HC Deb 05 May 1959 vol 605 cc247-57
Dr. Summerskill

I beg to move, in page 4, line 10, after "of", to insert "duly qualified".

This is a simple Amendment, but I think that it is a rather important one. We are anxious to think that in future the mental welfare officers, at least those who are newly recruited, should be qualified. We all know today of the duly authorised officer who will be the mental health officer, and we all recall his predecessor, the relieving officer. The relieving officer was a great friend to every general practitioner in the country and solved all kinds of difficult domestic problems as well as health problems.

The duly authorised officers derive from the relieving officers, and we shall now have the mental welfare officers. It is a very curious thing that most of them—I think that I am right in saying this—have no qualification whatsoever. They are honest, decent, hard working men who have to exercise judgment at the most difficult times, who are trusted by the public and by the doctors and who have, as I have already said, examined carefully this highly technical Bill and have made certain recommendations, one of which has been accepted this afternoon.

In the future, they want their ranks widened by people who have a qualification. I cannot quite understand why this should not be put into the Bill and why this Amendment should not be accepted. If the Amendment were accepted, paragraph (c) would read: the appointment of duly qualified officers to act as mental welfare officers. The mental welfare officers who are unqualified would not, of course, object to this. They are only too anxious to increase the prestige of their calling. Therefore, I ask the Minister to remember when he is reconsidering the matter that this is the kind of thing that these excellent men and women would like to see embodied in the Bill.

Mr. Sorensen

I wish very briefly to endorse the plea made by my right hon. Friend the Member for Warrington (Dr. Summerskill). We are all aware of how quite a number of social workers, and, indeed, professional workers, in the past at first had no qualifications. They did good work in many ways and gradually reached the stage when they realised that some recognised qualification should be attained by all those who wished in the future to pursue their calling. This surely applies to this office of mental welfare officer. I wish to bear testimony, as did every hon. Member on the Committee, to the splendid work done by these officers heretofore and, indeed, today.

I would add to what my right hon. Friend said in her eulogy of these officers by saying that many of them have acquired by experience considerable qualifications, and they, I am sure, will be able to continue in this work. But it is true that these worthy officers themselves desire that there should be a standard of qualification for future entrants. Even if they themselves did not aspire in their later years to acquiring these qualifications, they are very appreciative of the very onerous and responsible functions which they have to fulfil and they desire that those who take their place shall be so qualified.

I cannot understand why the Minister does not think it necessary to indicate that in the future the officers appointed to this task shall be duly qualified. I know, of course, that the right hon. and learned Gentleman desires that they shall be so qualified and that it is his intention ultimately that they should be so qualified. Why, then, should there not be this indication of his desire and intention in the Bill? I earnestly trust that the right hon. and learned Gentleman will reconsider the matter and accept the Amendment.

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

May I start by associating myself with the tribute paid by the right hon. Lady the Member for Warrington (Dr. Summerskill) and by her hon. Friend the Member for Leyton (Mr. Sorensen) to the work of the mental welfare officers? We are obviously going to lean on them very heavily when the Bill becomes an Act and their work is going to increase rather than decrease.

When we discussed this matter in Committee it was quite clear that there was a general feeling that it would be advantageous to the people carrying out these important tasks to have a recognised qualification. At that time the hon. Member for St. Pancras, North (Mr. K. Robinson) was particularly concerned about the matter. He felt that we were getting a lot of advice which was tending in certain directions, and he wondered whether we would be right to take it or not.

At that time I advised the Committee against accepting the Amendment, in the form in which it then was, because we were at the point in time when the Younghusband Committee was about to publish its Report. Indeed, I gave the hon. Member an assurance, which I am happy to say I just managed to honour by the margin of one day, that the Report would be published by the time we reached the Report stage.

The hon. Member will know, if he has studied the main conclusions of the Younghusband Report. that the recommendations germane to this matter are the one which referred to the setting up of a National Council for Social Work Training and that which referred to a programme for a training in social work leading to a national qualification.

The Report consists of 350 pages and has been between three and four years in preparation. It will obviously require very careful study as its conclusions are obviously highly germane to the point made in the Amendment, and we are not resting on this position. My right hon. and learned Friend is already seeking the views of the local authority associations, and the comments of the interested professional and other organisations will certainly be welcomed by him. I do not think that we should take a decision about the matter until after the consultations are completed, but we have at least now reached a further stage than we did in Committee.

I would remind the House that my right hon. and learned Friend has power under Section 66 of the National Health Service Act to make the necessary regulations to prescribe these qualifications at the appropriate time. Therefore, I would advise hon. Members to let us study thoroughly this most important document. As I say, it was published only yesterday, and it is obviously highly relevant to whatever we decide to do. We have the necessary powers to our hand to take whatever further steps may seem to be necessary. I hope that with that explanation it will not be thought necessary to press the Amendment.

