HC Deb 28 October 1949 vol 468 cc1662-8

11.7 a.m.

Mr. Linstead (Putney)

I beg to move, in page 2, line 7, after "Committee" to insert: (which shall hereinafter be referred to as the Enrolled Nurses Committee). This Amendment is the first of a number dealing with the same general question: namely, whether it is possible to give an assistant nurse the statutory title of "enrolled nurse," instead of, as at present, giving her the statutory title of "assistant nurse" while at the same time giving her the legal right to call herself a nurse. At the moment there is an anomaly, because although these nurses are on a roll called the "Roll of Assistant Nurses" they have the right to call themselves nurses without the word "assistant" in front of it. This Amendment is designed to cure that anomaly.

One recognises that this at once raises the question of what to call a State registered nurse, who is of course a registered nurse as distinct from an enrolled assistant nurse. Nevertheless, it seems to me that it would be better to have the anomaly that in an Act of Parliament, and nowhere else, the enrolled assistant nurse was called an enrolled nurse and the State registered nurse was called a registered nurse than to have the present anomaly of somebody being given a statutory title and yet being entitled to be called by something quite distinct from that title.

I am sure that if this change is made it will enhance the standing of the assistant nurse; and it will attract girls to take up nursing who otherwise would not do so because they would not be prepared for the long period of training for an examination in order to become State registered. We must remember that, whether we like it or not, many of our hospitals, particularly the hospitals for the chronic sick, will be staffed by these assistant nurses. Anything which can be done to encourage girls to become assistant nurses and to give them the status which will bring them under the control of the General Nursing Council either as assistant or enrolled nurses, should be done. It will in particular help in staffing the hospitals for the chronic sick.

I hope that the Parliamentary Secretary will not turn down this Amendment out of hand. I believe that it is worth further consideration. If he is able to accept it, and to persuade the State registered nurses to accept it, I seriously suggest that it will help to solve the difficult question of recruiting.

Mrs. Leah Manning (Epping)

I have a very great deal of sympathy with the object of the Amendment, but I would like to hear from the Parliamentary Secretary before I decide how to vote, particularly whether there are objections from the nurses or from the General Nursing Council. We ought to do something to help women who want to be assistant nurses because they do not feel that they can stand the strain of the whole course. There are large numbers of women who are already assistant nurses and who, because of the anomalous position which they occupy in the hospitals, will not go fully into the nursing service. Much could be done to help these women, who are in many cases experienced and sympathetic. I had a letter from one girl this morning who says that in her hospital she is not allowed to wear a cap and is not allowed to give an aperient. I doubt whether the conditions in many of these cases would be changed if we changed their name.

I hope, as a result of many things which will now happen in regard to examinations and training, that we shall remove some of the difficulties which confront girls who have not a very high academic ability but who have a real desire to nurse. The answer lies in shorter training and an easy examination at the end of it after, say, two years, and then to add to it all the other qualifications which one hopes that a fully-trained and qualified nurse would get. I hope we shall all feel that something has to be done about this question of the assistant nurse.

Mr. Diamond (Manchester, Blackley)

I, too, have every sympathy with what was said by the hon. Member for Putney (Mr. Linstead), but I do not think that the Amendment will achieve what is in the hearts of many of us. We desire every possible encouragement to be given to the nursing profession, but I do not think that the proposed alteration of title, which will be laid down from above as it were without anything like adequate consultation with members of the nursing profession, will do anything other than create harm. It is admitted that the title "assistant nurse" has defects. The hon. Gentleman says, "That is anomalous. Let us have a rather different and less anomalous anomaly."

I do not think that we would be doing our best service by removing one anomaly and putting in another one, especially when it does not achieve what I regard as the three essential things. It does not rest on the desire of the whole nursing profession, for the simple reason that they have not had a chance of considering it. It does not make a very clear distinction in the lay mind between the two categories of nurse. Thirdly—and I hope that I am not being in any way disrespectful—it is of no relevance in defining the quality of the nurses. It merely defines whether the nurse goes on a register or on a roll.

The real point is to have some definition of the type and quality of the nurse, whether she is a fully qualified nurse or—and then one is stuck for a title. One must say "assistant nurse." Having regard to those points I hope that the Parliamentary Secretary will not at this stage give his support to the Amendment. If this matter were allowed to be discussed generally in the course of the next three to five years, perhaps the problem would solve itself.

