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Mr. Sillars : Yes, that is the point I am making : there is nothing new about arbitration. It is a well-tried system employed to break down conflict and disputes or to resolve a dispute when that would be extremely difficult under normal circumstances.
Dame Jill Knight (Birmingham, Edgbaston) : I am following carefully what the hon. Gentleman is saying.
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Can he give some examples of arbitration used anywhere else in the Health Service instead of the Whitley council arrangements?Mr. Sillars : I have heard and read this argument before, and it is not relevant. Once upon a time, in every industry and undertaking, there must have been a first time when arbitration was invoked--[ Hon. Members :-- "Oh."] That is a logical proposition that no one could confound.
I have personal experience of arbitration ; I have served as a member of an arbitration panel which tried to solve a dispute between teachers and management in local government in the mid-1970s. Arbitration is not the handing over of management control to the arbiters. Arbitration does not take place in a vacuum. No one ignores the realities facing the management and the trade unions. An arbitration panel is a tripartite body. The chairman is neutral ; there is a nominee from the employers' side and another from the trade union side. They assess the award against the realities. I was the trade union nominee on an arbitration panel, and it sat in private. No one on it could get away with loose intellectual or economic arguments, or with stupid social arguments, no matter which side he represented. There was genuine concern on the part of the whole tribunal, and that applied to every arbitration that I have ever experienced--
Mr. Bill Walker : Will the hon. Gentleman give way?
These panels tried to reach certain objectives. One was to resolve the dispute fairly ; the second was to leave the structure of management-trade union relations intact ; the third was to injure neither party. Arbitration is a civilised way of resolving disputes. The hon. Member for Aberdeen, North (Mr. Hughes) was right : it is ironic that the Government urge arbitration on a group of workers whose claim they do not like, but deny arbitration to another group whose claims they like in no circumstances
Mr. Walker rose--
Mr. Sillars : I shall not give way. I do not want to upset the hon. Gentleman ; he will get in later, but he has to wait his turn. The Select Committee examined arbitration. As I said before, somewhere along the line there must be a first time for arbitration. In the debate on 11 January this year, the hon. Member for Eastleigh (Sir D. Price) said :
"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'."--[ Official Report, 11 January 1990 ; Vol. 164, c. 1133.]
The Select Committee foresaw difficulties of this kind, and put the idea forward. What a pity it was not accepted.
Mr. Walker : The hon. Gentleman has some knowledge of arbitration, but he is not the only Member with knowledge of it. These are complex and intricate matters. Will the hon. Gentleman tell the House from experience how Whitley works, and what impact arbitration for one group of workers would have on the standing of Whitley and on the Health Service?
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Mr. Sillars : One of the great problems of Whitley was beautifully summed up by Lord McCarthy, who said that it was made up of"employers who do not pay and paymasters who do not employ." I look forward to the day when I can stand here and claim to have piloted Concorde ; I am sure that the hon. Member for Tayside, North (Mr. Walker) would get up and claim that he had done the same--
Mr. Sillars : I make no such claim.
I now come to the second pillar of the Government's case--that no more cash can be offered because none is available, and that if it is made available it can only come out of patient care. The hon. Member for Livingston (Mr. Cook) has said several times that the cost of prolonging the dispute is twice as much as it would have taken to settle it. No Conservative Member, and especially not the Secretary of State for Health, has answered the question posed by the hon. Member for Livingston about how the Secretary of State can find money to prolong a dispute when he denies his ability to find money to settle it.
There are other costs. It is said that the money must be taken from patient care, but there are other costs not inside the Health Service that are important to the community. What about police time? According to a parliamentary answer, the police in Scotland have turned out to 6,700 cases. Some 166,060 police man hours in England have been devoted to trying to tackle the problem in the ambulance service. What about the loss of police manpower in a society in which people are concerned about crime and security? Of course the loss is unquantifiable, but the citizen is entitled to ask why police are being sent to try to do the work of the ambulance staff when the work that they should be doing is securing the position of people in society.
