Orders of the Day — National Health Service (Nursing, Medical and Other Professional Staffs)

Part of the debate – in the House of Commons at 12:00 am on 27 March 1962.

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Photo of Mr George Brown Mr George Brown , Belper 12:00, 27 March 1962

The noble Lord's economic lecture was addressed to the nation as a whole, but large sections of the nation, either because they have power to arrange it or because the Government refuse to take steps with them, are able to win increases for themselves in their income. They have been doing it since the start of the pay pause policy, they are doing it now, and they will go on doing it.

What the hon. Member is justifying is what the Minister sought to justify—a deliberate decision to impose it upon the only place where it can be imposed, which happens to be cases, like this, of small people who are quite hard hit and who have considerable grievances and injustices. It is imposed upon them just because they are small, because they cannot win a way out for themselves, because they cannot fight back without injuring their patients, and because the Minister, in this respect, has power that he does not have elsewhere. Without going into the details of the economic lecture, I do not see how one can possibly defend such a course, either as good economics, as a way out of inflation or as justice to the people we are considering.

The Minister made an appalling speech. There were three parts to it. He gave us a long, tendentious, distorted and quite meaningless dissertation on staffing. That occupied twenty-five minutes of his whole speech, which lasted for about thirty-five minutes. He then gave us a party version of the economic lecture, of which we have just heard a rather longer version and which, I gather, the Minister intends to repeat to the deputation in a few days' time. He wound up with a peroration about the glorious future that will come about for these devoted people, more and more of whom, I gather, are to be part-time rather than whole-time, in the grand new buildings which they are to have.

That was all there was to the Minister's speech. There was not at any stage a word about whether the claim was justified. There was no examination of whether the salaries were relatively out of line with comparable grades. There was not even a word of sympathy for these people and there was no examination of the shortages that exist side by side with the figures given by the Minister. There was no word about his own gross continual interference with the negotiating machinery and the conclusion which he expects to be drawn from it, nor was there a single word about why he was not prepared to accept the claim for an independent inquiry into the whole structure of the problems associated with staffing the service.

The things that the Minister did not discuss are what the debate is about. The things that he did discuss are not—or, if they are, they are only peripherally—concerned with it. Let me deal with the question of staffing. I do not know what the Minister, or the hon. Member for Hertford, who also took the point, sought to draw as a conclusion. The only real conclusion of what they said when they have proved that people axe still dedicated enough to want to serve their fellow citizens in the Service is that the Minister regards that as a reason for not raising the salary, but that if the people were walking out he might regard that as a case for raising the salary.

That could be the only purpose of the argument. I ask the Minister quite frankly if he thinks that, in putting that forward as the case—"You cannot have it because these people are so devoted, and because lots of young girls still feel the call for this service"—he thinks that he is living up to the devotion of the very people he is talking about? Does he think that he is making any contribution to raising the ethics in our materialist age?

Does the right hon. Gentleman think that he is making any contribution at all to anything other than conflict and dispute, because even these people, with all their devotion, will at some stage draw the conclusion which the Minister was trying to teach them, and at some stage somebody will learn that they need power and will have to exercise it, whatever the consequences, when they are met with this kind of approach from the Minister? Therefore, I do not see what he has achieved by his argument, even if it had been true.

Even if the Minister's figures show that there is a steady expansion in the numbers coming into the Service, the right hon. Gentleman glossed over some very interesting exceptions to that—the student teachers, the physiotherapists, and others. He knows as well as I do that the general picture of those coming into the service does not justify drawing the conclusion, which he left to be drawn, that this is a Service in which we are getting more and more and better and better manning, and in which we are expanding the provision. Side by side with the figures he gave are the figures that he did not give—for hospitals cutting down wards, hospitals shutting down only recently-built operating theatres, like the ones which his predecessor opened with such a fanfare of trumpets not so very long ago, but which now have had to be shut for want of staff to operate them.

The right hon. Gentleman knows as well as I do, because other people have told him, that side by side with his figures comes a picture of enormous dilution by people who are not skilled trying to cover the jobs of skilled people who are not there. He knows that, side by side with these cases, goes the kind of story, such as the hon. Member for Orpington (Mr. Lubbock) told in his maiden speech, of devoted women working enormously long hours to make up for the absence of others.

These figures are also relevant, and they show the situation at the moment. They show not a Health Service that is giving more and more facilities, but a Service that is not keeping up with the demands that our people are making on it, and which is not keeping up with the need that has grown up over these years. That is the side of the story that ought to worry the right hon. Gentleman.

Although the case for more pay for these people is not wholly made, and is not being made, by them on the grounds of the need to attract more people into the Service, or to retain the people already in it, it is relevant to it, and if the Minister rests, as he did, most of his refusal to grant an increase on the ground that it is not necessary, because people are coming in, I tell him that he is misreading the figures. He is reading only the figures that suit him, but he is leaving out the others, when any impartial examination of the situation in the Service would lead one to conclude that there is ground, even in that limited area, for doing something about salaries. He ought also to do something about conditions and hours of work in order to encourage people into the Service and to retain them there when they are in.

I thought that the right hon. Gentleman was very complacent about the whole thing. Obviously, he does know the other side of the picture. Why did he choose not to put the two pictures side by side? I do not understand. I had the terrifying feeling at the end that he was as complacent as he looked, and was not merely putting up one side of the argument to score a little debating point, but because that was how it looked to him. He was complacent, he did think that the Service was expanding, that the men and women situation was getting better, and that there was no need to do anything about it.

The Minister said that physiotherapists were one of those groups in which things were not as rosy as he seemed to think they were in all the others. He made two proposals to put that side of the picture right. Again, I was horrified, because the man is shown by his outlook. The right hon. Gentleman and I have crossed swords on this before and he knows that I have a great respect for him, more than I have for some of his colleagues. I understand him and his outlook and he always courageously stands by it.

One of the two proposals was to reduce the quality of the teachers by asking the Chartered Society to cut the two-year period, and the other was to cut the service by having patients much more carefully examined to see whether they should be receiving physiotherapeutic treatment. One proposal was to reduce the quality and the other to reduce the service. On that basis, one could solve a shortage of anything.

Although many Tories hide it from themselves, I believe that this is a fundamental Tory doctrine. It is what the right hon. Member for Woodford (Sir W. Churchill) meant when, in an election, he said that under the Tories the social services would be used as an ambulance service, a safety net catching those who fell through everything else, but only those. That is what was behind the Minister's thought today when he was talking about cutting the service and reducing the quality He had in mind something for what the hon. Lady the Member for Tynemouth (Dame Irene Ward) called the very poor, while others would provide privately for themselves elsewhere. This is the attitude which has gone along with all the developments of the idea of more and more private provision through insurance companies, and so on. It is that which terrifies me.