Strikes (Minimum Service Levels) Bill

Baroness Jones of Moulsecoomb Excerpts

Committee stage
Thursday 9th March 2023 Lords Chamber

[The Lord Bishop of London]

My Lords, I shall speak to Amendment 18 in the names of the noble Lords, Lord Patel and Lord Kakkar, and add my voice to many of the points already raised. I thank the Minister for being much more specific around health. I hope that we can define it much more clearly, rather than having that very broad category, as well as the issue around life and limb.

I remind the Government that, in this Chamber, they have resisted introducing legislation for minimum staffing levels on a number of occasions. It seems incredible that they now want to put in levels of minimum service, which clearly require minimum staffing levels, but are willing to do it only on strike days.

As I indicated earlier, this amendment goes to the heart of one of the key issues with the Bill; namely, that people in the health service who strike do so partly because safe staffing levels are not in place on non-strike days. We have already heard that the healthcare system is under huge pressure, trying to provide quality care with fewer staff, and there are workforce problems. The most recent statistic I have shows that there are 124,000 vacancies across the NHS—that is 13,000 more than this time last year. The Royal College of Nursing published a survey in May 2022 showing that only 25% of shifts have the planned number of registered nurses and 83% of respondents said that there were not enough nursing staff to meet all patient needs safely and effectively on their most recent shift.

Staff on non-strike days are thinly stretched and cannot provide the level of care that they would want to, which puts huge pressure on their health and well-being. The distress that they experience is causing an increase in illness to them. Reporting on the past year, the Healthcare Safety Investigation Branch noted that the additional pressure that staff were under was causing sickness. As a new student nurse put it, “I no longer want the career as it is. The reality feels as though I must sacrifice my own health and well-being for less than satisfactory pay.”

The notion that the Government could legislate to require minimum service levels in healthcare settings, which are already committed to safe strikes, while there is a lack of investment and workforce planning—which is the reason for the action—is unfathomable. I would welcome the Government legislating to ensure appropriate staffing levels on non-strike days that are greater than the strike day cover. That would be welcomed by nurses, because it would mean more resources and more workforce planning than the health service has seen for years. It would also resolve one of the reasons why nurses are taking strike action. I have spoken about trust, as have a number of noble Lords. Accepting this amendment would go some way towards to rebuilding the trust that has been eroded, and will be eroded further by this Bill.

Amendment 13 in the name of the noble Lord, Lord Fox, seeks to make a similar point but through a different route. Along with my right reverend friend the Bishop of Manchester, who is unable to be here, I express my support for that amendment as well.

[Baroness Jones of Moulsecoomb (GP)]

My Lords, I support both the amendments. I have sat in my office all afternoon listening to this debate. At times, it was difficult to concentrate, simply because there was a degree of repetition. I do not blame noble Lords for that; I blame the Government—as usual. At least I got lots of old paperwork sorted, which was real progress for me.

Despite trade unions sounding the alarm on unsafe levels of staffing in public services such as hospitals for quite some time, the Government refuse to implement legislation ensuring safe levels of staffing on any day other than a day when workers have chosen to withhold their labour by going on strike.

These amendments lay bare the ridiculousness of the Bill. Under this legislation, the Government will force workers to go to work against their will, with the perverse outcome being that strike days could see services with a higher number of staff than on non-strike days. It sounds like slavery to me. Is it not slavery when you force people to work against their will?

The Government propose that this is done by employers writing out a list of names of workers who must turn up and work on a strike day. Unlike on a normal work rota, workers will not be allowed to call in sick, take parental leave, take bereavement leave or even be in hospital having had a major condition of some sort. This legislation drags the workers in and forces them into a temporary state of servitude. That goes against every single principle of common law, contract law and employment rights in this country.

I have a cunning plan which would save the Government on this issue; it would just need a few tweaks in the Bill. If the Government want to make it illegal to go below minimum staffing levels in hospitals and the ambulance service, why do we not do that 24/7 and 365 days a year but, instead of the unions getting fined, we fine the CEOs and Government Ministers? That way, if you want someone to be responsible for old people waiting eight hours for an ambulance, you put the legal responsibility on the people at the top, not at the bottom. This seems eminently sensible and much more practical. Let us have laws that apply to the people in charge rather than target the overstretched staff on the front line, who are struggling for better pay and conditions. The Government will not be able to deliver either my idea or the Bill as it stands. In fact, this Government is too incompetent to deliver a pizza, so why should they be able to deliver a Bill such as this one?

If the next Government have any sort of involvement with the Green Party, they should know that we have committed to repealing this legislation and all other anti-trade union legislation passed since the Thatcher Government—that will be quite an exercise. We can create safe, well-run public services by working together with workers and unions, not by using authoritarian laws to strong-arm them into the workplace no matter how badly their working conditions get. I hope that the Government see sense on this, but I can tell from the looks of noble Lords on the Front Bench that it is not going to work.

