House of Commons Hansard Debates for 11 Jan 1990

Mr. Michael Jack (Fylde) : Does the hon. Lady agree that the word "privatisation" is an incorrect description of what may be a process involving competitive tendering for services, which has led to hundreds of millions of pounds worth of extra resources being available for patient care in the Health Service?

Ms. Primarolo : I should be delighted to debate the virtues of privatisation of the National Health Service, but that is not what we are discussing. So far, the contracts that have been negotiated, particularly for catering and laundry, show that three multinationals dominate--for profit and not out of public-mindedness--and that standards are dropping.

We should not be surprised that the true agenda is the privatisation of the ambulance service and that the pay claims of ambulance men and women have got in the way of that. The Secretary of State says in his letter :

"Pay negotiations for ambulance staff in future must allow for more flexibility".

He later continues :

"It would be a disaster for the NHS if every year the Whitley Council pay round opened with a bench mark award to ambulance staff based on some generous formula of the kind that the police have." It is obscene that the right hon. and learned Gentleman can say in a letter that he is not prepared to pay ambulance men and women the same as the police. What is wrong with being as generous to those men and women as he is to the police?

This is the gem of the letter. It says :

"We all know"--

the right hon. and learned Gentleman is referring to the people whom he identified--

"rather better than the general public, that hundreds of thousands of other NHS staff who work alongside ambulance men do not regard ambulance men as any kind of special case.' "

All I can say is that if those thousands exist, which I doubt, they are not among the 80 per cent. of the public who are loudly telling the Secretary of State to pay up and shut up.

We are sick to death of the Government, particularly the Prime Minister, acting as some latter-day vampire, attending every disaster, saying how wonderful the emergency services are but then refusing to pay them a decent wage. Some people have considered carrying a card that says, "Should I be in an accident and be admitted to hospital, I do not wish to be visited by the Prime Minister."

Perhaps the Secretary of State can explain to us what convictions and principles are involved in saying to the ambulance men and women, "We must pay you less, and we must cut your pay now in preparation for privatisation". Perhaps the Secretary of State can explain why he has engaged in vicious union-bashing and why he advertised, with public money, to break the dispute.

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Perhaps he can explain why he continues to use the inadequate services of the police and the Army and why he uses intimidation, such as suspension without pay. Can he explain, while he is doing all that, what happened to that famous offer to the Association of Professional Ambulance Personnel--on which it was going to be balloted-- which has disappeared into the mists of time, never to be mentioned again?

How much longer must his dispute be prolonged and at what cost to the public, and to ambulance men and women? It is about time that we said loudly and clearly that we have one of the best ambulance services in the world. If we intend to keep that service, we must pay the staff who work in it the money to which they are entitled. That is a decent principle and that is a decent conviction. I ask the Secretary of State to return to the negotiating table and to make those principles come to life.

6.20 pm

Sir David Price (Eastleigh) : I hope that the House will exonerate me from attempting to reply to the many points made by the hon. Member for Bristol, South (Ms. Primarolo), as I know that many hon. Members want to speak in the debate.

Personally, I regret that we are having this debate today. It will not help the necessary process of negotiation, which one hopes would lead to settlement, which is required urgently. Industrial disputes cannot be settled across the Floor of the House any more than in a television studio. They require the peace and seclusion of private discussion without the intrusion of cameras or of running commentaries, whether from below the Gangway or in a studio. However, the Opposition have decided to stage this debate, as is their right, so we must make the best of it. I hope that none of us will say anything that will make it harder to resolve this continuing and damaging dispute.

