POLITICS
If the bedpans go unemptied, it will be the nurses who forfeit sympathy
BORIS JOHNSON
It was with predictable terror that the Tory backbenches witnessed events in Har- rogate. In that delightful Yorkshire town the supposedly moderate Royal College of Nursing voted to scrap its no-strike clause, and an amply proportioned nurse called Diana Mark-Maran summed up the mood by shrilling: 'We can bring the system down. We can bring the Government down.' Oh dear, oh dear, said an MP with an interest in health. Surely we have failed to listen again. Something has gone terribly wrong.
To the average Tory MP, the nurses are ministering angels with watches on their starched bosoms, to be handled like a cup of warm gelignite: the nurses, that is. The MPs believe the public is historically sus- ceptible to those who plump pillows and perform enemas for as little as £7,325 per year. 'As Rab Butler said, they won't wear it in Steeple Bumpstead,' said our Tory backbencher. He continued, perhaps show- ing his vintage, 'As Harold Macmillan said, you shouldn't take on the miners or the brigade of guards, or the nurses.' And you can guess from the very timorousness of the response from Sir Bufton Tufton that the Government is doing pretty much the right thing in attempting to impose local pay and conditions.
It used to be said that the NHS was the largest single employer in Europe after the Red Army. Well, now that Mr Gorbachev and the Conventional Forces in Europe Treaty have done their worst to the Red Army, it would not be surprising to discov- er that the 473,000 British nurses are the largest bloc of employees with uniform pay and conditions this side of the Urals. On both counts, pay and terms, the system is farcically inflexible.
You will recall how back in January Sis- ter Valerie Tomlinson faced uproar and disciplinary action after she whipped out someone's appendix at Treliske hospital, Truro. She was under the supervision of one Dr Bhatti, a registrar trained in Karachi. He told her, 'In my country peo- ple of your experience perform operations of this type.' As it was, one of Sister Tom- linson's colleagues sneaked to the authori- ties. Never mind that Sister Tomlinson had spent 17 years watching appendectomies (and probably performing them), or even that the Royal College of Nursing itself is in favour of nurses taking on some of the functions of surgeons. She had breached the National Association of Theatre Nurses guidelines, and she faced suspension. What we had in that case was recognisably an old-fashioned demarcation dispute.
Nurse Tomlinson can presumably hold up the large intestine for the surgeon to inspect. She can point to the little remnant of mankind's ruminant past. But she cannot lop it off; or at least, not until the Govern- ment has been successful in introducing a new species of nurse-practitioner. There is the same 1970s feel in the dispute over pay.
Christine Hancock of the RCN (who is probably perfectly charming, though I don't think I'd want to see her bearing down on my bed with a brimming syringe) would like to maintain the centrally organised stratifi- cation of hundreds of thousands of people into wage spines and bands. This is partly because, Scargill-like, she wants to keep her power to negotiate for all, and partly because she is engaged in a turf war over membership with the more overtly left- wing public sector union, Unison. However, her legions also desire the rather generous 3 per cent pay rise offered by many of the trusts.
The strength of the Government's posi- tion is that the nurses will not receive that rise unless Hancock and co. are prepared to relax the national conditions for wage settlements. The view of Mr Gerry Malone, Health Minister, is that all will accordingly be well. He calculates that the nurses will recognise that the only way they will be able to bring the Government down will be by a strike which by definition upsets the patients; and that if bedpans go unemptied, it will be the nurses, not the Government who forfeit sympathy.
In the next weeks and months, therefore, when almost all the 480 trusts will offer 3 per cent, Mr Malone believes Christine Hancock will tell her people that they can `six of them aren't privatised utility executives.' negotiate locally. The RCN will claim the triumph of having secured 3 per cent in almost every case. But the nurses will have sold the pass. In future years, so says Mr Malone, local pay and conditions will be the norm.
Well, let us hope he is right, and that Diana Mark-Maran is wrong. Assuming he does pull it off, though, Mr Malone and the Government should go further. One of the reasons why the nurses were so mutinous at Harrogate is that last year Mr Malone funked a decision to force doctors, also, to accept local pay and conditions. They should be so forced. The economic argu- ments are unassailable: that you thereby enable regions with labour shortages to attract workers with higher wages, while in regions with no labour shortage and a lower cost of living, public bodies may offer the lower wages that reflect the market. The principle should help in the battle against inflation, and it should save money.
The Labour Party, which is wedded to the centralised Hancock system, can pro- pose nothing of the kind. And the Govern- ment should expand the system of local pay to other big bands of public sector employ- ees, beginning with the teachers; and it should also relate pay to performance, a system which already operates in journal- ism (the less you write the more you earn).
There is no reason why MPs, for instance, should not have performance- related pay of some kind. Clearly this could not be settled by the whips, since that would merely encourage more unreflecting toeing of the party line. But without inflat- ing the salaries of all nurses, and without reducing the salaries of all MPs, there must be some way of ending the anomaly where- by the best nurse in the country still earns about £10,000 less per year than the worst MP. Individual contracts hold the answer. If MPs are really worried about public sen- timent towards the angels, they should reflect on that.
To start the ball rolling, my nomination for this month's least deserving MP is the Conservative member for Falmouth, Mr Sebastion Coe. In betraying Sir Jerry Wig- gin's harmless legislative legerdemain he has revealed that, though he may have been a great athlete, he is not a good sport.
Boris Johnson is associate editor of the Daily Telegraph.
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