Strikes (Minimum Service Levels) Bill

Lord Allan of Hallam Excerpts

Committee stage
Thursday 9th March 2023 Lords Chamber

Debate on Amendment 3 resumed.

[Lord Allan of Hallam (LD)]

My Lords, I rise to support Amendments 3 and 4 in the names of the noble Lord, Lord Collins, and the noble Baroness, Lady O’Grady. First, looking at Amendment 3, which seeks to exclude health services altogether, I think the key question remains: who wants this legislation? As the noble Lord, Lord Balfe, who is not in his place, asked in relation to Amendment 1: who is asking for this power that the Government are legislating to grant them? We have the Health Minister in the Minister’s place. I hope he can inform the Committee which bodies within the National Health Service have been knocking on his door, asking to be given the powers that are set out in this legislation.

The noble Baroness, Lady O’Grady, quoted to us from the note that has been sent out by NHS Providers, which represents all the trusts in England, and it could not be clearer that not only is the legislation unwanted but it sees it as actively counterproductive to its efforts to work with the staff that it employs in order to deliver the service both on a day-to-day basis and during industrial action. We seem to be in a situation where the employers are saying that they do not want this, and the employees certainly do not want it, yet the Government are determined to stick their oar in and make a difficult situation worse. This potentially has significant short-term and long-term disadvantages that will be to the detriment of the health service.

I am sure the Government will say that this is about delivering health services to people in the United Kingdom, and we would agree that it is about that. The question is: what framework means that we are most likely to get those health services delivered effectively? It is one in which employers and employees are working hand in hand to deliver health services to people. It is not one in which we create artificial tensions between employers and employees, and it is not one in which we pass legislation and seek to impose measures that will increase those tensions and make things worse.

As well as NHS Providers, I have been contacted by a consultant who works in the health service, who said to me:

“Instead of focusing on minimum service levels on striking days, the Government should be taking action to ensure the NHS is safely staffed 365 days a year.”


We will come to amendments later on where we will talk specifically about that, but that is the prize—a 365-day-a-year service. That depends, crucially, on staff morale, staff recruitment—we all know that we have huge gaps right across the health service—and staff retention, which means making them feel valued. It certainly does not mean press-ganging them into working at times when they have exercised their legitimate right to withhold their labour because of an industrial dispute.

The consultant goes on to say:

“Instead of threatening workers and unions with heavy-handed tactics that put workers’ right to strike at risk, this means ensuring that there is meaningful engagement on pay and a commitment to enshrining and funding safe staffing. This would help stem the tide of doctors leaving the NHS every year for better jobs at home and abroad, in the best interests of the NHS and patient care.”


I asked the Minister this question at Second Reading; I will ask it again: is there anything in this legislation that the Minister can say, hand on heart, will help him and his department recruit more staff to the NHS and stem that flow away from the service?

On the specific consultations that the Government have put out, we now have one on the ambulance service; again, I have been talking to people who work in that service. First, I have to say that the consultation is one of those classics: if you ask people, “Do you want more or less service?”, who votes for less service? When the Government ask, “Do you want category 1 and category 2 or just category 1?”, I think we can reasonably predict the answer. But the consultation does not ask, “Do you want the Government to come to a fair settlement with ambulance workers so that you can have categories 1 and 2 all year round, delivered to a level of performance that would be a significant improvement on today’s level?” I think the Government would freely admit that they are failing on both categories today; again, we have to ask whether anything in this legislation will improve the service delivered by the ambulance service. There is nothing there.

The ambulance service points out that, if you include categories 1 and 2, that covers pretty much the entire service. It is pretty much business as usual that the Government are consulting on. In essence, they are asking, “Should we prevent ambulance workers going on strike?” That is the net effect of saying that the minimum service level is the entire service. Again, I think that there is some confusion there.

The ambulance service also points out that the Government are, in part, driven by the fact that they are failing to meet their targets. Now they are consulting on what should be in categories 1 and 2, so we may end up consulting on a minimum service that will itself have to change as the Government change their definition of what constitutes categories 1 and 2 because of the pressures on the ambulance service; for example, there are suggestions that some people may no longer be categorised as category 2 until a further assessment of their needs has been made. Again, we are consulting on something that may move as the consultation progresses. We have a problem both with the generality of the health service being included and around the specifics on the ambulance service.

