HC Deb 28 October 1949 vol 468 cc1687-95
Sir H. Lucas-Tooth

I beg to move, in page 5, line 3, after the first "of," to insert: not less than seven nor more than eleven. This Amendment has been put down in order to obtain from the Government some indication of what their intentions are regarding the numbers on the proposed finance committees. We have left a fairly wide margin, and we have kept the numbers fairly low. On this side of the Committee we feel that a finance com- mittee should not be a very large and unwieldly body, though, of course, it must be large enough to include those who will be required to deal with the extremely complex functions which have to be performed by the committee because of their duties under this Clause. I think it is unnecessary to detain the Committee by enlarging on the subject, but if we could get some indication from the Government of what they intend in this connection it will be of value to those of us who are interested in the matter.

12.30 p.m.

Mr. Blenkinsop

It is our general feeling that we do not want in any way to limit or unduly restrict the powers of the General Nursing Council in setting up this committee. I think it is commonly agreed that no one wishes to do that. We would all agree that it would be normally desirable that a finance committee should not be a large body, but I think we would be putting ourselves in some difficulty and taking a responsibility which we would rather leave to the General Nursing Council if we were to specify, even within the limits suggested in this Amendment, any kind of precise numbers for the finance committee. I believe the general view of the Committee is that it is normally desirable for the finance committee to be a reasonably small body, but I am sure that this is a matter which we ought to leave to the General Nursing Council itself to decide.

Perhaps I might refer to some of the other general points that are raised by other Amendments on the Order Paper which are obviously connected with this one. It is again our feeling that although we have sympathy with the object of some of the proposals in these Amendments. and although we are most anxious that the finance committee should be a committee of real standing, at the same time we want to make sure that the final responsibility is in the hands of the General Nursing Council and that the finance committee should not in any way be regarded as a body wholly independent of the General Nursing Council. It is, therefore, very important that while we consider what we can do to ensure that the finance committee is a responsible body fully able to deal with the important matters which will be referred to it, at the same time we must still realise that it is a committee of the General Nursing Council and that the final responsibility must be in the hands of the General Nursing Council itself.

Therefore, I do not want to do anything that would detract from the responsibility of the main body, while appreciating to the full the point made by hon. Members opposite who wish to ensure that the finance committee will itself be a body of real standing. I do not feel that we can accept this Amendment, but on the general point that has been raised I am willing to have a further look at the wording to see whether we can reconcile the two points of view—whether we can maintain the final authority of the General Nursing Council and at the same time ensure that the finance committee will be a body of real standing and importance.

Mr. Skinnard

rose—

Sir H. Lucas-Tooth

On a point of Order, Mr. Bowles. The discussion has gone rather wider than the scope of the Amendment which I moved. My hon. Friend the Member for Putney (Mr. Linstead) has an Amendment on the Order Paper which he is anxious to move, and the same point can adequately be raised on that Amendment. In view of what the Parliamentary Secretary has said, it might be convenient if I withdrew this Amendment so that my hon. Friend should move his Amendment, the terms of which are a good deal wider, and the discussion might take place more appropriately on that Amendment. I therefore beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Mr. Linstead

I beg to move, in page 5, line 3, at the end, to insert: which shall include the three members appointed by the Minister as appearing to him to have had experience of the control and management of hospitals. The point of this Amendment is, as has been said, wider than that which we have just been discussing. I gather than while the Parliamentary Secretary has not finally closed the door, the view he takes at present is that the Bill should stand more or less as it has come to us from another place in respect of this Clause. I am sorry that he should have come to that conclusion. I am not speaking entirely on a theoretical basis; I have had many years' experience of the relationship between a body prescribing standards and the training institutions in which those standards have to be reached.

I am certain that it is bad administration to bring into the hands of the same body the prescribing of standards and the prescribing of the ways and means by which those standards are achieved, because I am sure they are essentially two different functions. The body prescribing the standards ought to be engaged in a tug-of-war with the body providing the finance. I am certain that there is all the difference in the world between a General Nursing Council whose primary duty is to say what standards shall be laid down in the interests of the profession and the public, and a General Nursing Council which meets to decide how they shall distribute the money which is at their disposal. There are two different mental approaches to the problem according to which of those two functions one performs.

