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Mr. John Marshall (Hendon, South) : There has been more than a whiff of hypocrisy in the debate. It is well to remember the tactics that have been employed by the ambulance men in London this week. They were to maximise public inconvenience and minimise the cost to their own pay packets. Those are the tactics of the blackmailer and the bully-boy in the 1980s. [Interruption.] They are quite disgraceful tactics, and I thank the Opposition for their support. Faced with those tactics, any responsible Government would have done the same as the present Government have done. After all, the Labour Government put the green goddesses on to the streets in 1978-79.
Mr. Merlyn Rees (Morley and Leeds, South) : On that occasion, the fire service was shut down completely. Obviously, in that situation, any Government had to save lives. If the hon. Gentleman thinks that this is on all fours with the firemen's dispute, he is looking back 10 years to when he was not a Member of Parliament.
Mr. Marshall : As a former Home Secretary, the right hon. Gentleman knows that 90 per cent. of cases in London are not emergency cases, and those are the cases with which the ambulance men are not dealing. Surely, when 90 per cent. of cases are not being dealt with, it is the Government's duty to take some action. Labour Members' lectures on Health Service staff wages are like Satan rebuking sin. The last Labour Government were responsible for a massive decline in the living standards of nurses and others in the Health Service. This afternoon, we heard the Labour party's first commandment--"Thou shalt not annoy thy union paymasters." The House has heard from the hon. Member for Linlithgow (Mr. Dalyell) that he had been meeting ambulance workers for the past eight weeks. He did not say that he condemned their action or that he asked them to go back to their normal work. Labour party leaders will never condemn union action that creates hardship for others or is responsible for job losses.
Column 1211Some people say that the Government should pay whatever is necessary to end the dispute, but they do not consider the consequences. If people are paid a certain sum to stop an irresponsible strike, the result will be a rash of irresponsible public sector strikes. If the Government pay huge sums for every irresponsible strike, the result will be rip-roaring inflation. Opposition Members know all about that, because they were responsible for it before. Those who suffer most from rip -roaring inflation are those for whom the Labour party claims to stand--the elderly, the sick, and the poorest paid. The weakest members of the community suffer from rip-roaring inflation. That is why the Government are right to stand firm rather than to pay up and give in to blackmail, which is what they are being asked to do.
Mrs. Audrey Wise (Preston) : The ambulance workers of Lancashire are as keen as the ambulance workers in the rest of the country to achieve a proper wage structure. They are just as determined in their action, but there is a significant difference between the position of the people of Lancashire and that of the people of London and other parts of the country: the people of Lancashire have their emergency ambulance service secured, because the chief ambulance officer has decided that he will not have the Army, the police or any other organisation running ambulances in Lancashire. He talked to the trade unions and, as could be the position everywhere else, there is in Lancashire an emergency service covering 999 calls, maternity calls, the terminally ill, renal dialysis calls, radiotherapy and special categories of people at risk. There has been an agreement with the trade unions, the organisations that Conservative Members are castigating and slandering this evening.
The ambulance workers of Lancashire have shown determination to win their proper pay. In common with their colleagues throughout the country, they have also shown their devotion to the service. All ambulance workers would gladly sign the sort of agreement which was signed in Lancashire this morning.
I recommend that the Secretary of State consults the chief ambulance officer of Lancashire and follows his example. As it is supposed to be the trade unions alone who are making certain claims, I recommend that the right hon. and learned Gentleman reads yesterday's editorial comment in the Lancashire Evening Post, which states :
"It is a sad fact of life that too many people take too much for granted and that applies particularly to the three emergency services.
The only time we really take note of ambulancemen and women is either when we need the service personally or when its personnel are involved in saving life during the aftermath of a national disaster."
The article continues :
"Backed by public support and sympathy, the ambulancemen's case is a sound one."
That is right.
