New clause 9 does not include provision for a staff commission for Scotland. That is not to say for a moment that we are not concerned about the implications of the provisions of the Bill for staff problems in that country. My hon. Friend the Member for Wood Green (Mr. Race) referred to the decisions that have been taken by NALGO at its conference in Eastbourne today.
As the House knows, I am sponsored by the Confederaton of Health Service Employees which will no doubt be taking decisions on these precise matters at its conference next week. There is a good deal of concern about the implications of the Bill for staff employment. We shall no doubt have the chance to discuss, in the early hours of tomorrow morning, the Secretary of State for Scotland's paper "Structure and Management of the NHS in Scotland". Page 11, when dealing with implications for staff says :
The Secretary of State recognises that although his proposals do not involve any major reorganisation of the service "—
though that is challenged—
they have considerable and wide-ranging implications for many members of staff. The Government intend to be as fair as possible
to all staff involved in the changes ; and at an appropriate time will be discussing with staff interests arrangements for the filling of posts and for the protection of the interests of those adversely affected.
That is all and I presume that that means, by implication, that there will be the fullest consideration within the Whitley council procedure and with all the relevant trade unions. I guess that that will be the gist of the Minister's answer. But the Whitley council machinery is not adequate. The Minister and the Departments recognise that the Whitley council machinery leaves a lot to be desired. That is one of the reasons why we are putting forward the proposition in the new clause.
Though I have racked my brains, I find it difficult to see any merit in the Bill which is designed to do two things. It aims, first, to transfer resources from the public to the private sector in order to make people understand that their health depends on the depth of their pocket rather than on the willingness of the taxpayer to foot the bill for our health services. That is the main purpose of the Bill.
It is significant that the White Paper produced by the Scottish Office lacks any public relations element compared with the White Paper produced by the English Department. At least the English Ministers try to kid the people that patients come first. The Scottish Office is honest and more brutal. It never mentions patients once in its document. The English Department is disarmingly deceptive. It tries to convince the people that it is concerned about patients—but not about nurses. I shall say something brutal to the Minister about that later.
Whatever the merits of the Bill, there is no doubt that, since we are dealing with the second major upheaval in the National Health Service initiated by a Tory Government, whose record is appalling, there will be a deepening crisis of confidence among the staff and users of the Health Service. When the full implications of the Bill are realised there will be a serious deterioration in the morale of employees—and there are 1 million of them. The Health Service is one of our major industries.
The Bill, with the Government's overall policy to cut public expenditure on every other social service including education and housing, will lead to increasing bitterness among employees. In a relatively modest way we are seeking to remedy the situation. We are trying to decrease the bitterness and to give workers the knowledge that they will participate in any discussions that affect their jobs, their promotion prospects and the Service. The Government would be well advised not to reject the new clause out of hand. They should not argue that the Whitley machinery is adequate to deal with the problems.
If the Government cannot accept the new clause they should at least accept the principle behind it and emphasise the imperative need to negotiate with and consult the staff at all levels. If a worker in the Health Service, or anywhere else, loses his job he will find it almost impossible to get another. No alternative employment is available in many parts of the country, not least in Scotland. I hope that the Minister will not reject the new clause out of hand without outlining in detail how he sees the solution to the problems that will occur during the transitional period.