticism of that authority's arrangements for the management of private practice. I have taken steps to ensure that improved procedures are introduced and that the new health authorities will keep these under review to minimise the risk of loss of income.

As this was the second year running that those weaknesses occurred in that area health authority, is there not a case for trying to find out how much money was lost and then trying to collect it?

The auditor's second year's inquiry showed that the situation was improving. The former area treasurer resigned on the ground of ill-health, and a treasurer was installed by the regional health authority, which led to some improvement. We have discovered exactly what was wrong. It is simply not possible, because of the lack of records, to discover how much money was lost. The most important thing is that the new district health authorities are applying proper procedures, and we shall ensure that all charges are collected in future.

Will my hon. and learned Friend accept that, instead of spending a great deal of money on inquiring into the past, it would be far better for the district health authority, especially in Greenwich, to use what money it can to keep the Brook cardiac unit going and, if possible, to reopen the Eltham and Mottingham hospital?

I agree that it is pointless going back into the past when we know exactly what was wrong. That is fully set out in the statutory audit report. We have, therefore, taken steps to make sure that better procedures are applied by the new health authorities which have taken over from the now defunct area health authority in question. The Brook cardiac unit is a separate issue. I know of my hon. Friend's concern and I shall consider it carefully when I receive recommendations from the regional health authority.

Will the Minister give the House a guarantee that this practice has not been taking place in any other areas or districts, and that it will not happen in any areas or districts in the future?

In March of this year we issued a fresh circular setting out clear guidelines to all health authorities about the procedures that are to be followed, and with enough copies for them to be made available to all staff and consultants. I assure the hon. Gentleman that we are quite determined that the Health Service should recover proper charges, because the total of £52 million received by the NHS each year from private practice is a valuable contribution to our resources.

Industrial Injuries Scheme

4.

asked the Secretary of State for Social Services if he will make a statement on the Disablement Income Group's response to his White Paper on the future of the industrial injuries scheme.

The thoughtful comments of the Disablement Income Group are being closely studied. It gave a general welcome to the White Paper and supports most of the proposals that it contains. It has expressed reservations regarding three of the 13 main proposals, and of course those reservations will be taken into full account before any final decisions are taken.

Is the Minister aware that he has failed to reply to the Disablement Income Group's main charge that the proposed reduced earnings allowance flies in the face of the universally accepted case for a national disability income? I and the trade unions are deeply concerned. We fear that the proposals in the White Paper are a further attack on hard-won rights to social security benefits—for instance, the abolition of the injury benefit, the introduction of a 15-week waiting period for disablement benefit, and the abolition of the widows' industrial death benefit, to name but a few. Is the Minister—

Order. That is not a few. The hon. Gentleman has asked a long question.

I shall answer the first question. We recognise the problem and acknowledge the force of the DIG argument for a partial incapacity allowance. However, we cannot agree that an allowance for loss of earnings should be abolished. This is an important factor in compensating for the effects of industrial injuries and shows the difference of approach between the trade unions and the DIG, both of which the hon. Gentleman says that he represents today.

How, specifically, does the Minister respond to the Disablement Income Group's charge that abolishing the higher rates of constant attendance allowance will penalise the most severely disabled and make it yet more difficult for many of them to live at home? In view of the much higher costs of institutional care, is this not a silly and self-defeating proposal, as well as being inhumane? How does it square with the Conservative Party's pledge at the last election to single out the disabled for special help?

The proposal to abolish the constant attendance allowance must be seen in the general context of the package proposed in the White Paper. At present there are only 2,300 recipients of constant attendance allowance, against more than 250,000 in the main scheme's attendance allowance. It is administratively sensible to merge those, and, indeed, constant attendance allowance beneficiaries are likely to gain up to £48·30 a week by extra loss of earnings allowance.

Oral Contraceptives

5.

asked the Secretary of State for Social Services for how many woman oral contraceptives were prescribed in the past 12 months.

Provisional figures suggest that oral contraceptives were prescribed for just over 2·8 million women in England in 1981.