I scarcely need to remind the House that the dispute is now in its 18th week. It is doing no one any good and it is time that it was settled. The longer it goes on, the greater the hardship to the clients of the ambulance service because the deficiencies in the temporary arrangements will become increasingly apparent. All credit to the Army and to the police for what they are doing, but they are not as well trained or as well equipped as the professional ambulance crews. The longer the dispute goes on, the greater will be the legacy of bitterness in the ambulance service after it is finally resolved. The longer it goes on, the deeper each side will dig itself in and the harder a settlement will become. After 18 weeks, I find the prospect of prolonged trench warfare dismal. If we reject that prospect, as I suspect most hon. Members do--and certainly our constituents do--we have to accept that there must be compromise. I realise that "compromise" is a dirty word to some hon. Members, but I suggest to the House that a decent measure of compromise is the necessary lubricant of parliamentary democracy. It is certainly the lubricant of good industrial relations and, as the House knows, I had quite a bit of experience in years past in industrial relations. Rather than the macho aim of "winner takes all", we should follow the alternative aim of Lewis Caroll, who once wrote :

"Everybody has won, and all must have prizes."

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In that spirit, I proposed some 10 days ago on "Newsnight" that an "honest broker" should be appointed to mediate privately between the two sides. I must explain that, although I gave an interview of about seven minutes in the studio, only one sentence finally appeared on television, such is the way of the cutters of programmes. It was a jolly litle analogy--I was trying to lower the tension--in which I reminded viewers that Christmas was the season of pantomime and that it appeared to many of my constituents that my right hon. and learned Friend the Secretary of State and Roger Poole were cast in the role of the ugly sisters while the public, the poor old Cinderella, was suffering as Cinderellas do in this world. It seemed that what was needed was a Prince Charming. I suggested that the Select Committee on Social Services or even the hon. Member for Eastleigh might fulfil that role. As a result, I found that my proposal was taken up by the trade union side.

I have had numerous discussions with the trade union side. I am satisfied that a settlement is conceptually possible if there is a genuine willingness on both sides to reach such a settlement. I shall resist the temptation to suggest to the House what the basis of such a settlement might be, because I shall adhere to my own rule of not attempting to negotiate across the Floor of the House.

The only advice that I offer the negotiators comes again from Lewis Carroll :

"Take care of the sense, and the sounds will take care of themselves."

Let us not be distracted by the sounds!

There are some background features of the dispute that may not be wholly appreciated by all hon. Members, and certainly not by most of the public. First, this pay claim appertains to 1989 and not to 1990. It is the one unfulfilled claim in the public sector for last year. When settled, it will be backdated to April 1989, so fears about knock-on effects on other groups in the NHS are ill founded. Secondly, the trade unions are now preparing themselves for the 1990 pay round, and there the most important single factor, as always, is the anticipated rate of inflation. I suggest to the House that what happens at Ford and, above all, what the mandarins in the Civil Service receive is far more likely to set the framework for public sector pay norms in 1990 than what may happen in the ambulance dispute, which is now old hat in terms of pay negotiations. Thirdly, it is important for us all to recognise that the pay system in the NHS, with its 1 million staff, is not an elegant hierarchy of ascending reward for ascending qualifications, ascending work load or ascending responsibility, based on detailed job evaluation. On the contrary, it has grown up haphazardly over the years, and that haphazard character struck us on the Select Committee as a source of incoherence in the system.

The Select Committee produced a report last March on the Whitley system in the National Health Service. We said :

"In the course of this enquiry we have been struck by the complexity of the systems for negotiating and determining pay and conditions of service of NHS staff. There are, at present, three different mechanisms for the determination of pay in the NHS. Around 40 per cent. of staff have their pay and conditions of service negotiated in one of the functional Whitley Councils Nurses, Midwives, Health Visitors, Professions Allied to Medicine and Doctors and Dentists are covered by Pay Review Bodies. The remainder (around one

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per cent.) including general and senior managers, building operatives and maintenance staff, have their basic pay determined directly by the Secretary of State for Health."

For the 40 per cent. whose pay is determined by Whitley councils, there are six different functional Whitley councils in the NHS, of which the ambulance Whitley council is one. We also said : "we received evidence indicating that the structure of the councils presents a number of obstacles to efficient and effective negotiation."

The most obvious criticism of the whole system was made by Lord McCarthy, when he pointed out that, despite the apparent existence of two sides in the negotiations, there are in fact three parties : management, staff and Government. The management and the Government representatives are combined in the management side, which consists of

"Employers who do not pay and paymasters who do not employ." It is not surprising that the main criticism that is expressed by the staff side organisations is :

"although Management Side representatives are, in theory, free to negotiate with the staff sides of the Whitley Councils, in practice settlements can only be reached when there is prior approval from the Secretary of State or even the Treasury."