Mr. K. Robinson

I am sorry that the Parliamentary Secretary has not found it possible to go a little further this afternoon. In fact, I am sure that an examination of the words which he uttered in Committee would indicate that he went a little further then than he has gone today.

The fact is that the Younghusband Committee has now reported in very clear and specific terms about the desirability for a course of training and recognised qualification for mental welfare officers. There is no need to have further discussions with anybody about the matter. The only people who were not convinced of the desirability of having this training and qualification were the people at the Ministry of Health. I imagine that now, with this formidable body of opinion behind the views expressed all over the field of mental health for many years, the Ministry, and the right hon. and learned Gentleman in particular, must agree that this is something which needs doing and doing urgently.

The Younghusband Committee not only expressed its views on the desirability of training, but also set out very clearly, and, I thought, in very reasonable terms indeed, how the existing staffs doing the work of mental welfare officers, and doing it so admirably, could be worked into a system of training and qualification. I do not want to go over all the details. Briefly, if they had had a long experience and were over a certain age they would not be required to do anything. Below that age and with a shorter experience they would be required to do part I of the examination, and below the age of 40 would be required to take the whole course for the full qualification. That seemed to be a very reasonable compromise.

Recognising that no one is keener on this matter than the officers themselves and their organisation, I hope that the Minister or the Parliamentary Secretary can give us a little more assurance of the fact that they accept the need for this reform and will do something about it quickly.

5.0 p.m.

Mr. E. L. Mallalieu (Brigg)

The Parliamentary Secretary mentioned the powers for making regulations which the Minister has under the National Health Service Act. Can the hon. Gentleman tell us when the Minister is likely to make such regulations? It is not as if the Younghusband Report had gone against our view; on the contrary, it has gone very much in favour of the point of view we have been putting forward in the Committee and are now putting forward on the Floor of the House. Can the Minister not say that he has a definite intention of doing this, in the absence of anything else which might turn up to prevent it? It seems that he is trying to do something at the appropriate time. When is the appropriate time? If he could give us an assurance on that we might be prepared to allow this matter to proceed.

Mr. Thompson

I am very sensible of the discussion there has been over this question. I do feel that with this great body of advice, which was published only yesterday, we are not being unreasonable in asking for a little time to consider it and to ask interested people to give their views on it. If it will help the hon. and learned Member for Brigg (Mr. E. L. Mallalieu) and his hon. Friends in any way, I may say that when the Bill reaches another place we shall have had time to digest this advice further and it might be possible to go further.

Mr. Sorensen

Are we to take it that the Parliamentary Secretary and the Minister agree that there shall be a qualification for all future officers, but the Minister wishes to have time to consider the form of qualification?

Mr. Thompson

What we require is time to consider the whole of the implications of the recommendations of the Younghusband Committee. We certainly do not shut our minds to the particular point made by the hon. Member.

Mr. Hale

The Parliamentary Secretary has failed to answer two matters which are of importance. He was asked a direct question by my hon. Friend. He has had power since the passing of the National Health Service Act to make regulations. In this limited sphere, that was somewhat premature, because the duties of the mental welfare officer have somewhat altered, but if this Bill goes through they will have a much happier duty placed upon them by the new Clause which the right hon. and learned Gentleman moved and for which he secured the acquiescence of the House. It is now the duty of the mental welfare officer to initiate steps to take people to hospital and it is his duty to make the necessary recommendations in the necessary forms.

As my hon. Friend the Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop)—a former Parliamentary Secretary to the Ministry of Health—said in Committee, N.A.L.G.O. expressed a very strong view on this matter. It is all very well saying, "We are consulting people"—the advice of every representative person connected with this question has been, volunteered to the Minister. They all think it is an undesirable thing that men charged with so responsible a function and now with statutory duties, for which they are accountable if there is a breach or a neglect, can be appointed without any qualification at all, except perhaps, a remote relationship to a local councillor, or someone like that.

The problem of a transition period does not present, and never has presented. a problem. Time after time when this House has imposed qualifications on persons holding offices we have made suitable provisions to protect those who have performed the duty and who are performing it satisfactorily. We have never sought to impose academic qualifications on elderly officers doing their duty well. There always has to be a transitional provision, and I do not think it has presented great difficulty in practice.

Waiting for the Younghusband Working Party's Report in that situation is a rather remote alibi for failure to make a decision. The Minister has had advice and knows the view expressed from both sides of the Committee, from which, so far as I recollect, there was no particular dissent. All he has to say in response to my hon. Friend the Member for Leyton (Mr. Sorensen), who put the matter with clarity, is whether he is deferring the matter because he is considering the precise definition of the necessary qualification and that he has decided some qualifications must be encouraged. If he said that, we should be a great deal nearer our objective and, perhaps, the details of the qualifications could be left to further discussion, maybe through the usual channels. Surely the Minister is in the position now to say to the House, "I am not going to permit my powers under Section 66 of the National Health Service Act to be abused. I am going to exercise them in respect of these qualifications, but I should like another day or two to think over the qualifications. I shall let the House know when I have finished that particular mental exercise."

