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8.40 pm

Mr. Alan Keen (Feltham and Heston): We are debating the conditions of service in the national health service. I shall talk about a case that will have been going on for four years by September of this year--the Hillingdon hospital dispute. Before I do so, I note that the shadow Secretary of State for Health, the right hon. Member for Maidstone and The Weald (Miss Widdecombe), mentioned a commission on trolleys. Having listened to some of the contributions from Members on the Opposition Benches, it would not take long for a commission on who is off their trolley to arrive at its conclusions.

I was also reminded that at the West Middlesex University hospital, which will be rebuilt as a result of the Government's policies, patients were shifted around the hospital, from ward to ward and from ward to operating theatre, on what we called milk floats. Under this Government, that hospital will be replaced by a modern, new building. The previous Government took £10 million from the sale of the South Middlesex hospital to rebuild the Chelsea and Westminster hospital. Originally, that money had been promised to the West Middlesex. We shall at last have a decent hospital in the constituency of my hon. Friend the Member for Brentford and Isleworth (Ann Keen).

In relation to the Hillingdon hospital dispute, I remind hon. Members of what the duties of domestic staff in the health service used to be. There was a member of the domestic staff on each ward. That person not only cleaned the ward, but was often the only visitor for many patients. Members of the domestic staff used to go shopping for patients. Several years ago, their jobs were changed dramatically when the cleaning of hospitals was put out to contract.

Some of the women at the Hillingdon hospital have worked there for 30 years; at first, they worked directly for the NHS and then for the contract cleaners. That second system worked quite well until about four years ago last April when the Pall Mall company took over the contract. The company decided that it would be better--at least for its directors--if the pay of the domestic staff was reduced from about £3.50 to £2.50 an hour. Fifty-five mainly Asian women decided that, on principle, it was not acceptable to have their pay reduced by about 30 per cent. They came out on strike and have been on strike ever since. At one stage, they were the only people who believed that they could win. However, they were determined. They attended tribunals and maintained a picket line on every day of the year--including Christmas day, Boxing day and new year's day. I was on a token picket line with them on Christmas day last year.

The multi-million pound Pall Mall company was the original guilty party; it was part of the Davis group and has since been taken over by Granada, which is a member of the Low Pay Commission. Of the original 55 strikers, about 18 are left. They attended the latest tribunal which was held last week between 12 and 14 May. Those people have won on every occasion that they attended a tribunal. They are ordinary women who had never been involved in disputes; they are the nicest and most reasonable strikers I have ever met during my long career of involvement in industrial disputes. All that the women wanted was their jobs back at a reasonable rate of pay. They pressed on and, as I said, they have won at every tribunal; however, the company they want to be their employer continues to

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refuse to take them back. At the final tribunal last week, at which Granada appealed against having to take the workers back, the company lost once again.

I did not attend last week's tribunal, because I was on duty here, but I was astonished to hear of an admission made at that tribunal by Granada's senior manager of human resources--a man to whom I have spoken on several occasions when offering to try to bring the dispute to a happy conclusion, because I know the strikers so well. He appeared to me to be a reasonable and honourable man, but he admitted that it was he who had typed out a petition and forced people who were working at the hospital to sign it by threatening them with the loss of their jobs: the petition said that the signatories did not want the strikers back in any circumstances. He did that despite the fact that 220 doctors, nurses and ancillary workers had signed a petition saying that they would welcome the Hillingdon hospital strikers back.

That is how matters now stand. It has been the most honourable dispute I have seen, involving the most honourable strikers that I have ever represented, and the previous Government should be ashamed that the situation could have reached such a level.

I am speaking about industrial disputes because there has been criticism--even from Labour Members--of the current Government's proposals on changing the Employment Relations Bill; we felt that they did not go far enough. However, there have been three major disputes in west London alone that would have been rendered completely unnecessary by legislation introduced under the Labour Government. The Hillingdon hospital is one of those, because Pall Mall would not have been able to reduce pay from £3.50 an hour to £2.50 an hour under the National Minimum Wage Act 1998, so that four-year strike would never have happened. Let us think of how much suffering those women and their families have had to endure during that period.

Another major dispute occurred in west London when Noon's refused to recognise the GMB, despite 70 per cent. and more of the work force voting for union membership. Noon's has now given in, because it knows that the Employment Relations Bill will force it to do so, but the suffering the dispute has inflicted need never have taken place. In my constituency, the Lufthansa Skychefs strike--although it is hardly a strike--would have been rendered unnecessary by the same legislation. During an industrial dispute, on being given notice of a series of one-day strikes, Lufthansa Skychefs sacked the strikers immediately. That happened on three occasions and now 300 people have been sacked. Those sackings would have been illegal under the Employment Relations Bill.

The difference in the attitudes of the previous Government and the current Government is clear. Many hon. Members do not understand what workers have to face when they are forced into circumstances such as those which the workers at Hillingdon hospital have had to endure. We should all be ashamed that all those ordinary women have now had to go four years without work, and we should all wish them well now that the tribunal has finally awarded against Granada.

8.49 pm

Mrs. Marion Roe (Broxbourne): My right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe) has spoken eloquently about the

19 May 1999 : Column 1152

enormous difficulties affecting NHS staff, and the appalling proposal to worsen conditions of service by increasing to 65 the hours that junior doctors will be expected to work. That the best medical care is provided by keen, alert and wide-awake young doctors, not by those who struggle to stay attentive as they are ground down by excessive hours of work, is recognised by the whole population--the whole population, that is, except for the Secretary of State for Health and his henchmen.

The previous Conservative Government worked extremely hard to reduce progressively the hours worked by those highly valued medical men and women who are the core of tomorrow's health care system. Yet, at a stroke, the Secretary of State has thrown away all those hard-won improvements. He will not be able to deceive the public, who will see that the health service is not safe in his hands. Like the nurses who were robbed of their full pay rise and the consultants who are frustrated by the Government's failure to implement review body recommendations, doctors throughout the profession are suffering.

I wish to address the conditions of service for doctors who provide primary care for our population. Since the inception of the health service, general practitioners have provided the bedrock of care for the population and have acted as the gatekeepers for access to secondary care. More than 90 per cent. of all medical care is provided in the primary sector. Since the election of the Labour Government, GPs have seen their conditions of service decline steadily. They have been dragooned into primary care groups--in many cases, against their will--and they have seen the enormous benefits of the fundholding system snatched away from them. The fruits of the fundholders' labours--the entrepreneurialism that led to the creation of innovative primary care centres--have been largely destroyed.

The community clinics at GP surgeries, which were so valuable in improving the quality of care and providing effective and rapid local services, have been snatched away by a compulsory money-saving exercise by primary care group boards, which are constrained by debt that has resulted from inflexible and inappropriate financial instructions from the Department of Health to health authorities. Although primary care group boards currently enjoy a majority of GP members in most instances, they have the power to compel a practice or a doctor to follow board policy on pain of withholding practice finances.

In addition, if doctors are seduced into primary care trusts, they will lose their majority, their authority, the control of their staff and their premises. The individualist, independent practitioners will end up as salaried doctors working to the guidelines and protocols set for them by the National Institute for Clinical Excellence, which is driven by rationing rather than by quality. Let there be no doubt: Professor Rawlins, the chairman of NICE, has made it clear that no product or treatment will be recommended if there is no money to fund its introduction.

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