Roger Poole of NUPE gave us colourful evidence of what it was like to negotiate from the trade union side in a Whitley council. Time prevents me from quoting paragraph 40 of our report, but I commend it to the House.

This criticism is important in understanding the present dispute and why the trade unions wish to talk to my right hon. and learned Friend as well as with Mr. Duncan Nichol. I am convinced that the process could be assisted by the appointment of an honest broker if the two sides are reluctant to go straight into formal talks. In that context, it is worth remembering that no formal conciliation or arbitration system is presently available within the NHS. Last March, the Select Committee recommended that

"the Government take the initiative in getting discussions started between the Management and Staff sides with the purpose of developing a mutually agreed arbitration procedure. We suggest that arbitration should be a last resort and that a strict timetable should be established and adhered to for issues referred to arbitration." Do we not now wish that the Government had adopted our recommendation? As they did not, I offer the House my Prince Charming approach, which is rather more appealing than the prospect of continuing trench warfare. As I remain available to act as a little lubricant upon the grinding wheels of negotiation, it would not be appropriate or me to cast a vote tonight. The Government may not see the need for any lubricant at the moment, but they will do so before the dispute is finally resolved. I am a patient man.

6.31 pm

Sir Cyril Smith (Rochdale) : I have listened with great interest to the debate. The Secretary of State may have convinced himself, but, I am terribly sorry to say, he did not convince me. My colleagues and I will vote with the official Opposition this evening.

I agree with hon. Members who have said that it is a pity that this whole sorry business, to coin a phrase, has come to this. The Secretary of State did not want a debate and wishes that there were no debate, but matters have come to this for three reasons. First, the Government, Ministers or civil servants have been or are incapable of understanding the natural reaction of ordinary people.

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Secondly, with great respect to him, the Secretary of State may be an extremely able man in some respects, but he has demonstrated that he does not have a clue about how to conduct industrial relations. Thirdly, there is no doubt about whether the Secretary of State has much of a clue about how to conduct public relations.

When other people were getting 7 per cent., 7.5 per cent., 8.8 per cent., 9 per cent. and, in odd cases, more than 11 per cent., the Secretary of State said to the ambulance workers, "You must settle for 6.5 per cent. because that figure was talked about some months ago." Anybody who understands the reaction of ordinary people will understand that men will not accept 6.5 per cent. when other people are being offered greater increases. Anybody who thinks that they should accept 6.5 per cent. must be living in cloud- cuckoo-land. A more realistic offer should have been made. That is how industrial relations are usually carried on--not with employers saying, "Tell us by how much you are prepared to reduce your claim before we meet you." Usually, both sides meet, and the employer says, "There is no way you will get 11 per cent." The unions then ask, "What will you offer us? 7 per cent.?" The employer then says, "I am not prepared to go to 7 per cent." Slowly but surely they reach a consensus. However, if one side says, "Unless you tell me by how much you are prepared to reduce your claim, I am not prepared to meet you to discuss it," there is no way in which progress will be made.

The Secretary of State has demonstrated that he does not have a clue about industrial relations. I find it difficult to understand to whom we should be speaking in this dispute. As the hon. Member for Bristol, South (Ms. Primarolo) said, the Minister says, "It is nowt to do with me--it is up to some fellow called Nichol. He is doing the negotiations, not I." Within 24 hours he was on television saying, "If Nichol gives any more, he is not getting it from the Government." He went on to say, "He can give more, but it must come out of his existing budget. However, he must not give more, because it would create a precedent for national pay negotiations."

I am perplexed about whether I should criticise the absence of a statement by the Secretary of State or Mr. Nichol. We now have the Prime Minister sticking her oar in. She says, "We shall not give another penny." Who on earth is doing the negotiation? It is a clear demonstration that the Government are incapable of conducting good industrial relations and negotiations.