Will my hon. and learned Friend say what percentage or number from that figure were prescribed for girls under the age of 16? Will he categorically deny the report attributed to him in the DailyMail of 1 May that he recommended the prescription of the contraceptive pill for girls under the age of 16 and that doctors do so without consulting their parents?

In answer to my hon. Friend's first question, I cannot give any age breakdown for women who receive contraceptive advice, because GPs do not keep statistics on that basis. In answer to the second question, a sub-editor in the Daily Mail put a very racy headline on a speech of mine, saying that I was urging the pill for under-16s. I am glad to say that the text made it clear that I said that every effort should be made by doctors consulted by patients under 16 years of age to persuade them to involve their parents, before going on to give any advice.

Death Grant

6.

asked the Secretary of State for Social Services if he will make a statement on the response so far received to his consultative document on the death grant.

We have issued about 2,000 copies of the consultative document and have so far received replies from 31 organisations and 19 individuals commenting on the proposals.

As 10 weeks of the consultation period have now passed and there are only six weeks to go, will the Minister tell us how many of the 31 organisations and the 19 individuals supported any or all of the options put forward in the consultative paper?

Thirty-one of the correspondents would prefer a higher grant to be more widely available than in the proposals, eight are broadly in favour of one or other of the proposals, eight are non-committal, and three favour the abolition of the death grant.

Is the Minister aware that if the death grant had been index-linked, in the way that pensions are linked, the £30, even in the three years during which his party has been in Government, would now be £45? Surely there is good reason for making an immediate substantial award, which could always be clawed back in respect of people who can afford to die?

If it were index-linked, no doubt the contributions relating to it would also have to be index-linked.—[HON. MEMBERS: "Why?"] Because it is a contributory benefit under a national insurance scheme. This House is reluctant to increase national insurance contributions.

Even before all the representations on the consultative document have been received, will my hon. Friend say that the Government's preference is to change to a system in which there would be a substantially higher death grant, but payable particularly to those in need?

If the majority of the representations on the consultative document suggest that the Government should make an across-the-board substantial increase in the death grant, will the Government accept that?

The problem is that resources simply are not available to enable a substantial grant to be made to rich and poor alike.

Supplementary Benefit

7.

asked the Secretary of State for Social Services when he will implement the advice of the Social Security Advisory Committee to update the £300 limit for supplementary benefit single payment.

We are carefully reviewing the recommendations in the committee's annual report, including the suggestion of raising the level of the £300 capital rule for single payments. We considered very carefully earlier this year the possibility of increasing it but decided at present to concentrate the available resources on other aspects of the scheme, including raising the overall capital limit for all supplementary benefit claimants.

Is my hon. Friend aware that a significant number of elderly people put a few hundred pounds aside for their funerals and, as a result, are not eligible to receive a single payment towards the cost of high fuel bills either this winter or next winter?

I am very much aware of that point. That factor is much in our minds in reconsidering the future of this part of the rule.

Is the Minister aware that the number of those who have been unemployed for more than a year is now approaching 1 million and that many of them have saved to try to help their pensions when they reach the age of 65? Having saved £2,000 or more, they now find that they are not entitled to supplementary benefit. Do the Government really intend to penalise thrift in this way? If not, when do they propose to do something about the matter?

This is a difficult problem, as all Members will recognise. We are dealing with the means-tested safety net scheme of supplementary benefit and it is inevitable that there should be some rule that prevents that form of help going to those who have more than a certain amount of capital. Obviously, there is room for argument about where that limit should be. We would all like to do more in some respects. What we have been able to do so far is to announce that that limit will rise from £2,000 to £2,500 in November. That is not as much as many people would like, but it is a step in a better direction.

When the increase in capital allowance for periodic payments is made, what justification will there be for making no increase in single payments? Why keep it at the present miserable £300?

The justification is that we have to choose between priorities, just as the hon. Gentleman would have to if he were in Government. We decided that the top priority was to raise the overall limit.

Aids For The Disabled (Spending)

8.

asked the Secretary of State for Social Services for what reasons spending on aids for the disabled went down from £6·3 million in 1978–79 to £5·1 million in 1980–81.

