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Mr. Ernie Ross (Dundee, West) : The hon. Gentleman seems to think that the dispute is the result of a plot by Opposition Members. Every Saturday, I stand with the ambulance men in the city square in Dundee, and there is no lack of people going about their business--not people wearing Labour party, SNP or SLD stickers but ordinary people, from the very young to the very old--who put money into the ambulance men's buckets. Why does the hon. Gentleman think that is?
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Mr. Walker : The hon. Gentleman is old enough to remember other similar disputes, in which--
Mr. Walker : In that case, I apologise to the hon. Gentleman, who cannot be as old as I thought he was. As soon as a dispute is settled, feelings evaporate and views and attitudes change.
The conspiracy is not one by the ambulance men, some of whom are trying to deal with a genuine grievance. They are going about it wrongly, but that is a different matter. In a number of instances they have a case for saying that conditions should be altered. That is not unusual ; very few groups could not make such a case. The important point is that the Opposition regard the dispute as an opportunity. They are engaged in political opportunism. It is among Opposition Members that we find the intrigue and political machinations. I am not blaming the ambulance men, although they are mistaken in their methods and although they will live to regret the scrapping of Whitley. That is the important point and I want it on record.
Mr. Robert Hughes : The hon. Gentleman should be extremely careful not to put words into other people's mouths. By saying that there is a case for looking at the Whitley council procedures and possibly bringing in arbitration as an alternative to a review procedure, we are not saying that Whitley should be scrapped. Let us be perfectly clear about that. No one says, "Scrap Whitley." We are merely saying that the Government should look at Whitley and improve it rather than allow it to fall into disrepute.
Mr. Walker : The captain of the Titanic probably did not want to sink the Titanic, but people's actions have an effect-- [Laughter.] Hon. Members should listen carefully. The other 90-odd per cent. of staff who settled under Whitley take the view that the system works, but Whitley may be killed off by the very people who should be making it work. Hon. Members know that the machinery depends on the active involvement of both sides to make it work. If one group--the ambulance men--says no to Whitley and decides to pursue its claim in a different way, the other 96 per cent. of staff may be tempted to do the same, and that would amount to scrapping Whitley.
6.23 pm
Mr. Dafydd Wigley (Caernarfon) : In recent months, Wales has faced similar problems to those confronting Scotland and England. We are grateful to the Scottish National party for introducing the debate and to the hon. Member for Glasgow, Govan (Mr. Sillars) for his introductory remarks. I take issue with the hon. Member for Tayside, North (Mr. Walker) about the need for the Opposition to rattle round looking for causes to do in the Government. The Government are quite capable of doing incredible damage to themselves, as the poll tax and the ambulance dispute has proved.
I thank ambulance workers in my constituency, in Wales and in general for the tremendous work that they do and for the dignity and restraint with which they have conducted themselves in the recent most difficult weeks. As hon. Members have said, they command overwhelming support in the community. A BBC poll undertaken in Wales showed that 100 per cent. of those asked supported
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the ambulance workers. Only two people who were asked to sign a petition in my constituency, which carried 3,000 signatures, refused to do so.It is disgraceful that the dispute should have been drawn out for so long, when the Government could easily have found a way of reaching a settlement. The size of the ambulance workers' claim is quite reasonable. If hon. Members are happy to accept an annual salary increase in excess of 10 per cent., how can we say that the ambulance workers do not deserve a similar increase? What measuring rod can we use?
The method of pursuing the claim has also been reasonable by and large, although today is a sad day in Wales because, in South Glamorgan, we have seen what amounts to a lockout ; that represents a serious aggravation of the dispute, which the ambulance workers did not want. It is interesting to note that, this weekend, in the neighbouring county of Gwent, the ambulance manager passed control of the service to the ambulance workers themselves. That was an intriguing step forward, and reflects the sense of responsibility that the management felt the ambulance workers showed towards their work. I believe that that is generally so.