I want to raise one further issue, which relates to the speed with which the legislation has been introduced. I am not a civil claims lawyer but I know that their job is to pursue all possible angles in favour of their clients. We also know that the NHS is already paying out more than £2 billion a year in compensation claims, including claims made for failures to deliver on the agreed levels of service for ambulances and emergency care.

This legislation could change that landscape in several ways. First, if the minimum service level has been defined yet there is still a failure, there will potentially be a claim against the Government who set that minimum service level. If I am a claimant lawyer, I am going to go for every angle; one of the angles is to say, “The minimum service level was insufficient so I am going to try to drag the Government into the case”.

If the minimum service level was set but the work notices were insufficient, I would go after the trust and try to bring it into the case, saying that the only reason my claimant suffered was because the hospital trust failed to deliver sufficient work notices. Even the existence of this law could fundamentally change the landscape for those claims. If you fail to exercise that law, which the Government keep saying is a measure of last resort, claims could come in to the effect, “You had a law for minimum service. I suffered at the hands of the NHS because there was no minimum service level in place, but the Government could have done something because the legislation was there”. I see the noble Baroness, Lady Chakrabarti, nodding, which is encouraging given her legal experience.

I hope that the Minister can say in response, “We’ve worked all this out, don’t worry. When we drafted the legislation, we figured out the effect of having law on minimum service levels, questions around work notices of minimum service levels and how the responsibility of the Government, the trust and others would factor into the landscape of compensation claims once all this has occurred.” I fear that the Minister may not have all that to hand and, frankly, that it has not been done. This is another example of what happens when you rush legislation. There are all kinds of consequences to this Bill because it was not introduced in a thoughtful, careful manner but to fill a government communications grid: “We have strikes; we want to show that we are doing something for the public; we will bring this in.” The health service element creates more questions than answers. I appreciate that the Labour Front Bench has tabled amendments that would remove that.

Amendment 4, which lists the different professions that might be expected to be included, is also interesting. The noble Baroness, Lady Chakrabarti, mentioned earlier that we need foreseeability. The fact that there is no foreseeability in a phrase such “health services” makes it hard for any of us, and certainly for those professions, to understand whether they are in or out. I suspect that the Government will say that where the Opposition would exclude a list of professions, they would include it. Even that would be better than what we have today. If they do intend to include physiotherapists, pharmacists and other workers in the legislation, they should list them in the Bill.

It is not acceptable to use a phrase such as “health services”, which does not inform those hard-working professionals. There is not one profession on that list that does not have a staff shortage right now. We have this list of professionals, but we do not even have the decency to say to them in the legislation, “By the way, at some point you may be subject to minimum service levels being imposed and work notices being sent to you as an individual professional in that job.” We leave it open. We leave it for them to guess.

Both amendments make sense, in that they test the Government’s rationale for including health services and they have thought through the implications for health services in the longer term and try to get more predictability and certainty. If a particular group of professionals are to be included, let us see them in the Bill rather than just saying, “Well, ambulance workers, yes, they’re clear; but for the rest, maybe, maybe not.” That is not good enough when we are talking about people’s essential rights and things which may affect them personally, as they will be press-ganged into coming to work against their wishes at some unknown future date.

[Baroness Noakes (Con)]

My Lords, the noble Lord, Lord Allan, says “Who asks for this Bill?” He then tries to portray that as a binary thing—either workers and unions, or employers, claiming that neither of those groups wants it. However, he and others who oppose this Bill are missing out on a crucial third group: the users of services. This is the Government acting on behalf of the users of services generally. By taking the power to create minimum service levels, they are giving themselves the power to act for the users of services if the need ever arises. Broad terms are used to allow the detailed minimum service levels to be devised within that. Obviously, when regulations are produced they must be very precise, because they will affect whether individual workers will have to comply with work notices.