[Baroness Noakes (Con)]

My Lords, it is quite difficult to follow that speech. I do not think that anybody would want to encourage the dissipation of the Green Party in any Government, so the noble Baroness’s ideas will not go very far.

I will not talk about the NHS, which all noble Lords have spoken about so far; I will address only Amendment 13 tabled by the noble Lord, Lord Fox, but not in the context of the NHS, to which he addressed all his remarks.

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[Lord Callanan (Con)]

I readily concede to the noble Baroness that many public services are under pressure, despite the record sums that we are spending on them. Of course, there are pressures on many public services; I entirely accept that. I do not know the details of the fire and rescue services consultation, but I know that the noble Lord, Lord Sharpe, is very happy to continue to engage on that issue.

[Baroness Jones of Moulsecoomb (GP)]

I am so sick of that line about the record amounts being spent on our public services when a lot of that money goes to private companies, which employ nurses and doctors because the Government have allowed our public services to be so understaffed. Please stop misrepresenting the situation.

[Lord Callanan (Con)]

The noble Baroness is getting off the debate. I am very happy to debate these points with her another time, but I think I will stick to the amendments.

--- Later in debate ---

[Baroness Jones of Moulsecoomb]

I am following you.

[Lord Callanan]

It is the fact that we are spending record amounts on these services.

[Baroness Jones of Moulsecoomb (GP)]

My Lords—

[Lord Callanan (Con)]

I appreciate that the noble Baroness has a different opinion on how the money is spent, and with whom. That is an unarguable fact. Perhaps we can save the debate for another occasion when we are not talking about this legislation.

Minimising what the minimum service level could be sets a significant legal restriction on the ability to achieve this balance and would likely result in the public continuing to suffer the disproportionate impacts that strikes can have. Let me again thank my noble friend Baroness Noakes for her contribution; she eloquently highlighted the potential perverse consequence of Amendment 13, and I totally agree with my noble friend.

The Government value employers, employees, trade unions and their members, and members of the public, who pay for many of these services, being able to participate in the process of setting minimum service levels through the consultations that are required by the legislation. This amendment would reduce the importance of that process, and in turn reduce the influence that these important groups have.

The noble Baroness, Lady Chakrabarti, has left us, but it remains the case that any regulations that set minimum service levels in specified services will need to be compatible with the European Convention on Human Rights, including Article 11. Should any regulations go beyond what is necessary to achieve the aims of setting minimum service levels, which resulted in a breach of the ECHR, a court would be able to grant such remedy as it considers just and appropriate, following a judicial review. Levels of staffing on non-strike days will no doubt be one of the factors that they may wish to consider. I hope that this reassures noble Lords that we will act in a way that is proportionate, and so that there are appropriate routes for stakeholders to challenge any MSLs that they believe have been set at too high a level.

Amendment 18 deals specifically with health services. It seeks to delay any implementation of minimum service levels in health services on strike days by first requiring the Government to establish appropriate staffing levels on non-strike days through primary legislation. As always, it was a pleasure for me and the noble Lord, Lord Markham, to meet yesterday with the noble Lords, Lord Patel and Lord Kakkar, to discuss the amendment. I am grateful that both noble Lords took the time to explain their concerns. I bow to their superior knowledge of and service to the healthcare system, and for their contribution to the debate which, as ever, was constructive. Many of the points raised by the noble Lord, Lord Patel, were discussed in the earlier grouping; I know that the noble Lord was listening so I will not repeat all the points made by the noble Lord, Lord Markham, but I am very happy to have further discussions with both noble Lords if they think there are outstanding issues that we have not sufficiently covered.

I would say that the responsibility for issuing work notices is with the employer, rather than the Secretary of State, precisely because individual employers know better what level of staffing is required to achieve minimum service levels. The noble Lord, Lord Collins, will be irritated but I also repeat and emphasise the point that there is no statutory duty in the Bill on an employer to issue a work notice.

As we discussed, however, strike action in some areas of health services can put lives at risk or cause serious harm to patients. In many cases, it has the potential for far-reaching consequences for members of the public who are not directly involved in the dispute. As the consultation for applying minimum service levels in the ambulance services sets out, the aim is to protect life and health, and it is only right that the implementation of minimum service levels, where required, is not unnecessarily delayed.

I will pick up the point on non-strike days. Responsibility for staffing levels, in the Government’s view, should remain with clinical and other leaders at a local level, responding to local needs and supported by guidelines and national and professional bodies and overseen and regulated in England by the Care Quality Commission. People have been unable to access work, healthcare and education and been left worrying whether an ambulance would even be there when they needed one. Businesses have also been severely impacted. It is the Government’s view that these amendments would only delay or disrupt our ability to act on the disproportionate impacts that strikes can have on the public. Therefore, I hope the noble Lord will be able to withdraw Amendment 13.