I have taken the trouble to go round all three ambulance stations in my constituency--in Caernarfon, Pwllheli and Porth-madog--and I am deeply impressed by the sense of responsibility shown by the men and by the Transport and General Workers Union and its leadership. They have tried to stick to the rules laid down centrally by the unions, to ensure that those who could be adversely affected by industrial action are protected, and that the dispute does not endanger life and limb.
I have noted the long hours that the ambulance workers often have to work. I have known some to work an all-day shift and then go on to all-night standby, at a rate of pay of £4 per full standby shift. That rate of remuneration compares badly with those of electricity and gas workers on standby work. Ambulance men may work as long as 24 hours on the trot ; and one can well imagine the strain that that places on them.
What can be the Government's motive for prolonging the dispute? It cannot be to establish 9 per cent. over 18 months as the norm, given what is happening in industry--at Ford and elsewhere. It is widely believed among ambulance workers that there is an attempt to use the dispute to split their work into two, with a professional upgraded staff for the paramedical part of the work and a taxi-driver-type service for the other part, which is eventually to be privatised. It would be a woeful state of affairs if the Government used the dispute to pursue their own dogma and to make one more stride towards privatisation.
Perhaps some of the services in inner-city areas can be undertaken by something less than the full crew, and I understand that such a system has been experimented with in some cities. But in rural areas such as mine, it is not practical or possible to downgrade the service into a taxi-type service. Those areas need full-time professionals, because some parts of my constituency are 50 miles from the hospital to which the ambulance workers must take emergency cases. In my county, the average time for taking people to hospital is one hour, compared with seven minutes in some city areas. One cannot have a blanket approach, which I fear the Government have. Ambulance workers and emergency workers, who turn out to all sorts of emergencies--not just medical
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emergencies. When the fire engines are called out, the ambulances are also called out, and the ambulance workers are often there first. They are often called out in police emergencies, too. If the fire service is entitled to index-linked pay, it is ridiculous that the pay of ambulance workers should not be index-linked. There should at least be parity of approach, if not parity in pay scales. It is important that training should be adequate. It would not be right to pay a higher rate to only a limited number of highly trained staff if training is not made available to the overwhelming majority. As the dispute seems to be escalating, I am also worried about ambulance cover in rural counties, especially if we have to rely on the Army. I understand that six Army ambulances would be available to cover the whole of Gwynedd. That would be impossible.I believe that there is a solution to the problem. We should lay on one side for a moment the percentage increase for this year and consider other aspects. The Government ought to say that they are prepared to allow next year's pay award to go to arbitration. They ought to accept that decision and be prepared to index-link it to average industrial wages. The Government should not use such a settlement as a basis for privatisation. The Government ought to agree to review the equipment that is available to ambulance workers--a subject that causes them considerable worry.
If the Government adopted such an approach, I believe that there could be a settlement, based on a figure for this year which the Government could accept. We must find a way out of this dispute. An old constituent of mine, Wil Napoleon, who is dead now, had a very good dictum : "Never start a fight in a pub without a back door." I suspect that the Government have started a fight in a pub without a back door, and that they will have to pay the price.
6.31 pm
Sir Hector Monro (Dumfries) : I listened with interest to the speech of the hon. Member for Caernarfon (Mr. Wigley), and to his suggestions about how to resolve the dispute. It is important to hold negotiations as soon as possible without preconditions. I was a Health Minister in the early 1970s. There was a similar strike to this one in 1972-73, when we had to introduce civilian volunteer drivers. Fortunately, that dispute was resolved far more quickly than this one.
I pay tribute, as did the hon. Member for Glasgow, Govan (Mr. Sillars), to the ambulance men in my constituency, who provided such effective help at the time of the Lockerbie disaster. They have to deal with many serious accidents on the A74. They turn out rapidly in such emergencies. I pay great tribute to them.
The National Health Service and the unions agreed a negotiating structure in 1986. They decided to proceed under the Whitley procedure by means of freely agreed negotiations. There was no place for arbitration in the 1986 agreement. Furthermore, arbitration is not an option in other parts of the National Health Service. We cannot change the rules of the game.
