HC Deb 04 November 1949 vol 469 cc768-76

  1. (1) The Council shall appoint a training committee consisting of members of the Council.
  2. (2) The number of members of the training committee and their term of office shall be such as may be prescribed by rules made by the Council under subsection (1) of section three of the Act of 1919.
  3. (3) Any matter relating to the training of nurses (other than a matter referred to the finance committee under section eight or to the Mental Nurses Committee under section nine of this Act) shall stand referred to the training committee and any other matter may be referred by the Council to that committee; and the committee shall consider the matter and report upon it to the Council, and the Council, before taking any action on the matter, shall, unless in the opinion of the Council the matter is urgent, receive and consider the report of the committee.
    4. 769
  4. (4) The power of the Council under paragraph (f) of subsection (1) of section three of the Act of 1919 to make rules for authorising the delegation to committees of the powers of the Council and for regulating the proceedings (including quorum) of committees shall be exercisable in relation to the training committee.—[Mr. Howard.]

Brought up, and read the First time.

Mr. Howard (Westminster, St. George's)

I beg to move, "That the Clause be read a Second time.

The purpose of this new Clause is to restore a balance in the Bill which I think has got slightly unbalanced in the course of its passage through another place and through the various stages in this House. Perhaps I should make an apology to the Parliamentary Secretary and the Department for the late date at which this Clause appeared on the Order Paper, but the purpose of it was raised in the Second Reading Debate, and the Department are well aware of its object. Also, because the Minister's own Amendments appeared on the Order Paper only the day before yesterday, I was still hoping that a similar Clause would be down in his name, and I deferred putting down this one for that reason.

In any form of social service there is bound to be a pull in different directions. Those engaged in the service always want to do more and those responsible for finding the money always wonder where it is possible to find it. This is especially true in any circumstance where vitality is dependent on constant experiment and research. My purpose is to make it perfectly clear that when it is a question of what is professionally desirable for the training of nurses, there should be a recognised independent professional body which will declare its views. Then there will be set up under this Bill another statutory committee which will deal with the financial affairs, and, finally, the power of the Minister remains unimpaired.

I regret that the General Nursing Council have taken unto themselves financial powers of a character which are more apparent than real, because it may adversely affect the discharge of their professional duties. It is true that this is a machinery Bill but as a result we have been rather inclined to discuss the detailed parts of the machine and possibly to lose sight of the main purpose of this Bill, which is: … to reconstitute the General Nursing Council … and to make further provision with respect to the training of nurses … We are setting up within the General Nursing Council a statutory committee to deal with finance and a statutory committee to deal with mental nursing, but there is no statutory committee to deal with the most important function of all, which is the general supervision and improvement of the training of nurses over the whole field.

I have made this point on previous occasions and I do not wish to labour it, but I hope that even now the Ministry will see the advantages which would accrue from accepting this Clause. Whether this Bill works or not will depend upon whether the reconstituted General Nursing Council can get the full support and confidence of the profession. My fear is that they will find themselves placed in a position where it will be thought that something which is desirable for nurses has been turned down on financial grounds. If those responsible for the institution where nurse-training is carried out once get the idea that when they go to discuss a professional matter with the General Nursing Council they are not discussing it with a professional body but with a body which is merely an agent of the Treasury, their prestige will be lowered and their power for doing the thing which this Bill is intended to do will be minimised to that extent.

I am sorry if I feel so strongly on this point that my arguments may have been a little ragged. I hope that the Minister will see his way to accept this Clause, because I am convinced that it is desirable to achieve the purposes of this Bill in regard to which all sides of the House were in unanimous agreement.

11.15 a.m.

Mr. Linstead (Putney)

I beg to second the Motion.

My hon. Friend has moved this Motion With obvious feeling, which I (share. This Bill has much in it that is excellent, and yet on this side of the House we are gravely concerned about the essential change it is making in the character of the General Nursing Council. That Council is now ceasing to be an independent professional body and, as regards 50 per cent. of its activities, is becoming a paying agent of the Treasury. Once it becomes a function of Government administration, once it finds itself partially integrated into the Government machine, it is in danger of losing a great deal of the authority and independence which is absolutely essential for the maintenance of the standards of a great profession.

We seem to have been unable to move the Parliamentary Secretary or the right hon. Gentleman to recognise that fundamental change which is being made, a change which will weaken the status of the General Nursing Council in the eyes of the public and in the eyes of the profession.

Mr. Blenkinsop

indicated dissent.

