HC Deb 07 May 1962 vol 659 cc138-51

Amendment made: In page 2, line 5, leave out "Health Visitors Training Council" and insert: Council for the Training of Health Visitors".—[Miss Pitt.]

Mrs. Hill

I beg to move, in page 2, line 8, after "approving" to insert "or recognising".

Mr. Deputy-Speaker (Sir Robert Grimston)

I suggest that with this Amendment we could take that in page 2, line 13, after "may", to insert "recognise"; and that in page 2, line 14, after "examinations" to insert: or recognise as equivalent to such examinations examinations conducted by universities or university institutions".

Mrs. Hill

Yes, Mr. Deputy-Speaker.

This Amendment, and those you have also mentioned, seek to make it clear that the universities will be able to conduct courses, and that their examinations, and the results of the examinations, will be recognised by the councils.

Mr. K. Robinson

I support the principle behind this minor Amendment but the reason for the wording that my hon. Friends and I have chosen is to make quite clear what we have in mind. The fear is that since some health visitor courses are now conducted by universities, the universities will not be prepared to have their courses approved by the Council for the Training of Health Visitors. This is, I think, something slightly more than a question of status and prestige and it was thought that if the words "recognise as equivalent" were included under the functions of the council, we would have the benefit of the continuation of these university courses without their having to be formally approved by the council. I hope that this principle is accepted by the Government and, for my part, I am indifferent to which of the two forms of wording are used.

Miss Pitt

Two points, separate but related, are involved. The first Amendment in the name of my hon. Friend the Member for Manchester, Wythenshawe (Mrs. Hill) would, if accepted, mean that we should say that courses should be recognised as well as approved. Her second Amendment—and that in the name of the hon. Member for St. Pancras, North (Mr. K. Robinson)—then goes on to deal with examinations; that they should be recognised. I realise that it is convenient that we should discuss the two matters together.

Regarding the first, the question of recognising the courses, I would point out that if the Amendment were accepted it would detract from the council's responsibilities as the guardians of the standards which we hope they will lay down. Since the council will have university representation, particularly with the vice-chancellor of a university as its first chairman, I do not think that the interests of universities are likely to be overlooked and I do not feel, therefore, that we can accept the Amendment.

The second two Amendments, on the question of recognising examinations, are not really necessary because the council's power in Clause 2 (1, c) to conduct or make arrangements for the conducting of examinations is permissive and not mandatory, so the council will have power to recognise examinations conducted by other bodies and courses which satisfy the conditions which the council itself will specify in its rules for the award of its certificate.

I feel, therefore, that with that explanation the point in the minds of hon. Members has been covered by the Bill as now written, and I ask my hon. Friend to withdraw her Amendment.

Mrs. Hill

Having been given that assurance, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Miss Pitt

I beg to move, in page 2, line 10, to leave out "making such courses known" and to insert: seeking to attract persons to such courses". This, again, meets an undertaking I gave in Committee about the council's functions in relation to recruitment. The purpose of the Amendment is the same as that which the hon. Member for St. Pancras, North (Mr. K. Robinson) moved in Committee and which he withdrew on my undertaking to consider the matter further. We all had in mind the importance of showing that it was the responsibility of the council to stimulate recruitment, but we were at some pains to see that we did not intend that the council should take over the functions of recruiting for employment. I hope that this alteration in the wording will meet the point as agreed by the Committee, for it makes it quite clear that what we have in mind is recruitment to courses.

9.15 p.m.

Mr. K. Robinson

These words meet the point that we were seeking to make in Committee. I think that there is a touch of ingenuity about them, and I am happy, on behalf of my right hon. and hon. Friends, to accept this Amendment.

Amendment agreed to.

