HC Deb 18 November 1919 vol 121 cc864-80

Order for Second Reading read.

The MINISTER of HEALTH (Dr. Addison)

I beg to move. "That the Bill be now read a second time."

This Bill deals with a subject which has been before the House for very many years in a sporadic way, and has often been the subject of private Members' Bills, which have shared the usual vicissitudes of those measures, and. unfortunately, at different times its course has been a good deal interrupted, and sometimes, perhaps, made difficult, by various controversies which have arisen around this subject amongst different persons interested in it. It is one of our purposes to improve the condition of the nursing services through our the country, and there are few matters more important to the well-being and the health of sick people and the nurture and care of young children than an additional and better provision of well-qualified nurses. It is essential, as a first step to placing these services upon a proper basis, that we should know who those nurses are. Therefore, the provision of a register, properly drawn up, of those who are entitled to be registered is the first condition to an extensive improvement in the nursing services. Also, I hope it will indirectly do a great deal to improve the nurse's salary, because, I am sorry to say, that the payments which have boon made to nurses have often been of a very discreditable kind—much loss than the wages of an ordinary cook or kitchenmaid—and it is thoroughly discreditable that it should be so. At the same time, their training is exceedingly arduous, their hours are very long, and, I believe, arising out of this—although the Bill does not deal with their conditions of employment—we shall take the first essential step to put this great and important profession upon a proper basis.

This Bill is limited to the compilation of a register and to the setting up of the necessary authority to compile the register, and to prescribe the conditions necessary for admission to it. I think we should not have arrived at this stage—at any rate at this juncture—had it not been for the services which have been rendered to this cause by the Bill introduced earlier in the Session by the hon. and gallant Gentleman (Major Barnett), who brought the matter to a head. In the course of the discussions on his Bill and on another conflicting Bill which was introduced into the House of Lords it was quite, obvious that a number of controversies of a subordinate character needed to be settled outside before there was real hope of getting a measure through this House. We are not competent to settle here controversies as to the representation of this or that body. They are certainly not appropriate topics for discussion here or in the Committee Room upstairs. It therefore was agreed that if, after discussion with the different parties interested in this, and with all the responsible bodies, a common measure of agreement could be arrived at, I would undertake to introduce a measure to set up a register. After several meetings, which have been held in the most friendly spirit, a common measure of agreement has been arrived at, and is embodied in this Bill.

In the first place, it sets up a Council whose business it is to form a register, and it is provided that there shall be various parts of the register—a general section, a register of male nurses, children's nurses, mental nurses, and it may be others—and this Council is authorised to draw up rules relating to various subjects, which are subject to the approval of the Minister of Health. When they are made, they will be laid before Parliament, as prescribed by Sub-section (4) of Clause 3. The House will have cognisance of them before they become effective. One of the chief reasons for this provision is contained in paragraph (c). Sub-section (2) of Clause 3. The House has always taken the view, and, I am sure, rightly, that when a new register is set up we must safeguard the interests of persons who are in bonâ-fide practice in the profession, so as to secure that they have a proper chance of being registered upon that register, notwithstanding that they may not have complied with all the conditions of training that may hereafter be prescribed. That has been the case in all instances. It is provided that within a period of two years after the date on which the rules are made, any person may be admitted to the register on producing evidence that they are of good character, of prescribed age, and for at least three years before the 1st day of November, l919, were;bonâ-fide engaged in practice as nurses in attendance upon the sick. That means that a large body of women throughout the country who have been nursing faithfully for many years, but who may not have undergone all the highly-specialised training which may be thought desirable, or may be provided for hereafter, will be fully entitled to be entered upon the register. That, is a very important safeguard. The Council is given the necessary power to appoint officers and so forth.

