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Miss Widdecombe: I have asked the following question of the Secretary of State before. I have also asked it of the Minister of State. My right hon. Friend the Leader of the Opposition has asked it of the Prime Minister. We have had no answer. It is a terribly simple question, and I am sure that there is a terribly simple answer, for which we would be grateful.
The question is: if the right hon. Gentleman is so concerned to reduce junior doctors' hours, why did the United Kingdom delegation propose to Brussels that the hours should be 65, not 56, for eight years, and 60 for seven years?
Mr. Dobson:
I shall answer that in the course of my speech--[Hon. Members: "Answer it now."] All right, then. Let me read it slowly; perhaps that will help.
The European working time directive sets a maximum working week of 48 hours. The previous Government opposed the directive altogether. They fought its introduction tooth and nail, but, in their hapless way, they did not manage to stop it coming into law. At no stage did the previous Government try to achieve a reduction in junior doctors' hours to anything like 48, and it takes the biscuit that they should try to criticise us for doing so.
Clearly, a 48-hour week for junior doctors cannot be delivered quickly, because of the time it takes to train doctors. We have been negotiating a Europe-wide arrangement that will give Britain enough time to be able to reach the 48-hour target while, in the meantime,
permitting a limit on hours that the NHS can live with. Different EU countries have different health systems, different ways of training doctors and different definitions of being at work and being on call.
We have sought to ensure that we have a European law that enables us to continue to reduce the hours, improve the working conditions of junior doctors and provide cover for NHS patients. I am confident we will achieve that. We have not sought to make British doctors work longer hours, and anyone who says that we have is a liar.
Miss Widdecombe:
I say, because I have seen the document, that a proposal is before the European Council that 65 hours should be the hours of junior doctors. If the Secretary of State is trying to get from 56 hours to 48, that is laudable and I hope that he succeeds. But I cannot understand how he gets from 56 to 48 via 65. Is he calling me a liar? I have seen the document. Can he give me a simple answer to a simple question? If he wants to reduce junior doctors' hours, why has he proposed a limit of 65 rather than the current 56?
Mr. Dobson:
As the right hon. Lady acknowledged in her own speech, 20 per cent. of our doctors work more than 56 hours. It would be ridiculous to propose a 56-hour limit in the Health Bill or in Europe at present because we know that we are not delivering that. The right hon. Lady continually misrepresents us--I shall put it no stronger than that. We intend no increase in any doctor's hours. The object of the exercise is to reduce the hours that British doctors work, ultimately to 48 hours in line with the European directive.
Dr. Evan Harris (Oxford, West and Abingdon):
Will the Secretary of State give way?
Mr. Dobson:
No, we have dealt with that point.
Sir Brian Mawhinney:
Will the Secretary of State give way?
Mr. Dobson:
Yes, I will give way.
Sir Brian Mawhinney:
I have been trying to follow the Secretary of State's argument. In the United Kingdom, he talks about 56 hours. In Europe, he talks about 65 to make Europe feel more comfortable. He does not talk about 65 hours for 20 per cent., just about 65 hours. Will the Secretary of State stand up and call me a liar? I do not believe what he is trying to tell the House about the Government's policy on junior doctors.
Mr. Dobson:
What the right hon. Gentleman believes is a matter between him, his conscience and the truth.
Unlike the Tory Government, we accepted and implemented the recommendations of the doctors and dentists' review body for this year, in full, without staging. That applied to the junior doctors, consultants and general practitioners. In the case of the consultants the review body recommended that from 2000-01, an extra £50 million should be made available to reward consultants for increases in work load, contribution to the NHS and intensity of work.
The Government, as requested by the BMA, were already committed to renegotiating the contract for consultants. We have fed the review body's
recommendation for next year into the renegotiations because they cover the same ground. The doctors' negotiators have stated that they are optimistic that joint proposals from the BMA and the Department of Health can be put to the review body this autumn for implementation in 2000. I share their optimism. A joint approach would clearly be better from every point of view.
