I regret that information on the effect on waiting lists of the recent industrial action by ambulancemen and hospital ancillary workers is not yet available. More than 60,000 planned admissions to hospital were cancelled since the start of the dispute, but it is not possible to say from this what the effect on waiting lists will be.
We have recently had a seminar in which we looked at good practice in the handling of waiting lists, and we shall publish some of the recommendations that have come from that seminar. There is no doubt that the industrial dispute caused serious additions to the waiting lists. However, we must keep this in proportion. It is interesting to compare this with the 1973 ancillary workers dispute. In that year 30,000 beds were out of action compared with only 7,000 in 1979. Also, about 100,000 patients were added to waiting lists in 1973, more than any responsible estimate for 1979, and about 350,000 days were lost through strike action in 1973 compared with fewer than 250,000 in 1979. It is worth while getting the matter in proportion.
Will the Secretary of State answer my question on the Order Paper? With hospital waiting lists rising to a level higher than at any time since the National Health Service was first established, is it not folly to close down wards and hospitals like the highly praised Victoria hospital in my constituency? Will the Minister issue guidance to area health authorities to give greater priority to reducing the numbers awaiting admission to hospital?
The number of people on hospital waiting lists at present is higher than it has ever been. There is no question about that. But we must also recognise that the service provided for patients is at a higher level than ever before. In the first six months of 1978—the latest period for which figures are available—activities increased in comparison with the first six months of 1977. Discharges and deaths were up by 75,000. Day cases increased by more than 3,000, new outpatients were up by more than 100,000, out-patient attendances increased by nearly half a million, and accident and emergency department attendances were up by more than 64,000. We must compare the level of waiting lists with the standard of service and the amount done for our people through our National Health Service.
Is it not a matter for shame in a civilised country that nearly three-quarters of a million sick people are awaiting treatment in hospital? Is not the right hon. Member wholly responsible for this? The waiting lists have become worse and worse year after year.
It is quite absurd to say that any one factor is responsible for the lengthening of waiting lists. I do not doubt that the industrial dispute just ended has been an important factor. But over the past years there were never fewer than 400,000 people on our waiting lists since the NHS was started. Waiting lists, as a percentage of the population, have fluctuated between 1·1 per cent. and 1·3 per cent. There are many other factors, including the actual management of waiting lists, that have nothing to do with industrial disputes, that explain why the lists are higher today than ever before. One of the factors is that much more can be done for our patients than has ever been possible before.
What has been the effect on the waiting lists of the latest process by which general practitioners are advised by consultants that NHS patients must wait but that those who pay can get early treatment? Will my right hon. Friend strive to create a National Health Service where the need of the patient is uppermost and not the ability of the patient to pay? Will he resist the demand of the Conservatives to cut public expenditure on the Health Service?
Absolutely. As my hon. Friend knows, there has been a steady increase in expenditure on the NHS in real terms. It has not been as fast as any of us on these Benches would have liked, but I dread to think what the consequences would be if the Conservatives, with all their commitments to cuts in pub- lie expenditure, were returned to power. My hon. Friend will know that we have now taken the first step to introduce common waiting lists for NHS and private patients for urgent cases and for the seriously ill. I hope that not many months will pass before we can introduce common waiting lists across the whole of our Service. That will be an important achievement.
Does the Secretary of State recognise that for the first time ever patients needing urgent investigation are on waiting lists? Many of them have to wait months for admission to hospital. How does he explain the fact that, despite the figures that he has given, waiting lists went down under a Conservative Government and have gone up steadily under Socialism?
There have been periods when waiting lists have gone down under Labour Governments just as they have gone down under Conservative Governments. There is no doubt that the figure fluctuates. I draw the hon. Member's attention to a recent publication by the Royal Commission on the National Health Service which looked at the attitude of the public and of patients to waiting lists. This showed that more than one-quarter of the patients interviewed were admitted within two weeks of being told that they would have to go into hospital. Two-thirds were admitted within three months of being told, and four-fifths of patients expressed no distress or inconvenience as a result of the wait for admission. I have no doubt that those who have waited for a long time and have been in pain need and deserve our sympathy, but I say to hon. Members who are picking on this issue that this matter must be kept in proportion.