There is no Financial Resolution required for this Bill. It is provided that all nurses should pay a fee of one guinea, and there is to be a fee of 2s. 6d. required annually for keeping the register alive. One of the chief difficulties of this kind of thing is that people move about or die or enter some other profession, and so the register ceases to be a live register. It is very necessary that some steps of a reasonable kind should be taken to keep it as nearly accurate as may be. It may happen, though I do not think the necessity will a-rise, that the income of the Council derived from this source will be insufficient to meet its expenses. I do not think that is likely to arise, but, by agreement with the Treasury, I am authorised to say that if and when any appreciable deficit should occur which could nut reasonably have been avoided, and could not be met by other expedients, such as drawing upon accumulated funds or a temporary advance from the Civil Contingencies Fund, the Treasury would be prepared to give favourable consideration to any proposal by me to ask Parliament to Vote a special Grant in aid of such deficiency. It is provided that in the event of any register being set up in Scotland or in any other part of the United Kingdom, the persons thereon entered shall be entitled to be entered on the English and Welsh register. It is also provided that persons who meet the necessary requirements as to training in any part of the British Dominions shall be entitled to be entered upon the register. There are various provisions safeguarding removals from the register, and giving an appeal to the High Court in regard to any alleged unfair removals, and giving an appeal to the Minister of Health in regard to the refusal of the Council to approve any institution for training for the purposes of the rules provided under the Act.

The main difficulties which arose last year are dealt with in the schedule. The schedule deals with the constitution of the Council. It is very desirable that the Council should contain a considerable element of nurses actually engaged in the practice of nursing. It is provided that the first council shall consist of twenty-five persons. We have included in this the decision which was arrived at in the discussion in. Committee last summer, and it is provided that sixteen persons who are or have at some time been nurses actually engaged in rendering services in connection with the nursing of the sick shall be appointed by the Minister of Health, who is to consult the two main bodies which have been interested in this question, also the nursing body which at the present time has a Royal Charter, and such other bodies as it may be found desirable to consult. The House will remember that the rock upon which the other Bills split was the dispute which arose on the point as to how the Council was to be set up. It is to be set up in the manner here proposed in the schedule after consultation, in order to get the register into being. It is then prescribed that after the termination of the office of the first council—and it shall not hold office for longer than three years—the sixteen persons mentioned shall be elected by the nurses on the register, and they, together with nine persons appointed by the Privy Council, the Board of Education and the Minister of Health, will form a permanent Council in the manner prescribed in the Bill. In this way we have got over the difficult points of the controversy. I am sure that the more this Bill is examined the more the House will agree that it is the only way to deal effectively and fairly with the points that have hitherto been in dispute. It is essential as a first step to get the nursing profession on to a better and more national basis, and I cordially recommond this Bill to the House for a Second Reading.


I have the honour to represent in Parliament the great majority of nurses in Manchester, and in that capacity I should like to welcome this Bill. I congratulate the right hon. Gentleman on his wisdom in recognising the necessity for the State registration of nurses, and also on his judgment in being able to reconcile so many warring elements among the nursing profession. The great merit of this reform is that it is a social reform which comes from inside the body affected and not from outside. The real framers of this measure are not the State or the State officials, but the pioneers in this cause among the nurses themselves. It is well to recognise that a debt of gratitude is due to those who have been pioneers of this movement for many years, and to recognise the very fruitful and brilliant propaganda by which the College of Nursing have brought this scheme within the range of practical politics within the last few years. While recognising the point of what the right hon. Gentleman said, that nurses who may not have had special training, but who are engaged in practice at the present time, should have the right to be placed upon the register, I hope that in the rules that are made enabling such persons to get on the register, care will be taken that they have had some experience and some considerable practice, arid that it will not be an illusory test, because if this register is to be a real register of nurses it must be a register on which it is an honour to have your name inscribed. If it is going to be an honour we do not want the standard which is adopted to be an illusory test, but we want a real test of merit and experience.