Mr. Jeremy Corbyn (Islington, North) : Will the hon. Gentleman reflect on the quality of service given by the police, the Army, the Navy and the Royal Air Force in undertaking emergency duties that should be carried out by the ambulance service? That service is of a low standard simply because the people in those services are untrained and inexperienced in carrying it out. They are not qualified to do it, they do not want to do it and they should not have to do it. The issue could be resolved if the Government stopped being so awkward and understood the desire of the ambulance workers to carry out the service that they have been trained for and should be paid to do.
Mr. Sillars : I do not think that I have met anyone in the police who would argue for a moment that the police provide exactly the same standard of service. There is no question of that.
Mr. Ieuan Wyn Jones (Ynys Mo n) : Is the hon. Gentleman aware that the Police Federation of England and Wales supports the claim of the ambulance men?
Mr. Sillars : I am aware of that. I am a former fireman, and all the firemen that I know take exactly the same position.
Pillars three and four of the Government's case are intertwined. They are a no-pay-review formula, linked to the assertion that, while ambulance crews are part of an
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emergency service, they are somehow or other, in the Secretary of State's eyes, of a lower status. Last year, the Secretary of State said :"I do not accept that comparisons can be made with other emergency services, when only one tenth of the mileage of the ambulance service is taken up by emergencies."--[ Official Report, 7 November 1989 ; Vol. 159, c. 855.]
That is deeply insulting to ambulance crews.
I hope that that gibe was not aimed at the crew in Lockerbie, which turned out within three minutes of the call about that disaster. If we went to Lockerbie ambulance station and looked at the log book, we could probably prove that only one tenth of the mileage was for emergency services, but that is not the relevant point. The relevant point is that, when the emergency arose, the ambulance men had the commitment to fulfil their obligations to the community.
The Secretary of State's point of view shows a total
incomprehension of how all our emergency services operate and the demands that they make upon the psychology, the physical condition, the bravery and the commitment of those engaged in them.
Mr. Richard Holt (Langbaurgh) : Will the hon. Gentleman give way.
Mr. Sillars : No. I have given way fairly generously.
I should like to compare the police, the fire service and the ambulance service. Some police officers undertake duties such as school crossing patrols. Those duties are important, but they do not constitute an emergency. Crime prevention is important, but it is not an immediate emergency. We can only guess at what special branch does, but I do not think that it engages in emergencies. The police have duties in community involvement and desk duties, and much time is taken up in court attendance. Those are all non-emergency activities, but no one would argue for a moment that the police are not an emergency service, because, when required, police officers have the ability to turn out.
Mr. Holt : Will the hon. Gentleman give way now?
Mr. Sillars : No. I am sorry, but the hon. Gentleman is not getting in.
I am a former fireman, and my brother recently retired as a fire officer. Over the years, I have kept in touch with my mates in the fire service. They are involved in non-emergency work such as equipment cleaning, maintenance and repairs. Fire prevention staff rarely turn out in emergencies, and the service also uses part-time and retained firemen in various parts of the country who, by their very definition, do not work mainly in the fire service. Nevertheless, they turn out for emergencies. Lockerbie has a part-time fire station, yet it turned out within six minutes the first appliance to attend the disaster there. In the case of the police and fire services, it is not necessary to prove that their staff are always engaged in emergency turnouts.
Ambulance staff are in exactly the same position. They undertake a great deal of routine work, but when there is a Clapham, a King's Cross, a Lockerbie or a Hillsborough, ambulance staff or whatever grade turn out to provide emergency services--and they all bring professionalism, skills, commitment and will power to the job in hand.
From my own experience as someone who has served in the fire brigade, I can tell the House that a great deal is required of men and women who respond to emergency
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calls. They are expected to go from dead stop to full ahead. One's heart is pounding and one's nerves are jangling, because one knows that one is about to encounter an horrific or potentially horrific situation. The police might find themselves confronted by an armed criminal. Firemen are expected to enter buildings full of flame and smoke from which other people are escaping. Ambulance staff must suppress the nausea they feel when dealing with injuries and burns that are horrible to contemplate and even worse to treat. My brother, a former fire officer, made a very good point to me over the weekend. He pointed out that firemen save lives in the sense that they take people out of burning buildings and other difficult situations, but that their work is only potentially life- saving. If a life is saved, it is saved by the ambulance staff who take over and use the skills that firemen do not have, from the moment the firemen hand over a burned or devastated human being into the caring hands of the ambulance service.The three services all have different characters, but they integrate in an emergency. When the Secretary of State says in a sarcastic voice that ambulance staff do not compare with firemen, we should remember that firemen acknowledge that ambulance crews turn out for more emergencies than they do. Also, every time that an ambulance crew is called out, it has to deal with a human being--which is not always the case in the fire service.
