My Lords, given the lateness of the hour, I will not say all the things I was going to. Most of them have already been said, perhaps more expertly than I could. I want to speak about the health service, and about Amendment 90A. I know a little bit about the health service. I started life as a nurse, involved in my local branch. I eventually became a senior official and general secretary of a health service union. Many years ago, in a new district general hospital, where we formed a branch of over 300 members—largely nurses—we were first regarded by management as some sort of devil incarnate. That mood changed very quickly when they realised that they needed staff support to get a transition from the old healthcare into the brand new DGH. Very quickly, long before it became fashionable, one of our branch officials was given facility time. It was not me: I was a theatre nurse and it was not suitable for me to have that time, but I did plenty when I was off duty.
Given my experience over the years, it is difficult to see where the Government are now going with Clause 13. There is no evidence whatever to back up the contention that the taxpayer is lying awake at night worrying about Staff Nurse Smith from Unison or the RCN or Dietician Jones from the British Dietetic Association having some facility time. Sometimes I think that things have not moved on very far. Recently, a nurse told me that she spoke to a manager about her concerns with an issue bordering on bullying. That manager was quite clear. He said, “I do not like clypes”. Clypes is not a word in my vocabulary, but I gather it is Lowland Scots vernacular for a teller of tales, a sneak or an informer. Clearly, one manager north of the
border has not had the post Mid Staffordshire situation imprinted on his mind. That is why we still need unions and why we need people to undertake union duties: to represent a nurse who is now afraid of repercussions and who will, in all probability, not dare to speak out unsupported again. That is why we need sensible facility time.
The reality is that, in the health service, we all support high-quality patient care, but we need that to be cost effective. We need to find ways to increase productivity and, at the same time, improve outcomes. That is a lot of horses to ride at the same time. Most human resources people working in healthcare would acknowledge that if they are to take staff with them on the road ahead, whatever the future holds for the service, the staff have to be willing and engaged. All the health service unions invest a lot of money in training union stewards and representatives. We invest in quality training in health and safety skills, which is extremely important in the multiple practice environments of hospitals. As we heard a number of times today, we invest in training learning representatives. All of that helps to have a more confident staff.
Does the Minister—or the Government—really think that nurses and other staff representatives to whom we have given high-quality training are sitting around planning strikes and mayhem? Of course the Minister does not believe that. So will she acknowledge what really happens: that staff sides in NHS trusts try very hard to have sensible working relationships with management? One only has to look at the series of reports from the Social Partnership Forum to see what good work goes on. I can commend to her those from Guy’s and St Thomas’, University Hospital Birmingham NHS Trust and many others, not least those many dealing with the outcomes of the Francis report into Mid Staffordshire. Why do the Government want to damage that? Why do they need to take powers to limit trade union facility time? Is it really going to be a position—as has been suggested—where a Minister looks at figures supplied by a health trust or another employer, about which he or she has no detailed knowledge, and instructs that authority to cap facility time to some fraction of its pay bill? If so, we are going to make life much more difficult for the health service than it needs to be. Research has shown that, far from the costs alleged in the impact assessment, there are actual savings to be made by having union representatives in the workplace.
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The Royal College of Nursing’s recent research mirrors that of the DTI some years ago, showing that where there is union representation there is much lower staff turnover, lower dismissal rates and far fewer industrial tribunals. It is perfectly obvious that that must mean real cost savings to the National Health Service. So I hope the Minister will acknowledge that she will look carefully at that research as well as that produced by ACAS showing how trade union representatives play such an important role in improving workplace morale.
I know from personal experience that facility time, properly agreed between staff, unions and management, leads to productive partnership working. Of course,
in the nature of things there will be disagreements from time to time, but we have to live in the real world. For the NHS, that real world at the moment has a number of very difficult issues, including constrained finance, unresolved issues of workforce planning, issues of student nurse education, continuing pay restraint and, not least, the continuing saga of safe staffing levels on hospital wards.
We have the review by my noble friend Lord Carter of Coles, which has suggested ways to save up to £20 million over the next four years. We have the National Audit Office report complaining about not getting the right staff in the right place at the right time. And so it goes on. It always has gone on; there have always been major problems to be dealt with. But with this particularly troublesome pot bubbling away not very far under the surface, do we really want to do anything to demotivate health service staff any further than they already are?
I say to the Minister with the greatest respect: the Government should leave well alone, particularly in the National Health Service. Leave it to managers and unions to do as they do at present, which is, by and large, to work sensibly and constructively together. Let us drop Clause 13 from the Bill.