I should like to congratulate the right hon. Gentleman in making the point in Clause 3 with regard to the uniform and badge to be worn by nurses who are on the register. I take it that that means that the nurses on the register will have the exclusive right to wear one certain type of uniform and badge. That is an element which must meet with success. It is a guarantee on the one side to the public that the nurses have had real training and real experience if they wear that uniform and that badge. To the profession itself it must be of very great value, because the possession of the uniform and the badge gives to those who wear them that sense of professional solidarity and that pride in the art which they practise, which he at the root of all corporate efficiency. There is one limitation in the Bill which I hope the right hon. Gentleman will see fit in time to do away with. That is, that as now drafted, the powers of the council are strictly limited, and its functions are more or less to prescribe rules of admission to the register and rules for striking names off the register. As the right hon. Gentleman said, there is nothing in the Bill which, in terms, gives the Council any jurisdiction over what are the dominating questions in the life of nurses—questions of pay and questions of hours. It would be a very great pity if this scheme, which is a great scheme of reform, is unaccompanied by any Clause which gives the Council potential jurisdiction over conditions of employment. There is no person in the world of less bargaining capacity than the nurse, and it has been an unhappy tendency in past times to exploit her economic weakness and inexperience. I hope that before this Bill passes into law it will not only fulfils the one useful purpose which it now fulfils, namely, of recognising the place which this profession occupies in the life of the country, but that it will do something more than that, that it will in the ordinary daily practice of the nurses' work be something in the nature of a great charter, which will guard them against the two great evils which overshadow the careers of so many women in this country, and particularly women in the nursing profession: first, the evil of overwork, and, secondly, the evil of underpayment.


As the promoter of the Nurses Registration (No. 1) Bill, I wish to say a few words in support of the Second Reading of this measure. I congratulate the right hon. Gentleman on the promptitude with which he has kept his pledge to introduce a Government measure. I was a little sceptical when the pledge was given whether it would be fulfilled so soon. It was only given last July, and to-day we have this Bill brought forward; a great measure which will put the principle of the State registration of nurses on the Statute Book, As the sponsor of the No. 1 Bill I cannot say that this Bill is in every respect an improvement on my own proposals. I very much regret its limitation to England. When a measure, introduced by a private Member, which had got as far as the Report stage, provided a single register for the whole of the United Kingdom, one might have hoped that a Government measure would do the same, but I can imagine that what was possible for a private Member's Bill was not so easy for a Government Bill, in view of the fact that a Ministry of Health has been set up for Scotland and something tantamount is contemplated for Ireland. I hope and believe that, if this measure finds its way to the Statute Book, in the course of a few months we shall have a Scottish Registration Bill and an Irish Registration Bill as well.

My right hon. Friend referred to the rock on which the discussions on my Bill were wrecked—the question of the initial Nursing Council. As the right hon. Gentleman has pointed out, the difficulty is to choose the nurses who are to sit on the Council, because ex hypothesi we have no register, and cannot have an election by the nurses of those who are to represent them. My Bill endeavoured to solve that by giving rights of appointment to many societies and individuals. Here I can congratulate my right hon. Friend on having cut down the Council to reasonable dimensions. I think that twenty-five members is quite enough for such a body, but in attempting to create a Council by nomination from various nurses' societies we found we were continually increasing the number of the Council. We had gone up to forty-three, and I am not sure that we should not have gone up to forty-five. The difficulty was to get the respective societies to agree as to their respective rights of nomination to the Council. With the greatest courage my right hon. Friend has cut the Gordian knot. He has decided to nominate the nurses to the initial Council himself. I do not know which to admire more, the courage of my right hon. Friend or the skill with which he addressed himself to this problem. It is a courageous act, for my right hon. Friend will have to select the ladies to sit on this Council. No doubt he will do it very well, because he will do it in consultation with the societies, and any society that thinks itself entitled to be consulted has only got to say so. My hon. and gallant Friend opposite spoke of this measure having become a matter of practical politics owing to the exertions of a certain body to which he referred. I do not wish to introduce into this discussion any element of dissension, but the Central Committee for the State Registration of Nurses have been advocating State registration for over thirty years, in season and out of season, and it is a triumph for their principles, on which they are to be congratulated, to have the Minister of Health introducing the measure which is brought before us this afternoon. Nothing will please me better than to have this Bill with or without Amendment—I do not think it requires Amendment—passed into law.