Over the weekend it appeared to be leaked that there was more money on the table or that more money was available if the parties could meet. On Monday, the Secretary of State said, "There is no more money. I never said that when I met the press reporters. They have got it wrong." That rings a bell. I am sure that I have heard that before in the past six months in relation to other matters. Ministers have secret meetings with reporters, and they then say, "I am speaking off the cuff, on a lobby basis." When their comments appear in the papers they say, "I never said that. I never meant to say that." That is a strange way to perform.

I was the managing director of a company--I am not now, thank God. It would not be tolerated in private industry if a managing director did the negotiating and the company chairman constantly made public statements about what the managing director was allowed to negotiate. The Government should not tolerate it, either.

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Mr. Hayes : The hon. Gentleman would be absolutely accurate in his description if his description were accurate, which it is not. If he had bothered to read the first edition of The Sunday Correspondent, he would have seen precisely what happened at the so-called meeting. It appears that a journalist from a newspaper--I shall not name it, to spare his blushes, but everyone knows the name--rolled up late, thought he had a good story, did not consult his colleagues, and splashed the story on the front page. All the other newspapers whose front-page stories were totally different rushed in like the Gadarene swine. That is how the confusion arose. It is not because of my right hon. and learned Friend the Secretary of State--convenient as it may be to blame him.

Sir Cyril Smith : I am not blaming the Secretary of State for the fact that that appeared in the paper. I am talking about what appeared in the paper. Such meetings take place. It is not the first time that we have heard of them. As soon as certain stories appear, Ministers say, "It was a private dinner. I did not say that." It is confusing. We do not know whether we are coming or going.

Mr. Kenneth Clarke : I am grateful to my hon. Friend the Member for Harlow (Mr. Hayes). I issued a press release this morning. One newspaper got it wrong and the other six followed.

On the serious point raised by the hon. Member for Rochdale (Sir C. Smith), I have made repeated attempts to make clear the difference between the chairman and the managing director. The hon. Gentleman drew a good analogy. The managing director of the National Health Service, although we call him the chief executive, is Duncan Nichol. The negotiator of ambulance men's pay is Mr. David Rennie, the chairman of the Whitley council. He conducts negotiations on behalf of the management side, with the chief executive, Duncan Nichol, obviously being closely involved in the management side's view. The hon. Gentleman will be aware, if he is conducting a serious discussion about good industrial relations, that one cannot have long negotiations and suddenly find the chairman intervening personally, pushing the managing director out of the way, saying that he intends to take over the negotiations and ordering everybody to pay more. That would create chaos. Some car companies used to do that in the 1970s and it destroyed the authority of their managements. The problem is that some politicians such as the hon. Gentleman will not accept that and, because they can only question me, they insist on turning the whole thing into a political issue involving the Prime Minister and me, when the Prime Minister and I and my hon. Friends are supporting the management in its position because it is a sensible position for the National Health Service and its patients.

Sir Cyril Smith : I gather that the chairman is now somebody called Rennie and that a man named Nichol is the managing director. We are not sure where the Secretary of State fits into the jigsaw. The right hon. and learned Gentleman now appears to be saying, "I am merely making statements in support of what Messrs. Rennie and Nichol are saying." I did not get that impression from his remarks earlier in the debate. I thought that Messrs. Rennie and Nichol were being told by the Secretary of State how far they could go and that if they went further they would have to find the money

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from elsewhere. I understood the right hon. and learned Gentleman to be saying that that money was not available elsewhere because that would involve closing hospital beds, that a terrible situation would ensue and that the NHS would collapse--all for the sake of £5 million. I did not find that argument convincing.

Reference has been made to a union called APAP, the Association of Professional Ambulance Personnel. In December 1988, the hon. Member for Torridge and Devon, West (Miss Nicholson) and I led a deputation to the hon. Member for Derbyshire, South (Mrs. Currie), who was then the Parliamentary Under-Secretary of State for Health and Social Security. I am delighted to see her in her place. We appealed for the recognition of APAP. That appeal had been going on for three years. Prior to our visit, there had been various early-day motions on the subject.