Miss Pitt

I beg to move, in page 2, line 11, to leave out paragraph (b) and to insert: (b) if it appears to them that adequate provision is not being made for the further training of health visitors, shall provide or secure the provision of courses for this purpose. This Amendment again arises from our discussion in Committee when an Amendment was moved to leave out "may" and to insert "shall", on the ground that further training was too important for this function to be left permissive. I explained that the council might well not need to take the initiative for further training facilities, a point which I think was accepted in Committee, but I did promise to consider whether the word "may" could not be replaced by "shall" where needed. Indeed, this is another suggestion which I think the hon. Member for Stoke-on-Trent, Central (Dr. Stross) made to the Committee.

Having given the further consideration that I promised, I feel that this is a way of making clear what we have in mind. It does no more than clarify our original intention. The power is still permissive, but I think that it meets any doubts which hon. Members may have had, and I hope that it is acceptable.

Amendment agreed to.

Mr. Powell

I beg to move, in page 2, line 17, to leave out "relating" and to insert "relevant".

The hon. Member for St. Pancras, North (Mr. K. Robinson) was good enough just now to characterise an Amendment which the House has made as showing "a touch of ingenuity". I hope that he will recognise the same quality in the Amendment that I am now moving.

It was pointed out at an earlier stage that "matters relating to the training of health visitors" might circumscribe very narrowly the field of research which was opened under paragraph (d) of this subsection. By substituting the word "relevant" one greatly widens the field, since a great many matters affecting the work of health visiting are clearly relevant although they might not be held to relate to the training of health visitors. At any rate, I am advised that with the word "relevant" there will be no effective circumscription of the field of research in relation to health visiting which the council can carry out or assist in.

Mr. K. Robinson

I am a little reassured by the brief words with which the Minister introduced this Amendment. When I saw it on the Amendment Paper I recognised at once that it went some way towards meeting the point that we made in Committee. I thought then that it went only a very small part of the way.

I have looked up the definition of the word "relevant" in one or two dictionaries and certainly it is wider than "relating to"—it is not quite synonymous. I am not sure that it is quite as wide open as the Minister sug- gests, but I hope that he is right. On the whole, I still think that it might have been better to take out altogether from the subsection the word "training", which was our original proposal. However, on the assurance that the Minister has given—no doubt, on the authority of people more skilled in drafting than I am—I am quite happy to accept the word "relevant" as substantially meeting our point.

Amendment agreed to.

Mr. Powell

I beg to move, in page 2, line 18, to leave out from "visitors" to the end of line 21.

The House, in Committee, has just decided, upon a Division, not to make to Clause 3 an addition corresponding to Clause 2 (1, e). In moving that Amendment in Committee the hon. Member for St. Pancras, North (Mr. K. Robinson) did say that the reasons for it were stronger in relation to social workers than in relation to health visitors. I shall not trouble the House, therefore, by putting forward again the grounds, which are identical, why this paragraph should not stand part of Clause 2.

Mr. K. Robinson

For the same reason as that given by the Minister, I shall not expand on the arguments in favour of retaining this paragraph, which were, I think, very fully expressed on the other Amendment during recommittal of the Bill. I shall be content to deal with the matter in the Division Lobby.

Dame Irene Ward

I want to draw attention to this fact, that this is the first time in Committee or on Report of a Bill that I have known the Minister in charge of a Bill not to receive the support of a single Member attending the debate. That ought to be on record.

I shall not continue the arguments rejected by the Minister, but I cannot help wondering what has happened and in what direction our democracy is going, because here we have a Minister, without any support at all, either from his own side or the Opposition, rejecting arguments which are based upon considerations put forward by many most important people, and based on a Report produced by a body chaired by a very distinguished woman, and whose deliberations lasted for three and a half years.

The Minister rejects the arguments, and then at the ringing of the Division bell Members come in not knowing what it is about and rush the Minister triumphantly through. It is not my idea of Parliamentary government, and I want to make the strongest possible protest about it.

Miss Herbison

I should like the Minister to explain something which was raised a number of times, but to which we have got no explanation at all from him. He was so anxious to say that social training was in no way different from any other type of further education, although he was faced with the training for child care, the training for the work of almoners, the training for the work of probation officers. Why, if these people, essential as they are, can be treated in this way, is it impossible to treat the few people in this important social or health visiting work in a similar way?

