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Sir Nicholas Lyell: I am glad to know that the Liberal Democrats are interested in this matter. New clause13 will be taken along with new clause 28 and amendment No.180, and I have already written a speech that I hope to have an opportunity to deliver. In the guillotine debate,

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however, I must emphasise the need for time and the wrongness of reducing the amount of time available to discuss these issues.

The country should know, through debate in Parliament, the sheer intensity of the work done by the national health service today. Some hon. Members may have heard "Any Questions" the other day. Baroness Jay said that her husband, a distinguished consultant, had told her that he had had to go through all this and that long hours were necessary for training. I do not deny that long hours and rigorous discipline are necessary for training. However, with improved procedures, in-patients being treated in the national health service today are much iller than they were. Patients are discharged much quicker and those who are left in hospital are much iller.

Doctors in general surgery, general medicine or paediatrics--some of the major specialties--do not get to bed. Another story on which we dine out--

Mr. Fabricant: I am grateful to my right hon. and learned Friend for giving way before he dines out. Is he aware that a house officer at Addenbrooke's hospital gets only £4.02 in overtime compared with £6.24 for a cleaner? Is that not a slap in the face for workers in the health service from this so-called caring Government?

Sir Nicholas Lyell: My hon. Friend's argument emphasises how much this matter needs to be debated in detail. Part of the problem, which is admittedly inherited because this has been going on for some time, is that overtime rates--it is almost an insult to use that expression--for young doctors are not calculated as they would be in any other civilised job. Instead of being paid half as much again or twice as much, they are paid 50 or 70 per cent. of their normal rate.

Health service trusts are under great pressure in all sorts of ways and always have been, but they have been put under even greater pressure as a result of the Government's over-emphasis on waiting lists, as my right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe) said. We must have time to get across the fact that NHS trusts are abusing that style of payment, as my hon. Friend the Member for Lichfield (Mr. Fabricant) highlighted. It is not right for them to get young doctors on the cheap, when those young people are staggering through the night, hardly able to cope.

I am not exaggerating, as right hon. and hon. Members on the Government Front Bench also know. We need time to develop ways to improve that position. In the time available for the debate, we should give credit where it is due. The Government have built on some of our new deal methods. NHS circular 1998/240 set out specific timetables, hours and amounts of rest for young doctors. That circular states that young doctors who are working overnight for 16 hours, from 5 pm to 9 am the following day, should get at least eight hours' rest, of which half should be continuous. We should have time to discuss that, but this debate does not allow us the time to get across to the House and the country the fact that those doctors do not get that rest. It just does not happen in the busy specialties, such as general medicine, paediatrics and general surgery. My goodness, the classic example is renal medicine--there are jokes about that, but they are

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in poor taste and I will not make them. Those doctors do not get time to sleep--they stagger on, grossly abused and overworked.

We need time to study in practice what can be done. Something can be done to assist if only we put our minds to it. I am grateful to see the Minister of State nodding. I am sure that he would like to crack that problem. In a funny way, he would probably be grateful if we could find the time to highlight the sheer seriousness of it, so that he could squeeze a little more money out of his right hon. Friend the Chancellor to help him crack it. There are sensible ways to overcome organisational problems, such as bleep systems with senior night nurses, which can relieve the pressure.

One of the difficulties caused by the pressure on waiting times and the extra people who are being put through the hospital system is the sheer amount of time that that takes on admission. We need time to explain that. When we have a chance to debate the matter, we shall find that it means that young doctors are spending their time up until 11 pm--or even later--simply admitting the patients who are coming into hospital to the beds that have become available during that day. We need to debate the sensible suggestions that have been made, such as the one that there should be dedicated admissions units, staffed by young doctors, or other doctors, so that there is rather less pressure on those who are dealing with patients who have already been admitted.

Where shall we find those extra doctors? We need time during the debate for an answer from the Minister as to whether they could not be found--as I have been told--overseas, in the European Union. I hope that that matter can be discussed during the allocated time. I understand that, at present, there is something of a glut--probably only a temporary one--of young medical practitioners in other EU countries. We should invite them over to this country and pay them to assist in tackling the problem.

We need to deal with some important matters. Our objection to these guillotine motions is not merely tactical, nor is it cynical; it is real. These are matters that it is vital for Parliament to discuss. Unless they come out into the open, the country will not be governed and legislation will not be scrutinised in a way that makes a reality of a democratic society.

Mr. Fabricant: Is my right hon. and learned Friend as puzzled as I am as to why the guillotine motion was required in the first place? Last night, everyone had accepted that we might sit through the night, and was prepared to do so, if necessary, in order to discuss those issues in detail. When was the House asked to rise? Was it at 1 o'clock, 2 o'clock or 3 o'clock in the morning? No, it was asked to rise at 10 o'clock at night. Does my right hon. and learned Friend have any idea of why that was?

Sir Nicholas Lyell: The Government should take heed of that point. There is something a little more civilised about the hours that the Government have tried to introduce for the business of the House. However, it is neither civilised nor democratic if that restricts debate on matters of vital importance in such a way that legislation is not properly scrutinised.

At present, the Government have an enormous majority. Why do they not operate shift systems, like those that they should be instituting in the NHS? In a

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shift system, even if people were working long and hard, they would not be engaged in the idiotic business of working through for 32 hours on the trot during the week, with no rest, and for 54 hours on the trot at weekends, with only four or five hours of continuous rest throughout that period. That is a scandal and it has to be stopped. I am sure that the Government can look to the full assistance of the Opposition in encouraging the right measures to ensure that it is stopped. We know that such measures exist. We need time to debate the matter. This guillotine should not be imposed.