I turn to the fifth pillar--the Secretary of State's accusation about the morality of the dispute. In the debate on 11 January, he said :
"the industrial action organised and taken by the trade unions concerned is against patients and patient services, and it cannot be justified--as industrial action in any essential service cannot be justified."-- [Official Report, 11 January 1990 ; Vol. 164, c.1115.] That is not a moral statement--it is moral blackmail. We as a society have no right to tell people that, because we need them, they must meet our demands, irrespective of the costs to themselves and to their families.
If one were to try to lift the Secretary of State's views out of the depths of moral blackmail and on to a plane of genuine morality, the wording of that statement would instead read, "As industrial action in any essential service cannot be justified, we have special review mechanisms to ensure that our emergency services are never taken advantage of."
If there is a moral equation between society and the emergency services, as in every other decent equation, morally there are two sides--there are rights on the public side but the public also have obligations to the people who serve them. The words that I read out are the moral equation ; they are applied to the police and the fire service and they should be applied to ambulance staff.
Now I come to the issue raised by my hon. Friend the Member for Newham, North-West (Mr. Banks). He said that the Secretary of State had a personal responsibility to intervene. Hon. Members may have seen him on the Channel 4 programme. I thought at first that he was at a Nottingham Forest game, tossing the coin, but it turned out to be a commentary by him on the dispute. There is no question of his being a key player. He said on that programme that he is the man who provides the money, and how could he respond to ambulance staff demands? He has produced and presented radio programmes, and produced and presented the Channel 4 programme. I turned on the television set, and there he was in a
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helicopter above the north of England. The public want him to come down out of the air, and get to the negotiating chamber along with the trade unions.Finally, there are the changed circumstances that I mentioned earlier--the Government's electoral prospects. My remarks bypass Conservative Members on the Front Bench, and are intended for Tory Back Benchers--an extremely anxious Conservative Party at present. The more that the hon. Member for Tayside, North (Mr. Walker) shakes his head, the more convinced I am about the accuracy of my statement. I shall quote from Scotland on Sunday , published yesterday, 18 February. Under the headline "Thatcher set to ride out stormy spell", the article quotes a "Downing Street source"--there are no guesses or prizes for who that might be--who
"disclosed yesterday that Thatcher was reconciled to electoral setbacks as an inevitable consequence of mounting mortgage rates and high poll tax charges in England"--
she is in the same boat in Scotland--
" The Prime Minister knows that the path of true love is never smooth' ".
It must come as a great surprise to all members of the public, racked by inflation, mortgage interest payments and high rents, that they are embraced in a passionate love affair with the Prime Minister, or that they are at least being propositioned by her.
" Of course it's all very painful. But it's painful because it's working' ".
Has it never struck the Tory Party that it is painful and that it is not working?
If this is Bernard Ingham speaking he must be losing his marbles completely, because the article continues :
"Medicine that works is always painful."
That has never been my experience ; it is sometimes true, but often it is not.
"But this attitude is certain to deepen despair among back-benchers who fear a bitter backlash in the Tory heartlands."
The article goes on to comment on the mid-Staffordshire by-election and the local government elections in England, Wales and Scotland. The quotation within a quotation from Scotland on Sunday demonstrates that the Tory Party's leader is now deep in the bunker, obsessed with a bunker mentality- -a leader denying reality. She appears to have drawn into the bunker with her the Secretary of State for Health. Like first world war generals, they are driving their troops in front of them into the electoral slaughterhouse. Does anyone think that it will be pleasant to be a Tory canvasser on the streets for the Mid-Staffordshire election or the local government elections in England, Wales and Scotland? Let us consider those elections. The Government must attend to this problem, because their vested interests are involved. Do they want to go canvassing on the poll tax, water charges, the current level of inflation, current interest rates or current mortgages and rents, or on the difficult Budget that we are all told is coming, or with the National Health Service Bill still in Committee, agitating the general population? The Government cannot avoid campaigning on any of those issues. Do they really want to add to that poisonous cocktail their continuing dispute with the ambulance staff? Do their canvassers in the Mid-Staffordshire by-election campaign want to go down the pavements bumping into people who have just put money in the buckets of the ambulance staff, and asking them to vote Tory? It is absurd.
