The title of the debate--"Crisis in the National Health Service"—may cause disappointment inside and outside the House because we have addressed ourselves to the narrow issue of the pay dispute and to party political in-fighting. Both aspects are relatively unimportant in the context of the crisis in the Health Service. If the pay dispute were solved tomorrow, the National Health Service would still have basic problems and there would be a crisis to discuss. If there were a general election and a change of Government tomorrow, there would still be a crisis in the NHS. The fundamental problems involved in the provision of health care are so important and complex that they cannot be solved by anything that could happen in a matter of hours or days.
Like many other hon. Members, I met the lobbyists yesterday. I say to my right hon. Friend the Secretary of State and my hon. and learned Friend the Minister for Health that I did not find those people militant, though I fear that there is a danger that they may be pushed into militancy if the dispute drags on for longer than is necessary.
The workers told me not only that they wished their low pay to be raised and that they wished the dispute to go to arbitration, but that the ordinary NHS workers did not stick firm on 12 per cent., and they asked me to give that message to the Secretary of State. They hope that there will be meaningful negotiations, and I recommended that they should make those points to their union leaders.
I was told that a hospital porter with years of experience and, say, a wife and two children would take home only £74 for a 54-hour week. I agree with the suggestion that there seems to be something radically wrong with the pay levels in the lower ranks of the NHS.
However, another worker told me that his wife was a cleaner for Marks and Spencer on an hourly paid rate that was one-and-a-half times what he was paid. He suggested that that showed that NHS workers were badly paid, but I suggest that it shows that when labour is used efficiently and effectively it can be well paid. There would be great advantage in radical thinking within the NHS about how money is spent. If workers were better deployed, equipped and trained, and perhaps managed by private enterprise, they could hope to obtain increased income through increased productivity.
The major issue in the NHS, which I should like to have had time to discuss at length, is how we are to afford the ever-increasing cost of long-term stays in hospital by geriatric and psychiatric patients. Most live in old buildings that need rapid improvement, and the quality of life would be improved more for those patients than for others if the necessary work were carried out.
The Opposition seem to assume that the funds must come from the public sector—from taxation or contributions. Why can they not come from payments by patients for the services that they wish to receive? One of the reasons why business men choose private treatment is that they need facilities to carry on their businesses. Why cannot such facilities be offered on the NHS at a premium price?
If we offered more facilities within the NHS, so that those who wished to use them put their money into the Health Service, we would not need a dual system of private health services side by side with the NHS.
I gave up my membership of a private health insurance scheme before I became a Member of Parliament, because I concluded that it was essential that the resources of both the State and the individual should go into the NHS. That is one of the ways in which we could improve service for everyone.
We should have addressed ourselves to the real issues today. Many in the country will be disappointed by what they have heard in the debate.