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Child Care
5. Ms Rosie Winterton: If he will make a statement about the future regulation of children's day care services and supervised activities under the Children Act 1989. [13813]
Mr. Boateng: The Under-Secretaries of State for Education and Employment, my hon. Friends the Members for Birmingham, Yardley (Ms Morris) and for Newport, East (Mr. Howarth), and I will be consulting, early in the new year, on our plans to develop an integrated regulation and inspection system that will promote day care and early-years education for young children, provide a quality assurance framework in which parents can have confidence and reduce bureaucracy for providers. That was another commitment in our general election manifesto which we are carrying out.
Ms Winterton: Is my hon. Friend aware of a case in my constituency where a two-year-old child, Ben Chorlton, walked out of a creche provided by a private gym into a nearby bus station? The creche was not registered because it operated for less than two hours per day. Does he believe that it is acceptable for a creche to operate for one hour and 55 minutes per day solely to avoid registration and inspection? Will he meet me to discuss the implications of the case?
Mr. Boateng: No, it is thoroughly unacceptable. The two-hour time limit for registration was introduced to ensure that one-off or less formal, unremunerated short-term care arrangements were not unnecessarily burdened by unworkable regulations.
It was never intended that proper regulation and supervision should be undermined by attempts such as my hon. Friend has described to remove the basis on which they are carried out. I look forward to meeting her to do all that we can to support Doncaster social services in ensuring that the facility puts itself in order.
NHS Pay
6. Mr. Whittingdale: If he will make a statement on the study which he has commissioned on pay rates in the NHS. [13814]
Mr. Dobson: I have ordered a survey of earnings in the national health service, to make available to the Government information that any employer would want to have. The previous Government stopped collecting that information, presumably on the basis of the motto, "Ignorance is strength".
Mr. Whittingdale: In conducting his survey, does the Secretary of State intend to take account of the effect of introducing a minimum wage, which is bound to cost the NHS tens of millions of pounds? Can he guarantee that the NHS budget will be increased to cover that cost and that it will not be met at the expense of patient care?
Mr. Dobson: It is precisely so that we can advise the Treasury and the rest of the Government on the possible
impact on the national health service of a national minimum wage that we are collecting the information. It was the hon. Gentleman's own stupid, ignorant Government--for want of a better expression--who, for their own benighted reasons, stopped collecting the information; yet Tory Ministers from the Department of Health came to the Dispatch Box and announced figures of the impact on the national health service of a national minimum wage. As they did not know how many people were earning £2.50, £3, £3.50, £4 or whatever an hour in the national health service, that was pure speculation, like all the rest of the Tory attacks on a national minimum wage.
Mr. Hinchliffe: On NHS pay rates, may I take my right hon. Friend back to the answer that he gave a few moments ago to my hon. Friend the Member for Leicester, South (Mr. Marshall) about the formula for allocating resources to individual health authorities? What consideration has he given to removing the market forces factor from the current formula, which assumes that NHS wages are low in generally low-waged areas, such as my constituency, and badly penalises those areas?
Mr. Dobson: We have changed the arrangements for this year and we are considering next year's. To the people who graced--if that is the word--the Treasury Benches for the previous 18 years, all I can say is that I am astonished that they are not ashamed to acknowledge, let alone claim, to the House that a substantial number of the 1 million hard-working people in the national health service are likely to be paid less than what would be a reasonable national minimum wage. They are saying that our national health service depends on paying poverty wages, when they know that poverty makes people ill.
Rev. Martin Smyth: Will the Secretary of State confirm that the Unison recommendation of £4.42 an hour as the national minimum wage would be more than what is earned by 96.4 per cent. of ancillary workers in the health service; by 5 per cent. of clerical and administrative workers; and by 8 per cent. of professional and technical workers? Does he acknowledge that, if those workers were not paid properly, the health service would suffer?
Mr. Dobson: Exactly. As the hon. Gentleman knows, the Low Pay Commission is currently considering what the national minimum wage should be. As he points out to Conservative Members, who sit on the same side of the House as him but with whom he is generally not associated, I am glad to say, a substantial number of badly paid people in the national health service nevertheless provide services that are vital if the highly paid professionals are to be able to do their jobs properly. Once again, it is shameful that Tories should be asking me what the impact on the national health service of a national minimum wage is likely to be, when they are apparently proud of paying poverty wages to people who provide treatment and care for the sick and injured.