I want to reinforce what has just been said by the hon. Member for Tynemouth (Dame Irene Ward). In Committee, the matter was discussed very fully, and, in spite of the Government, an Amendment was made to the Bill. We have Members on both sides of the House taking part in the discussion in which they are very interested, but the Minister can sit there so assured that when the Division bell goes his "troops" will come in and do for him what he is not able to do for himself by logical, sensible argument.

The only point that I want the Minister to deal with is the question why

Division No. 175.] AYES [9.28 p.m.
Ainsley, William Hamilton, William (West Fife) Parker, John
Blackburn, F. Harper, Joseph Pavitt, Laurence
Blyton, William Hayman, F. H. Pentland, Norman
Bottomley, Rt. Hon. A. G. Henderson, Rt. Hn. Arthur (Rwy Regis) Prentice, R. E.
Bowden, Rt. Hn. H. W. (Leics, S. W.) Herbison, Miss Margaret Price, J. T. (Westhoughton)
Braddock, Mrs. E. M. Hill, Mrs. Eveline (Wythenshawe) Pursey, Cmdr. Harry
Brockway, A. Fenner Hilton, A. V. Rankin, John
Corbet, Mrs. Freda Holman, Percy Robinson, Kenneth (St. Pancras, N.)
Craddock, George (Bradford, S.) Houghton, Douglas
Cullen, Mrs. Alice Hunter, A. E. Rogers, G. H. R. (Kensington, N.)
Deer, George Hynd, John (Attercliffe) Ross, William
Delargy, Hugh Jones, Rt. Hn. A. Creech (Wakefield) Short, Edward
Diamond, John King, Dr. Horace Skeffington, Arthur
Ede, Rt. Hon. C. Lawson, George Slater, Mrs. Harriet (Stoke, N.)
Edwards, Robert (Bilston) Lee, Frederick (Newton) Slater, Joseph (Sedgefield)
Emmet, Hon. Mrs. Evelyn Lubbock, Eric Soskice, Rt. Hon. Sir Frank
Fernyhough, E. MacColl, James Spriggs, Leslie
Fletcher, Eric McInnes, James Steele, Thomas
Gaitskell, Rt. Hon. Hugh McKay, John (Wallsend) Stewart, Michael (Fulham)
Galpern, Sir Myer Marsh, Richard Stones, William
George, Lady Megan Lloyd J. (Crmrthn) Mason, Roy Stross, Dr. Barnett (Stoke-on-Trent, C.)
Gourlay, Harry Millan, Bruce Taylor, Bernard (Mansfield)
Grey, Charles Mitchison, G. R. Tomney, Frank

other types of social workers are treated so differently from those whom we have been discussing this evening.

Mr. Powell

By leave of the House, Mr. Speaker, may I say that the course for almoners and psychiatric social workers are courses which normally follow a university course. Therefore, they are not the first course of further education in relation to which the grant-making powers of the local education authorities are normally exercised. They are not, therefore, an all fours with the courses to which we are referring.

That cannot be said of the child-care or probation officer courses, which as the hon. Lady for Lanarkshire, North {Miss Herbison) knows, in one case some time ago, were instituted in special circumstances to meet a special need, but which, I must advise the House, do not, although anomalous, constitute a ground for taking these courses out of the procedures and finances of further education courses generally.

Mr. Ede

Since I came to the House I have tried to convince Governments that training for one's livelihood is a legitimate part of education. I have always been met by the educational establishments with the plea that vocational training is not education. At last I have managed to persuade a Minister that I am right, but, unfortunately, I persuaded the wrong Minister.

Question put, That the words proposed to be left out stand part of the Bill:—

The House divided: Ayes 76, Noes 145.