As one who opposed the former Bill in the interest of the great majority of nurses, both in Committee upstairs and on the Report stage downstairs, I desire on my own behalf and also on behalf of the College of Nurses to give this Bill a very warm welcome. It is most satisfactory to find that the Minister of Health has been able in so short a time to fulfil the pledge which he gave, and which we nil expected him to fulfil, though we did not expect him to fulfil it in so short a time, and ROW that they have introduced it I hope that the Government will push forward this Bill with the least possible delay and give the nurses the thing which they have so long desired. But I desire to make perfectly clear that on the question of State registration we who opposed the former Bill have always taken up precisely the same attitude which we take up this evening. We also were always in favour of State registration of nurses. Certain statements have been made to the contrary; they are entirely unfounded. When the former Bill was introduced I said that we accepted the principle of State registration and everything depended on how the reasonable objections of a great number, I think I might almost say the majority, of nurses were met as to what support we could give to the precise Bill that was introduced. Everybody knows the result. I do not wish to travel over that ground to-night or to introduce any discordant element, but we found it impossible to support the Bill because we felt that we had a duty to the great body of nurses and that they were not getting fair play. But now we have another Bill and I think the Minister of Health has been exceedingly clever, because he bus been able to introduce a Bill which is acceptable to both sides. That is no mean achievement. He has seen representatives of both sides and ho has been able to produce what I think will prove to be a non-controversial measure. He has excised the breaking spot of the last Bill, which was the constitution of the Council, and has taken the selection of the provisional Council on his oven shoulders. Of course he is a very bold man to do that, but I do not think that any other course would have met the case, and I have not the least doubt that the decisions he will make will be received and abided by loyally by the great majority of nurses. I hope that the House will accept the Bill and that the Government will put it through without delay, and that those splended women will secure what they have long been asking for, namely, official recognition of their glorious profession.


I hope this Bill will become an Act as rapidly as possible. I have gone through it carefully, and see very little room for disagreement or amendment. In thinking as we all must do seriously over the past and present position of the nurses of Great Britain, it is impossible for anyone to estimate the loss to the nation owing to the absence of a status for one of the most valuable services or professions of which this country can boast. I feel that it is so interwoven with the Ministry of Health that it will become a very effective piece of machinery in the general health and development of the nation, and that it will give a status to the profession, and though there is an absence of any powers to the Council to deal with the question of professional fees, yet the mere fact of obtaining a status will lead the profession to become recognised as worthy of a greater financial return than that which it, unfortunately, gets at the present moment. One great good which I think will be brought about by this Bill is that it will attract to the profession many who at the moment hesitate, because they know of the small fees payable and of the weak bargaining powers that have been referred to, and of the shortness of the number in the profession to cope with the enormous amount of necessary work which its members are called upon to perform.

Having established a status for this profession, you will attract to it many young women who will devote all their future to it knowing that they have something to look forward to, and that they will be recognised. The very machinery itself that if, set up will give them that bargaining power that will enable them to secure much better remuneration than they obtain at the moment. I welcome this Bill also because it will help to remedy the lack of professional attendance on mentally deficient persons, the absence of professional nurses with due knowledge of the care of the health of children, the absence of a sufficient number of fully qualified maternity nurses. All these matters will under the Bill be kept in touch with the Ministry of Health, and we shall soon find a general improvement in the health of the people and the condition of the profession that will make us and the country thank the right hon. Gentleman for introducing a Bill, simple yet understandable in its language, flee from all those unnecessary phrases that too often find their way into Acts of Parliament, and in itself a great encouragement to this very important section of health administration. I was particularly pleased with the remarks of the right hon. Gentleman as to his provision to assure to the general nursing profession a Council which will be largely nominated by him, but shall not be representative of any particular class or organisation, but that the general body of working nurses shall have full and adequate representation. I do not think there is anyone qualified to assist the Minister of Health in establishing the permanent machinery better than would be found among working nurses, who come more in contact with everyday difficulties. I hope there will be no more Amendments to the Bill than are absolutely necessary. The people of the country and the nursing profession are asking that this great measure should become an Act of Parliament at the earliest date.


