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Standing Committee E
Thursday 15 May 2003
[Mr. Win Griffiths in the Chair]
Constitution of public benefit corporations
The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): I beg to move amendment No. 152, in
The Chairman: With this it will be convenient to discuss Government amendment No. 153.
Ms Blears: The purpose of the two amendments is to clarify further the eligibility of staff members to stand for the staff constituency of the governing bodies for foundation trusts. As the Committee discussed on Tuesday, NHS foundation trusts will design their own governance arrangements to reflect the needs and circumstances of their stakeholder communities within the framework set out in schedule 1. We have tried to devise the framework with as light a touch as possible. Foundation trusts need flexibility, but it is important that the statutory requirements be sufficiently robust to provide for a fair and representative membership.
The amendments clarify, for the avoidance of doubt, who is eligible to become a member of an NHS foundation trust staff constituency in line with the guide that was published in December 2002. The amendments provide that employees must be employed under a contract of employment of not less than 12 months. The amendments are simple and straightforward.
Mr. Simon Burns (West Chelmsford): The Under-Secretary said that the amendments are simple and straightforward, but I am not convinced that that tells the whole story; it glibly passes over what the Government seek to do.
Amendment No. 152 would allow a member of staff to join the staff constituency only if they had an employment contract with the public benefit corporation. That is perfectly reasonable. It is amendment No. 153 that concerns me, because it would restrict membership of the staff constituency to employees who have an employment contract with that corporation that is valid for a year or more. That time scale causes me some concern, because it would potentially disfranchise many staff who have worked for a corporation for what most people would consider to be a reasonable amount of time.
In recent years, as the Under-Secretary knows, staff in the NHS and elsewhere have increasingly been employed on temporary contracts or through agencies. Dr. Beverly Malone at the Royal College of Nursing
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has confirmed, and the Under-Secretary will doubtless acknowledge, that the NHS remains heavily reliant on, for example, agency nurses. Latest statistics show that, on the average ward, 10 per cent. of staff are bank and agency nurses. Over the past seven years, NHS spending on agency nurses has increased to the point that, last year, it reached £520 million. That suggests that a significant number of agency nurses are working in the NHS. The amendment would disfranchise and undermine those who, although agency nurses, have a stake in the corporation because they work there—and not just for the odd week or so.
Mr. Stephen Pound (Ealing, North): I am not being antagonistic, but I want to make the point—as one who has spent most of his life surrounded by a coven of nurses, be they sisters, wives or whatever—that, by definition, a bank nurse is one who is employed in the NHS and who is working on his or her day off or during a leave period. An extremely high percentage of agency nurses, and almost all bank nurses, are contracted NHS employees who have in their substantive employment precisely the rights that the hon. Gentleman fears that they may be surrendering.
Mr. Burns: I am grateful to the hon. Gentleman, because I understand his point, which may well be valid. I look forward to seeing whether the Under-Secretary will confirm that when she replies.
Mr. Andrew Lansley (South Cambridgeshire): Since we are trading relatives, my hon. Friend may wish to be aware that my sister-in-law is an agency nurse. She does not have a permanent contract of employment, but works on an agency basis, albeit that that sometimes amounts to almost a full-time week.
Mr. Burns: My hon. Friend has picked up a point, and I will come to it in a moment, because—notwithstanding what the hon. Member for Ealing, North (Mr. Pound) said—my understanding of amendment No.153 is that, regardless of where bank or agency nurses come from, if they do not have a contract of more than 12 months with that corporation, they will not be eligible to vote. My hon. Friend pointed out that, contrary to what the hon. Member for Ealing, North said, not all agency nurses do extra work in the NHS. I have a problem with that amendment, because the period of more than 12 months is too long and will unfairly impact on corporation staff who have a stakehold in that corporation but who are disfranchised.