Vickers, Miss Joan Whitlock, William
Wade, Donald Wilkins, W. A. TELLERS FOR THE AYES:
Wainwright, Edwin Willis, E. G. (Edinburgh, E.) Mr. Charles A. Howell and
Ward, Dame Irene Yates, Victor (Ladywood) Mr. McCann.
Aitken, W. T. Green, Alan Powell, Rt. Hon. J. Enoch
Atkins, Humphrey Gresham Cooke, R. Prior, J. M. L.
Barlow, Sir John Grosvenor, Lt.-Col. R. G. Prior-Palmer, Brig. Sir Otho
Batsford, Brian Gurden, Harold Proudfoot, Wilfred
Baxter, Sir Beverley (Southgate) Hastings, Stephen Pym, Francis
Bennett, F. M. (Torquay) Hay, John Quennell, Miss J. M.
Bidgood, John C. Heald, Rt. Hon. Sir Lionel Redmayne, Rt. Hon. Martin
Biffen, John Henderson, John (Cathcart) Rees-Davies, W. R.
Bingham, R. M. Hendry, Forbes Renton, David
Bishop, F. P. Hill, J. E. B. (S. Norfolk) Ridley, Hon. Nicholas
Black, Sir Cyril Holland, Philip Robinson, Rt. Hn. Sir R. (B'pool, S.)
Bourne-Arton, A. Hopkins, Alan Rodgers, John (Sevenoaks)
Box, Donald Hornby, R. P. Roots, William
Boyd-Carpenter, Rt. Hon. John Hughes-Young, Michael Ropner, Col. Sir Leonard
Boyle, Sir Edward Hulbert, Sir Norman Russell, Ronald
Brown, Alan (Tottenham) Iremonger, T. L. Seymour, Leslie
Browne, Percy (Torrington) Irvine, Bryant Godman (Rye) Sharples, Richard
Bryan, Paul James, David Shepherd, William
Bullus, Wing Commander Eric Johnson, Eric (Blackley) Skeet, T. H. H.
Butcher, Sir Herbert Johnson Smith, Geoffrey Smith, Dudley (Br'ntf'd & Chiswick)
Campbell, Gordon (Moray & Nairn) Kaberry, Sir Donald Smithers, Peter
Carr, Compton (Barons Court) Kerans, Cdr. J. S. Smyth, Brig. Sir John (Norwood)
Chataway, Christopher Kerr, Sir Hamilton Steward, Harold (Stockport, S.)
Chichester-Clark, R. Kershaw, Anthony Studholme, Sir Henry
Clark, Henry (Antrim, N.) Kirk, Peter Taylor, Sir Charles (Eastbourne)
Clark, William (Nottingham, S.) Lewis, Kenneth (Rutland) Taylor Frank (M'ch'st'r, Moss Side)
Cleaver, Leonard Litchfield, Capt John Temple, John M.
Collard, Richard Loveys, Walter H. Thatcher, Mrs. Margaret
Cooke, Robert Lucas-Tooth, Sir Hugh Thompson, Kenneth (Walton)
Cooper-Key, Sir Neill McLaren, Martin Touche, Rt. Hon. Sir Gordon
Cordle, John McMaster, Stanley R. Tweedsmuir, Lady
Corfield, F. V. Macpherson, Niall (Dumfries) van Straubenzee, W. R.
Costain, A. P. Maddan, Martin Walder, David
Courtney, Cdr. Anthony Maginnis, John E. Walker, Peter
Critchley, Julian Markham, Major Sir Frank Walker-Smith, Rt. Hon. Sir Derek
Crosthwaite-Eyre, Col. Sir Oliver Mathew, Robert (Honiton) Wells, John (Maidstone)
Cunningham, Knox Matthews, Gordon (Meriden) Williams, Dudley (Exeter)
Curran, Charles Maxwell-Hyslop, R. J. Williams, Paul (Sunderland, S.)
d'Avigdor-Goldsmid, Sir Henry Maydon, Lieut. Cmdr. S. L. C. Wilson, Geoffrey (Truro)
Deedes, W. F. Mills, Stratton Wise, A. R.
Elliot, Capt. Walter (Carshalton) Mott-Radclyffe, Sir Charles Wolrige-Gordon, Patrick
Emery, Peter Noble, Michael Wood, Rt. Hon. Richard
Farey-Jones, F. W. Page, Graham (Crosby) Woodhouse, C. M.
Farr, John Pearson, Frank (Clitheroe) Woollam, John
Finlay, Graeme Peel, John Worsley, Marcus
Fraser, Ian (Plymouth, Sutton) Pickthorn, Sir Kenneth
Gammans, Lady Pilkington, Sir Richard TELLERS FOR THE NOES:
Gardner, Edward Pitman, Sir James Mr. Whitelaw and
Gilmour, Sir John Pitt, Miss Edith Mr. Michael Hamilton.
Glover, Sir Douglas Pott, Percivall
Mrs. Hill

