CLAUSE 2—(Rules.) (Hansard, 22 June 1943)

§ Mr. Storey (Sunderland)
I beg to move, in page 2, line 38, to leave out Sub-section (3).
Apart from the fact that I believe the retention of this Sub-section would cause the Secretary of State to fail in his intention to protect Scotland from what he called the sub-standard nurses—for if, as I understand is the intention, there is to be complete reciprocity between England and Scotland, there is the possibility that English assistant nurses who start training five years after the Bill has become an Act will still be able to go to Scotland and work there—my main reason for moving the Amendment is that I feel that it would be a mistake to stop the training 1087 of assistant nurses in five years' time. With all respect to the Alness Committee, the Debate on the English Bill showed, I think, that there is work that assistant nurses can do, and that our health services and hospital services need them. That need with the development which we expect in our National Health and hospital services is not likely to be less in five years' time.
My chief objection is that I think the inclusion of the Sub-section would close a valuable recruiting source for candidates for the State Register. The County of Essex has proved that it is possible to take women who are not fitted at the time for training for the State Register and, by a proper system of education and training, not only to fit them to be assistant nurses but to fit a fair proportion of them to be able to take the full training for the State Register. It would be a mistake to close this source of recruiting to a profession which needs many recruits. I hope that the Secretary of State will agree to accept the Amendment and will concentrate on seeing that there is a proper system of training and education which will enable many assistant nurses to go on and accept the full training for the State Register.

§ Mr. Linstead (Putney)
I support what has just been said. There seems to have been a difference of opinion between two committees which were set up to consider the position of nurses in Scotland, as to the number of assistant nurses available in that country. The Black Committee, which preceded the Alness Committee, found that there was a substantial number of assistant nurses in Scotland. After allowing for the State registered and the student nurses, the Black figures indicated that some 2,500 assistant nurses existed in Scotland at that time. The Alness Committee were able to find only 250. As a further check upon the numbers, there are the figures which were found when the Civil Nursing Reserve was set up in Scotland. There were then something like 2,500 assistant nurses. It appears from this that the Black figure was right and the Alness figure an under-estimate.
If that is true, we are likely to find that, although there are no more entrants, after five years there will still be a demand for assistant nurses and that the demand will be filled either by immigration from England or by the appointment of women by 1088 hospitals without their being enrolled or registered, simply because they are needed. For this reason it seems desirable that the door should be kept open after the five years' period. I hope that the Secretary of State will find it possible to give further thought to the actual wording of the Sub-section. I have not found in any other Act of Parliament the phrase: unless Parliament shall hereafter otherwise determine. That suggests that the rest of the Bill is not capable of amendment by this House and that this is the only Clause which Parliament may amend.
I would also draw attention to the fact that the Sub-section refers to training of persons for admission to be enrolled. In fact, training is not sufficient for that purpose. Training and examination are needed, as is clear from the subsequent Amendment which my hon. Friend has upon the Paper. It seems that the wording should be looked at again. I hope that the Secretary of State will find it possible to omit the period of five years and to take power himself to close the door if he finds it necessary. We should not close the door five years before we know whether it will be necessary to do so, and I hope that some alteration may be made in this Clause at the Report stage.

§ Mrs. Hardie (Glasgow, Springburn)
This is the one Clause which has made the Bill acceptable to the nursing profession in Scotland. It can be reconsidered at the end of five years. In view of the fact that the Committee in Scotland was against the introduction of assistant nurses, this is a departure from the findings of that Committee. It was wise of the Secretary of State to put it into the Clause, and I think it should be left in.

§ The Secretary of State for Scotland (Mr. T. Johnston)
The Mover and Seconder of the Amendment referred to the Report of the Alness Committee. There were two committees, the Athlone Committee, of which Lord Athlone was chairman and which inquired into the position in England, and the Alness Committee, of which the chairman was Lord Alness, late Secretary of State for Scotland and Lord Justice-Clerk. Those two committees reported in absolutely contrary directions on this matter. The Alness Committee was very representative and 1089 was unanimous in reporting that there should be no assistant-nurses grade set up in Scotland. They repeatedly said that they thought it would be a retrograde step to do so. On page 16 they said: We feel that the adoption of the suggestion to recognise assistant nurses might even, if an attempt was made to draw a distinction between them and the nurses on the existing part of the General Nursing Council Register, nullify many of the advantages of the benefits under the Act of 1919, tend to lower the status of the profession and would not be in the public interest. They wound up by saying: After careful consideration of all the circumstances we do not recommend the setting up of a grade of assistant nurses. In that they may have been right or wrong, but I can assure my hon. Friends that they had a variety of evidence tendered to them. There is no subject in the nursing profession over which there is, I believe, greater disputation than over this.
The Athlone Committee, on the other hand, upon the evidence before them, were unanimous in saying that they would set up for England and Wales a separate assistant-nurses roll. This was the difficulty with which the Government were faced; what were we to do about it? The Minister of Health properly produced a Bill in which he endorsed the conclusions of the Athlone Committee, I was then faced with the problem of doing something about the position. I asked the Alness Committee to come and meet me to see whether they still adhered to their opinions in the awkward situation. They most emphatically said that they did. I can assure the mover of the Amendment that 1 did not stop there. I saw the representatives of the General Nursing Council for Scotland and of the Royal College of Nursing, and I was at no end of pains to try to resolve the deep-seated difference of opinion. After long and anxious negotiations I induced Lord Alness and his Committee and the other bodies who were equally opposed to the English Clause, to agree to the setting-up of this additional supplementary register, as I call it, but over a period of five years only. If at the end of five years the necessity for it continues to be justified, it is an easy matter in the light of the later experience to get the Clause continued by a short supplementary Bill. But in the present stage of opinion, with the vital, almost irreconcilable, differences on this 1090 matter, I submit that there is nothing else that we could do than get through the Bill on the terms in which it is drafted.
May I assure my hon. Friends who moved and seconded this Amendment that unless we can put in this limit of five years we shall never get the assent of the local authorities, who are opposed to this grade of assistant nurses? At least, so far as they are vocal, local authority associations were opposed to it, and really it is impossible to get a move on in the provision of more nurses in Scotland, and get harmony in the nursing profession, unless some such Clause as we have drafted in this Bill is agreed to by Parliament. I think I am right in saying, though I speak here with diffidence, that even the Royal College of Nursing now, although they dislike this Clause, are agreed to accept it as the lesser of two evils, and as most steps in life are a choice between two evils, I commend it to the Committee.