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Any professional politician who wants to be in that position is in the bunker with the lady in Downing street--on the point of being medically unfit for leadership. The only conclusion that a Tory can draw from the present state of affairs--in his own interests, if not in the interests of the ambulance staff--is that he should seek to get genuine negotiations reopened to end the dispute. Tory Back Benchers can save themselves only by saving themselves from the folly of those on their own Front Bench.4.20 pm
The Parliamentary Under-Secretary of State for Scotland (Mr. Michael Forsyth) : I beg to move, to leave out from "House" to the end of the Question and to add instead thereof :
"recognises the important contribution made by the skilled and dedicated service of ambulance staff ; regrets that some have seen fit to prolong and intensify the action taken against patients in furtherance of the current pay dispute ; appreciates the work of the police, the armed forces and the voluntary services in maintaining an adequate emergency service ; supports the Government and National Health Service management on their handling of the dispute ; calls on the trade union leaders to ensure that the undertakings they have given to maintain an adequate emergency service are met ; believes that the dispute can only be resolved by the resumption of negotiations ; and calls on the trade union leadership to recognise and act upon this.".
Let me begin by saying to the hon. Member for Glasgow, Govan (Mr. Sillars) in respect of his latter remarks that, judging by the opinion polls in Scotland, we should not be taking any advice from him about how to maintain our position. After all, his party is sliding gracefully into third place behind the Scottish Conservative party.
When we face the electorate, we shall expect to be judged on our record of good management of the Health Service, which can be seen partly in the record number of patients being treated in Scotland. Our record of good management of the Health Service arises from the fact that this Government have always sought to do what is right by the Health Service--which is not, perhaps, to take the advice of Opposition Members.
No party represented in the House has a monopoly on admiration for the work of the ambulance service, and no party can claim that it alone supports the ambulance service and its workers. The Government support the ambulance workers and recognise their skill and dedication. It is interesting to note that, in a long speech, the hon. Member for Govan never once referred to the patient transport services arm of the ambulance service, but instead addressed all his remarks to the emergency services. The hon. Gentleman will be aware that the trade unions' claim is for recognition across the board for all sections of the ambulance service on an equal basis.
Having acknowledged the marvellous job done by the ambulance service, I must add that it is unfortunate that there should be industrial action in pursuit of a pay claim within that service, because there is no doubt that it is causing substantial disruption to the service and serious damage to patient care. The elderly are not being taken to their day centres. People are not getting to hospital for their courses of physiotherapy treatment, and waiting lists are being lengthened at a time when the Government are investing £7 million in reducing waiting lists in Scotland.
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Once again, the Opposition support those who take industrial action resulting in waiting lists being lengthened and in patient care being disrupted.The admiration that we have for the ambulance service is perhaps reflected among those staff, of whom there are many thousands, who have continued to provide a full service and to carry out their duties, thus putting patients first. I should have thought that all Opposition Members would acknowledge and welcome their actions. I want to put on record the strain placed on senior management and on officers working to maintain essential services. I am sorry that the hon. Gentleman for Glasgow, Rutherglen (Mr. McAvoy) should be shaking his head, because some people in the ambulance service have worked extremely hard to ensure that the 999 service has continued.
Mr. John McAllion (Dundee, East) : The Minister will be aware that, two weekends ago, three people died in Dundee who might have been saved if ambulance workers had been able to attend them. However, the management locked out the ambulance workers and denied them access to life-saving equipment.
Mr. Forsyth : If the hon. Gentleman wants to refer to examples in Dundee, I am sure that he saw the same BBC programme as I did, in which an ambulance man confessed that he had put attendance at a union meeting before answering an emergency call. To his credit, he has apologised. If the hon. Gentleman thinks that the dispute will be settled by engaging in that kind of argument, I have to disagree with him. There is a clear duty on the ambulance service management to ensure that the Scottish ambulance service procedures are followed. Management have made it perfectly clear that, when those procedures are followed, they will do everything in their power to ensure that the service continues.