Mr. Sorensen (Leyton, West)

I am sure that we all sympathise with the intention of the mover of the Amendment. I am sure also that many excellent nurses feel humiliated by being restricted in the work that they can do in their nursing functions, and by having to accept a title which seems to them to be unnecessarily a sign of inferiority. I hope that some attempt will be made to discover a more suitable title than "assistant nurse." She is a nurse, and not merely an assistant. Just as "a rose by any other name would smell as sweet," so the term suggested in the Amendment would cause the same trouble as the existing term. Therefore, the proposal is unattractive.

One part of the intention of the mover is to secure a larger number of those who would perform this function, heretofore known as that of assistant nurse. By calling these nurses "enrolled nurses" we shall not get any more of them. The problem is much deeper than that. We can put aside any assumption that by altering the name we shall get more recruits. That leaves us with the difficulty whether we can find some term which is less mildly offensive than "assistant nurse." As yet, the Minister has not discovered one and the hon. Member for Putney (Mr. Linstead) has not discovered one either. For those reasons I cannot support the Amendment.

11.15 a.m.

The Parliamentary Secretary to the Ministry of Health (Mr. Blenkinsop)

I must add my word of sympathy with the object of the Amendment to those that have been expressed on this side of the Committee. We do not regard the term "assistant nurse" as being a final choice of especial value. I must agree with my hon. Friends who have spoken and who have suggested that we have not yet been able to find any suitable alternative. My hon. Friend the Member for Epping (Mrs. Manning) suggested that we wanted, as indeed we do, to recruit more nurses, both assistant and fully qualified. She suggested that we must look to simplification of training for certain categories of nurses. We have recently shortened the period of training for assistant nurses, and for that very reason this is perhaps rather a bad moment to choose for suggesting a new name, which would, in the mind of the ordinary general public, cause rather more confusion.

It would be difficult for the average person to differentiate between enrolled nurses and registered nurses. For that reason, among others, we would, not be able to accept the Amendment and the consequential Amendments that are on the Order Paper. At the same time, I would emphasise that we are very willing indeed to have general discussions and that, if at any future time we can find a name which will be more suitable and that will express the different job that has to be done and the different training that has been carried through without in any way reducing the status of the registered nurse—who has gone through a very long and arduous period of training—we shall be only too glad. I am afraid that the Amendment does not help us in that matter.

Mr. Linstead

Perhaps I may be allowed to make one or two comments on the sympathetic and helpful speeches to which the Committee have listened. I recognise that what I have done today is to begin an involved process, and although I would not take the period of time which the hon. Gentleman has suggested before it comes to fruition, I appreciate that the time is not ripe today.

I would like to comment briefly on the three objections which the hon. Member for Blackley (Mr. Diamond) raised. He said first that, so far as can be ascertained at very short notice, the proposed change was not the desire of the profession. The first point I want to emphasise is that it is an error to suggest that the profession of nursing is composed only of State registered nurses. If we were to take a vote of the profession as represented by all those men and women who are engaged in nursing the sick, I am more than doubtful whether we should not find that there were more in favour of this proposal than against it.

Mr. Sorensen

Would not the hon. Gentleman agree that the State registered nurse should form, so to speak, the criterion of all kinds of nursing?

Mr. Linstead

One might say the "aristocracy," but I would not necessarily say the "criterion."

The second point raised by the hon. Member for Blackley was that by changing the name we should be doing away with the distinction which at present exists. It is relevant to read from Section 6 of the Nurses Act, 1943, the following words, which have a bearing on that question: …. any person who, not being a duly registered nurse under the principal Act or a duly enrolled assistant nurse, takes or uses the name or title of nurse … shall be liable … In other words, that Section does away with any distinction except a distinction of laymen for the purposes of the Statute. I am advocating that what is declared in that Section shall in due course be made still clearer by the actual title which is bestowed upon those concerned.

The hon. Member said, finally, that the Amendment would have no relevance in defining the quality of the nurses. It has, at least, this considerable relevance. The people of whom we are speaking are nurses, actually engaged in nursing, and I think that that statement was a mistake. We are not defining the quality of the nurse by calling her an assistant nurse, because in a very large number of hospitals she is, in fact, the nurse. She may be acting as an assistant to a sister, for instance; not as an assistant nurse, but as a nurse.

As we gradually begin to examine this problem and bring it forward into the light of day, there is more to be said for the point of view I have put forward. In view, however, of the expressions of opinion which we have heard, I will not pursue the matter further now, but I hope that there will be other opportunities when the same point can be discussed, particularly among the profession itself. In the circumstances, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Clause ordered to stand part of the Bill.