I should also say that no employer is ever forced under this legislation to issue a work notice; it remains entirely voluntary. Noble Lords should start to see the Bill in a much broader sense, rather than that of trying to create yet more disharmony between employers and their workers.

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[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

I thank the noble Lord, Lord Collins, and the noble Baroness, Lady O’Grady, for their amendments. I also thank the noble Baroness, Lady Chakrabarti, for her kind words.

Amendments 3 and 4 seek to remove the health sector and health services from being within scope of having minimum service levels implemented. As my noble friend Lord Callanan said earlier, the key sectors outlined in the Bill broadly stem from the 1992 Act, as amended by the Trade Union Act 2016, as they have long been recognised as important for society to function effectively. Strike action in some areas of health services can put lives at risk or cause serious harm to patients. As my noble friend Lady Noakes rightly pointed out, it is about protecting the patients; that is why we have brought this provision. It has the potential for far-reaching consequences for members of the public who are not involved in the dispute. That is why we are looking to include the health services within the legislation.

I will try to answer some of the specific questions from the noble Baroness, Lady O’Grady, the noble Lord, Lord Allan, and others on why we are including health in the minimum service levels. We need to point only to recent experience in the ambulance negotiations, where there were concerns that many trusts were not sure, right up until the night before, whether derogations would be approved. The thinking behind the need for consultation was that we can have that certainty.

At the same time, the nurses’ and the doctors’ unions said, in their recent strikes, that they would not cover A&E. In those circumstances, noble Lords must accept that there was a real possibility of not being able to provide A&E services, which would obviously threaten the lives of patients. That is why we feel the need to put those protections in the minimum service levels. However, the most important thing in all this is that the Bill is just enabling legislation; our sincere hope is that it is never needed.

[Lord Allan of Hallam (LD)]

On the recent actions, the Minister talked about how often discussions went to the wire and agreements were reached the night before. Are there any instances he would share with the Committee in which the cover of the voluntary arrangements actually failed, as opposed to going to the wire but getting there in the end?

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[Lord Markham (Con)]

I thank the noble Lord. I believe that there will be a group of amendments specifically on transport later on. That will be the opportunity to answer those questions. I have been drafted in—dare I say it—at the last moment, because it is a very important issue and I wanted personally to talk about the health aspects, which I am attempting to do, so please forgive me if I try not to stray into other areas. There will be the opportunity to discuss transport later on.

The noble Lord, Lord Allan, asked who wants this. It is a backstop power. Trusts will never need to use it if they do not want to. I believe that most trusts, and I hope all, have excellent relations and are able to make sure that these provisions are never used or needed.

[Lord Allan of Hallam (LD)]

It is helpful having the Minister here—we appreciate it—because he will be responsible for those health trusts. I am cautious about the notion that it is a backstop power. It is something that the Minister repeats often, but is he concerned that there will be pressure either for the legal reasons that the noble Baroness, Lady Chakrabarti, and I have outlined—that there will be judicial processes that force trusts to think that they have to impose a minimum service level whether or not they want to—or just political pressure? The Government have brought this legislation in. If trusts say, “Look, we don’t want to impose this, because we think it is bad for our area”, are Ministers really going to sit back and say, “Fine, we’re not going to bother”?

[Lord Markham (Con)]

As I answered earlier on the devolved Governments, by definition, we accept that different trusts have the ability to work out what is best for their own area. Clearly, devolved Governments will each have their own opinion on how they want to act. The same principle exists in each place. We are not saying to each trust, “Thou shalt enact it in this way”; we are just giving those backstop powers. The most important thing here, which I think we all agree on, is for there to be the ability in all circumstances to protect life and limb. If doctors, nurses and ambulance crews all go on strike at the same time and say as part of that that they do not want to provide A&E cover, that is a circumstance where we are not able to provide those minimum services. I think that most fair-minded people would conclude that there is a risk to life and limb in that case.

The points made about civil claims—I know that they are very much the concern of the noble Lords, Lord Kakkar and Lord Patel—will be addressed in considering later amendments.