5.13 pm

Mrs. Gwyneth Dunwoody (Crewe and Nantwich): I hope that the right hon. and learned Member for North-East Bedfordshire (Sir N. Lyell) will forgive me if I do not follow him along the esoteric lines of his sudden involvement in the national health service. One thing that distinguishes Back-Bench Members from Front-Bench Members of the House is the enormous short-term memory loss that seems to be a condition of having been a member of any Government. Somehow, Members who have pushed through guillotine motions, during many hours and with great vigour, forget that fact instantly when they cross the Floor and find themselves on the Opposition Benches.

Sir Nicholas Lyell rose--

Mrs. Dunwoody: If the right hon. and learned Gentleman wants me to go into the question of doctors' hours, I can keep going on that subject for the next four hours with no difficulty whatever. I too have a consultant in my family, who makes precisely the point that, unless people get some general training, they are not as useful as they used to be.

Mr. Fabricant: Will the hon. Lady give way?

Mrs. Dunwoody: I should be terribly thrilled to do so, but I think that I shall give way to the right hon. and learned Member for North-East Bedfordshire, if the hon. Member for Lichfield will forgive me.

Sir Nicholas Lyell: May I take it that the hon. Lady believes that the points I have made are fair ones, or is she telling the House that such intolerably long hours, not only on call but continuously working, are a sensible form of training? I cannot believe the latter, but perhaps she will clarify her view.

Mrs. Dunwoody: The right hon. and learned Gentleman might like to know that, in a long married life, most of it spent living in hospitals, I discovered that many doctors work extremely long hours and that some of them should not be allowed to work at all, which is an entirely different matter--but if he wants chapter and verse, I can supply them. As I said, I am delighted that he has suddenly discovered the problem of doctors' hours in the NHS, which has been known to some of us for the past 40 years.

If the House will forgive me, I should like to make a serious point. I have been a Member of Parliament long enough to know that all Governments, when faced with timetable problems, almost inevitably demand faster

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movement of their legislation--that it should pass through both Houses at the speed they desire, preferably with no examination by anybody. Most Governments are fairly evenhanded; it is not that they do not want their own Back Benchers to examine legislation: they do not want anyone at all to look at it. So it is not new to me to find my colleagues--albeit the two members of the Cabinet for whom I have greatest affection, if I can say that without entirely wrecking their parliamentary careers--demanding greater speed and, indeed, a double guillotine.

However, it would be wrong to allow the guillotine to be passed without saying that I do not think it a very good idea. There are those who believe that, if every single piece of legislation that passes through the House is programmed, it will always be possible to issue statements at a time when the press will use them, the House will respond in a manner that keeps my right hon. and hon. Friends in the Whips Office happy, and life will be a garden filled with the most beautiful flowers. That is not my experience. The House of Commons and the other place operate best when their Members have the opportunity to take pieces of legislation and talk about them in detail.

That is not to say that scrutiny is done with malice aforethought. There are those of us who want to argue about legislation because we think that it is sometimes badly framed and that, sometimes, even if it is well framed, the implications have not been fully thought out. All Members of Parliament ought to have the right to express an opinion. I was therefore saddened--I put it no higher than that--to see that the Immigration and Asylum Bill had been included in the guillotine.

The simple reason for that feeling is that there are aspects of that Bill that still give me pause, even though the Home Secretary has been sensible enough and gracious enough to speak in some detail to his parliamentary colleagues. He knows that our concerns are genuine and that we still retain some of them. He also knows me well enough to know that I shall express my view with some vigour, whether in public or in private--not that he has been noticeably put off by that.

When we consider a guillotine motion, it is important to ask whether it is justified and whether it will produce the desired result, which is good legislation--not necessarily hasty legislation, but good legislation. Will it result in our having to return to the measure at some point in the future and apologise for having got something wrong, not because we meant to get it wrong, but because we did not have time to consider it properly and the people who would have raised questions did not have the time or opportunity to talk to others?

The Secretary of State for Health and the Home Secretary can both say, with considerable justification, that both Bills have spent a long time passing through the House; people have had the opportunity to consult, and that stage should be long behind us. However, in reality, all Governments table new clauses and amendments. Even though the current Government are way behind the previous one, not yet having reached the point of tabling 400 amendments on Third Reading--there is always hope--it is sad to see this guillotine being moved at this stage in respect of these Bills.

I know why the guillotine has been moved and I understand all the pressures, but I am not persuaded that it is the right way to proceed. The policies with which the

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Bills deal are tremendously and fundamentally important because they affect the lives of people when they are at their most damaged and at their most vulnerable. The decisions we take will have an enormous impact, way beyond the number of people whom we currently believe might be adversely affected.

I do not want to say more. I think the House of Commons should be reminded occasionally that, even when it appears to be doing its best and to be at its most disciplined and most organised, and even when it responds with alacrity to the wishes of the Whips Office and the desires of Front Benchers on both sides--neither side changes: they both play the same games, some well and some badly--it needs to be watched closely. I am sorry, but I do not think this is a good idea. I did not think the guillotine was a good idea when the previous Government used it and I do not think it is a good idea now. I am extremely sorry that it has been applied to this legislation.


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