In May 1989, management and unions reached agreement on 6.5 per cent. The unions put that agreement to their members on 20 June, but it was rejected. After that, the dispute began. On 4 December 1989, the National Health Service offered 9 per cent., backdated to 1 April
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1989 and running through to September 1990. Leading ambulance men would have an increase of about £1,000 over 12 months and ambulance men and women would receive an additional £650, while those who are trained as paramedics would receive an additional £500. The unions responded with an 11 per cent. demand, with pay to be linked to police and fire service pay.The Labour party set out the terms of reference of the Clegg inquiry. The unions' demand was linked to the Clegg report, but Clegg said that there should be no link between the fire service, the police and the National Health Service.
The 1986 agreement ought to be reviewed. There should be no preconditions. I do not understand why the unions insist on preconditions and will not return to the negotiating table. A 9 per cent. offer is on the table. To offer to renegotiate the structure without preconditions seems to me to be reasonable. A restructuring of the pay system, including Whitley and arbitration, would be on the table. Whether agreement would eventually be reached about that is another matter.
The ambulance men and the unions would, if they were wise, start afresh and try to resolve the problem during the next few months. They have already been offered 9 per cent., backdated to April 1989. That is a reasonable offer. The unions ought to get round the table with the National Health Service and resolve the problem between now and September 1990. Between now and September, 9 per cent. would be paid to the ambulance men. If the unions took that course, it could lead to much happier times for ambulance men and women.
6.37 pm
Mr. Thomas McAvoy (Glasgow, Rutherglen) : The main reason for this claim is to retain the value of ambulance men's earnings. The unions have said that a pay mechanism, such as a pay review body, would be given serious and constructive consideration. Alternatively, the Government could propose a new pay mechanism. The unions have been flexible.
The hon. Member for Glasgow, Govan (Mr. Sillars) referred to five key parts of the union's case. They have said that they are willing to drop those demands if that would help to solve the dispute. The unions are ready to negotiate on both the pay claim of 11.14 per cent. and the nature of the pay formula. Flexibility is there. The Government ought to respond.
The emergency work of ambulance crews has been well illustrated. During the last few days, newspaper articles have suggested that the unions are almost defeated. I do not know whether those articles have been influenced by Government sources. If this dispute ends in defeat for the ambulance workers, working practices will be seriously affected.
A disgraceful attack on Scottish ambulance staff was instigated by Mr. Wilby, the director of the Scottish ambulance service. He called into question the ambulance workers' commitment to the service and to their professional duties. How he thinks that that will contribute to future harmony in the Scottish ambulance service I do not know. Perhaps he got carried away by conducting the Government's political fight on their behalf. No doubt he will be rewarded with a mention in
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either the new year's or the birthday honours list. When that happens, clearly it will be a reward for political service. The position in Scotland contrasts with that in Gwent, where common sense prevails and obviously the priority of the management in charge of the ambulance service is public service instead of defending the Government's battle ramparts. There should be no totem poles, as the Government have sufficient strength. To their credit, many Conservative Members, particularly the hon. Members for Macclesfield (Mr. Winterton) and for Harlow (Mr. Hayes), have tried to get the Government to move, but the Government's position seems to echo the miners' strike. They are trying to show their strength and be macho, but true strength is the ability to be flexible and to negotiate. The Government should show their strength by negotiating with the ambulance workers.6.40 pm
Mrs. Margaret Ewing (Moray) : I intend to be brief in summing up, first because the case is self-evident and has already been put more than adequately by my hon. Friend the Member for Glasgow, Govan (Mr. Sillars), the hon. Member for Caernarfon (Mr. Wigley) and hon. Members from other Opposition parties. Secondly, I should not like to give the Minister the excuse that he could not reply to all the points that have been raised because he ran out of time before we forced the issue to a Division. Therefore, I shall ask the Minister some basic questions.