The hon. Gentleman is referring to expenditure on aids by local authorities where the number of cases assisted increased over the period in question from 237,372 to 262,109, namely by 10 per cent.

Over the same period expenditure on aids provided direct by the DHSS increased from £42,226,000 to £51,998,000, namely, by 23 per cent.

Are not the figures a disgrace, and do they not contradict the promise by the Tory Party at the general election that it would concentrate aid on those most in need? Is it not time that the hon. Gentleman resigned from his office in protest at such appalling figures?

I am not quite sure how the hon. Gentleman terms it a disgrace for more cases at a far larger expense overall to be assisted now than were assisted two years ago.

Will my hon. Friend confirm that in the International Year of Disabled People last year the Government were widely congratulated the efforts that they made on behalf of the disabled—

The International Year of Disabled People was an outstanding success and exceeded all expectations. Indeed, it was a matter for congratulation not merely from within Great Britain but internationally.

Will the hon. Gentleman explain why Ministers go on and on about this awful word "compassion", when many disabled people are being deprived of aid, despite the figures that he has quoted? Many are deprived of aid as a direct consequence of Government policy. What will the Minister do about that?

Not all the people who require help have yet received it, but it is our endeavour to try to fulfil the need as quickly as resources enable us to do so.

Does my hon. Friend agree that one way to aid the disabled without further expenditure from his Department would be for his Department to encourage the owners of public buildings to improve access for the disabled? Will my hon. Friend undertake to do that?

We are encouraging that all the time. A recent Private Member's Bill places obligations on developers and also on planning authorities.

Is it not true that in terms of cost effectiveness it would be far better to spend more money on aid?

I should like to spend all the money that could possibly be made available to me.

Chronically Sick And Disabled Persons (Telephones)

9.

asked the Secretary of State for Social Services what has been the change in the number of telephones installed under the Chronically Sick and Disabled Persons Act between 1979 and 1981; and if he will make a statement.

In the year ending 31 March 1979 local authorities assisted with the installation of 16,884 telephones. For the year ending 31 March 1981 the figure was 8,949. However, the total number of telephones in respect of which rentals were being paid was 90,503. This is a matter for local authority decision in each case.

Does the Minister agree that this is a disgraceful state of affairs? It represents a 50 per cent. cut in the number of telephones that have been given to the disabled. Since it has been impressed on local authorities that to accept the need for a telephone and then to put a person on a long waiting list is unlawful, will the Minister now state that it is equally unlawful for local authorities to reassess the individuals and therefore to escape their responsibilities under the Act?

Local authorities are looking more carefully at whether individuals applying for this form of assistance really need it. However, over the same period local authorities have increased assistance with telephone rentals, and total expenditure on assistance with telephones fell to a far lesser degree. If unlawful waiting lists are referred to me, I shall look into them.

Will the Minister accept that the figures are deeply disquieting? With regard to help for disabled people from local authorities, will he say what action he is taking to improve his Department's procedures in the light of the Ombudsman's report about the case of Mrs. Palfrey.

The right hon. Gentleman should be careful about what he says about Mrs. Palfrey's case. If the reports in newspapers concerning his remarks are accurate, he has misunderstood the matter. Mrs. Palfrey's case was found to be ill-founded. There were delays in dealing with the matter which are being examined and for which regrets have been expressed. Nevertheless, the result would not have been changed in any way if there had been less pressure on the staff dealing with the case.

Home Helps

10.

asked the Secretary of State for Social Services how many local authorities now charge the long term sick and disabled for home helps supplied under the Chronically Sick and Disabled Persons Act.

Eighty-seven local authorities are known to have charged at least some of their clients for home helps during the financial year 1980–81. No information is held centrally about the numbers of long-term sick and disabled people who were charged for home helps nor about the particular statutory provision under which home helps were provided.

Is that not an appalling tax on the most needy and poorest members in our community? Did not the Government specifically ask local authorities not to charge when they stopped the Supplementary Benefits Commission from aiding those people in 1980? Were they not warned about this by my right hon. Friend the Member for Manchester, Wythenshawe (Mr. Morris) at the time?