The Government are making a tremendous error in thinking that they can distinguish between patient care and the work of the ambulance service. That is their excuse for refusing arbitration. In the terms of the Government's
Column 1212reply to the Select Committee on Social Services, they are afraid that money will be "diverted from patient care", but the ambulance service and ambulance workers are patient care. There is no patient care unless these workers do their job as they want to do. The population is behind them, as the Secretary of State will learn to his cost. Come to Lancashire, Secretary of State, and learn from those who have saved the emergency service in the county without the ambulance workers having to lose pay--
Mr. Kenneth Clarke : Does the hon. Lady appreciate that the management in London entered into an agreement with the unions on 24 October which put ambulances back on the street? Earlier this week, with the approval of her party, the unions cynically broke that agreement and returned to the old operation of their 14-point plan.
Mrs. Wise : Like the Secretary of State, I have had the privilege of listening to my hon. Friend the Member for Livingston (Mr. Cook). Consequently, I am fully seized of the situation in London. The London ambulance workers are willing to run an ambulance service which would be entirely adequate. As my hon. Friend the Member for Crewe and Nantwich (Mrs. Dunwoody) has said, that service may even have advantages. The right hon. and learned Gentleman's argument will not wash.
The ambulance and emergency services for Lancashire have been saved. If the Secretary of State would give way and cease his provocation, the emergency service for the rest of the country could be saved as well.
Mr. Richard Holt (Langbaurgh) : We all know the story about the man who asked the yokel where he was and the route that he should take, whereupon the yokel told him that he had come from the wrong place. Where are we in this dispute? We are in a mess. In fact, we are in a hell of a mess. Why are we in it? I suggest that there are many historical reasons, which have not all surfaced today.
The first roots of the dispute were established in 1978, and they were part and parcel of what led to the Clegg report of 1979. If ayone wants to dispute that, let me make it clear that I have the report with me and can quote from it if necessary.
I am a practising personnel man who has been involved in industrial relations for over 20 years, but I could not find my way around, or understand, what is going on. There are far too many negotiators. There are far too many people who have their fingers in the pie. There is the Whitley council. What is that body and where is it? How are the members of the council appointed and where are they appointed? There are unions with leaders who clearly do not have the trust of their members ; if they did, they would be able to strike a deal and adhere to it. Management is not negotiating because it does not have control of the finances. A financial limit is imposed upon it. No self-respecting management that is in that position can enter negotiations and strike a deal.
What is the role of the Secretary of State? He is player No. 5 in this game. No one knows what his role is, but we all have suspicions. Finally, there is the Treasury, which is player No. 6. We are still not sure about the nature of the Treasury's role.
Much is said about comparability and the Clegg report. Hon. Members talk about the report as if it came down from the mountains. They suggest that it is inviolate and
Column 1213right for all time, and never could have been wrong in the first place. We must recall the days when the Clegg commission was established. What was the climate of that time? How many people were in dispute at that time? When we read the Clegg report and everything that is related to it, we find that it is one, two or three, and then the ambulance men. The report states that it had to make assumptions when it came to determining comparability because it did not have time to discover the facts. The Clegg commission was given too great a brief and too little time. As a result, the ambulance men's case came last. The commission did not do its job properly. If there were a re-examination now of the ambulance men alone, we might come to different conclusions.
Who can put his hand on his heart and say that in his opinion ambulance men are dealing with emergency cases all the time? The figure of 10 per cent. refers to time and not to cases. How many firemen are dealing with emergencies for more than 10 per cent. of their working day? I would back the firemen's snooker, darts and other teams in my area against the teams formed by the ambulance men in the area, even though the firemen do not have quite so much free and down time as the ambulance men. However, we are told that the ambulance men must have more. The Clegg commission made a mistake and did not do its job properly. It considered the issues in hindsight and as a consequence the argument that is advanced on the basis of the Clegg report is unsound.
Mr. Eddie Loyden (Liverpool, Garston) : Does the hon. Gentleman realise that firemen are always ready to respond to calls? The only way in which we could oblige the hon. Gentleman would be to set fire to our cities so that the firemen could work 24 hours a day. Is that not ridiculous?