It was with pleasure that a few minutes ago I heard the Minister say that all the way through this service we have never had a need to separate the academic side of professional work from the provision of what he called the physical apparatus. That is the principle which I want to establish—that the body which provides the standards shall not provide the apparatus for carrying them out. I am surprised to find that we still have in the Bill, and apparently acceptable to the Ministry, provisions which seem to conflict with what the Minister, I thought quite properly, said to us just now.

I ask the Committee to look at the prescribed functions of the General Nursing Council in the 1919 Act. Among other functions that Council has the duty of making rules regulating the conditions of admission to the register; for regulating the conduct of any examinations … and any matters ancillary to or connected with any such examinations. I suppose that includes courses of training. Then disciplinary rules can be made prescribing the conditions under which nurses may be removed from the register. The General Nursing Council is constituted with not merely one eye on those functions but with both eyes on them. It was for that purpose that the constitution of the General Nursing Council was determined as it is.

By the accident of Parliamentary machinery a new function has been put upon the General Nursing Council by the decision taken in another place, and that is the function of distributing grants. That not only conflicts, for the reason which I have stated, with the duty of prescribing standards, but it also brings into question the suitability of the General Nursing Council, as constituted for its first purpose, to carry out adequately its second purpose. It is for that reason that I put down the Amendment, which was not called, in page 5, line 2, to leave out "consisting of members of the Council," and to insert which shall include, in addition to members of the Council, persons experienced in the administration of grants to educational institutions. That Amendment seeks to add additional people to the Council in order to give it a better balance for its new purpose. It is for the same reason that my hon. Friend has put down the Amendment which we are now discussing. If we have to accept the situation which the Parliamentary Secretary has presented to us this morning, namely, that the General Nursing Council is to have the power to prescribe standards and also to distribute the money by which those standards can be reached, there must be a very substantial element of delegation within the machinery of the General Nursing Council. I think it is a mistake to bring them under the same umbrella, but if both—

Mr. Blenkinsop

The hon. Member will realise that in one case it is merely a matter of distributing money. The money made available for training, unlike the professional requirements of the General Nursing Council, will come from the Government in future, but the professional fees, the sums required purely on the professional side, will come out of the Council's own finance.

Mr. Linstead

The Parliamentary Secretary is now saying that the expenses incurred under Clause 6, that is: All expenses incurred by a standing nurse-training committee with the approval of the Council shall be defrayed by the Council, are not the same expenses as those referred to in Clause 4, namely, estimates approved by the standing nurse-training committee shall be defrayed by that committee. Is the Parliamentary Secretary now saying that the expenditure which they defray under Clause 4 is not the same thing as the expenses under Clause 6?

The Deputy-Chairman (Mr. Bowles)

Might I suggest to the hon. Member that he should complete the moving of his Amendment rather than invite the Government to reply at this stage. There is no Question before the Committee?

Mr. Linstead

I wanted to deal with the most helpful interruption of the Parliamentary Secretary, because I am not at all sure that it does not take a great deal away from my Amendment, but in order to give the Parliamentary Secretary an opportunity to reply at slightly greater length, I will conclude.

Mr. Diamond

This discussion has gone to the root of certain matters covered both by this Clause and by other Clauses. It is rather difficult to pick up all these matters at the same time. May I say that I appreciate the spirit behind this Amendment? I am not sure that there is any difference of opinion as to the views of the hon. Member for Putney (Mr. Linstead) has put forward, that there seems to be a reasonable distinction between these two functions, and that where there is a clash the same person should not have the responsibility of answering in two different capacities—no one can do that successfully. But it seems to me that that is not the position under the Clause.

12.45 p.m.

It is true, of course, that the two functions will go together, and it is only at a certain point that these differences to which the hon. Member has referred may arise. If these functions are vested in two different persons sitting down at a table together, I am sure the hon. Member will agree that, as far as possible it will be beneficial if they can see eye to eye with each other and co-operate as far as their respective points of view are capable of being satisfied. It is only when we come to the stage where these points of view differ that provision should be made for different persons answering the two different questions, which is exactly what we have under the Bill. We have the General Nursing Council giving the answer on certain questions, and the Minister, with the General Nursing Council, giving answers to certain other questions where disputes arise. In these circumstances, I think the Bill has been satisfactorily drawn up.