Mr. Linstead

I know that we differ. In this proposed new Clause my hon. Friend is seeking to do the next best thing. He is saying, in effect, that if we cannot keep the paying agency outside the functions of the Council, we should at least separate, within the ambit of the Council, the agency functions of the Government from the educational functions proper to a professional body, and that we should do so by the outward and visible sign of creating a finance committee to act as paymaster for the Treasury—which is what is comes to—and an education committee to act as the body prescribing the professional standards.

In that way we should do something, although we do not think enough, to redress the balance and cure the fundamental mistake which is being made of handing part of the Minister's functions directly over to a professional body and destroying its balance. I hope that the Parliamentary Secretary and possibly the hon. Member for Blackley (Mr. Diamond) who, in a sense, speaks here for the General Nursing Council, if they are not able to accept this proposed Clause, will at least tell us that the spirit behind it is appreciated within the General Nursing Council, and that they will do their utmost to make certain that the two functions are kept separate so that one does not get confused with the other to the detriment of the main purpose for which the Council was created.

Mr. Blenkinsop

I certainly appreciate the way in which the hon. Members opposite have raised this matter and I do not complain about the lateness of the appearance of the Clause on the Order Paper. On the other hand, I do not share the anxiety of hon. Members on this point because the reconstituted General Nursing Council will be a much stronger and more authoritative body than perhaps the General Nursing Council of the past has been to meet the new responsibilities which it has to face.

My anxiety is to avoid in this Measure such provisions as will unduly restrict and hamper the work of that newly-constituted body. It is a had principle in general to fetter unduly this type of public body in the way in which it is to work, because in whatever way we may set down machinery—and it is set down in some detail in the new Clause—situations are bound to arise which call for a variation. What is more, under the present rules of the Council provision is made for an education and examination committee, for example, and the rules constituting it must be approved by my right hon. Friend and laid before Parliament. At the same time, its constitution and procedure can be altered at any time by an amendment of the rules as circumstances may require.

Mr. Howard

The hon. Gentleman has used the word "fetter." Would he elaborate on that and explain, in view of what he has said, how the new Clause could possibly fetter the discretion of the General Nursing Council?

Mr. Blenkinsop

It seems to me that this is the main function of the General Nursing Council and it is quite clear that they will set up a committee, as they have done in the past, to look after this feature of their work; but it must always be regarded as the main work of the Council. We have already gone as far as we ought to go in sub-dividing statutorily the General Nursing Council.

We have tried to meet the point which hon. Members opposite have raised by giving power to my right hon. Friend to make appointments to the Finance Committee. If we go beyond that, we are endangering the liberty of the Council. I should be very sorry if we were statutorily to divide up the General Nursing Council into these hard-and-fast statutory committees throughout the whole of their work, which would not be to the benefit of their operation.

I appreciate the point which the hon. Member for St. George's, Westminster (Mr. Howard) has raised and the desirability of doing what we can to separate the two issues, but when we try to particularise we strike, as we found in another place, other difficulties which override the particular issue which the hon. Member is raising. I hope, therefore, that hon. Members opposite will not press the Clause, but will accept my assurance that this is a matter that we will certainly examine carefully when the rules are being made; and in a friendly way, in discussion with the General Nursing Council, I am sure we can satisfy the main object of hon. Members opposite.

Mr. Diamond

I should like to welcome the sympathetic and considerate thought which has been given by the hon. Members for St. George's, Westminster (Mr. Howard), and Putney (Mr. Linstead), who put down the new Clause, to the welfare of the Council and to seeing that the Council shall function as everybody intends it to function. I do not share the fear of the hon. Member for Putney about the effect of the Bill on the status or ability of the Council to perform a very useful function. As to this particular point, I can tell the hon. Member that the Council as at present constituted—no one can speak of the future Council—certainly recognises this to be its main function.

As far as the committees are concerned—I have a list of them before me—the hon. Members will be interested to know that, with the exception of the education and examination committee, which of course carries out the function which hon. Gentlemen opposite would now define in this way, the membership of the committees is limited to eight or less; but that the education and examination committee has a membership of 12, half as many again as any other committee, including the finance committee. It is clear, therefore, that the Council, not only those members on it at present but those who may be on the reconstituted Council in the future, recognise that this work is the main function of the Council.