We found the hon. Member for Derbyshire, South helpful and courteous and extremely knowledgeable about the subject under discussion. I had nothing but praise for her attitude during that discussion, and I wrote to the Prime Minister saying so, although I regret that it resulted in the hon. Member for Derbyshire, South having to resign.

The Government did not give the union recognition at a time when it would have been in a position to influence affairs. They waited until its members were in the midst of industrial action, and suddenly APAP was given recognition, presumably in the hope of that action splitting the unions. What did they expect the members of APAP to do in that situation? They were already out, working to rule. It was too late for recognition to be given. I mention that only to illustrate the Government's ineptitude in these matters. They recognised APAP in the middle of a dispute.

I have discussed the matter this week with representatives of APAP. I accept that APAP has lost some members, but nothing like 50 per cent. of its membership. It has also recruited some members during the dispute. I am assured that, come the end of the dispute, its membership will be about what it was at the beginning, although there will be some change in its constitution.

Mr. Kenneth Clarke : I first met deputations from APAP about six years ago. Ministers have always wanted to recognise APAP. I am delighted to hear that, as I should have expected, my hon. Friend the Member for Derbyshire, South (Mrs. Currie) dealt with the hon. Gentleman's deputation sympathetically. We did not recognise APAP earlier because NUPE, COHSE and the others were bitterly opposed to it. Industrial action was threatened. The hon. Gentleman will recall the time when they used to ask the management to sack ambulance staff who went about wearing APAP pin stickers, so much did they disapprove of the trade union.

The position was reached when obviously we could not regard the objections of NUPE and COHSE, when the Whitley council at that stage could not even meet because they would not attend meetings. I trust that the present position has not been a setback to APAP. It is up to the ambulance men and women themselves to decide what union they should join, and whatever union they choose to join should take part in the negotiating process.

Sir Cyril Smith : The timing of the recognition was a bit of a goggle in terms of industrial relations. Indeed, I wrote to the successor to the hon. Member for Derbyshire, South, acquainting him with the discussions that had

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taken place in December 1988. He replied saying that he was aware of them and that he saw no reason to disagree with what the hon. Lady had said at the meeting that we had with her. I have given an example of the Government's attitude to industrial relations and how not to conduct them.

We come to public relations and the Secretary of State's classic comment that ambulance personnel are profess-ional drivers. Such a comment could be made only by somebody who did not know much about the ambulance service. This letter was written to me on 5 January by a lady in Rossendale :

"During his career to date my husband has been both physically and verbally abused by patients and members of the public, particularly when attending incidents late at night and in the early hours of the morning. He has been pursued by a man brandishing a pick-axe handle in the middle of the night while he was endeavouring to treat and transport the man's badly beaten wife to hospital ; he has narrowly escaped a knife attack while treating a stabbed youth ; he has delivered babies, climbed into vehicles after road traffic accidents, regardless of his personal safety, to treat and comfort trapped occupants, he has picked up victims' severed limbs from the roadway, comforted bereaved relatives and much, much more. He is not unique --he is merely a member of today's highly dedicated and skilled ambulance service My last remaining remnants of hope for a satisfactory conclusion to this unnecessary dispute were torn asunder by Mr. Clarke's recent description of ambulance personnel as professional drivers'."

That is typical of the feeling of a large number of people, and I am sure that the right hon. and learned Gentleman regrets expressing his view. He should now publicly withdraw the comment and apologise for making it.

Everything in that letter about that ambulance driver from Rossendale is absolutely true. I can say that because my brother was a member of the ambulance service for 14 years until he was invalided out about two years ago. He, too, picked up limbs and dead bodies from the motorway, delivered babies and dealt with cases of cardiac arrest. My brother was not a paramedic. Indeed, when he joined the ambulance service, there were no paramedics in this country. Initially the Government resisted the idea of having paramedics, as they were known in the United States but not in Britain. In my view, the argument about paramedics is a bit of a red herring.

