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Dr. Harris: Oxford, West and Abingdon.

Mr. Amess: The hon. Member for Oxford, East--

Dr. Harris: Oxford, West and Abingdon.

Mr. Amess: --and his colleagues have changed the name of their political party on four occasions, so, okay, it is now the Liberal Democrat party, but all I say to the hon. Gentleman, who was elected on 1 May 1997, is that we want to know where the Liberal party stands on the issue. Does it support the Labour Government? Does its leader want a position in the Cabinet, or, this morning, are we to take seriously--its Members were massed on two Benches--its attack on Her Majesty's Government?

I know that, when the Minister of State stands up, he is going to have quite a bit of briefing that will blame everything on the 18 years of the Conservative

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Government and say nothing at all about the Liberal party. I do not think that Conservatives and the rest of the country will accept that.

Like the hon. Members for Southwark, North and Bermondsey and for Bolsover, I should like to pay tribute to the work done by health visitors, nurses and midwives in the United Kingdom. We owe all of them a great debt of gratitude. However, I should like to deal with the difficult matter of pay, which is all about management of the economy and setting priorities, which the Liberals, or the Liberal Democrats--unlike the hon. Member for Bolsover, who at least clearly stated his priorities--never want to face up to.

As hon. Members will know, nurses are the backbone of the national health service and provide 80 per cent. of direct patient care. However, there are between 12,000 and 13,000 empty nursing posts in Britain. Moreover, the turnover rate of registered nurses is high--currently at 21 per cent., whereas it was 12 per cent. in 1992.

There are also widespread problems in recruiting nurses. The Government know all about those problems. A survey of 73 NHS trusts, shows that 78 per cent. of trusts now report recruitment problems. The percentage reporting such problems was just above 50 per cent. in 1997 and was 33 per cent. in 1996. The statistics show that, regardless of what the Minister says today, there is a growing recruitment crisis. As the hon. Member for Southwark, North and Bermondsey said, the nursing profession also faces a "retirement bulge".

The first brief that I shall use today came from the Royal College of Nursing, which would have supplied the brief to any hon. Member who asked for it. That organisation states that

Dr. Harris: And in January 1997.

Mr. Amess: Yes. However, the brief states that the decision in 1998

The hon. Member for Oxford, East and Abingdon (Dr. Harris), supported by the hon. Member for Newbury (Mr. Rendel), wants to attack not only the Conservatives but the Government. The Liberal Democrats want to have their cake and eat it.

Dr. Peter Brand (Isle of Wight): Will the hon. Gentleman give way?

Mr. Amess: Yes, I shall give way to a fellow Health Select Committee member, who is also a practising doctor and is working so hard.

Dr. Brand: I am grateful to the hon. Gentleman for giving way. I am especially grateful that he has now started to talk about nurses' pay. He has listed a number of problems in nursing. Does he accept that one of the issues affecting not only recruitment but retention of nurses is the constant regrading process, in which senior nurses have to apply for their jobs and are reappointed at a lower grade? It is the most demoralising process for a professional. Does he agree also that that process is a

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consequence of trusts being told to do their own thing--thereby destroying a national pay and career structure in the United Kingdom?

Mr. Amess: Unlike the hon. Gentleman, I was a Member of Parliament when nurse regrading was developed. Like the Secretary of State--who takes responsibility for everything that happens in his Department--I should be very happy to defend the previous Government's 18 years in office. However, nurse grading is not the straightforward matter that the hon. Gentleman implies that it is.

The Royal College of Nursing wants specifically to compare nurse grading with teacher grading. The college believes that the position of nurses has become much worse compared to that of teachers. I do not know whether the Minister thinks that it is sensible to have such a relative decline.

The Royal College of Nursing believes that the only way in which nurses can earn extra money is by working unsociable and extra hours. The college believes that it is wrong for such a situation to continue, and that retention of nurses would be much improved if there were a real career development plan. Perhaps the Minister will be able today to tell us about such a plan. The Royal College of Nursing also wants the Government to develop family-friendly employment policies, and believes that serious health and safety priorities in the NHS must be addressed.

Two months ago, the hon. Member for Moray (Mrs. Ewing), the parliamentary leader of the Scottish National party, sat next to me at a midwife rally, which was an interesting occasion. Such rallies were held regularly throughout the 18 years of the Conservative Government, and Labour Members and spokesmen were always there to address the masses, by whom they were applauded. Two months ago, when I attended, and spoke to, a rally, some Labour Members showed up, although no Minister was available to do so.

Mr. Skinner: I was there.

Mr. Simon Hughes: I was there.

Mr. Amess: I know that the hon. Member for Southwark, North and Bermondsey was there, and that he received a good reception.

Mr. Alan Duncan (Rutland and Melton): I was there, too.

Mr. Amess: Yes, I know. However, I should like to deal with the point about the Minister not being at the rally. During the rally, the Health Secretary's special adviser came in, looking extremely worried, and passed a bit of paper to the front of the audience. The audience was subsequently told that Baroness Hayman would meet a delegation a little later in the day. My word, it certainly takes great guts and courage to meet a delegation privately.

The Government did not say to the electorate, "Hang on; we'll have to wait two years for reform because the Conservatives have left the health service in a terrible mess. It is very sad that people are dying and operations are not being performed, but you'll have to wait at least

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two years. The Chancellor of the Exchequer has told us that 1999 is the year of delivery, and we can't do anything immediately." The Government should have had the courage during the general election to face up to that difficult audience.

I owe a great debt of gratitude to midwives. The rally that I attended two months ago was attended also by midwives from Southend and from my former constituency of Basildon. Midwives in Southend would like me to say that the midwifery situation there is good. Southend hospital does not have problems in recruiting midwives. Midwives from Southend were at the rally to support midwives in Basildon.

I was present at the birth of all five of my children, all of whom were delivered at Basildon hospital, and some of the midwives at the hospital have become great friends of mine. Midwives at Basildon face grave problems, which are shared by midwives across the country. In the past five years in the United Kingdom, for example, there has been a decrease of 2,500 in the number of midwives. Increasing numbers of midwives--a 13 per cent. increase in the past 10 years--are working part time. There is also a high wastage rate of midwifery students.

Health visitors are perhaps not as well represented as the other two groups of health service workers. Nevertheless, they, too, do a very valuable job.

I tell the Minister that I do not doubt for one minute that the Labour Government are genuine in their aspirations. On his return to the United Kingdom, the Prime Minister said that he wanted to be judged not on the Government's difficulties during the Christmas recess but on his achievements in health and education. I should be more than happy to make such a judgment. The British people, too, will make such a judgment.

It was a gross deception, on 1 May 1997, to give the British people the impression that the health service would be transformed quickly. The Secretary of State has now accepted that the health service is in crisis. Nevertheless, about six weeks ago, the Minister for Public Health said that there is no rationing in the health service. That statement was laughable. The Government have to be more straightforward in dealing with the difficulties in the health service.

The wonderful men and women working in the health service are of course overworked and underpaid, as health service workers always have been. Ultimately, however, it will be up to the Government to tell us their priorities. Achieving those priorities will depend entirely on the Government's management of the economy. The press has recently reported rumours about giving certainly student nurses a substantial pay increase. I should welcome such an increase. I welcome also the opportunity provided today by the hon. Member for Southwark, North and Bermondsey to share our views on such important matters.

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