HC Deb 10 December 1962 vol 669 cc12-8
25 and 26. Mr. Fell

asked the Minister of Health (1) whether there is a shortage of nursing staff in the eastern area; and

(2) which hospitals in the Eastern Area have stopped recruiting additional nursing staff.

Mr. Braine

There is no general shortage: numbers in post have increased further in the last year, and recruitment continues within the financial allocations.

Mr. Fell

That is a most extraordinary Answer. I am stuck for words and therefore hope that hon. Members will forgive me if I take more time than I should. Is not my hon. Friend aware that an instruction has gone out from the Board that no additional nurses shall be taken on for any hospital in the eastern area and that hospitals have stopped even replacing nurses who leave? It is an extraordinary thing that after fifteen years of the National Health Service, or whatever the number of years may be, that—

Mr. Speaker

This is the time for Questions. Would the hon. Gentleman ask a question?

Mr. Fell

I suggest that it is very relevant to the Question that after fifteen years of the National Health Service it should have come to the point at which the recruitment of nurses, who, with doctors, are the basis of the whole Health Service, should have been stopped in an area where no hospital is up to establishment.

Mr. Speaker

It may be very relevant but it is not a question. That is the point.

Mr. Fell

With great respect, Mr. Speaker, I am asking the Minister what the answer is to this question: Why has the board stopped recruiting nurses in the eastern area? If it has no money left, which I understand is the basic reason, to recruit nurses, will my hon. Friend answer two questions? First, what is—[Interruption.] Perhaps hon. Members do not want to know the truth, but will my hon. Friend answer these two questions? First, what effect will this have on the future training of nurses in this country, particularly if what has happened in the eastern area applies to other areas? Secondly, will my hon. Friend consider the question of administrative staff with a view to cutting down form-filling, and so on, that goes on at requests from the centre so that the board has more money to spend on recruiting nursing staffs which it is no longer able to recruit in the eastern area?

Mr. Braine

Over the East Anglian area as a whole, in the twelve months ended 30th September last, numbers in post increased by 1.7 per cent. and 13.5 per cent. for whole-time and part-time staff, respectively.

Mr. Fell

The hospitals are not up to establishment.

Mr. Braine

Perhaps my hon. Friend will permit me to answer his extremely lengthy, confused and muddled question. Recruitment continues, but it is restricted at a number of hospitals. Increased real expenditure has been allowed for this year, but the responsibility for spending their money rests with the regional hospital boards, as the House well knows.

Mr. Fell

In view of the fact that recruitment does not increase and that the reply to the question is thoroughly unsatisfactory, I beg to give notice that I shall raise the matter on the Adjournment at the first available opportunity.

28. Mr. K. Robinson

asked the Minister of Health what advice he has given or proposes to give to hospital authorities who are in a position to fill nursing vacancies in their establishment but have insufficient funds to meet the salaries of additional nurses.

Mr. Powell

It is for hospital authorities to decide how best to use their allocations.

Mr. Robinson

Is not the Minister aware that region after region has given instructions to hospital management committees to stop recruiting nursing staff, and, indeed, replacing staff, as the hon. Member for Yarmouth (Mr. Fell) said on the previous Question? We cannot possibly recruit nurses up to establishment when allocations are cut as finely as they have been cut this year, in some cases down to 1 per cent. and even just over ½ per cent. increase on last year. How can one possibly run an expanding Health Service on this financial basis?

Mr. Powell

The hon. Gentleman's last words—"an expanding Health Service" —are right. Allocations everywhere have provided for an increase in expenditure at constant prices and wages as well as for the increase in service which is constantly taking place from a growth in efficiency, but hospital authorities must work within their allocations. These allocations have been adjusted and increased to allow for the increases in salaries and wage awards, and hospital authorities have now, as in the past, a duty to keep within them. Nevertheless, the hospital service has continued to recruit nurses throughout the last twelve months at a high rate, and, in the case of part-time nurses, at the highest rate ever known.

Lord Balniel

While recognising that there may be a problem in some areas, is not the great problem the wastage of trainees? Since student nurse recruiting is improving, is it not right that regional boards and matrons recruiting nurses should place greater emphasis on the quality of recruits rather than go for unlimited quantities of nurses?

Mr. Powell

I agree. It is noteworthy that the increase this year has taken place at a time when the standards required for entry into the nursing profession have been increasing.

Mr. Diamond

Is the Minister aware that in two hospitals in my constituency, which come in the South-West Region, far from there being a limitation on recruitment, existing nurses have as a result of his Department's financial stringency been dismissed? Thirty-one nurses and others in two mental hospitals alone have been dismissed. Are not mental hospitals the least well served of all the nursing service? If the Minister's answer is that this must be done because of a proportionate increase in expenditure allotted to every hospital, is it not the case that these two hospitals, which have always shown a very small cost per bed, are, as a result of their economies in years gone by, condemned the whole time to an inadequate standard of nursing?

Mr. Powell

I am glad that the hon. Gentleman has found the means to ask the question that he wished to ask about his constituency. The ratio of nursing staff in these hospitals compares very favourably with that in similar hospitals generally. The reductions which have taken place are eleven nurses, of whom six were part-time and four were of pensionable age, and 21 other staff. In many cases these reductions were called for anyhow in the interests of efficiency and good management.