Mr. Harry Greenway (Ealing, North) rose --

Sir Cyril Smith : I shall give way, but I hope that Mr. Speaker has taken note of the many interventions in my speech. I am flattered by them, but I am anxious not to delay the House for too long.

Mr. Greenway : Does the hon. Gentleman believe that such medical qualifications are acquired by experience or that, as people have suggested to me at my surgery, ambulance drivers need to go on courses to obtain qualifications? If the latter, does he agree with the Minister that many more such courses are required?

Sir Cyril Smith : It takes 12 full weeks to train a paramedic. In other words, he must be seconded on to a course for that time. Many of the qualifications that paramedics have are acquired on local, rather than national, courses. Many people believe that the £500 being offered to paramedics applies to those who are nationally trained. There are 200 ambulance men in Lancashire who have been trained in specialist skills, but they have not been nationally trained. As the offer stands, not a single

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member of the Lancashire ambulance service- -I checked this yesterday--will qualify for the £500 for paramedics, although they have done a great deal of training.

The four skills that a paramedic must have relate to the administration of some drugs, administering drip lines to patients, administering special airways to patients and--I mentioned this point in my earlier intervention- -the ability to use defibrillators. However, defibrillators are not provided as standard equipment on ambulances anywhere in this country. Indeed, every defibrillator that has been provided so far has been provided either as a result of charity or as a result of the efforts of the ambulance men themselves, who have run dances, whist drives and concerts and done all the other things that people do to raise money. It is not on for the Secretary of State to hide behind the paramedic qualification at this stage of the argument.

I now refer to the future and in a moment shall therefore be more conciliatory about paramedics. The first thing that the Secretary of State must do is to be prepared to increase the offer of 6.5 per cent.--

Mr. Kenneth Clarke indicated dissent.

Sir Cyril Smith : The Minister is shaking his head. I know what he is saying--he is saying that the offer is 9 per cent., but it is for 9 per cent. over 18 months, which is 6.5 per cent. over 12 months. The Secretary of State must not assume that because people work in the ambulance service they are idiots. Ambulance staff can and have worked all this out. They know the offer perfectly well. Quite honestly, the amount of money involved is very small.

I want to make it absolutely clear that I am not in favour of an 11 per cent. increase. I am not even in favour of a 10 per cent. increase. However, I believe that somewhere between 6.5 per cent and 10 per cent. there is a figure that could be negotiated and reached. I refer now to the second thing that the Secretary of State must do. If he did them both, he would settle the dispute quickly. He must establish some sort of pay review body for the ambulance service. I agree with him again that it must not be a pay body that relates ambulance staff pay to the pay or increases of other services. However, pay review bodies are already in existence in the National Health Service. Both nurses and doctors have had their own pay review bodies for over six years. Making such a pay review body available to the ambulance service, together with a small movement in the pay offer, would settle the dispute and I urge the Secretary of State to think again.

The Secretary of State referred to the joint review that has already been agreed, of the 1986 salary structure. I appeal to the right hon. and learned Gentleman. There is a need to review the ambulance service, its structure and everything about it. Many things about the future of the ambulance service need to be discussed. However, I have to tell the Secretary of State--and I am sorry to have to do this--that one should not discuss basic changes to the service in the middle of a wage dispute. One should sit down and discuss them rationally and logically at quiet moments in history when both sides are looking for solutions that they can evolve together. One should not try to do it when both sides are around the table thinking that they are at loggerheads and have a dispute to sort out.

I believe that the principle that the Secretary of State has evolved about the future of the ambulance service is

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right. What is wrong is his timing. He must settle the dispute and then get down to sorting out the future of the ambulance service and the other things that have been mentioned, such as pay for overtime and for unsocial hours, and incremental pay rises for long service. All those things should be discussed in the context of a new concept for the ambulance service for the 1990s. However, the Secretary of State must get this dispute out of the way before sitting down to bring effect to the joint review that I am glad has already been agreed. I urge the Secretary of State to get the dispute out of the way because once he has he will find that he has a lot of constructive support within the House and the ambulance service. I hope that the Secretary of State will press the ambulance negotiating body to come back to the table and to have another go, and when he has, I hope that he will shut up and let those concerned get on with the service. I hope that he will stop making public statements because it appears that every time he opens his mouth he exacerbates the position.

