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Mr. Hammond: Does the hon. Gentleman acknowledge that the president of the Royal College of Nursing said that the 4.7 per cent. pay increase would do nothing to stem the flow of nurses out of the profession?
Mr. Barron: She may have said that, but it is not in the brief. I have just read what it says. The RCN believes that pay is the single most important way in which to boost nurses' morale, but not the only way. I shall refer to the areas in which their morale has been battered over the years.
My right hon. Friend the Secretary of State referred to family-friendly employment policies. I mentioned GPs when I intervened on the hon. Member for Southwark, North and Bermondsey. The NHS is now able to employ general practitioners: they have had independent contractor status for the past 50 years. Fifty-eight per cent. of nurses have caring responsibilities for dependent children or dependent adults, yet only now after, all these years, is the NHS beginning to adopt flexible employment practices. It should have done that 50 years ago. We must ensure that we retain nurses who leave the service because of the pressures of the system.
The RCN refers to career progression, which is another issue that my right hon. Friend addressed. The Government have some good proposals to develop the potential of nurses to help them to get on in the profession. We should not ignore that.
My right hon. Friend also mentioned violence in accident and emergency departments, and threats to staff. About 12 months ago, the then Health Minister, my right hon. Friend the Member for Darlington (Mr. Milburn), gave a speech about violence to NHS staff. It received some derogatory comments from people working in the NHS. In some areas, stress caused by the likelihood of attacks is a major factor affecting people's decision on whether to stay in their job. The Government are setting targets that health trusts must meet to get such violence out of the system and to make the workplace safe for NHS staff. We must ensure that they do not have the stresses that they have had in the past.
I realise that in opposition we sometimes have to put awkward arguments that get thrown back in our faces. I sat on the Opposition Benches from 1983 until two
years ago. The Opposition motion takes the biscuit when we consider how NHS staff were treated during that time. We are talking about a party that imposed an internal market on the national health service, and forced hospital staff to compete with colleagues in other hospitals--doctor against doctor, and, by extension, patient against patient. The hon. Member for Broxbourne (Mrs. Roe) said that the end of fundholding was a great loss. I must tell her that, for most of the time that the system operated, the vast majority of patients were disadvantaged by fundholding, because the patients of fundholders were jumping hospital queues. There was no pain measurement; the measurement related to whether the Government had created what they did create--a two-tier health service, meaning that those who were not served by a fundholding general practice might have to wait until the following financial year before getting into the local hospital, regardless of their pain. The Conservatives still try to defend what I have always considered to be an indefensible situation, but we all know what really happened.
The staff did not like the two-tier health system, which forced them to keep new developments and better ways of treating patients secret so that hospitals would not undermine their competitive advantage over their neighbours. The Government want to ensure that we share the practice in the NHS. The National Institute for Clinical Excellence, and other organisations that are being set up, are about improving patient care. They are not about central diktats and telling clinicians what they should or should not do; they are about sharing the practice, so that all of us, as patients, get a better deal in the health service than we have in the past.
Another aspect of morale in the NHS--it was mentioned by my right hon. Friend the Secretary of State--concerns short-term contracts. If any one thing has lowered the morale of NHS personnel, since the early 1980s when the practice began in catering and cleaning, it is short-term contracts. NHS employees wanted to know that their jobs were there, and would be there for many years.
What was done was done in two ways. First, there was the internal market, which acted in very marked ways; secondly, there was the question of the funding of the NHS. It was much better for trusts to employ people on short-term contracts, which meant that staff did not know whether their wages would be lower in the following year than they had been in the preceding year. They did not know whether central Government were prepared to continue to fund them, and whether they could continue to provide staff with what most of us would consider to be reasonable pay and conditions and reasonable longevity in terms of employment.
Other things have created morale problems in the NHS over many years. A nursing recruitment crisis has been caused by years of training cuts and complacency, for instance. My right hon. Friend the Secretary of State mentioned the thousands that we have lost in the last five years in terms of nurse training. It will be difficult to turn the corner, but we have begun to do so.
Not once was my right hon. Friend challenged by Conservative Members on the reason for the present crisis in nursing. The hon. Member for Runnymede and Weybridge (Mr. Hammond) says that it is about the fact
that nurses were given only a 4.7 per cent. pay increase this year, but that is bunkum, and the hon. Gentleman must know that it is bunkum--as would anyone who had talked to nurses about the fact that they have been batted from pillar to post, and have also had to deal with the additional work imposed on them by the internal market.
There is also the problem of overseeing the spread of gagging clauses in staff contracts, forbidding staff from telling the truth about what is going on. That, too, causes problems of morale in the NHS; that is another corner that we must turn.
The Opposition may be able to have a go at the Government on a number of counts, but I do not think that they can do so on the basis of the money that is coming into the NHS, or the way in which the Government are taking on the responsibility of getting rid of the morale problems that we inherited in May 1997. I know that the Opposition have to table motions such as this, but they should take advice now and again. This motion completely misses the mark, and some of its rhetoric will be seen by the NHS as being way off the mark.
Mr. Graham Brady (Altrincham and Sale, West):
I shall try to keep my remarks brief because I have something to say and because I am aware that many of my hon. Friends wish to participate in the debate, as do Labour Members.
I want to talk about some of the reality of what is happening in the NHS--not the rosy view that we have heard from the Secretary of State for Health and from the hon. Member for Rother Valley (Mr. Barron), but some of the truth. I shall discuss some of the things that are affecting my constituents and that are coming to light as time goes on.
I refer not only to the fact that nurses in the Trafford Healthcare NHS trust did not receive their pay rise in April, as they had been promised. That is a matter of timing and perhaps is not that significant in overall terms. I am more concerned about what the implications of that are, what the reasoning behind it was and what it tells us about the true situation of the NHS under the Government's stewardship.
I want to talk in particular, because it is a useful example to illustrate the position, about Altrincham general hospital. On 10 May, Trafford Healthcare NHS trust announced to the press that two of the three wards would be closed in July. The announcement was made four days after local elections in the borough of Trafford, which were closely fought, and in which the Labour party held on to its majority by just three seats. The trust chairman is a Trafford Labour councillor, yet the announcement was made four days after the local elections.
The announcement was made without any consultation whatever with the public, or the community health council. It was made without any consultation even with
the health authority. I find it impossible to believe that the decision was taken between Thursday 6 May, when the local elections took place, and Monday 10 May, when the announcement was made, so the inescapable conclusion is that the decision was made before the local elections, that it was suppressed and that no consultation could be undertaken because it was a politically sensitive issue.
The result of the decision was announced in a blatant fashion just four days after local elections, without anyone in the local community having been consulted, or even told about it. The arrogant treatment of the community that I represent and the disregard for a well-respected, well-loved institution in my constituency are staggering. It is a picture of the way in which the NHS is being run under the Government markedly different from that which Labour Members have described.
A few days ago, I asked the Department some questions. I have had confirmation that the regional executive knew something of the decision on 8 April--again, some confirmation of what is really going on in the borough of Trafford and in my constituency.
The devastating thing--the implications of which go far wider than Altrincham general hospital--is the reason that was given for the closure of the wards by the chief executive of Trafford Healthcare NHS trust to the chief officer of the community health council on Monday 10 May, when the decision was announced. He said that the trust was left with no choice because the Government had not funded the nurses' pay award, which had forced it to make savings by closing wards.
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