Mr. Skinner: Does my right hon. Friend agree that it is staggering to hear the Tories attacking low-paid workers when a previous Tory Secretary of State for Health, who later became Chancellor of the Exchequer, has now got four extra moonlighting jobs, picking up something approaching £500,000 a year? There are gangs
of them on the Tory Benches, all lining their pockets with outside interests, and they have got the cheek to attack low-paid workers in the national health service. Gang of hypocrites!
Mr. Dobson: As my hon. Friend points out, yet again, the Tories are for the few rather than the many, and we are proud to be for the many rather than the few.
NHS Waiting Lists
7. Mr. Ian Bruce: What has been the trend in NHS waiting lists since May 1997; and what targets he is setting for the next 12 months. [13815]
Mr. Dobson: In May 1997, the new Government inherited from the Tory Government the longest hospital waiting lists in the history of the national health service after 18 years of Tory rule. Inevitably, those waiting lists have continued to grow. [Interruption.] I am astonished that Tory Members are surprised. We inherited the longest hospital waiting lists in history, and they were rising faster than ever before in the history of the NHS. The extra £300 million that we have made available to the NHS this winter should help restrain the rate of growth but reducing waiting lists will take time. We will shortly announce a package of measures designed to deliver our clear manifesto commitment that waiting lists will be reduced before the end of this Parliament.
Mr. Bruce: I notice that the Secretary of State, who had a very easy question from me, did not give us the target for the next 12 months. He keeps prevaricating. May I give him an easier question? Dorset never had a problem with waiting lists until this Government came to power. He says that the extra money was given to areas where sparsity was a factor. Dorset must be one of the sparsest counties, so why have we had one of the smallest amounts of money? Why is no attempt being made to keep what the Government said was a top-priority promise?
Mr. Dobson: I really do not think that I can be reasonably expected to plead guilty to the immediate devastation of South Dorset; nor am I responsible for the hon. Gentleman's majority of 77. Given the sparsity factor, his area will next year get an increase of 4.14 per cent. on its spending this year--an extra £13 million. If he did not have barefaced cheek, he would get up and thank me for it.
Mr. Gunnell: May I say to my right hon. Friend that the extra money to stop waiting lists rising enormously this winter is welcome? What flexibility will there be in the spending of that money between the health service and social services? Dealing with the problem means tackling bed blocking and putting money into social services. How will that flexibility be applied locally? Who will be involved in the decision making?
Mr. Dobson: Since we took over, we have emphasised at every stage that the problems faced by the national health and the social services this winter can be dealt with only if they are working together. I have written twice to health service bosses in each area and to local authority bosses. The chief inspector of social services and the chief
executive of the NHS have made joint visits to all the areas, to ensure that they are working together. I have made it plain that regional offices should allocate funds only to those areas in which it is clear that social and national health services are working together. Only when they work together will they be able to succeed.
Mr. Nicholls: The right hon. Gentleman will be aware that waiting lists in Cornwall will rise dramatically if the health authority there carries out its proposal to close four community hospitals. Is he aware that the people of Cornwall regard the so-called public consultation as a complete sham, bearing in mind that the chief executive has said that he would close those four hospitals even if he had unlimited resources? Given that the Secretary of State, to his credit, has on a number of occasions paid due credit to the work done by community and cottage hospitals, will he avoid passing judgment on what the eventual plans may be, but use his residuary powers to quash the present public consultation process and introduce a new one in which the public could have confidence? He acted with commendable speed last week to deal with a crisis in Exeter. Will he act today and intervene to safeguard the position of the people of Cornwall?
Mr. Dobson: I do not think that that would be sensible. I welcome the hon. Gentleman to the Opposition Front Bench and thank him for his kind remarks about our response to the breast cancer screening crisis in Devon and Exeter. However, it would probably not serve the people of Cornwall to blow the whistle on the existing consultation process and start all over again--that would simply prolong the uncertainty. I give him and the people of Cornwall the assurance that when the proposals come before me, as they certainly will because the community health councils are opposed to them, I shall scrutinise them very carefully indeed.
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