Mr Holt : A great deal of what we are discussing is ridiculous. The ambulance men's dispute should never have reached its present stage. That is ridiculous. To some extent, it is ridiculous to talk about the events of 10 years ago. To talk about 6.5 per cent. when everyone else, including ourselves, is getting more is also ridiculous. We are told that there is a man who has the freedom to negotiate when he has not, and he is saying silly things about the ambulance men having £600 to come, for example, when that is their money, money which has been withheld for the past few months. It is said that they can have some of next year's money, but that is not the way for anyone to negotiate this year's agreement. That is entirely the wrong approach.
The Clegg report states :
"We have no direct information relating to comparable conditions of service, but ambulancemen's conditions of service are broadly the same as for NHS ancillaries."
That is how out of touch Clegg was in his report. He actually equated ambulance men, who deal with emergencies, with cooks and porters in hospitals.
I am a little closer to this issue than some of my colleagues because I am one of the few Conservative Members who have actually met Roger Poole and the others concerned with the dispute. Far too many unions are involved--we are trying to deal with five unions, and we should be trying to do something about that. Roger Poole, in a letter to me, states that the unions are looking
Column 1214for a pay formula that would ensure that never again would ambulance staff have to take industrial action over a national wage claim.
One of the comments in the Clegg report is that these people do not feel that society gives them the status that they should be given. It suggests that they should be monthly salaried--but 10 years on, no one has actually thought about it. That is something that the Government could be doing now. The pay review body should be thinking about the status of ambulance staff, and we should be considering no-strike agreements similar to those with the police and others in the public sector. The Government Front Bench are snared, but they can get themselves off the hook if they listren to their friends on the Conservative Benches.
Mr. Nigel Spearing (Newham, South) : The hon. Member for Langbaurgh (Mr. Holt) has properly pinpointed some of the anomalies as they are perceived by a Conservative Member. There is a powerful case for those anomalies to be referred to the Arbitration, Conciliation and Advisory Service. I hope that he agrees with that, and that he will condemn the disgraceful speech of the Secretary of State. The right hon. and learned Gentleman's speech demeaned the occasion and, indeed, demeaned him.
I do not enter this debate with a National Union of Public Employees briefing or with a briefing from any union. My interest lies in the death of Mrs. Margaret Lander, a constituent of mine, and the suffering of a Mr. Lambert, both of Canning Town. More than a fortnight ago, they waited an hour for an ambulance when, only five minutes away at the Plaistow ambulance station, ambulance crews were willing and waiting to take them to hospital. Last Tuesday, the Secretary of State had the effrontery to say that ambulance people were only pretending to be available. I can tell him that since 9 am yesterday, more than 100 calls to the London ambulance service have been answered by ambulance personnel, most in voluntary time and through the radiotelephone system.
The Secretary of State's conduct has been very bad, and I criticise him on two main grounds. However, before doing so I want to comment on the points made by the hon. Member for Birmingham, Edgbaston (Dame J. Knight), who referred to pay. If she believes in market forces, as do most Conservative Members, she should pay attention to the haemorrhage in the personnel of the London ambulance service. Of the 2,700 staff, 680 left during the two years to June and of those, 380 left before normal retirement age and 200 because they were unfit. Dame Jill Knight rose --
Mr. Spearing : I am sorry, but I cannot give way. I am responding to points made by the hon. Lady. She knows, as do all those who referred to the 10 per cent. time factor, that it is misleading because those who deal with non-emergency cases are still dealing with sick people who are in distress. Those who care for those who are in distress are necessarily under stress themselves. All ambulance crews are under stress all the time.