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[Lord Markham (Con)]

Again, I believe that it is trying to work off the 1992 definitions and work. The beauty of these debates, as I have come to appreciate about the House of Lords and the job that it does, even in the short time that I have been involved, is that they make sure, through this good critical challenge, that we can ensure that the legislation is doing exactly what we want it to do. We need to make sure that we get those definitions correct and, clearly, the beauty of where we are at this stage is that we have that ability. I thank noble Lords for that, and I hope that they can see by my responses that this is something that I want to make sure we get right.

I am glancing through the remaining questions—but I hope that I have answered the substance of the questions.

[Lord Allan of Hallam (LD)]

I appreciate the Minister taking so many interventions. On the question of whether the Government have done any modelling, when they did their analysis of the legislation, was any modelling done to try to understand the potential impact on legal liability, civil claims and claims against the NHS for compensation? It would be helpful for us to have that information, because it will be a material factor as to whether a trust, as the Bill says “may” issue work orders; it says “may” rather than “shall”. Whether the trust feels that it can exercise that discretion will depend very much on whether it is incurring additional legal risk. If there is material on that, it would be helpful for us to have it as we go through the scrutiny process.

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[Baroness Blower (Lab)]

My Lords, it is a pleasure to follow the noble Lord, Lord Mann, in many respects. I began teaching in 1973 and I can count on the fingers of both hands—probably not even using them all—the number of times that I have been on strike. One of the reasons why I was not on strike in the early phases of my career was because we had sectoral collective bargaining: we could make an impact on what was happening with our pay and conditions. I very much regret the loss of collective bargaining in education because it has had a material impact on the way in which teachers are able to pursue issues with their own pay and conditions.

However, let us move on to what the Bill would do. The noble Lords, Lord Mann and Lord Fox, are of course right: there is a very serious situation with regard to recruitment and retention of teachers. That is one of the reasons why there is such a high rate of parental and carers’ support for the action that teachers are taking. To take just one example, one in eight maths lessons in schools in England is taught by someone who has no qualification in mathematics. What chance do we have of providing coherent maths teaching to the age of 18 or 19, as the Prime Minister would like, if we cannot provide it for all the children who have it at the moment?

I cannot tell you how many emails, messages and phone calls I had after people read the WhatsApp messages. The notion that a Secretary of State would say that all teachers were work-shy and did not like or want to go to work beggars belief, to be honest. For anyone who has never been a teacher, I can tell you that teaching is not for everybody, and there are people who voluntarily leave teaching because going into a classroom every day and not being successful is devastating. That is why lots of people leave the profession—because they cannot manage the stress of not just the teaching but all the accountability measures. We really need to hang on to the teachers we have, who are still going to school every day and, for the most part, enjoying their jobs, notwithstanding the terrible levels of pressure that they face. We really need to make sure that we have a proper retention system.

It seems to me that threatening those teachers with the possibility that they will be sacked if they have legitimately voted for and taken industrial action, very much as a last resort—as I am sure everybody in this Chamber knows and as has been said by Kevin Courtney and Mary Bousted, the joint general secretaries of the NEU—will not only risk the possibility of more people leaving teaching, but I cannot imagine that anyone is going to want to come into teaching when there are so many difficulties and challenges that we have at the moment.

On the other issue about cogs and wheels, I am not in favour of the fragmentation that we have seen in our education service, but fragmentation we have. The idea that we can have a minimum service level across 26,000 or 28,000 schools, not accounting for alternative provision and so on, simply is not workable. Much more importantly for me, it is not desirable. It conveys exactly the wrong impression to teachers, and we need to be talking up teaching—I am very prepared to do it—because even on a slightly bad day it is a wonderful job when you are actually in there with the children. It is not so great when you are dealing with Ofsted, and when you look at your pay at the end of the month, but it is fantastic when you are actually dealing with children and young people.

This is absolutely the wrong place to be going. I oppose this Bill in its totality, but I certainly oppose what is being said about education in this.