I am sorry that attitudes appear to have hardened in the Government. I regret that and advise the Government that they will, too. They must give a little in pay and in future review promises because the alternative is to try to batter the ambulance personnel into submission. If they do the former, it will be to their credit. If they do the latter, it will be to their discredit and shame because this service is second to none in its loyalty, skill, dedication, professionalism and concern for others. To batter that group of people into submission would mean an embittered service for many years to come. It might finish the present dispute and the ambulance personnel might go back to work, but they would go back with such bitterness in their soul that I believe that it would be felt for years throughout the Health Service. More than that, it would be both unfair and unjust.

I appeal to the Government and to the Secretary of State to see some sense now and to urge the negotiating body to sit down again around the table and to reach a settlement that will bring honour to both sides, with neither side winning and with each side earning respect.

6.56 pm

Mrs. Edwina Currie (Derbyshire, South) : First, may I offer my thanks to the hon. Member for Rochdale (Sir C. Smith) for his kind personal remarks about me? I hope that he will forgive me if I do not join him in the Opposition Lobby tonight, because I intend to give full support to my right hon. and learned Friend the Secretary of State. However, the hon. Gentleman knows--and, like the hon. Member for Livingston (Mr. Cook), he has heard me say in the House--that I admire the ambulance service very greatly.

The ambulance men and women in my own area of Derbyshire offer an outstanding service. I think that they are worth about £200 per week. Therefore, I looked up exactly what is on offer to the ambulance men and women in my area. This is what I found. The qualified and the leading ambulance men and women in my area are to be offered over £11,000 per year. That is the pay scale, and there is possibly overtime on top of that. I think that the unqualified staff--or rather the non-qualified staff, which is a less pejorative way of describing them--are worth at

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least £150 per week, and that is exactly what is on offer in my area. In my area, leading ambulance staff are being offered £228 per week basic, qualified ambulance staff are being offered £211 per week basic and non-qualified ambulance staff are being offered £153 per week. That is a great deal more than many other people in my constituency are living on. I repeat that that is the basic rate, and there is overtime on top of that.

I think the ambulance personnel are worth it, and that is why I urge them, in the interests both of themselves and of my other constituents, to accept that offer. Apart from anything else, that is the pay scale until September this year, and there will presumably be more money after that. I hope that they will accept it. In London, it is more. I have not mentioned paramedics. Like Staffordshire, we have hardly any in Derbyshire. However, those are the pay rates and the pay scales that are on offer to my constituents. There is well over £200 per week for those with qualifications. I hope that they will accept it.

The ambulance men are a proud part of the National Health Service. That is why they have attracted so much public support. However, most National Health Service staff have settled in large numbers for an increase of around 6.5 per cent. The nurses have settled for 6.8 per cent. I attended a meeting of the Derby branch of the Royal College of Nursing last week and asked at the end why nobody had spoken up for the ambulance men. The nurses said, "Because we settled for 6.8 per cent. and we feel that on the whole it is a reasonable settlement."

That is the settlement for the nurses after three years of gaining qualifications and of full-time study, and after their refusal to go on strike. I have a feeling that, if that is good enough for my nurses, it should be good enough for my ambulance men as well. The hon. Member for Livingston made the comparison with the global figures for the public sector, but I must respectfully remind him that that figure includes large numbers of people working for local councils. It is precisely because large pay increases have been given by local councils recently that people in my constituency, in the remainder of Derbyshire, in Birmingham and in other areas are complaining bitterly about the community charge that is being set by those councils. We can pay people what we like, as long as we are prepared to foot the bill through community charges and business rates. Many of my constituents are now counting the cost and wondering whether that was wise.

Nor is it appropriate to make the comparison with the doctors and nurses review bodies' reports that are due shortly. That is next year's pay rise, and the ambulance men can negotiate another rise next year. To suggest that the pay rise to doctors, after a minimum of five years' full-time study, should be the same as the pay rise for ambulance people is taking equality to preposterous lengths. That is not right or acceptable.