The Government may, with reason, say that if part of a work force is transitory because it is sourced through an agency or because the trust employs staff directly only on short-term contracts of less than 12 months, which may or may not be renewed, those people will be disfranchised. If a trust's policy was to employ some staff, not as agency nurses or as bank staff, but as employees on short-term contracts of, say, six months that are open for renewal by the trust at the end of each six-month period, that could be an open-ended process, and under amendment No.153, I assume that staff could work, for example, for up to five years. However, because their contracts are only for six months but are renewable, under amendment No.153 they would presumably, for the whole period they work in that hospital, not be eligible to be part of
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the constituency. That is wrong. Had the Government tabled the amendment and specified a month, so that it applied to transitory workers who came to the trust for a month on a contract and then moved on, I would have understood and accepted that that is too flexible and disruptive. A person working only for a month for a corporation does not have commitment. I would understand that. However, more than 12 months seems too long, and disfranchises too many people.
Mr. Stephen McCabe (Birmingham, Hall Green): This is a genuine inquiry. Is someone who works as an agency nurse over a prolonged time an employee of the trust or of the agency who seconds them to the trust?
Mr. Burns: The factual answer is that they are not employees of the trust; they are with the agency that the trust uses to supply a service to that hospital. I hope that the Minister will accept that.
Dr. Evan Harris (Oxford, West and Abingdon): The hon. Gentleman started by saying that he did not have much of a problem with amendment No.152, but if his view is that agency staff, particularly those working for long periods but still nevertheless employed by the agency, need to be enfranchised, he would have to take issue with amendment No.152. He rightly says that amendment No. 153 is a separate point. If he is concerned about the position of agency staff, he should be opposing the imposition of the condition that they work under a contract of employment with the public benefit corporation.
Mr. Burns: I am grateful to the hon. Gentleman because, if the Under-Secretary confirms that what he has just said is factually correct, I would agree with him that that is a valid point that would have to be looked at. What I have assumed, perhaps erroneously, is that if a corporation were to use agency staff, the contract that the corporation had with the agency for those staff would, to all intents and purposes, be considered to be employment by the trust, albeit through a third party. For that reason I assume that, presuming that the contract was for more than 12 months, those staff would not be caught up by amendment No. 152 in that respect. I would be grateful if the Under-Secretary could confirm whether that is correct.
Can the Under-Secretary provide better particulars on this? If she confirms that our fears are grounded and correct, is she prepared to think again? Ministers, particularly in this Administration, would not wish willingly to disfranchise people simply because of a time scale that is too long. It is important that everyone involved in the provision of health care through a foundation trust feels that they are part of the system and that they are linked into it, to ensure that morale is high and that they are part of a team that is determined to ensure the success of that foundation trust.
Dr. Andrew Murrison (Westbury): I am rather surprised by this amendment because it seems to ignore the reality of employment in the NHS in two respects. First, junior doctors in particular often work on relatively short-term contracts, which tend to be in
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blocks of six months. I have worked in such a capacity, and I am sure that the hon. Member for Oxford, West and Abingdon (Dr. Harris) has too. Very often, doctors go from six-month block to six-month block, and that can continue for years and years. If this amendment were to be accepted, I fear that such individuals would be excluded from the public constituency.
Secondly, Ministers have ignored the reality of the situation for agency staff. As my hon. Friend the Member for West Chelmsford (Mr. Burns) pointed out, agency staff are not employed by an NHS trust, but may nevertheless have an ongoing commitment to a particular hospital. Perhaps Ministers take the view that agency staff flit from one trust to another. Of course the reality is that many of them are particularly focused on one trust, and will often work in that trust for many years. Were this amendment to be accepted, we might create a situation in which people who work part-time for a trust would be part of the staff constituency, but agency staff who work full-time would not be. That seems to be quite wrong.
I urge Ministers to think about whom they are excluding with this amendment, and to recognise that it would be a real shame if these two groups of extremely valuable staff, on whom the NHS relies very heavily, were to be excluded from the staff constituency.