Under legislation passed by the House, these are matters for determination by the local authorities. Nevertheless, the Government have made it clear time and again that in effecting economies they do not wish to see the local authorities disadvantaging the most vulnerable in our society.

While no one particularly enjoys charging the disabled for home helps, is it not true that in present economic circumstances an alternative might have been to reduce the total number of home helps? Is it not arguable that that would have been of even greater disadvantage to the people to whom the questioner refers?

According to the figures published by the Chartered Institute of Public Finance and Accountancy there has been an increase in the number of hours provided by home helps.

Is it not the case that in successive questions on telephones and home helps we have seen that the cuts undertaken by the local authorities at the direction of the Government are harming the most vulnerable in our society? When will the Government do something about that?

Nurses

11.

asked the Secretary of State for Social Services whether the long-term arrangements for nurses currently being negotiated have yet been settled.

Following my discussions with the nurses and midwives Whitley council on 17 March, a small working group under the chairmanship of my hon. and learned Friend the Minister for Health had its first meeting on 10 June. At that meeting it was agreed that the aim should be to have a new permanent arrangement in place in time for next year's pay settlement. However, it remains clear that a great deal of work needs to be done to develop the ideas that have been discussed so far and the next meeting will therefore be held shortly.

The nurses, physiotherapists and similar workers in the Health Service take no pleasure in these annual negotiations, and I am happy that my right hon. Friend is proceeding towards a long-term agreement. May I express the hope that it will be borne in mind that if there cannot be a permanent agreement for the long term, even a two, three or four-year agreement would be useful in saving this annual strife?

I entirely agree with the generality of my hon. Friend's remarks. We are seeking new permanent arrangements that will continue year after year. I do not think that anyone in the Health Service wants the annual strife that we have seen. We want something that is more sophisticated, more accurate and fairer than the Clegg Commision of last year.

Will the right hon. Gentleman confirm that in the paper sent to the staff side organisations in February 1982 the Government laid the greatest stress on what they called the concept of affordability? Will he tell the House precisely what he means by that? Will he tell the House also why his hon. and learned Friend the Minister for Health gave strong hints at the meeting of 10 June to all the staff organisations to the effect that the special arrangements for pay for the police and the firemen were to be abolished?

I do not think that the hon. Gentleman has given an accurate description of what my hon. and learned Friend said. The hon. Gentleman must by now be aware that we have said that the new arrangement should have a number of elements. One element is the job position within the profession. Another element is comparability and a further element is what the nation can afford. That is why it is an improvement upon anything that has gone before.

I appreciate what my right hon. Friend has said, but will he accept that the nursing profession, especially the Royal College of Nursing and the paramedical staff, do not and will not go on strike, and for that reason they deserve to be treated as a special case? Will he give an assurance to the House that the special arrangement that he has mentioned today will definitely be implemented for the next financial year? Will he accept that many of his right hon. and hon. Friends would like to see it implemented during the present financial year?

I give the assurance that we shall do our utmost to have the new arrangement in position by April 1983. I am glad to repeat that assurance to my hon. Friend. I repeat also that we recognise the special position of nurses and, of course, that of the Royal College of Nursing.

Whatever the long-term arrangements that are being negotiated, which no doubt will be welcomed because they will replace the annual bargaining, will the right hon. Gentleman accept that the offer of 6 per cent. for nurses and 4 per cent. for other Health Service workers has been greeted with a sense of outrage, especially when senior civil servants and judges can get 18 per cent. without even asking for an increase? Health Service workers are being driven to take industrial action by the Government's parsimony. Is the right hon. Gentleman aware that Health Service workers in the Airedale general hospital in my constituency welcome the support of Arthur Scargill and the miners in their struggle?

I know of very few who work in the National Health Service and who respect the interests of the service who welcome Mr. Scargill's intervention, which, from the point of view of the Health Service, is a disaster. It will result in a great deal of lost support within the Health Service.