Throughout the debate, we have heard that it is costing £20 million- plus to subsidise alternative forms of support to replace the ambulance crews. Will the Minister give us a straight answer as to who is paying that money? Exactly where is it coming from? It has been mentioned that, were we to spend £10 million, which is all that it would take to settle the dispute, we should open the floodgates. I should be interested if the Minister could name any individual group that has ever used the emergency services as leverage to argue its own case in industrial discussions about wages. The entire industrial community recognises that the emergency services are different, and there is widespread support from all working people for the settlement of the dispute. I suspect that no one would try to use it as a lever.
As we are referring to the emergency services, perhaps the Minister will be more forthcoming about dealing with the letter of 22 August 1978 from the private office of the then Leader of the Opposition than the Under- Secretary of State for Scotland was on "Left, Right and Centre" on Friday night, when his subdued and humble demeanour made me wonder how many charm schools he had visited recently. That letter was signed by Matthew Parris on behalf of the then Leader of the Opposition. It stated :
"In all the comments she made during the Firemen's strike, Mrs. Thatcher linked her remarks not just to the firemen but to what she, and you, call Emergency Services. All three deserve to have their pay negotiations put outside the arena of industrial dispute by being given firm and automatic linkage to national price or wage rises." Will the Minister comment on that and tell us why the Conservative party seems to have changed its mind about the Clegg report? Conservative Members use it in their defence when we call for arbitration, but I was in the House in the 1970s when the Clegg report was published and the Conservative Opposition were very much against it. What has made the Conservatives change their minds in the intervening 10 years? Does the Minister accept that the report has been discredited in so far as it affects the
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ambulance men, because it is quite clear that there was no real analysis of their situation then, and there is now a strong argument for a much better analysis?I should like to know exactly what the Under-Secretary of State for Scotland meant when he said that the current offer would hold good until October. He led us a merry dance round various statistics, mentioning 9 per cent., 6 per cent., 6.4 per cent., 6.5 per cent., 18 months, 12 months and the rest. But when he said that the offer would hold good until October, it was not clear whether it would hold good after October, and that seems a strange way of offering the ambulance workers a negotiating base. If the Government are not guaranteeing the ambulance men the continuation of their wage increase after October, surely there is little point in them even considering negotiation.
The hon. Member for Dumfries (Sir H. Monro) said that negotiations should be reopened without preconditions, but the Government have placed preconditions on the ambulance staff in their negotiations because they are saying that there will be no pay review and no further increase forthcoming. Those are very tight preconditions for the Government to place on the ambulance staff, and I ask the Government to rescind them.
The Minister referred to investment. According to a press release from the Scottish Office this month, it amounts to some £4.7 million in Scotland. Of course, everyone welcomes investment in the ambulance service. It was disingenuous of the Minister to say that those of us who support the ambulance staff do not want such investment in the ambulance service. No one knows better than the ambulance staff how desperately that investment is needed. In my constituency, and I am sure in the constituencies of many other hon. Members representing rural areas, there is not a single fete, show or bazaar during the summer months where the ambulance men do not have an ambulance on display--and available for use in the event of an emergency --to raise funds to provide equipment to improve the service to the local community. When we talk about improving health provision and the need for investment, the Minister should note that the ambulance men have done a great deal to improve the service through their own voluntary efforts to buy vital equipment such as defibrillators.
I studied history, and one of my favourite books is "1066 and All That". Others who have studied history will know it well. One part of that book mentioned the arrival of what was known as "the face" and its implications for historical developments. Wars were fought over the face and deaths were caused by the face. It seems to me that the Government are more intent on saving their face than on resolving the ambulance dispute.
If ambulance staff are at the point of ceasing to observe the TUC guidelines, that must mean that they are being forced into total despair, anger and frustration at Government action. No Opposition Member wants the TUC guidelines to be broken, nor do the vast majority of the ambulance staff, but the frustration is being caused by the growing chasm between the Government, and the ambulance staff and the public. If the Government were to accept our motion, they would show a genuine commitment to resolving the dispute, which we all want to be resolved.