Hon. Members opposite have therefore done a valuable service in giving an opportunity for these facts to be made clear and to be stated with such authority as one can in these circumstances pro- duce. I feel, however, with my hon. Friend the Parliamentary Secretary that one does not necessarily add a great deal to the usefulness of a committee by placing it in a statute and therefore making it a statutory committee. As long as one realises what the function of the committee is, it would on the whole be a pity to place in the statute words which make it in any way difficult, in any administrative sense, to appoint to the committee, to define its function or membership, and in particular to alter that definition from time to time as the work of the committee becomes greater, less or more varied. To the extent that it would make it more difficult for the work of the committee to be carried out effectively, it would be on the whole a pity that the Council should be, even to that small extent, limited in carrying out its work as it sees best.

Sir Hugh Lucas-Tooth (Hendon, South)

It will be clear to the House that we on this side have a good many apprehensions about the result of passing finance and training through the General Nursing Council, but that is now agreed and no question of that arises on the new Clause. The issue is, therefore, how we are to make that arrangement work for the best. The result of the arrangement is that the General Nursing Council will have two functions, which have been very fully described by my hon. Friends: the functions of training and of finance.

The Parliamentary Secretary said that as the function of training was the principal function—I think that was what he said—that was a matter for the Council as a whole and that it would be wrong to lay down any method by which they should do it, and that as finance was a relatively subsidiary matter it would be dealt with by a statutory committee. That was not a very realistic view. It seems to me inevitable that the Council must, both in training and in finance, operate through committees, and the fact that finance is to be dealt with through a statutory committee is bound to attract more emphasis to that function than to training. It is obviously a late hour of the day to consider our proposal, and it is too late to ask the Government to look at the matter again, because there will be no further opportunity on the consideration of the Bill.

The Parliamentary Secretary has said that there will be discussions between him and the General Nursing Council before the scheme begins to operate, and he has indicated that he will make certain that the views and fears expressed in the House this morning are taken into consideration when the new set-up is being prepared. We shall have to be satisfied with that assurance, although with a good deal of apprehension; and we hope very much that the Government will be sure to see that everything is done to avoid the kind of risks which have been expressed by my hon. Friends. It may, of course, be possible for these factors, if need be, to be taken into account if and when the introduction of amending legislation should be necessary.

11.30 a.m.

Mr. Somerville Hastings (Barking)

All hon. Members will fully appreciate the high objects and the high ideals of hon. Members opposite who have brought forward the Clause, but I believe that on the whole the Clause would be undesirable. The object of the Bill is to separate nurse-training from the administration of the hospitals. We admit that that will not be possible at first, but we all hope that by gradual stages it will be achieved. If that is to be achieved, a great deal of fluidity in connection with the work of both the General Nursing Council and the standing nurse-training committees is essential. That is recognised by Clause 3, which gives the right of experiment in connection with nurse-training. Anything which will in any way bind the General Nursing Council or the standing nurse-training committees may make it more difficult for that gradual transition to take place. Although I appreciate the high ideals which have prompted the Clause, I believe that the Bill will be freer and more fluid without it.

Lieut.-Colonel Elliot

As always, the Parliamentary Secretary has been most friendly and understanding on this matter. I am sure that he realises our uneasiness, just as the hon. Member for Barking (Mr. Hastings) would realise the apprehension in our profession if the General Medical Council were given the administration of the university grants scheme, which would seem to be an unusual duality of purpose. Of course, this is an experimental body which will have to work its own way and find its own solution. There is nothing derogatory about the idea of a statutory committee, because we enjoy statutory committees in connection with important local government bodies, such as education committees.

I can see the point of the argument adduced by the hon. Member for Blackley (Mr. Diamond) that fluidity ought to be preserved in the early stages and that prescribing numbers, and so on, in a statute sometimes produces a fettering effect when these things have to be altered. The Parliamentary Secretary has said that this will be very carefully examined when the rules are made, and for the moment we must be satisfied with that.

We do not intend to divide the House on this Clause. It is a matter not for division but for argument. The final responsibility must lie with the Minister. We merely trust that our fears will prove to be unfounded. We ask the Minister to take carefully into consideration the arguments that have been adduced with so much sincerity and to draw the rules when they are made to the attention of my hon. Friends, because, owing to the flood of paper which pours over us from time to time, the rules may easily escape their attention. I am sure that the Minister will be anxious to have the skilled criticism which my hon. Friends can afford when the rules are made. I take it that my hon. Friend will ask the leave of the House to withdraw the Clause.

Mr. Howard

I bow to the inevitable, Mr. Speaker, and beg to ask leave to withdraw the Motion.

Motion and Clause, by leave, withdrawn.