Will my right hon. Friend accept that the Conservatives are so impervious to factual data that no matter what he says they will condemn him? Will he also accept that the Tories are so totally committed to massive public expenditure cuts that if they were returned to power the NHS would be the victim of tremendous cuts in every area?
It is clear to me that under the Tories there would be either very substantial reductions in expenditure on the NHS or substantial increases in charges for seeing general practitioners or specialists or going to hospital. Also there would be great additions to prescription charges which, in my view, would undermine the whole principle on which our National Health Service was created.
Agreement on a pay settlement was reached at the meeting of the Nurses and Midwives Whitley Council held on 27 March. The agreement provided for consolidation of the existing £130 per annum supplement; an increase of 8·8 per cent. on the consolidated pay scales; a reference to the Standing Commission for a comparability study, with the results to be implemented by equal stages on 1 August 1979 and 1 April 1980; and advance payments on account from 1 April 1979, for staff working 35 hours a week or more, of £2·00 per week for unqualified staff, students and pupils, and £2·50 per week for qualified staff.
Does my right hon. Friend realise that he is bound to be condemned by the Conservative Party for making this award to the nurses, but will he bear in mind the crocodile tears shed by the Tory Party at the fact that the nurses wanted more money, and set them against the demand by the Tory Party for cuts in public spending? After the interval of the election, will my right hon. Friend when he returns to the House ensure that there is an increase in public expenditure across the board on the National Health Service and ignore the two-faced attitude of the Tory Party?
No doubt the right hon. Member for Wanstead and Woodford (Mr. Jenkin) is about to leap to his feet to criticise the Government for additional public expenditure incurred in the settlement with the nurses. However, I believe that most people will warmly welcome this agreement. I believe that the nurses richly deserve the pay increases which they will receive immediately and the fuller study of their pay which the Standing Commission is about to undertake. Nurses have earned great respect for their attitude throughout the weeks of dispute in the National Health Service. Most of the House will share my pleasure in the fact that a satisfactory pay settlement has been reached, and will join me in paying tribute to the dignified and restrained way in which nurses have conducted themselves in recent weeks.
Since the terms announced by the Secretary of State represent the Government's recognition of the nurses' claim to be treated as a special case, why on earth did the nurses have to wait 12 solid months before the Government came round to that point of view? Why did the right hon. Gentleman drive this dignified and honourable profession into demonstrating all over the country? Why did he not respond to the nurses' pledge not to strike before he agreed to treat them as a special case?
The right hon. Gentleman is suggesting that the Government should in the course of the pay year which ended last week have made an additional payment to the nurses. I can well understand how much the nurses would appreciate having had a second payment in the course of one year. But the Labour Government, quite unlike the Opposition, felt that they had a responsibility to the public in the maintenance of pay policy. We thought that the special case sought by the nurses should be properly considered independently by the Standing Commission, which will now take that course. The sanctimonious stuff we have just heard from the right hon. Gentleman comes ill from the Opposition Benches when we remember the way in which the Conservatives have treated nurses' claims over the years. In the last 10 years it has always been a Labour Government who have brought in proper pay for our nurses—[Interruption.]
Order. I suppose it is inevitable that on these two days there will be a little more excitement than usual, but this is similar to presiding over a general election meeting. I hope that hon. Members will confine themselves, although I do not expect them to do so, as much as they can to the Order Paper.
Will my right hon. Friend bear in mind that this agreement with the nurses is important so that we may keep faith with them? Many people are prepared to support an incomes policy, whatever political party is in power, provided that it can be shown to be fair. But if it is to be fair, we must take into account not only those on low pay but those who lack industrial muscle, such as the Armed Forces, the police and—because they will not strike—the nurses? Is it not important to see that any pay policy is fair?