Mrs. Fyfe : On a point of order, Mr. Deputy Speaker. Does the House have the right to demand to know whether
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the Secretary of State for Health and the Secretary of State for Scotland have a reasonable excuse for absenting themselves for the entire debate?6.48 pm
The Parliamentary Under-Secretary of State for Health (Mr. Roger Freeman) : As the hon. Member for Livingston (Mr. Cook) rightly reminded the House, we have debated the subject a number of times. The best contribution that I can make to this short debate is to shed further light on Government policy on five particular points. I approach those five issues in a constructive and, I hope, enlightening fashion that will help to carry the debate further. I appreciate that a number of hon. Gentlemen have spoken with great passion and a sense of loyalty to their union colleagues and to the issues involved, but it seems to me that I can best serve the debate by answering the five key points that have arisen.
First, the hon. Member for Livingston implied that in some way we undervalued the contribution of ambulance men and women. That is not the case. As my hon. Friend the Member for Stirling (Mr. Forsyth), who has responsibility for health in Scotland, said, we all value greatly the role of ambulance men and women. Although I accept the very strong public sympathy for ambulance men and women and the understanding of their role, there is a difference between accepting that public sympathy and stressing that the Government have responsibility for settling public sector pay, however important a particular sector may be. It is not inconsistent for me to say that although the Government understand that public sympathy, we have a sense of responsibility.
The hon. Member for Livingston asked me specifically about retirement and stress. He was right to make that point. Unquestionably some ambulance men and women suffer great stress, particularly when they leave a horrific road traffic accident to deal with another rostered duty. In due course we will consider the reports on this issue. Although it is true that policemen retire earlier than ambulance men, I must stress that the police pay twice as much superannuation contributions as ambulance men and women to achieve earlier retirement. Nevertheless, the hon. Member for Livingston was right to raise the issue, and we shall consider it in due course.
The second of the five main topics to arise in the debate was cost. The hon. Member for Livingston said that we could have settled the dispute some months ago, and that the dispute is inconsequential. He said that the cost of the police and Army services helping to provide emergency cover in certain areas has amounted to about £20 million. I do not dissociate myself from that figure, although it is an estimate and not all the bills have come in yet. In response to the hon. Member for Moray (Mrs. Ewing), I can state that those costs will be paid by the National Health Service--by the appropriate ambulance authorities.
We are considering an additional cost because, although there may be some savings from staff who have absented themselves or are on lower pay, there will still be a burden. We cannot set the costs of the services provided by the police and the Army against the cost of increasing the pay of ambulance men and women in one year, because the cost recurs. The implications of agreeing to the union's demands for a pay review body or, failing that, binding
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arbitration, would be much more expensive for the ambulance service. We must remember that the ambulance service costs about £200 million a year.My hon. Friend the Member for Tayside, North (Mr. Walker) referred to the 390,000 Whitley staff who would wish to share in any pay review body, mechanism or binding arbitration. The NHS pay bill is about £13 billion. In the debate before Christmas, the hon. Member for Livingston said that it was Labour party policy to agree to a pay formula. I hope that he has cleared that with his right hon. Friends the shadow Chancellor and the shadow Chief Secretary to the Treasury, because such a pay formula would have significant financial implications for the Health Service and for public sector pay. My hon. Friend the Member for Lancaster (Dame E. Kellett-Bowman) asked a specific question about the offer that is on the table. That offer is backdated to 1 April, to increase the rate of pay by 9 per cent. per annum over an 18-month period. From 1 October this year, fresh negotiations on the further increase in pay will have to take place. My hon. Friend the Member for Lancaster reminded the House, rightly, that the increase is more than 9 per cent. in London--12 per cent.--and that we are putting on the table £500 per annum to increase pay for trained paramedics. That represents an extra £900 in cash for ambulance men and women over the 12 months beginning 1 April. The third main point to arise from the debate relates to emergency and non-emergency work about which the hon. Member for Livingston asked specific questions. All hon. Members would agree that some parts of the ambulance service are non- emergency in nature ; there can be no dispute about that. I can give the hon. Member for Livingston the figures. In terms of the number of patients carried, 10 per cent. of the activity of the ambulance service is emergency work, to which should be added another 5 per cent. for doctors' urgent cases. That means that 15 per cent. of ambulance service activities involves emergency work. That figure is not dissimilar to the one that the hon. Member for Livingston quoted for York. We are in danger of confusing functions with the argument that we must have a full roster of ambulance men and women on which to draw in the event of an emergency. I suggest that some functions of the ambulance service are not of an emergency nature and can be contracted out. The experience in Northumbria and Wiltshire supports that contention.