The Secretary of State says that Mr. Nichol is concerned with the highly skilled. He may not realise, and neither may Mr. Spry--who is not the administrator of the ambulance service, but the general manager of South- West
Column 1215Thames regional health authority--that before one can become skilled at dealing with accidents on the A1 one must do an apprenticeship in dealing with the less difficult cases. I challenge the Secretary of State to say that he and the South-West Thames regional health authority are not putting out feelers for privatising the non- emergency services--for hiving off the so-called non-emergency service. Are they not in contact with such organisations as Securicor, London Regional Transport and even borough transport authorities? I have asked the right hon. and learned Gentleman about that, but he appears not to know the answer. As Secretary of State, he should know the answer. Will he get up and tell me whether that is the case?
Mr. Kenneth Clarke : Currently, the non-emergency staff in London are offering to do about 2 per cent. of their work, but want to be paid in full. The management will not accept that. That led to the trade unions breaking their agreement on the accident and emergency services and coming out in sympathy. The money that was previously being spent on non-emergency crews is, of course, now required to pay for the hospital car service, the taxis and the other vehicles that are being used to carry non-emergency patients. There are already parts of the country where the non-emergency service has been adequately replaced by other forms of transport. The strike is accelerating that day throughout the country.
Mr. Spearing : The right hon. and learned Gentleman did not deny my main charge. He has destabilised public service after public service--in which Conservative Members appear to have no interest--by threatening the integrity of those services and calling them into question. I challenge him to say that he is not doing that, but he has already confirmed my fears in his intervention. How can we extend the hospital ambulance service by expenditure on a minicab or a black taxi to take an elderly lady to hospital? That is what the Government are doing, and it undermines the morale and the cohesion of the ambulance service. The dispute is not simply about the immediate matter of pay.
On 31 October 1986, I had a debate with the hon. Member for Derbyshire, South (Mrs. Currie). I am sorry that she is not in her place today. She said :
"About 10,500 fewer walking patients were being transported--a reduction of 44 per cent. I am more than happy at that
development."--[ Official Report, 31 October 1986 ; Vol. 103, c. 666.]
It was absolute sauce and a scandal for the hon. Lady to say that. She is no longer a Minister, but the Secretary of State and his colleagues are responsible for that policy. They are responsible for capping the funds of the ambulance service in London, when, in fact, it should be demand-led.
The right hon. and learned Gentleman mentioned the radio service. That service was introduced a few months ago, but it is an electronic computer system that does not always work properly. It sometimes jams. The Poplar ambulance station sent a detailed memorandum to the so-called administrators of the London ambulance service asking them to put it right. They have not even received a reply-- [Interruption.] I ask the Secretary of State to pay attention to what I am saying. I hope that he will stop talking to his right hon. Friend the Member for Mole Valley (Mr. Baker) and attend to the detail of the shocking maladministration of the ambulance service in London. That is the background to the dispute.
Column 1216My constituents in Canning Town were waiting for an ambulance from the local ambulance station. The administrators of the London ambulance service decreed that they should not receive their ambulance calls, and the Secretary of State must take responsibility for that decision because it was made by one man, whom I will not name, with the Secretary of State's connivance. It is he and he alone who is responsible.
Ms. Harriet Harman (Peckham) : The Secretary of State commented on how many Labour Members were in the House when he spoke tonight. They are here because they had hoped to hear something from him tonight which showed that we could look forward to the resolution of the dispute. We have heard nothing of that tonight. Those Labour Members who are present tonight are reflecting the high level of public concern in their constituencies that there should be an urgent resolution to the dispute.
The situation is serious. The Army and police vehicles and the voluntary ambulances cannot cope adequately with accidents and emergencies. To expect them to do so is unfair on ambulance crews who want to work and who have been prevented from doing so, and it is unfair on the police and the Army, who are put in the front line of a situation which is not of their making and with which they know that they cannot cope.
The Government have been right in the past to praise the ambulance service, particularly when ambulance officers and crews have risked their lives to save others. But when it comes to a pay award, they are offered less than the rate of inflation. They are offered a pay award that would let them see their standard of living slide, and that is wrong ; that would see a widening gap between their pay and the pay of the other emergency services- -the police and the fire service--with whom they have to work as a team.
The dispute need never have happened. It should never have happened. Having created the dispute, the Government are now making things worse every day and every hour.