Kidney Transplants

12.

asked the Secretary of State for Social Services, further to his answer on 9 March, Official Report, columns 714–15, whether he will give an explanation of the procedure to be followed in deciding which patient should receive a kidney transplant.

14.

asked the Secretary of State for Social Services, further to his answer on 9 March, Official Report, columns 714–15, whether he will give an explanation of the procedure to be followed in deciding which patient should receive a kidney transplant.

The procedure is mainly designed to ensure that the best possible medical match is achieved between donor and recipient. When a kidney becomes available for transplant, it is tissue typed and the details are checked with patient records to obtain a list of suitable patients in priority order.

Will the Minister give an assurance that no priority will be given to private patients in the provision of kidney transplants? Will he give a further assurance that at least some consideration will be given to the 20,000 patients who are awaiting transplants? If the estimated cost is £70 million, will he put pressure on the Cabinet to allocate that sum, instead of spending billions of pounds on the Falklands dispute?

I can give the hon. Gentleman the first assurance that he seeks. No priority has been given to private patients and none will be given. Patient needs will be assessed on medical grounds alone. The major inhibition in reducing waiting lists is the shortage of kidney donors. The "Panorama" television programme on brain death did considerable harm in reducing the number of donors available. I am glad to say that the position is now recovering. We are as anxious as the hon. Gentleman to reduce waiting lists.

As there is an unmet need for kidney transplants approaching about 14,000, is it not unethical for kidneys specifically donated to the National Health Service to be made available to private patients? Will he give an absolute assurance that no private patient will ever receive a kidney transplant which, according to the criteria of allocation operated in the public sector, he would not get if he were not paying?

I hope that I have already made it clear that National Health Service kidneys are made available only to patients who are eligible for NHS treatment. Priority is determined on medical grounds alone. On the assumption that the procedure is being followed properly, and I have no evidence that it is not, no one should get priority in receiving a kidney transplant because he has opted for private treatment. On the other hand, there is no point in stopping patients opting for private treatment when they receive kidneys in the right priority order.

Does the hon. and learned Gentleman agree that the consultant who performs a kidney transplant in the private sector is not the most impartial person to decide which person on the common waiting list is the most suitable for an available kidney?

Kidneys, which are in short supply, are distributed largely by the United Kingdom transplant service. The tests that it applies to judge priority take no account of whether the patient will be a private patient or an NHS patient.

We welcome the Minister's assurance. Will he now give an undertaking that there will be a positive publicity campaign to tell the public how many people die unnecessarily every year when kidney donors could be found if only they could be encouraged to carry kidney donor cards?

I am grateful to the hon. Lady for her support. The major problem is the reluctance of many medical people to begin the procedures for obtaining a donor kidney when they have a patient who, unfortunately, has died while in their hands.

Invalidity Benefit

16.

asked the Secretary of State for Social Services how much it would now cost to restore the 5 per cent. cut in invalidity benefit; and how many people would have their incomes increased by restoration of the cut.

The estimated net cost in 1982–83 of restoring the 5 per cent. cut in invalidity benefit is £50 million. The numbers of invalidity pensioners who would have their incomes increased by restoration is estimated to be 620,000.

The Minister will be aware that the 5 per cent. cut was introduced in lieu of taxation and that there are 600,000 currently suffering an adverse poll tax. Will he give a categoric assurance that the benefit will be restored in full and that the Government will not cheat as they did on unemployment benefit?

Yes. I can give that categoric assurance. Indeed, it has been given on many occasions by my right hon. and hon. Friends.

My hon. Friend has stated that the estimated cost of restoring the cut is only £50 million and that about 650,000 would enjoy the benefit of the restoration. Bearing in mind his personal interest in invalids, will he do his utmost to ensure that restoration takes place in the course of this year?

We estimate that the amount of tax that would be paid on bringing the benefit into tax would be rather higher than £50 million. It seems certain that almost all invalidity pensioners would pay tax if it were taxable.

When is it now proposed to tax invalidity benefit? Why has the timetable gone wrong?