Mrs. Gorman : Will my hon. Friend confirm now or later the figures that I heard in a BBC broadcast to the effect that the average cost of a non-emergency journey is £40 per person? If that is correct, it must be cheaper to contract such work out.
Mr. Freeman : My hon. Friend is right to draw attention to the fact that non-emergency functions, when contracted out, can be cheaper. We are not being prescriptive, and it is for the various ambulance authorities to decide which part of the service to contract out and when. However, my hon. Friend was correct--
Mr. Wigley : Will the Minister give way?
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Mr. Freeman : No. I have only three minutes left and two points with which to deal, and one of those points was made by the hon. Gentleman himself.
The fourth point to arise from the debate concerns training and equipment to which my hon. Friend the Member for Birmingham, Edgbaston (Dame J. Knight) referred. The hon. Member for Livingston mentioned 14,000 qualified ambulance men. Of those, only 2,000 are fully qualified paramedics. My hon. Friend the Member for Edgbaston wanted to know whether those 2,000 qualified staff have to pay for that additional training. They do not.
We need to increase the proportion of ambulance men and women who are qualified paramedics. We want one paramedic in each emergency ambulance. Paramedics are qualified to provide drips, to unblock airways and to control heartbeats. We have only 2,000 ambulance men and women who are so qualified. I agree with the hon. Member for Livingston that we need to devote additional resources to training and equipment in the ambulance service. My hon. Friend the Under-Secretary of State for Scotland referred to steps that have already been taken to that end in Scotland. I confirm that my right hon. and learned Friend the Secretary of State for Health takes that issue very seriously. Over the coming months, we will be concentrating on how to improve training and the resources devoted to equipment in the Health Service.
On national pay, we want greater local flexibility which, in some cases, means higher pay, paid for by productivity in the ambulance service. That should be possible. That is the correct route further to reward ambulance men and women.
Mr. Poole knows that this dispute, including the pay review body, cannot be won on his terms. Surely both sides should sit down, without rancour or loss of face, but with common sense and good grace, and solve the dispute.
Question put, That the original words stand part of the Question :--
The House divided : Ayes 207, Noes 276.
Division No. 83] [6.59 pm
AYES
Abbott, Ms Diane
Allen, Graham
Anderson, Donald
Archer, Rt Hon Peter
Ashdown, Rt Hon Paddy
Ashley, Rt Hon Jack
Ashton, Joe
Banks, Tony (Newham NW)
Barnes, Harry (Derbyshire NE)
Barnes, Mrs Rosie (Greenwich)
Barron, Kevin
Battle, John
Beckett, Margaret
Beith, A. J.
Bennett, A. F. (D'nt'n & R'dish)
Bermingham, Gerald
Bidwell, Sydney
Blair, Tony
Blunkett, David
Boateng, Paul
Boyes, Roland
Bradley, Keith
Bray, Dr Jeremy
Brown, Ron (Edinburgh Leith)
Bruce, Malcolm (Gordon)
Buchan, Norman
Buckley, George J.
Caborn, Richard
Callaghan, Jim
Campbell, Menzies (Fife NE)
Campbell, Ron (Blyth Valley)
Campbell-Savours, D. N.
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