That takes me to the other groups covered by review body awards--some of the professions allied to medicine. This year, they received the biggest real terms pay increase in a decade, and for the first time in five years, it is to be paid nationally, in full and without staging. All staff covered have received 4.7 per cent. The starting pay for newly qualified professions allied to medicine has gone up by 8.7 per cent. All basic grade staff will receive at least 8.4 per cent., and some senior grades have received an increase of 7.7 per cent. Yet the Tory motion
Let us compare this year's settlement with what the professions allied to medicine received under the last Tory settlement. The Labour settlement provides 8.7 per cent. for newly qualified professionals. The Tory settlement provided 3.3 per cent. The Labour settlement is paid in full from 1 April. The Tory settlement allowed 2 per cent. from April, and 1.3 per cent. from December. The Tories delivered far less in the past than they claim.
Neither are the Tories promising anything better now. Only last month in a letter to one of her colleagues, the right hon. Member for Maidstone and The Weald (Miss Widdecombe)--or her research assistant, writing on her behalf--said:
Miss Widdecombe:
Will the Secretary of State give way?
Mr. Dobson:
I will carry on, if necessary. The letter continued:
Miss Widdecombe:
The right hon. Gentleman knows very well that we have welcomed the pay awards that the Government have announced, even if the Government have not delivered them. He will be aware that I would never make the irresponsible comments that people try to lead me into before any announcements are made.
Mr. Dobson:
I would not like to be welcomed by the right hon. Lady. Her form of welcome is:
So the Tories may be concerned, but they are not sufficiently concerned to do anything. That is the truth about the charges that the Tories have levelled in this debate against the Government. We are not extending the hours of junior doctors. We are reducing them, and the Tories know it. We are paying the nurses their full pay increases with effect from 1 April, and the Tories know it. We have accepted the review body recommendations on consultants' pay for this year, and the Tories know it. The review body has just awarded the professions allied to medicine their best real-terms pay increase for 10 years, and the Tories know that too. So the Tory motion gets no marks for technical merit and, like every work of fiction, owes everything to artistic licence.
The most revealing aspect of the Tory motion was what it left out. It did not refer to the offers that we have made of up to 6.9 per cent for some medical laboratory scientific officers--the ones whom the right hon. Member for Maidstone and The Weald wants to rely on market forces. We offered them and trainee cyto-screeners that amount, and up to 11.2 per cent to qualified cyto- screeners. These are part of the continuing negotiations with non-pay review body staff which will be carried forward very soon with an improved pay offer.
Nor did the Tory motion refer to all the welcome changes that the new Government have brought to the NHS, which are designed to be better not just for patients but for the staff. For a start, we are building new hospitals and modernising old ones. We have already started work on 15 major hospital building projects--part of the biggest building programme in the history of the NHS. This year, more than £100 million is being invested specifically in improving accident and emergency departments, to make them both better for patients and safer for staff. Another £100 million from the lottery is being invested in new and better equipment to diagnose and treat cancer on top of the £350 million already earmarked for renewing unreliable hospital equipment this year.
"notes the concerns of Professions Allied to Medicine".
That falls short of qualifying even to be described as every assistance short of actual help.
"We have had to be necessarily circumspect about commenting on pay awards, as our own fiscal policy in respect of public sector pay has not yet been finalised. The line we have taken, and I acknowledge that it is not entirely satisfactory runs something like:
That is about as far as the right hon. Lady's policy goes.
"'I would certainly not seek to justify or defend the X per cent. award offered to X by this Government.'"
"It is worth noting that we excluded laboratory scientists from representation by a pay review body because, unlike some other 'professions allied to medicine', laboratory scientists were not entirely dependent on the NHS for employment. The pay review body system was an acknowledgment of the 'monopoly' status of the NHS as an employer, and it was felt that the 'market place' would be a sufficient force to set levels of pay for laboratory workers, given their scope for employment elsewhere."
Yet the right hon. Lady will not justify or defend the award offered by the Government.
"I would certainly not seek to justify or defend the . . . award offered by the Government."
That is the sort of welcome that she gives in private correspondence.
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