NHS Industrial Action: Government Preparations

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on Government preparations for industrial action in the NHS.

I am grateful to the hon. Member for his question, which I am taking on behalf of the Department as the Secretary of State is attending a Cobra meeting on contingency planning for industrial action in the NHS. He also came before the House on the subject twice last week: at departmental questions and for the Opposition day debate.

We are all hugely grateful for the hard work and dedication of NHS staff, so we deeply regret that some union members have voted for industrial action. Our priority must be to keep patients safe. That begins with keeping the door open. The Secretary of State wrote to the Royal College of Nursing on Saturday asking for further discussions as a matter of urgency. At the same time, we are working with the NHS to minimise the disruption to patients if the strikes do go ahead. We are engaged with providers, professional bodies and trade unions to agree safe levels of cover should any action take place.

In addition, this afternoon, Ministers—including the Secretary of State—are attending a Cobra meeting focused on our contingency plans. Our plans draw on extra support from a range of places, including service personnel and the private sector. While we aim to minimise disruption, with the NHS already under significant pressure from the covid pandemic and winter pressures, we remain deeply concerned about the risk that strikes pose to patients.

I want to be clear that, even at this moment of uncertainty, people must keep coming forward to get the care that they need. People should continue to use NHS 111 if they need medical help and dial 999 in the event of an emergency. For more routine treatment, hospitals will do everything they can to ensure that planned procedures go ahead, but it is inevitable that any strike would mean some patients would have their treatment delayed. People will be contacted if their appointments need to be changed.

Thank you, Mr Speaker, for granting this urgent question. The power to stop these strikes likes squarely with the Government and the Secretary of State. The Royal College of Nursing and Unison have said that they will call off strikes this week if the Government are willing to negotiate with them seriously on pay. That reasonable offer of compromise is surely too good to refuse, so what on earth are the Government playing at? After 12 years of Conservative government, patients can no longer get seen on time and staff have been pushed to breaking point—and the Government cannot even be bothered to try to negotiate to prevent strikes from going ahead, at the worst possible time for patients and the NHS. The Government should ask themselves why, under a Conservative Government, nurses feel they have to take industrial action for the first time in more than 100 years and why ambulance workers are set to follow them for the first time since 1989.

It should be obvious by now what the Conservative agenda is. The Government know that patients are going to suffer this winter and they have no plan to fix the problems of their own making, so instead of taking responsibility for their failure they want to use nurses and paramedics as scapegoats to avoid the blame. It is a disgusting plan, it is a dangerous plan, and it is a plan that will not work. The public know that the power to stop these strikes is in the Government’s hands. If they fail to act now, patients will never forgive them.

How many operations have already been cancelled? How does the Minister expect those on the waiting list to feel if their operations are cancelled because of the Government’s gross negligence? Can he tell patients which services will be impacted if these strikes go ahead? Is the Secretary of State not embarrassed at Cobra today, asking the Army to come in to clean up the Government’s mess?

Even at this last minute, it is not too late to prevent strikes from going ahead. Perhaps the Minister can tell us whether the meeting with the RCN later today will involve discussions on pay. And if not, why not? Because that is all it takes: just a few minutes or a few hours of talk can avoid strike action. Why will they not do it?

The fact is that Labour is all over the place when it comes to strikes. They criticise Ministers while admitting that the unions’ pay demands are unaffordable. The hon. Gentleman and his party leader are too tied to their union paymasters to be on the side of patients. He knows that we have an independent pay review body, and is important that both sides respect that independent body. We accepted the independent body’s recommendations for this year’s increase in full, meaning that over 1 million NHS staff have been given at least a £1,400 increase in their pay. That is on top of a 3% pay rise last year at a time when pay was frozen across the wider public sector. The RCN, one of the unions taking action, is asking for an increase that is 5% above the retail prices index. Based on latest figures, that is an increase of 19.2%, or the equivalent of 6.5% of the NHS budget. To meet such demands, we would have to take money away from clearing the elective backlog that the hon. Gentleman referred to, something no responsible Government would wish to do.

Throughout this period, we have always sought to have a balanced process. Those in the private sector will not be getting a 19% uplift, and there is a clear need to be fair to the wider economy. We have to avoid inflationary pressures that would make us all poorer in the end.

We will continue to listen to colleagues’ concerns, not just about pay but many other issues affecting the working lives of those in the NHS. We will work with them to make improvements in a range of areas, from working conditions to patient safety, because we believe there is so much that we can agree on. Strike action is in no one’s best interest. We will keep working so that the NHS continues to be there for those who need it most.

I call the Chair of the Health Committee, Steve Brine.

With your indulgence, Mr Speaker, may I send our heartfelt sympathies to the parents of the little boys who have lost their lives in the west midlands overnight and say thank you to the emergency service workers, many of whom will have been from the NHS? I am sure they have done their best for those they pulled out and those they were unable to save.

The Minister is right that we have an independent pay review process, but it seems that we are coming to an interesting junction point: either we believe in an independent pay review process, or we do not. We cannot be in a situation where everything is agreed until it is simply not, and then Ministers are negotiating pay. That is not what Ministers do.

I am glad the Minister mentioned patients them at the end of his remarks. We must keep them as our focus. I have more information about my train services over the next few weeks than I do about health services. Is the Minister satisfied that patients have enough information about what is being affected and when, and how much it will impact on the backlog? I suspect none of this will help the workload pressures that are impacting our NHS.

I thank my hon. Friend for his question, and I echo his comments on the tragic events in Solihull, the boys who lost their lives and the heroic actions of those in the emergency services.

My hon. Friend is also right to say that we have an independent pay review body, and we either agree and accept that that is the process, or we do not.