As my right hon. and learned Friend the Chancellor of the Exchequer said in his Budget Statement last year, implementation has been put off for 1982. No further date has yet been given. Obviously it is for my right hon. and learned Friend to give a date.

Nhs (Ancillary Workers)

17.

asked the Secretary of State for Social Services what is the average pay for ancillary workers in the National Health Service.

Average earnings are £104·17 a week for full-time men and £84 a week for full-time women. For staff working in London, earnings are increased by allowances of up to £13·68 a week.

Is the Secretary of State aware that those wages are about the same as those of building workers and almost as much as those of skilled workers in British Leyland?

Yes. During the past three years there is no question but that earnings have increased by about 50 per cent.

Is the Minister aware that many ancillary workers are still extremely badly paid? Why does he insist on offering a long-term arrangement implicitly only to nurses and other similar groups in the NHS? Does he agree that the best approach is to get all Health Service workers to accept that, in return for a "no-strike" undertaking, they will receive proper and regular special treatment to keep their pay up with those outside?

If the hon. Gentleman had listened to what I said in the debate on this matter last week, he would have heard me give almost exactly the assurance for which he now asks. I am quite prepared to discuss new, permanent arrangements for other NHS staff.

The Minister gave the statistics for "a week"? How many hours is that? Does he agree that he is including overtime, which means that it is often a week and a half or 50 to 60 hours? Does he agree that figures are gross and that they take no account of compulsory superannuation deductions or income tax? Will he give the income for a basic 37–40-hour week?

I have already given the average earnings figures. I shall give the hon. Gentleman the overtime figures, which he has grossly exaggerated. The average overtime worked by a male ancilliary is 5½ hours a week and that of a woman is 1½ hours a week.

Is my right hon. Friend aware that workers carrying out general duties in the Health Service take twice the share of the cake of total expenditure as they do in the United States? Will my right hon. Friend take steps to increase the provision of private facilities to carry out those services, as opposed to the overwhelming percentage now being carried out by the public sector?

My hon. Friend knows that we are examing that area of policy. He also knows that we have not cut NHS finance. We have increased spending on it by 6 per cent. in real terms. We now spend more than £12 billion a year on it.

Is the Minister aware that many ancillary workers will resent the fact that he has used figures that have been twisted to provide the Government with a stronger case? Is he aware that many ancillary workers will resent that, especially as they know that many of them take only half of the sum that he quoted in net pay? Is he also aware that they will deeply resent the fact that the hon. Member for Chorley (Mr. Dover), who raised the matter, is the same hon. Member who was not satisfied with his parliamentary salary and wanted to keep his local government salary as well when he came to the House?

I published the average earnings of ancillaries some weeks ago. They have not been challenged by any reputable body or person.

Nhs (Hospital Beds)

18.

asked the Secretary of State for Social Services what is the latest figure for unopened new beds in National Health Service hospitals; and what action is proposed to bring them into use.

In March this year 934 new beds in seven NHS hospitals were unopened. These beds are being progressively brought into use as resources permit. Continuing delays in commissioning new beds will be discussed with regional health authority chairmen at annual review meetings.

Irrespective of past poor planning, which created the problem, does my hon. and learned Friend agree that the beds remaining unopened represent a serious waste of national resources? Will he ensure that the beds are opened by the end of 1983?

The problem is entirely the result of poor planning and unrealistic resource expectations. We are solving that. When the Comptroller and Auditor General produced a report on the matter he revealed that there were 3,434 unopened beds in 1979–80. We have reduced that figure to 934 and hope to eliminate the problem.

Does the Minister agree that it is disgraceful that there are still 1,000 beds that are not being used in the Health Service, at a time when the Government are encouraging private clinics, such as the Yorkshire clinic, which is near my constituency, to open and thus draw resources from the NHS? Does he agree that the Government's first priority should be to ensure a decent National Health Service for the use of all?

It is a waste. It is as a result of poor planning. We are putting increased resources into the NHS. By next year we shall have increased spending on the NHS in real terms by 6 per cent. as compared with when we came into office. That is helping to eliminate the problem of wasted unopened beds in new hospitals.