Most of the criticisms I have to make are really Committee points, and can be dealt with in Committee. I join with others in congratulating the Minister of Health on the introduction of this Bill and on escaping some difficulties by handing over to this primary Council the task of drawing up regulations. I think we should have an opportunity somehow or other of discussing the regulations for registration after they have been drawn up by this Council. I am very disappointed that this Bill is limited to England. I think that a great pity. It has probably arisen from the idea that there is a Health Board in the other two countries. This, however, is not a case of locality at all. We want to get a register of all the nurses in the United Kingdom; we do not want a Scottish, an Irish, and an English register. A further point is that you are having three examinations. You may have different standards. It is the evil of the medical profession. There are ever so many bodies, twenty, or thirty or more, granting degrees, each of which qualifies to register, and these degrees are by no means equal. Nurses should have exactly the same training and the same entrance examination in the whole Kingdom. I wish some method could be found by which this end could he attained.


As a medical man I would like to say how heartily I approve of this Bill. I have read it very carefully and I think it meets all the requirements of the profession. I agree with the remark that it is unfortunate it is not extended to the whole United Kingdom. I congratulate the Minister of Health on the strong position he has taken up in regard to the Council. The last Bill was lost through the unfortunate diversity of interests. This Bill requires very few Amendments, and I hope we shall not lose it over any small item.

Captain ELLIOT

I see the Secretary for Scotland is here. I understand that one of the chief criticisms against this Bill is that it does not apply to Scotland. I hope he will be able to assure us that a Scottish Bill is in a forward state of preparation, because we are keenly anxious for State registration of nurses in Scotland. With such an assurance there is no reason why Scottish Members should not give this Bill their blessing.


On behalf of the members on the Labour Benches I give a welcome to the Bill. I wish that wages and hours of employment and pensions had been taken into account in dealing with this matter. Nursing is a noble profession; but one of the most overworked. I know something of it. I know of the great sacrifices that many of these noble women have made for the children of the workers. Even lives have been given up for the sake of the children, and many nurses have been affected in after life by having contracted infectious diseases from their patients.


Perhaps I may intervene for a moment to answer the query put to me. I need hardly assure the House that we recognise fully in Scotland the importance of this subject. A Hill on lines similar to this is in an active state of preparation; it is already drafted, and I hope it will be possible to bring it before the House without any avoidable delay. With that assurance, I trust my Scottish colleagues will have no hesitation whatever in supporting the Minister of Health in this Bill.

7.0 P. M.

Captain BOWYER

I want to couple with my congratulations to the right hon. Gentleman a request on behalf of the resident nurses who tend the poor in outlying country districts. The Cottage Benefit Nursing Association is, I believe, the only association which supplies these resident nurses, except in a certain number of maternity cases, and these nurses, in addition to the nursing they undertake, do with great loyalty the housework of the houses in which they are nursing, more especially if the woman of the house happens to be the patient. At the present moment under the organisation of this association they are given one year's training on enlistment, in the association's home at Edmonton, and are then sent to the branches on a three years' engagement. The training, as prescribed in this Bill, would be, I gather, for three years, and the point I want to raise is that for the purpose of this class of nurse the training cannot be, and ought not to be, for more than one year, for if the minimum of three years is insisted upon it will surely mean the trebling of subscriptions, many of which are paid by the inhabitants of cottages, although the lists may include subscriptions from wealthy people. Moreover, if a nurse is trained for three years, I fear that she would, perhaps, feel herself a little above going into a cottage and doing the housework, and, of course, in the scattered country districts it is absolutely imperative, if the woman in the cottage is the patient, that someone who is nursing her should be prepared to do the housework. This class of nurse at the moment is self-supporting. The voluntary contributions range from 3s. a year upwards. I am not asking the right hon. Gentleman for any representation on the Council, but I do seriously suggest that we might have, a fourth supplementary part added to the register so that separate rules could be made for this class of nurse. I am aware that I may seem to be pleading for a lower minimum standard of training, but the Bill, I submit, considers the status of nurses in this respect perhaps to the disadvantage of the patient. If the right hon. Gentleman says to me, "Why not leave them out of the Bill altogether?" then I reply, "If only fully-trained hospital nurses are to be registered, then no harm will be done to our nurses, but, as the Bill is drafted, other special classes without full training, such as children's nurses and mental nurses, are to be admitted on to a supplementary register, and the cottage nurses, who are doing equally useful work, will feel slighted if they are not given equal recognition." The result will be that you will get no more cottage nurses, or, at any rate, that there will be a deficiency. I would like to ask from what other source the right hon. Gentleman proposes to supply resident nurses for the poor in the outlying country districts?