Dame Irene Ward

Since there is very great anxiety throughout the country about the problem which has arisen, could my right hon. Friend tell me whether he has yet received the request from the Royal College of Nursing to bring a deputation on this subject? Has he yet seen the report from the matron of the Royal Victoria Infirmary, Newcastle-upon-Tyne, dealing with the problem on the North-East Coast? Will my right hon. Friend not dismiss this matter in quite such strong terms, as there really is a problem here, as I am sure he is aware?

Mr. Powell

The rate at which this service and the nursing staff as an integral part of it can be expanded is, of course, limited, although the rate from year to year is one that we can now foresee over a period of years. That is enabling hospital authorities to plan and recruit much more effectively than they could do in the past. I do not recollect offhand having personally seen either of the communications to which my hon. Friend refers, but I will certainly ensure that if they have been received they are brought to my attention.

Mr. Robinson

Does not the Minister appreciate that there is a special problem here? For various reasons, it is now easier to recruit student nurses than it has been for very many years. Is not he aware that a considerable number of nursing vacancies still exist? If girls who are willing to come forward are not recruited now they will be lost to the nursing profession for good, and it will be entirely the right hon. Gentleman's fault.

Mr. Powell

The fact is that recruits to the nursing profession are being obtained in increasing numbers. I see no reason to doubt that this will go on in the future. The rate at which the hospital service can be developed is limited not by the rate which the resources offer but by the rate at which resources can be made available along with the other commitments.

46. Dame Irene Ward

asked the Minister of Health whether he is satisfied that the waiting lists for hospital treatment do not reflect a shortage of nursing staff which is accentuated by the financial position in many hospitals; and if he will make an inquiry into the position in other than teaching hospitals.

Mr. Powell

Yes. All hospital authorities are reviewing their waiting lists.

Dame Irene Ward

I ask my right hon. Friend whether in fact this decision to stop recruiting on the part of the regional hospital boards in order to match up with the financial commitments is going to be a deterrent in dealing with the waiting lists. Could my right hon. Friend please realise that it is not really doing his position any good to give again the argument he has used on previous occasions about this matter? Let us face the facts fairly and squarely.

Mr. Powell

The hospital authorities have given no general indication that recruitment should be stopped. They only accept the obligation to keep within their financial allocations, which have enabled them to expand their nursing staff in the course of the past year and to go on doing so. The shortage of nursing staff is not the limiting factor in disposing of the waiting lists, which, in many cases, I regard as much too long, and I intend to make 1963 a year in which the reduction of these waiting lists drastically is one of the prime objects of the hospital service.

Mrs. Braddock

Is not the right hon. Gentleman aware that he has told the House a complete untruth in relation to the statements which have been made about the requirements of hospital management committees, and that it is a fact that the hospital management committees have been asked to consider the question of their nursing staff and not to recruit any more nurses unless they can save money in other ways? Is he not also aware that one of the ways suggested is a reduction in the sort of food which is being given to patients—so that the committees can recruit more nursing staff?

Mr. Powell

No, Sir. There has been no general requirement or instruction that recruitment should be held up. Some hospital authorities have been able to push recruitment forward fast in the earlier part of the financial year, and therefore, naturally they must recruit more slowly during the latter part in order to keep within their financial allocation. Those financial allocations permit an expansion in this aspect as in other aspects of the hospital service.

Mrs. Braddock

That is not true.

Mr. Fell

I think there is a great misunderstanding in the House on this point. Is my right hon. Friend not aware that the Eastern Area Hospital Board has sent out a notice to all its hospitals saying that there shall be no increase in staff and that no new nursing staff shall be taken on, and that this is having the effect that even the nursing staff who are leaving are not being replaced at the moment? If that is happening in the eastern area, might it not be happening in other areas as well? I am not suggesting that my right hon. Friend is responsible for it, but I challenge him to tell me that this is is not true, that the Eastern Area Hospital Board is—

Mr. Speaker

I must point out to the hon. Member that this is not the moment for issuing challenges. This is the time for asking questions.

Mr. Fell

I am very sorry, Mr. Speaker, and I apologise, but this is a matter about which I feel extremely strongly. I do not recall a time, even before the war, even before we had a hospital service, when this sort of thing happened. Nurses are getting no incentive at all to be taken on.

Mr. Speaker

The hon. Gentleman must realise that in the interests of the House as a whole I have to ask hon. Members to conform to the rules of order, however strongly they feel about a topic.

Mr. Fell

I apologise, Mr. Speaker. I will simply confine myself to a question. Will the Minister please say whether this instruction has been issued by the Eastern Area Hospital Board or not?

Mr. Powell

I have looked in detail into the position in the area where my hon. Friend represents a constituency. I shall be glad to discuss the position there with him at any time. Recruitment is still proceeding in that area—

Mr. Fell

No.

Mr. Powell

—and recruitment over the past year has resulted in a substantial increase of nurses, wholetime and part-time.

Mrs. Braddock

That is misleading.