Mr. Thomas McAvoy (Glasgow, Rutherglen) : I intervene only because the Minister referred to me earlier. He has referred to the senior management in the Scottish ambulance service. Does he not believe that morale in the ambulance service will be affected by Mr. James Wilby questioning the integrity of the people with whom he will have to work in future?
Mr. Forsyth : I am sure that the hon. Gentleman knows that his name is John, not James, Wilby. I believe that he is just as inaccurate in suggesting that Mr. Wilby has questioned the integrity of his staff. I know John Wilby, and his dedication to the ambulance service. He has spent most of his career in the service. It does not help to attack him in that way.
Senior management and officers have worked extremely hard to maintain essential services. If only for the benefit of the hon. Member for Islington, North (Mr. Corbyn), I want to place on record my thanks to the police, the voluntary services and the Army, who have had to step in when patients have been put at risk. They have done so because there has been no alternative, despite the fact that a clear undertaking had been given by trade union leaders that the emergency service would be maintained. That undertaking has not been met in a number of instances.
Dame Elaine Kellett-Bowman (Lancaster) : A very dear friend of mine had to be taken to hospital by the police because no ambulance was available. When I was at the West Kensington tube station the other day, some
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ambulance men were collecting money from the public in buckets. An ambulance came along. I thought that it was going about its normal duties, but it just picked up the ambulance men, complete with cash buckets--presumably to take them to their next cash collection point.Mr. Forsyth : The House will have heard what my hon. Friend said. It is to be regretted that, despite the clear undertaking by trade union leaders that the emergency service would be maintained, that has not happened in a number of cases.
Mr. Corbyn Will the Minister give way?
Mr. Forsyth : I shall give way to the hon. Gentleman in a moment. I noted that, over the weekend, the hon. Member for Govan was quoted in the newspapers as describing the tactics that are being pursued as "brilliant and exemplary". If he thinks that there is anything brilliant or exemplary about Edinburgh being left with only two ambulances to cover the whole city, I could not disagree with him more. He has a responsibility to ask those men, who are not even following the advice of their trade union leaders, to ensure that a proper service is maintained.
Mr. Corbyn : Does the Minister accept that, all over the country, ambulance managements are standing down ambulance workers who are ready, able and willing to provide an emergency service, that they are asking the poice or the armed forces to deal with emergency cases instead, and that those who are sent in to carry out emergency work do not want to do it, are not qualified to do it and, furthermore, are not equipped to do it? Those whom they blame for having to do that work are the Conservative party and the Government. If he is genuine, why does the Minister not demonstrate his support for the ambulance workers by meeting the unions and coming to an agreement, so that a proper emergency service can be restored?
Mr. Forsyth : If the men in the Scottish ambulance service are prepared to work to the TUC guidelines and to provide an emergency service, they will be paid 100 per cent. on the emergency side. On the patient transport side, if the TUC guidelines are followed and if the ambulance men are prepared to take elderly people to their day hospitals, they will also be paid 100 per cent. There is absolutely no need for local authorities to set up alternative services at a cost to the community charge payer, and there is every opportunity for an emergency service to be maintained within TUC guidelines if that is what the trade unions wish to deliver. The public are entitled to that.
Mr. Sillars : Does not the Minister realise that, when a dispute involving an important public service continues for six months, there is at the heart of it a great struggle between the Government and the ambulance workers for public support, as that is a key element in any such dispute? Have not the public themselves passed judgment that the ambulance unions have conducted a brilliant campaign strategically and tactically, in that they have never withdrawn their services from the general public, who believe that, far from being brilliant, the Government's performance has been lamentable?
Mr. Forsyth : I am sure that every person in Glasgow will note that the hon. Member for Govan is completely
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unaware that a 999 service was withdrawn from his own constituency, and that he has described that as "brilliant and exemplary".Mrs. Maria Fyfe (Glasgow, Maryhill) : I wonder whether the hon. Gentleman cares to respond to the point just made by the hon. Member for Glasgow, Govan (Mr. Sillars)--that the public support the ambulance workers and have made that very clear for six months?