[Lord Allan of Hallam (LD)]

My Lords, I just wanted to rise briefly to follow up on a couple of points we made in the previous group that I think are applicable here. In some ways, we are dealing with apples and pears; the Health Minister talked about the legislation as being essential because of life and death situations, and I do not think that any of us, however much we value education, would argue that we are in the same game here. But on another level it is apples and apples, because the problem with both the framings in the Bill is that they just say “health services” or “education services” in this incredibly vague way. I think that some of the same criticisms about foreseeability and predictability apply here, as they did with the previous group.

Specifically in the context of education, I am keen to hear from the Education Minister a similar assurance to that we were given by the Health Minister that these are permissive powers: that affected entities may give work orders, but that they will never be forced by the Government to do so. Even if a minimum service level is established in education, I hope we are going to hear that no school, college or university would be made to give work orders; they are simply empowered to do so. I hope that will be the Government’s position; that would be consistent with the previous group. Even if they agree that this is the case, I still have concerns about the effect in practice, as I did with the previous group.

I have children who are, at the moment, in a school affected by strikes. The school is managing incredibly well; it is keeping the children in exam years in school and finding ways to safeguard the others. The principal writes to us and explains why he supports his striking staff and why they deserve a better deal. That principal is never going to implement these work orders if the Government put them in place, except in two circumstances. I think we need to explore that in the context of all the powers in this Bill.

The first circumstance is that the Government in some way try to make the principal give work orders that he does not want to give to his staff. They can do that through funding mechanisms—“You don’t have to give the work orders but, if you don’t, we’ll kick your windows in”. That is not really a free choice, yet we have to worry that this is the intention of the Government. Certainly if this Government stay in power, that is the way they would handle future disputes: “Now we’ve done the minimum service levels, there is no excuse for any school not to implement it and issue work orders, whether they like it or not”.

The second mechanism was again raised on the health trust situation, and I think it is also relevant here. It is that an educational institution feels legally vulnerable if it does not implement the minimum service levels. It could be the case for schools, but it is particularly a concern for universities. We already see universities being sued by students for alleged failures to deliver the service that they signed up for. I will not go into the rights and wrongs of those cases, but again you can imagine a situation in which a university says, “Our industrial relations are good. Yes, there is a strike. Yes, we can manage it. Yes, there is a government regulation that talks about minimum service levels, but we don’t want to give work orders to our staff because we think that will worsen the situation, not improve it”, and then find itself subject to legal action. With that threat hanging over them, the leadership of our education institutions ends up doing things it does not want to do and has not chosen to do.

The word “may” sits in the Bill and is at the heart of everything. I think this Minister will say, as the previous Minister said, “This is all optional—a backstop power—and we are not going to force anyone”. That only works if the Government can give us assurances that they are not going to run a protection racket—“Issue the work orders or we kick the window in”, name and shame, or whatever mechanism they want to use—and that they have taken the advice that says that even if they have implemented the regulations, our institutions are not required to implement them and cannot be sued through civil claims simply for failing to implement a minimum service level in a regulation under this legislation.

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[Lord Allan of Hallam (LD)]

My Lords, when this subject first came up in the Bill—the idea of talking about minimum service levels around services for 365 days a year—I initially thought that there was a cheeky and a serious aspect to it. The cheeky aspect is that it is an opportunity to make a political response to the Government’s political legislation, and to talk about service levels all year round and the failings we have seen since this party has been in power as our public services have worsened.

The serious aspect, which in a sense is more interesting and which has come out in the debate today, is around the definition of “minimum”. The noble Baroness, Lady Noakes, keeps reminding us to think about what the public see and perceive. There are two quite different ways in which to interpret “minimum”. One version is “comfortable”, when services are at a reasonable and sustainable level and are effective. In the context of healthcare, that would mean that I can see a GP when I need to, or get hold of an NHS dentist. If I am a woman who needs hormone replacement therapy, or if I have a child who needs antibiotics, I can get the drugs. When I call an ambulance, one comes in a reasonable period of time—and when I go to A&E, I can get through it and into a bed. When I need to be discharged, there is a care home for me to go to. Of all those things, I think most members of the public would say that that is a minimum. It is not the gold-standard service—it is the baseline that they expect.