On advice to the public, my hon. Friend is right that we have more to do in this space. Derogations are still being worked through with both individual unions and trusts. Patients should continue to call 999 as normal if it is an emergency and someone is seriously ill or injured. If they do not have life-threatening conditions, they should use NHS 111. Ambulances will still be responding to 999 calls. If patients have appointments, they should please turn up unless advised not to do so. He is right to make the point about communications, and I will be ramping this up when we know more about derogations.

I call the SNP spokesperson.

Scotland’s First Minister has managed in one day to do what the Tory Government could not—agree with the nursing unions to call off strikes planned for this month. NHS workers are the backbone of these countries. If they do not work, the country does not work, and if the country is not working, it is broken. Britain is broken, is it not? And Brexit has broken Britain, has it not? The Tories will not negotiate and the Labour Opposition spokesperson has branded the British Medical Association as “hostile”, while in Scotland the strikes are off, and they are off permanently. An offer of 7.5% has been negotiated and agreed, with an 11.24% pay rise for the lowest paid across the board in NHS Scotland. Why are the UK Government refusing to give public servants a decent pay increase when they have all the financial power to do so?

I thank the hon. Gentleman for his question. My understanding is that the industrial action in Scotland has been suspended, not cancelled, as the hon. Gentleman suggested. The Scottish Government have made a considerably higher offer, partly because a politician has got involved in pay negotiations, directly in contrast to the independent pay review body, and it will be interesting to see whether the First Minister of Scotland is going to do this every single year and go against the recommendations of their pay review body.

Would the hon. Gentleman like to confirm—I appreciate he cannot do it now—whether the Scottish Government have also looked at things such as leave and working times? I think it is important to stress that every 1% increase for the “Agenda for Change” workforce equates to about £750 million. That is £750 million that will come out of the NHS budget and that we will not be able to spend on things such as tackling the elective backlog, which is so important to people up and down the country.

Our military actually enjoy stepping in when a Government Department occasionally cannot manage, such as with flooding and so forth, or on rare occasions when a strike takes place. However, what we are seeing this month is unprecedented, with so many sectors choosing to strike exactly at the same time, and this places a huge burden on our armed forces. Could I ask the Minister, first, whether all the units that may be required to mobilise have been informed already, and whether, if we are going to see strikes at this level, it is now time for Departments to introduce minimum service levels to make sure that our armed forces are not overwhelmed?

Representing the garrison city of Colchester, I have nothing but the utmost respect for our armed forces. It has not escaped my notice that many of them are on lower pay than NHS staff and will be giving up their time over Christmas to cover strike action. My right hon. Friend is right that to mitigate the impact of planned industrial action in the ambulance sector, NHS England has explored a range of measures, which include engaging with the Ministry of Defence on military support. As a contingency, a MACA request—a request for military aid to civil authorities—for a limited number of personnel has been submitted to the MOD. It was submitted at the end of last week, and the plan is that MOD personnel will be trained to drive ambulances, but only deployed where they are needed across the country.

The Government need to stop hiding behind the pay review body. The pay review body sorts out the distribution of the funding, while it is the Government who determine the size of the envelope, and it is the envelope that is in dispute. Why will the Minister not get a Treasury Minister alongside him and make sure they negotiate on the size of the envelope? If they can afford the right hon. Member for South West Norfolk (Elizabeth Truss), they can afford a nurse.

The average pay settlements in the private sector range between 4% and 6%, and we want to have a fair deal for both NHS staff and the taxpayer. The hon. Lady makes reference to the pay review bodies, but it is important to stress that they are made up of independent experts. They recommended the uplifts for NHS staff, and in formulating their recommendations, the review bodies carefully considered evidence from a wide range of stakeholders, including NHS system partners and trade unions. The independent pay review body is a respected mechanism, and we should accept its recommendations, which we have.

May I commend my hon. Friend on his response to the urgent question, and say how much I agree with him? Can he set out his thoughts on how things would be likely to proceed in the NHS if we ended up in the scenario which the shadow Secretary of State appears to want, in which Ministers negotiate directly with unions on pay every winter? Does he think that that would lead to upward pressure on pay at the expense, crucially, of the public, whom we serve and who need those operations and the elective care for which we have budgeted, and that that should not be eroded by unrealistic pay demands of 19%?

My right hon. Friend is right. We have an independent pay review body mechanism for a reason, and it has worked for a number of years. That is why I made reference to the First Minister in Scotland. Is this a procedure we are going to go through every single year when a pay review body recommendation is made and unions do not like it, and politicians have to get involved? The point of the independent pay review body is that it depoliticises the issue, and Ministers do not negotiate directly with unions. The independent pay review body looks at the issue in the round, along with the wider economy and a number of other factors, then forms a recommendation which the Government can choose to accept or refuse. It is important to stress that in this case the Government accepted the recommendations in full.

I was a nurse for 25 years. Nurses work long hours, day in, day out, to support people all over the country, often on very low pay. I know from experience how tough it can be, and it is shameful that many hospitals have opened food banks specially to feed their staff. Let us be absolutely clear: the power to stop these strikes, which nurses themselves do not really want, lies squarely with the Government. How can Ministers justify refusing to talk to the unions?

I thank the hon. Lady for her question and for her service as a nurse. We value hugely and appreciate all our NHS staff. We have given them a pay rise this year, on top of 3% last year, when pay was frozen in the wider public sector. As I have said a handful of times, we accepted in full the recommendations from the independent pay review body. Of course, I do not want to see anybody needing to use a food bank, let alone a member of our NHS. That is exactly why the Government have a broader package of support in place.

I have to take issue with one of the hon. Lady’s comments. She asked who held the power to call off these strikes. There is only one answer: the unions.