HC Deb 14 December 1959 vol 615 cc1026-30
16. Sir W. Wakefield

asked the Minister of Health if he is aware of the widespread concern at the proposal of the London County Council to take over the Home Nursing Service on 1st September, 1960: whether he has given his approval to this scheme under Section 20 of the National Health Service Act; and if he will make a statement.

17. Dr. A. Glyn

asked the Minister of Health if he is aware of the value of the services rendered by the District Nurses Association and the public esteem in which this voluntary organisation is held; and if he will take this into account in considering proposals to take over the administration of these services submitted for his approval under the National Health Service Act, 1946, by the London County Council.

18. Mr. Compton Carr

asked the Minister of Health if he will ensure that, when the London County Council, in accordance with plans approved by him, takes over the district nursing associations on 1st September, 1960, the pensions and other rights of the nurses are safeguarded under powers conferred on him by the National Health Service Act.

19. Mr. Partridge

asked the Minister of Health if his attention has been drawn to the fact that 23 superintendents of district nurses' homes in London have been asked by the London County Council to apply for posts which would be available in the new scheme; whether he has given his approval to the scheme under Section 20 of the National Health Service Act, 1946; and if he will make a statement.

20. Mr. Roots

asked the Minister of Health if he is aware of the anxiety and concern which exists in view of the London County Council's decision to take over the District Nursing Service on 1st September, 1960; whether he has given his approval to this scheme under Section 20 of the National Health Service Act. 1946: and if he will make a statement.

28. Sir J. Smyth

asked the Minister of Health if, when considering the proposals of the London County Council to take over the District Nursing Service in 1960, he will give first consideration to the comfort of the old people who benefit from the service at present, and the wishes and rights of its nurses.

Mr. Walker-Smith

I have received from the London County Council proposals for altering, as from 1st September next, the present arrangements for providing home nursing and, in certain areas, domiciliary midwifery services. These proposals require my approval before they can be brought into operation, and under the statutory procedure interested organisations have until 22nd December to make recommendations to me for their modification. I have already received a number of such recommendations and shall take these, together with all other relevant circumstances, into account in reaching a decision.

Sir W. Wakefield

Is my right hon. and learned Friend aware that his statement will give great satisfaction to many people who are under the impression that the decision of the London County Council could not be revoked and that he was merely a "stooge" in this matter? When he makes his decision, as he is required to do by Statute, will he further bear in mind the extremely valuable services of a personal nature which are rendered and which are quite unsuitable for central control?

Mr. Walker-Smith

There should be no room for any misunderstanding in this matter. There can be no decision save that made by the Minister under the duty imposed on him by Section 20 of the National Health Service Act. The London County Council has submitted proposals, but it is for me to make a decision having regard to all the relevant factors and the public interest as a whole.

Sir J. Smyth

When my right hon. and learned Friend is considering his decision, will he bear in mind that the close personal relationships of trust and confidence which at present exist in the service between the elderly sick and the disabled and the devoted band of nurses who look after them are priceless assets which cannot easily be replaced by a more impersonal and centralised service?

Mr. Walker-Smith

I am sure that we all have very much in mind the quality of the service and the devotion of the people rendering this service, as my hon. and gallant Friend has been good enough to say. Regarding the further matters, he will, I know, understand that it is better for me who am seized with this duty not to make any observations which might seem to anticipate my final decision.

Mr. Partridge

Will my right hon. and learned Friend realise that in this matter he is regarded as the bulwark between freedom and a virulent bureaucracy and, under those circumstances, will he repulse with vigour the marauding raids of the "buccaneers" of County Hall?

Mr. Walker-Smith

I shall seek to discharge the duty imposed on me under Section 20 of the National Health Service Act and try conscientiously to arrive at a decision which seems to reflect the public interest in regard to all the relevant circumstances.

Dr. A. Glyn

Is my right hon. Friend aware of the great services which have been rendered, and will he make it quite clear that, since there has been no question of a lack of efficiency, there can be no case on the grounds of efficiency for a take-over by the L.C.C.?

Mr. Walker-Smith

I will certainly have in mind what my hon. Friend has been good enough to say.

Dr. Summerskill

Should not the right hon. Gentleman tell the House what are the facts; that the London County Council has been providing 93 per cent. of the cost of this service, and that, far from this being revolutionary, 70 per cent. of the local authorities in a similar position have already taken over the District Nursing Service? Is not the House aware that, in these days of comprehensive domiciliary service, this action is in the interests both of the nurses and the patients?

Mr. Partridge

Oh no, it is our money anyway.

Mr. Walker-Smith

Under Section 25—

Dr. Summerskill

Silly old man.

Hon. Members

Oh.

Mr. Speaker

The right hon. Lady should address her observations to me.

Dr. Summerskill

I beg your pardon, Mr. Speaker. Under no circumstances would I address that observation to you.

Mr. Walker-Smith

I hope I may assume that such an observation could not possibly be addressed to me either.

Under Section 25 of the National Health Service Act, a local health authority must provide a service of home nurses, but it may do so in one of two ways, either through a voluntary organisation, as in London so far, or by employing nurses itself. It is a fact that 107 local health authorities do employ nurses directly, but I have a duty to look at this matter in all the circumstances of the case, which is what I propose to do.

Mr. Compton Carr

I thank my right hon. and learned Friend for that satisfactory reply. Is he aware that at the present moment the London County Council, through its clerk, is recruiting staff for the new scheme which is supposed not to take effect until 1st September, 1960, and then only with his consent? Is he aware that the District Nursing Association members have today received a letter calling them to County Hall for interviews for posts under this scheme on 18th December—

Mr. Snow

And very prudent, too.

Mr. Compton Carr

—and will my right hon. and learned Friend express a view about whether there is any need for apprehension in view of these forthcoming arrangements?

Mr. Walker-Smith

I do not think so. The County Council, I understand, has held discussions with the District Nursing Associations and has invited applications from superintendents of district nurses' homes for posts that would become available were these proposals approved. But I understand that it has stated expressly that these discussions commit nobody. The proposed new posts cannot become effective in advance of my decision, as I have explained, and I understand that the London County Council did not intend otherwise.