Mr. Forsyth : The hon. Lady will have heard me say that the Government also support the ambulance workers. We support them for the service that they provide. But if we were to take the advice of the hon. Lady and the hon. Member for Govan, which seems to be the same, and if we were to allow some procedure for determining pay such as the hon. Gentleman suggests, pay in the Health Service would press upon resources and the hon. Lady would find that the public in her constituency would complain about the loss of the development of services in the Health Service.
Mr. Robert Hughes : Will the Minister give way?
Mr. Forsyth : I should like to make some progress. I shall give way to the hon. Gentleman later.
For the benefit of the hon. Member for East Lothian (Mr. Home Robertson), perhaps we should go back to 1986, as it is important to recognise the importance to the dispute of what has happened since then. Back in 1986, a new salary structure was agreed for the ambulance service, which included revised working practices and improved conditions. It was acknowledged by everyone on all sides that that represented a good deal for the ambulance service. I have examined what had happened to prices and to wages in the ambulance service since that good deal was obtained. I discovered that prices to April 1989 have gone up by 23 per cent. and the pay of ambulance men, including the current offer which applies from April 1989, has gone up by 31 per cent. So there has been a real increase in ambulance men's pay of 8 per cent. over the 1986 settlement, which every ambulance man to whom I have spoken has acknowledged as a good settlement ; they are on record as saying that it was a good deal.
Mr. Charles Kennedy (Ross, Cromarty and Skye) : The Minister is talking about the increase in ambulance men's pay since 1986, but he should compare it with that of firemen and policemen over the same period. Firemen's pay has gone from a 7.3 per cent. increase in 1986 to one of 8.6 per cent. for the current financial year ; policemen's pay has gone from a 7.5 per cent. increase to 9.25 per cent. for the current financial year, and ambulance men's pay has gone from an increase of 6 per cent. to the current offer of between 6.5 per cent. and 9 per cent. over the past 18 months ; but in the intervening two years, their pay increase dropped to between 5 and 6 per cent. They have consistently lost in comparison to other emergency services.
Dame Elaine Kellett-Bowman : It is not an emergency service : it is the emergency arm of the NHS, not the NHS arm of the emergency services. [Interruption.]
Mr. Forsyth : Perhaps I can answer the hon. Gentleman's point, as I did not hear what my hon. Friend said.
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The hon. Member for Ross, Cromarty and Skye (Mr. Kennedy), is arguing a separate point. My point is that, in 1986, the ambulance service was completely restructured in terms of pay and conditions, and the ambulance men acknowledged that as a good deal. When we compare their position in 1986 to what it is now, we see that ambulance men's pay has increased 8 per cent. faster than prices. In real terms, their pay is better than it was in 1986.The hon. Member for Ross, Cromarty and Skye asked me to make a comparison between ambulance men, fifth-year firefighters and other groups. I must be fair and say that the hon. Gentleman was right to say that, in terms of a comparison with firemen, the pay of ambulance men has not risen by as much, but in terms of the 1986 settlement, their pay has risen well ahead of inflation.
The management's final offer to the ambulance men is fair and reasonable. I am not sure whether everyone is aware of the nature of that offer, but I am certain that the hon. Member for Govan, judging by his speech, is completely unaware of it. I know that the hon. Member for Govan is aware that the offer is a 9 per cent. increase in pay, backdated to 1 April 1989.
Mr. Henry McLeish (Fife, Central) : It is over 18 months. Will the Minister give way?
Mr. Forsyth : I will give way to the hon. Gentleman later. I have already been very generous in giving way.
The nature of the offer is a 9 per cent. increase on all rates, backdated to 1 April last year. That is 9 per cent. over the current year, and that would run until the end of September this year. On 1 October, there will be an opportunity to negotiate a further increase. In addition to that, there is an extra £500 for all staff with paramedical skills.
Mr. Sillars : Will the Minister give way on that point?
Mr. Forsyth : If the hon. Gentleman will contain himself until I have explained the offer--
Mr. Sillars : There are only eight people in Scotland with paramedical skills.
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