I hear the demands from all sides for arbitration, independent review bodies and long-term linking. Some of those arguments are misplaced. As my distinguished colleague, my hon. Friend the Member for Eastleigh (Sir D. Price) said, we have had a Whitley council system for years, and it has been revised half a dozen times. As the hon. Member for Rochdale pointed out, if I had my way I would have had APAP on it as well. To accept some of the proposals for arbitration would drive a coach and horses through the Whitley council system.

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Some of us might like the end of national collective bargaining for pay rates in a business as diverse as the Health Service, which covers the entire country. However, that is not the way to do it just yet. I invite the hon. Member for Peckham (Ms. Harman), who will reply on behalf of the Opposition, to say whether the Labour party is in favour of the Whitley council system or wants to abolish it. If it wants to abolish it, what does it want to put in its place? Would the Opposition support local pay bargaining? I would, because some of my local people would do better under it than under national pay bargaining, which is based so heavily in London. That should be a matter of record.

We should be aware that if the Government give in on this dispute, NUPE, among other unions, has plenty of other groups lined up with demands that are just as deserving. I am not challenging the ambulance service as being undeserving. The case for those other groups will be just as slickly presented by Mr. Roger Poole. If we are talking about presentation and trying to give people nicknames, perhaps his nickname should be "Angel Face". He presents things in an immaculate way and makes a good case for his members. However, it is all presentation.

If Roger Poole or any of the other senior ambulance people went on television in my area and said, "I am being offered £228 per week basic and I do not think it is enough," some of the support expressed for them in areas such as mine, where many people are earning less than that, would fall away.

I have not heard anyone say what has been offered. If Mr. Poole and some of the others, who earnestly and honestly and quite rightly are arguing for big pay rises, told people what they are earning, some of the support would diminish. Mr. Poole and the other leaders say that the ambulance men are a special case. Butter would not melt in their mouths. I would not trust them as far as I could throw them. Mr. Jeremy Corbyn (Islington, North) rose--

Mrs. Currie : I am happy to give way to the hon. Gentleman, who I understand is sponsored by NUPE.

Mr. Corbyn : I am happy to inform the House that I am sponsored by NUPE. I am proud of that, as it is an excellent union. While the hon. Lady is delivering her oration attacking the ambulance staff and their apparent greed, would she tell us what the comparative pay rates are for the police and fire services, which do equally valuable emergency work at the scene of accidents and save lives?

Mrs. Currie : The NHS, for which I once had a small amount of responsibility, is a major and important public service. The way that the comparisons are done is within the Health Service. Each group has its Whitley council. It is a fiendishly complicated, cumbersome and old- fashioned negotiating system. I would be delighted if it were banished and my local hospitals and health authorities were given the power to negotiate the pay deals that seem appropriate. Ministers have been pressed many times by hon. Members on both sides to make the link with the police and fire service. It is not appropriate or necessary and, in my view, it should not be done.

I am happy to call in aid a previous Labour party member. In 1979 I was a member of the Birmingham area health authority. My hon. Friend the Member for Solihull (Mr. Taylor) will recall that the west midlands had a major

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dispute in the ambulance service. There was also a major dispute in London at the same time. I looked up the discussions in the House at that time. On 22 January 1979, in response to a private notice question by the then Member for Reading, East, Sir Gerard Vaughan--a Conservative party spokesman--the then Secretary of State for Social Services--now the noble Lord Ennals--was obliged to put down his point of view. Just as now, there was "widespread disruption" and "no emergency cover" available in various places. The London service was the "most serious example" and it had "refused to cover emergencies". He announced that he had

"authorised the use of Army ambulances".

My hon. Friend the Member for Solihull will remember that the west midlands was also an area where the ambulance crews had refused to provide an emergency service. The then Secretary of State said that that service would be

"provided by the police and voluntary organisations."

He said :

"The ambulance men have put their case 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 ... 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 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."

Amen to that.

Several Hon. Members rose

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