|Health and Social Care Bill
Mr. Adrian Bailey (West Bromwich, West): Will the hon. Gentleman acknowledge that, by advocating extra rewards and remuneration for people in high value areas, which are likely to be high value because they offer superior amenities to those in inner cities, he is promoting a course of action that would exacerbate the problems of inner cities in recruiting staff for the health service?
Mr. Hammond: In fact, the inner-city areas often have the high property prices and the high cost of living that cause NHS staff such problems.
Mr. Bailey: Not in the black country.
Mr. Hammond: The hon. Gentleman may be aware that we are in the greatest inner-city area in the United Kingdom. He should get on the tube tomorrow and pop down to talk to people in NHS trusts in east London about the problems of recruiting and retaining staff on NHS salaries. If he does so, he will understand the problems caused by the relatively high cost of accommodation in that area.
There is no blanket solution and that is precisely why I have great fears about the Secretary of State in Whitehall trying to decide the NHS pay and condition structure across the whole country. It is the wrong direction to take; all modern commercial and organisational experience is against centralising power and making single sets of rules and decisions apply across a 1-million strong, geographically disparate organisation. Whether we like it or not, the cost of living varies enormously in different parts of the country and the bottom line is that people on NHS salaries who live in areas with a low cost of living have a much higher quality of life and standard of living than those in areas where the cost of living is high.
Mr. Denham: The hon. Gentleman may benefit from reading the proposals in ``Agenda for ChangeModernising the NHS Pay System'', which we are negotiating with the unions. It provides precisely the right balance between the national framework for employment, which the clause will ensure is followed in every trust, and the local flexibility needed by individual employees in the NHS.
The problems are an inflexible employment structure, even on existing national Whitley contracts, a working week that ranges from 35 to 39 hours and big variations in payments for unsocial hours. That makes it difficult to introduce team working and to break down demarcations between professions, both of which are essential to the modernised NHS. The previous Government dealt with the problems by sweeping away such considerations and allowing full local contracts. However, in practice there is an even more complex and inflexible system at local level. That is the impetus for change in the NHS suggested by the hon. Gentleman's theories.
Our pay modernisation proposals envisage local flexibility within a consistent national framework. For example, in the current negotiations we want NHS trusts to be flexible in assigning jobs, but there will be a consistent national system for allocating them to a pay band. The exact point within a pay band to which someone is allocated should take into account local market forces and factors of the type we discussed. The right way properly to remunerate a flexible work force is to agree a national framework with NHS staff representatives, but to allow local flexibility. That must be part of our agreement, but we do not have the power at present to ensure that those employment conditions apply consistently in every trust in England. That is what the clause would provide.
Question accordingly agreed to.
Clause 6 ordered to stand part of the Bill.
Further consideration adjourned.[Mr. Jamieson.]
Adjourned accordingly at thirteen minutes past Seven o'clock till Thursday 25 January at half-past Nine o'clock.
The following Members attended the Committee:
|©Parliamentary copyright 2001||Prepared 23 January 2001|