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Lord Hunt of Kings Heath: My Lords, that was well worth waiting for. There are many lessons to be learnt from the débâcle over the clinical grading restructuring that my noble friend referred to. It was a remarkable achievement some years ago to require the health service to undertake such a massive exercise, to put more money in and at the end to demoralise the whole nursing staff. It is clearly very important that we get the negotiations right and end up with a pay system that enables us to reward innovation and encourages staff to take on extra responsibility. I confirm that my right honourable friend the Secretary of State for Health told the RCN conference in Harrogate a few weeks ago that he is fully committed to Agenda for Change. He said:
Lord Astor of Hever: My Lords, following on from the Minister's last point, what proportion of the annual increase in NHS expenditure announced in the Budget does he expect to be spent on increased staff costs?
Lord Hunt of Kings Heath: My Lords, the noble Lord cannot possibly expect me to answer that question at the moment. We are negotiating on taking the Agenda for Change proposals forward. For me to state to your Lordships' House how much money we intend to budget for such a proposition would be ridiculous. The noble Lord cannot expect me to do so.
The Earl of Onslow: My Lords, if the Minister does not know the answer to that question, he cannot possibly do a budget for the health service. If that is so, it may be why the National Health Service is in such a mess. They cannot get their sums right.
Lord Hunt of Kings Heath: My Lords, I fail to follow the logic of the noble Earl's argument. Only three or four weeks ago, we received the Budget settlement which sets out the resources that the NHS is to receive over a five-year period. We put the negotiations on Agenda for Change on hold until we knew the outcome of the spending review settlement. Currently, we are engaged on working through the potential costs of Agenda for Change. Later in the year, we shall be able to start negotiation. The noble Earl is asking me to reveal my negotiating hand in front of your Lordships. However tempting that may be, I shall not do it.
Lord Hunt of Kings Heath: My Lords, I could not agree more with the noble Lord; we spend too much money on agency staff. In November, we launched a strategy for NHS professionals which is designed as a nation-wide service to bring much greater co-ordination and consistency to the use of temporary staff inside the NHS. We are also urging NHS employers to become much more flexible in their employment practices so that they can offer some of the flexibility that agency nurse agencies offer in addition to the rewards of being a full member of staff in an NHS organisation.
Lord Stoddart of Swindon: My Lords, does the Minister agree that one of the problems we still have with the health service is the deplorable wages and salaries that have been paid in it for very many years, with the result that properly qualified staff are not attracted to the service? That in turn has had an effect on productivity and, therefore, on the efficiency and availability of the health service which the people of this country expect.
Lord Hunt of Kings Heath: My Lords, of course pay is an issue in recruiting and retaining staff, but it is not the only issue. Other matters are important as well, including flexible working and support for staff to continue their development and professional training. It is worth reporting to the House that, since 1997, pay for nurses, midwives and health visitors has increased by at least 26 per cent in cash terms. We have also introduced new consultant nurse grades which give opportunities for earning up to just less than £47,000 per year. As the Agenda for Change negotiations culminate, we expect the result to be a much more sensible arrangement for pay which enables proper comparisons to be made across the NHS professions, encourages people to take on greater responsibility, and enables us to deliver the NHS Plan.
Baroness Finlay of Llandaff: My Lords, will the Minister please outline his plans to ensure that physiotherapists, occupational therapists and other highly skilled people, of whom there is currently a shortage in the NHS, are encouraged to continue working within the new structures of the NHS?
Lord Hunt of Kings Heath: My Lords, they will be covered by our general discussions on the way in which pay and other matters are dealt with in the National Health Service. There is no doubt that the staff groups which the noble Baroness mentioned have a vital role to play not only in the new health service, but in taking
Lord Tebbit: My Lords, in his answer to my noble friend Lord Onslow, was the Minister saying that in the negotiations between the Secretary of State and the Chief Secretary to the Treasury, the Treasury did not secure undertakings on how much of the money being granted would be spent on staff salaries? Or is he just saying that he knows how much they are prepared to spend, but is not prepared to say it because he does not want his noble friend on the Back Benches there and the other members of the unions to know?
Lord Hunt of Kings Heath: My Lords, the noble Lord will know from his wide experience in government that many discussions take place between spending departments and the Treasury, and issues to do with the cost of pay of NHS staff is of course one of the factors. However, the noble Earl seemed to suggest that because I was not prepared here and now to say the exact sum to be spent on NHS staff
Lord Hunt of Kings Heath: With the greatest respect, my Lords, he was. He was saying that if I was not prepared to do that, then we were not competent to run the National Health Service. If I were to come here today and say, "This is the exact amount of money that we have reserved for the cost of NHS salaries", when we have not yet completed the final negotiations, I would not be fit to run the health service.
The Parliamentary Under-Secretary of State, Department for Education and Skills (Baroness Ashton of Upholland): My Lords, I beg to move that the House do now again resolve itself into Committee on this Bill.
In Amendment No. 140, I use the five-term year as an example of the way in which the provisions in this part of the Bill are being used to impose on all schools without proper consultation a particular pattern for the year. So it would be helpful if the Minister would give us not only the Government's view on a five-term year, but assurances that, if there were to be any changes along the lines of a five or even six-term year, as is now being advocated, there will be proper safeguards in the consultation process.
I return to subsection (3). The Bill provides, I think, for a record number of sets of regulations. Each of those sets of regulations is usually supported by another document described as guidelines and/or guidance which will be sent to each school. As I have said so often, our schools are now so overburdened by the task of interpreting the legalese of regulations and following guidance and guidelines that they have to spend almost more time on that than working in the classroom with our children. Every time I seek to remove regulations from the Bill, I do so really in the interests of teachers and the time available to them. Predominantly, however, I do so in the interests of the children who wish to have teachers' attention focused on their learning rather than on interpreting regulations generated from the centre.
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