Lieut.-Colonel RAW

I should like in one single word heartily to support this Bill so ably introduced by my right hon. Friend.


The right hon. Gentleman is to be heartily congratulated on the introduction of this Bill, but in my opinion, it does not take a sufficiently comprehensive and complete view of the situation as a whole. One of the very first duties of the Ministry of Health should be to arrange completely and fully the forces that it is going to utilise in its fight against ill-health and disease in this country. The Ministry of Health should bring itself into direct relationship with all groups of workers in that field—nurses, chemists, dentists, and doctors. Those four separate, distinct bodies ought in some form or other to be under some kind of benignant control exercised by the Ministry of Health. The Ministry of Health is recognised as having a position under this Bill, but it does not go far enough. The Ministry ought itself to be the registering body. The Ministry of Health has just taken over the duties of the Registrar-General, and I fail to see that there is anything more mysterious or difficult in registering a nurse, properly and truly qualified, by that branch of the Ministry than in registering a birth, death or marriage. I venture to suggest that is a function which is particularly cognate to a Ministry of Health. A special branch of the Registrar-General's Department would obviate the necessity for this roundabout establishment of a council, which will involve considerable expense of the costliness of the General Medical Council is any evidence of the cost of such bodies, I am perfectly sure that there is not a nurse in the Kingdom who would not be equally content to be registered within, the Ministry of Health as to be registered by a separate council which is only indirectly in relation with the Ministry.

There is one other point that I would like to put, and that is the care which we must exercise in the constitution of a body which is going to have more or less judicial power. Section 3 really gives this new Council judicial power, and I want to draw the attention of the House very seriously to the manner in which this extension of judicial power operates in the case of the General Medical Council. This Bill is drafted more or less on the Medical Act of 1858. It follows that precedent more closely than the Midwives Act, which erected a somewhat similar body. Those who follow the proceedings of the General Medical Council know—it is one of the saddest and most unseemly spectacles known to the whole judicial procedure of this country—that a man who has been convicted of an offence, of whatsoever nature, has to undergo what is practically a second trial at great cost, at much pain, and with undue publicity before this body, and to be defended by counsel in order to save his livelihood, and the whole sordid details are exposed once again in order that this body shall decide whether the man has been guilty of the infamous conduct alleged against him. There are three simple words in the Medical Act of 1858, "after due inquiry," upon which has been erected this extraordinary semi-judicial body. Due inquiry in 1858 has become this most terrible and costly procedure. It certainly gives the accused person an opportunity of defending himself, but I suggest that that defence could be given without all this undue publicity and harrowing circumstance. I do hope that we shall have nothing of the kind in connection with this Nursing Council. The procedure which is now adopted is contrary to all the principles of the British Constitution, and it is practically the absolute negation of the judicial principle that a man shall never be tried a second time for the same offence. We have advanced our social arrangements very much since 1858, and I certainly hope that nothing in this Act or in any rule or regulation will reproduce the spectacle which we witness in connection with the British Medical Council. There is a relationship established between this Nursing Council and the Ministry of Health, but there are three other bodies which ought to be brought into relationship, the General Medical Council, the Dental Council, and, above all, the Chemists. The State now is a contracting party with a large body of the chemists in the country, and they must bring the whole of these great forces which are essential to the well being and health of the people into some direct and controlling relationship, a relationship which in course of time shall become benignant, and which shall give the doctor, the nurse, the dentist, and the chemist a sense of sureness and which shall also be a deterrent to the person who is disposed to do wrong. If the present loose relationship is to go on and the Ministry of Health is to be a recreation of the National Health Insurance Commissioners and of the Local Government Board, if there is not going to be a wide view of what is before the Ministry, and if there is not going to be a linking up of its forces, then the Ministry will be a failure. That is the point that I wish to make: The necessity of establishing a direct relationship with the vital agencies which are now at the command of the Ministry of Health. This Bill foreshadows nothing of that kind. It leaves the Ministry of Health a select Department and makes it an appeal body against the doings of this Council. This Council is going to define everything with regard to the education, the standard of training, the method by which persons are going to be put on to the register, and the still more important matter as to how persons are to be removed from the register. Take, for instance, the question of a, judicial appeal. Cannot the Ministry of Health deal with the question whether a poor erring creature is to be taken off the register? There is the precedent of the National Health Insurance Act. There is power under that Act lo appoint a certain appellate body, and it would be perfectly simple, instead of referring these questions to a Council composed of comers and goers, to refer them to a judicial body of the right hon. Gentleman's own nomination within the four walls of the Ministry. This Bill has many good features, and I commend it heartily, but I do think that along these lines it might be very properly and wisely modified not only to the benefit of the Ministry but also of the nursing body and everybody working for the general well-being of the country.