In regard to the more limited point about the three members appointed by the Minister and other matters the hon. Member has discussed in relation to it, I can only support what my hon. Friend has said, that this Committee, however strong it may be, must be a committee of the General Nursing Council. In this connection, it is of interest that the present finance committee of the General Nursing Council consists of eight persons, which is somewhat more than seven and somewhat less than 11. I have no doubt it will automatically follow that members of the General Nursing Council with special ability in this connection will find themselves on the finance committee. I hope, therefore, that it will be possible for us to agree with the Parliamentary Secretary that the General Nursing Council should not be any more than it is at present. I hope that this Amendment will not be carried any further than is absolutely necessary.

Mr. Blenkinsop

I am very anxious that we should be clear on this. I subscribe entirely to what my hon. Friend the Member for Blackley (Mr. Diamond) has just said. We naturally expect that these three persons who have been appointed to the General Nursing Council, for the reason that they have experience of the control and management of hospitals, will most probably be the people appointed to the finance committee, but we do not wish to tie down the General Nursing Council completely to the appointment of these three people, which would be a little unreasonable. We have every confidence in the General Nursing Council, but it may be that among these three persons there is one who is not as suitable for working on the finance committee as the others. We must leave this reasonable amount of latitude to the General Nursing Council.

Expenditure under Clause 6 is the same as under Clause 4, but there is also expenditure provided for in Clause 19. It is true that the standing nurse-training committees will be responsible for the general training expenses, which will be submitted through the budgets coming down from the hospital management committees and the boards of governors. The peculiar expenses of the General Nursing Council of a professional character will remain their own responsibility, and they will be met out of the contributions and fees of their members. There is that clear division between the two. I accept the principle, which is an important principle, that there should be as much division as we can administratively provide between the actual training and the responsibility for standards. I think we have got as near to it as we can within a framework that is workable.

Attempts were made in another place to make certain changes which it was finally agreed would not operate successfully, and general satisfaction was expressed with the Amendments we were able to make, including the setting up of this finance committee in the terms as they now appear on the Notice Paper. I assure the hon. Member that we are very conscious of the point he has raised. If there is any further clarification we can make in Clause 8, without interfering with the final responsibility of the General Nursing Council itself, then we are quite prepared to look at it.

Mr. Howard

We are in complete agreement as to what we want to achieve, but we are not in complete agreement yet as to whether we have achieved the best possible result or not. I want to make this one suggestion. Will the Parliamentary Secretary turn over in his mind between now and the Report Stage the possibility which, without being egotistical, I would remind him that I mentioned on Second Reading, that it might go some way to solve this problem if, as well as having a statutory finance committee of the G.N.C., its education or training committee were also given statutory position. I am not certain whether it is called an educational or training committee. Then we should, perhaps, secure a better balance. There are probably objections to it, but I throw it out as a possibility which I think is worthy of serious consideration between now and the Report stage.

Mr. Linstead

I have, unfortunately, committed myself to, an engagement which makes it necessary for me to leave the Committee shortly, and I hope that the Parliamentary Secretary and the Committee will accept my apologies. I am grateful to the Parliamentary Secretary for what he said, but I feel again that I am on firm ground. I thought for the moment there was a differentiation between two forms of expenditure. It is clear to me now that there is not, and that, in fact, the General Nursing Council is being asked to do the very thing the hon. Member for Blackley (Mr. Diamond) said they should not be asked to do. In his own words, "One and the same person has power to answer two different questions." I am sure that, as experience accumulates, it will be found that that is a mistake.

After all, this new arrangement is not an intrinsic part of the structure of the Bill. It is something which got grafted on to the Bill, and I am sure that enough consideration has not been given to all the implications that follow from making the general standard prescribing body a general granting body, which, in fact, is what this does. I hope very much that the suggestion thrown out by my hon. Friend the Member for Westminster, St. George's (Mr. Howard) will be considered even in the short time we have between now and Report, because I am certain there is something fundamentally weak in the structure of the General Nursing Council as we are leaving it. I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Clause ordered to stand part of the Bill.

Clauses 9 to 11 ordered to stand part of the Bill.