The Secretary of State has insulted the ambulance crews that have been praised in the past by accusing them of posturing and pretending. He has twisted the facts, saying that the unions first accepted the pay offer when it is clear that the pay offer was twice refused on a ballot of all the membership. He said again and again in the House tonight that the union is on strike. The ambulance crews are not on strike ; they have been suspended. Is he so out of touch with what is happening outside the House that he has not seen today the London ambulance service vehicles taking ambulance calls with signs on the side saying, "Suspended but still working"? Those ambulance crews want to work, but they are being prevented from doing so. The ambulance crews are rightly concerned about the pay offer, not just as a matter of justice for themselves, but because they rightly have long-term fears for the future of the service. As my hon. Friend the Member for Newham, South (Mr. Spearing) said, ambulance crews are voting with their feet and leaving the ambulance service. The fact that the London ambulance service, like other ambulance services, is understaffed contributes to the fact that only half our ambulance services meet the Government guidelines for getting to accidents and emergencies on time. The Surrey
Column 1217ambulance service, which serves the constituency of the Minister for Health, does not meet the Government target for getting to accidents and emergencies on time.
The Secretary of State talked of bonds of common humanity. I hope that he will listen to the case of Mavis Thomas, whose sister came to see me in my surgery. Mavis Thomas, aged 17, had an asthma attack and an ambulance was called. The London ambulance service told me that no vehicles were available at the nearest three ambulance stations. It took half an hour for the nearest ambulance to arrive, and by the time Mavis Thomas reached hospital it was too late to resuscitate her and she died. Understaffing has contributed to the situation where the service cannot provide the ambulance service that we all want to see.
If the Secretary of State had talked to ambulance crews, he would know, as we do, that they do not want to be prevented from working. He would know, as we do, that they do not want to be in an industrial dispute. They do not want to be in political controversy. They want to do their job, and it is that job that the public want them to do. The Government are gambling with people's lives, both currently and in the future. They must agree to arbitration.
The Secretary of State has offered no hope of a solution tonight. The House must vote for arbitration to replace confrontation. If we do, the dispute could be ended tonight.
The Minister for Health (Mrs. Virginia Bottomley) : All of us in the House feel strongly about the important contribution made by the skilled and dedicated service of ambulance staff. None of us wants to underestimate the important part that they play in caring for the sick and the injured, often in stressful and difficult circumstances.
I want to pay a special tribute to the chief ambulance officers and all their staff who are struggling to maintain services to the public. Many have refused to turn their backs on their
responsibilities. Members of the Association of Professional Ambulance Personnel have declared themselves unwilling to countenance action that would hurt patients.
But having said that, I want to make it clear that today we have seen the Opposition in their true colours. It sends a shudder down one's back to think that, were the country ever so unfortunate as to have the Labour party in power again, once again it would be beer and sandwiches and, "Let's sort this out. Let's pay up. Who cares?" The frail and the vulnerable cannot speak. They do not have the strong arm of the trade unions. What they need is the long arm of the Government.
It is an interesting contrast that a week ago, when we were discussing the fundamental element of our primary health care proposals, the contract for the general practitioners, the Opposition Benches were almost empty. But today, with the whiff of industrial action, they come out of their lairs. With the prospect of a picket line, they stir from their lethargy.
Once again, we are reminded of the winter of discontent. Health care is to be decided not by those with the skills to decide on how best to meet patients' needs, not by medical and other practitioners, but by trade union
Column 1218guidelines, by the COHSE and NUPE convenors, who take it upon themselves to decide whether a case is urgent or needy.