While I congratulate the right hon. Gentleman upon bringing in this Bill, and especially for steering clear of the rocks that wrecked the other Bill, I must say that I am bitterly disappointed, he spoke of England, of Scotland, and of the Colonies, but the name of Ireland has never been mentioned by any of the speakers who have preceded me. I wish to get an assurance from the right hon. Gentleman that a similar measure will be brought in for Ireland. He cannot surely expect that we shall loyally hasten this Bill through the House if Ireland is entirely ignored.


I do not quite understand, when the House is obviously going to rise at an early hour, why every Member who has risen to speak on this Bill should have thought it necessary to state that he. would not exceed two or three minutes in his remarks. As a matter of fact, I am only going to speak for two minutes, because I only wish to deal with one point. I was greatly impressed by what the hon. Member (Sir W. Cheyne) said in regard to the desirability of having a uniform system of qualification and one form of entry to the nursing profession. This is one of those quite exceptional cases in which uniform legislation for England and Scotland is very desirable. We have not heard from the Minister of Health or the Secretary for Scotland any reason why this Bill cannot be made applicable to the three countries, or, at any rate, to England and Scotland. I think the House ought to have some explanation on that point before they are asked to accept a limitation of the Bill to England alone. The inconvenience of three registers is so obvious and so great that I cannot imagine anyone ignoring it or wishing to encourage it unless there is some overmastering reason for doing so. We would not contemplate having a separate system for the medical profession in England and in Scotland and in Ireland, and why should we have a different rule in regard to nursing?


I am very sorry if I omitted to mention Ireland, but I thought I had done so. While I am not in a position to give a formal assurance, I know that the Irish Office has the in alter under consideration, and I think there is reason to expect that there will be a similar proposal in the case of Ireland. I would point out that when the Ministry of Health Act was introduced it was, in consequence of the teachings of which my hon. Friend (Sir H. Cowan) is an able and consistent exponent, split into different parts, including one for Scotland.


That was a board, not a Ministry.


It was a separate Department. It is very desirable to consider the Scottish point of view as there are some differences which require careful consideration, and the Secretary for Scotland is looking into the matter. I think with the arrangements we have made for interchange of registers and no doubt there may be set up a common register, we have really met the point. I have gone into the matter with great care, and I think, on the whole, the way proposed is the simplest.


When will the Scottish Bill be introduced?


By leave of the House, may I say I cannot specify the date when the Bill will he introduced, but it will be introduced without any avoidable delay.

Question put, and agreed to.

Bill accordingly read a second time, and committed to a Standing Committee.