Mrs. Braddock

I completely agree with the comments of my hon. Friends, but there is a point about which I am a little disturbed and I should like the Parliamentary Secretary to clear it up. If these two words are put in and we get the qualification, on what date will it be necessary to start appointing duly qualified officers?

There will have to be a period of training. There will have to be people appointed between now and the time when the qualifications are dealt with or obtained. The inclusion of these words at the moment would not, I hope, prevent local authorities and those responsible from appointing people because they have not the qualifications. If these words were in without some specific date being included, would it be possible to put in a date at which duly qualified officers would be appointed? I should like to be perfectly certain that the inclusion of these words will not mean that when the Bill becomes an Act the only people local authorities can appoint will be those who are duly qualified officers, although there will not be the necessary number of people to accept the positions in the interim period.

I agree that in future there must he duly qualified officers holding a special qualification, but I am a little concerned about the fact that local authorities will have to make appointments before those qualifications are obtained. I do not want local authorities to be in the position of not being able to make appointments of people for work in the extended service because those people are not qualified and have not had an opportunity of being qualified because time has not allowed for them to become qualified.

Mr. Walker-Smith

These are exactly the sort of complications which arise in this matter. This is one of the reasons why it is a little difficult, as it were, to legislate off the cuff. As I think we all know, when making any change in a system which affects the professional careers and livelihood of people as well as the interests of local authorities, we have to be able to tie in very clearly the transitional provisions, the timing and so on. It is precisely the sort of very practical consideration to which the hon. Lady has drawn attention which militates against doing what we are asked to do and writing these words, "duly qualified," into the Bill at this stage.

Mr. Sorensen

As the Minister himself is competent to decide who is and who is not duly qualified, is it not possible for him to declare a certain number of officers are qualified, but that in future an extra qualification will be necessary?

Mr. Walker-Smith

No, not in the Bill as drafted. That would require a further provision somewhere else in the Bill saying what would be considered "duly qualified". It might be possible to put such a provision in the Bill, but in any case that would necessitate action in another place. I do not want it to be thought that my hon. Friend or I are in any way dragging our feet about this matter. We are not. We have received a very authoritative and weighty—in every sense of the word—Report from the Younghusband Committee which, among other things, recommends the provision of a new general training in social work to be provided outside the universities, leading to a national qualification. The stress there is upon qualification. That is obviously the road which we would all wish to travel, but we have to tie up these various points both with the local authority associations and with any professional organisations interested.

I would prefer not to be pressed to put in these words now, because they are necessarily incomplete and may give rise to the sort of misunderstanding to which the hon. Lady has referred. We shall be able by the time this Bill goes to another place to see whether we can proceed more appropriately and quickly by regulation or by introducing something in another place, and we shall seek so far as in us lies to expedite the consultations, which I am sure all hon. Members, and especially those who have personal experience of local authority work and the like, will recognise to be necessary.

It is not all quite as easy as some hon. Members made it appear, because of the necessity to consult and the need that we should have effective transitional arrangements, whatever may ultimately be decided. For example, one recalls the Dentists Act, 1921, when some people came in on their qualifications and some came in because, though they had not got academic qualifications, they had that other sort of qualification which derives from long experience and practice in actually doing the job. It is all these things which we have to get straight, and we will get them straight as soon as we can, before our consultations, and then proceed either by way of regulations or Amendment in another place, whichever seems to be the most appropriate.

Dr. Summerskill

The Minister is now on an entirely different point. I agree with my hon. Friend the Member for the Exchange Division of Liverpool (Mrs. Braddock), whose point was entirely practical. In effect, if we put these words in it may mean that we would be unable to obtain sufficient recruits to operate the Bill. That is a very practical approach, but why was it not said in the first place. Why does the Parliamentary Secretary come here and tell us that there is something curious to consider, something abstract? This is the practical approach. If there are not sufficient people to operate the Bill, then we must reconsider the position.

On the other hand, I would say that at this stage the Minister should know that. This is not a question which he has to discover from the Report of the Young-husband Committee. He should know that. He has a vast Ministry and should know precisely how many people there are whom we could secure to do this work. He still says that he may be able to do something in another place, but I should have thought that he would have known the position now and would know precisely how many people were available.

Mr. Walker-Smith

I am anxious not to confront the local authority associations and others with a fait accompli at the same time as I am putting the matter to them for consultation. I think that is right.

Dr. Summerskill

I am a little sorry that all of us here this afternoon, who found great interest in this Bill, have not been able to make this courteous gesture towards mental welfare officers in this place. I am a little jealous on this score of what the Minister is prepared to do in another place, and I am sorry that the Minister did not find that extra time in which to have said "Yes, this is a good thing and these excellent people should know that their prestige and their status have been increased in this place." However, in view of the assurance which the right hon. and learned Gentleman has given, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.