Mr. Nellist rose --
Mr. Jeremy Corbyn (Islington, North) rose --
Mr. Corbyn : It is a point of order, Mr. Speaker. The Secretary of State and the Minister of State have, throughout their speeches, vilified the National Union of Public Employees, which is my union, and at no stage have they been prepared--
Mrs. Bottomley : Much has also been said about those who are not involved in emergency work. All of us agree that the nine out of 10 miles that the ambulance crews ride looking after those who are not accident or emergency cases are equally important. They are vulnerable and frail people who need the services that the ambulance crews should properly and rightly provide. Nor will the people of London think much of the argument that ambulance crews who are not carrying out a full day's work should receive their full pay. The facts speak for themselves. This year the Government have provided the largest ever increase in NHS funds, far in excess of anything that the Labour party would ever have been able to provide. Within those generous resources, it must be right that the NHS management should decide how the resources are to be allocated, which are the cases that should be dealt with and how the rewards should be paid to those who work.
If patients are to experience the high standards of health care that we are determined to provide, Health Service employees must know that we shall protect them from the reckless and excessive claims of trade unions. Patients--the frail and the vulnerable ; those who cannot speak, and who have not the strong arm of the unions behind them--must know that they can have confidence in our running of the National Health Service.
We want a speedy resolution of the dispute. We want to see service personnel return to their barracks, and not to be forced to man the ambulance service. And, of course, we want the unions to return to the Whitley council so that we can discuss in detail many of the aspects that have already been raised.
In London, where the thrust of this appalling action is taking place, this year's settlement would ensure that the pay of ambulance staff was well ahead of inflation. I ask
Column 1219the House to reject the outrageous claims of the Opposition, and to reject the motion. The Government believe in the National Health Service ; we believe in those who work for it ; and, above all, we believe in the patients. We do not believe that the National Health Service should be run by the excessive claims of irresponsible trade unionists.
Question put :--
The House divided : Ayes 204, Noes 297.
Division No. 386] [7 pm
Abbott, Ms Diane
Adams, Allen (Paisley N)
Archer, Rt Hon Peter
Ashdown, Rt Hon Paddy
Ashley, Rt Hon Jack
Barnes, Harry (Derbyshire NE)
Barnes, Mrs Rosie (Greenwich)
Benn, Rt Hon Tony
Bennett, A. F. (D'nt'n & R'dish)
Bray, Dr Jeremy
Brown, Gordon (D'mline E)
Brown, Nicholas (Newcastle E)
Bruce, Malcolm (Gordon)
Buckley, George J.
Campbell, Menzies (Fife NE)
Campbell, Ron (Blyth Valley)
Campbell-Savours, D. N.
Carlile, Alex (Mont'g)
Clark, Dr David (S Shields)
Clarke, Tom (Monklands W)
Clwyd, Mrs Ann
Cook, Robin (Livingston)
Davies, Rt Hon Denzil (Llanelli)
Davies, Ron (Caerphilly)
Davis, Terry (B'ham Hodge H'l)
Duffy, A. E. P.
Dunwoody, Hon Mrs Gwyneth
Evans, John (St Helens N)
Ewing, Harry (Falkirk E)
Ewing, Mrs Margaret (Moray)
Fields, Terry (L'pool B G'n)
Garrett, John (Norwich South)
Godman, Dr Norman A.
Golding, Mrs Llin
Griffiths, Nigel (Edinburgh S)
Griffiths, Win (Bridgend)
Harman, Ms Harriet
Healey, Rt Hon Denis
Heffer, Eric S.
Hoey, Ms Kate (Vauxhall)
Hogg, N. (C'nauld & Kilsyth)
Home Robertson, John
Howarth, George (Knowsley N)
Howell, Rt Hon D. (S'heath)
Howells, Dr. Kim (Pontypridd)
Hughes, John (Coventry NE)
Hughes, Robert (Aberdeen N)
Hughes, Roy (Newport E)
Hughes, Simon (Southwark)
Jones, Barry (Alyn & Deeside)
Jones, Ieuan (Ynys Mo n)
Jones, Martyn (Clwyd S W)
Macdonald, Calum A.
McKay, Allen (Barnsley West)
Mahon, Mrs Alice
Marek, Dr John
Marshall, David (Shettleston)
Marshall, Jim (Leicester S)
Martin, Michael J. (Springburn)