I beg to move, in page 2, line 21, at the end to insert: (f) shall prepare and maintain a register of health visitors. It may be argued that there is no need for this Amendment or that there is no room for it within the scope of the Bill. When I raised the matter with my hon. Friend the Parliamentary Secretary, she wrote to me at great length in that sense. On the other hand, the health visitors are concerned that they themselves will not, under the Bill, be able to issue certificates and maintain a register of the certificates issued. I think I am right in saying that there was, in 1959, a suggestion that this should be one of their functions. While it may be said that, since health visitors must be nurses first, there is no need for this provision, I must tell the House that in 1960, dietitians were empowered to maintain a register although they, too, are State-registered nurses before taking up training as dietitians. It seems only fair that health visitors should have a similar opportunity.

Although, if a health visitor commits a misdemeanour, the matter will go to the General Nursing Council, it is not provided in the Bill that the G.N.C. would report such a matter to the health visitors. Health visitors feel that they, too, should have the opportunity of issuing certificates and maintaining a register so that they may keep a good eye on the work done by members of their profession. It has happened in the past that people who were not health visitors have been said to be visitors, and it is the opinion of the profession that the matter should be reconsidered. I hope that the Minister will be able to help us a little more than the Parliamentary Secretary's letter to me did.

Miss Vickers

The Women Public Health Officers' Association passed the following resolution at its annual general meeting in March this year: This meeting reaffirms in the strongest manner possible that the long-standing policy of the Women Public Health Officers' Association that the establishment of a register of health visitors is vital for the protection of the title of the health visitor and for the safeguarding of the profession, and resolves that the necessity for this register be urged on those responsible for the planning of the future of health visiting". For that reason and others, I support the Amendment.

During discussion on the Professions Supplementary to Medicine Act, 1960, it was decided that there should be registers for these various professions. I recognise that health visitors are registered as nurses and are subject to the general discipline of the General Nursing Council, but it may not always be known to the council, if a nurse has removed her name from the register, whether she was a health visitor or not.

I understand that some health visitor courses are held under the aegis of the universities and I have been advised that the universities will not accept an arrangement under which courses which they conduct have to be approved by an outside body, which, I presume, in this case would be the General Nursing Council. The universities, as is well known, run their own courses and examinations without the help of an outside body.

In view of the two points which I have mentioned, namely, the necessity of safeguarding the profession of the health visitor and the point about the universities, I hope that my hon. Friend the Parliamentary Secretary will accept the Amendment.

Mr. Pavitt

I support the case made out so admirably by the hon. Ladies the Members for Manchester, Wythenshawe (Mrs. Hill) and Plymouth, Devonport, (Miss Vickers). The hon. Lady the Member for Wythenshawe said that this matter is pertinent and relevant to the Bill. Throughout the Bill we have been concerned with status, which can be achieved only if there is some form of register which enables people to see that this is a sector of the health service to which they are attached and for which certain qualifications are required. Such a register would enable it to be defined clearly that, although they are already on the nurses register, they have this additional qualification which enables them to be health visitors.

I have received representations from the Women Public Health Officers' Association. I also had the good fortune recently to attend the conference of the Royal Society of Health at Scarborough, during which I had representations from many quarters about the need for a register to enable the qualifications obtained under the Bill to be clearly seen and stated.

I am very glad that the hon. Lady the Member for Wythenshawe has moved this Amendment. I pay tribute to the fact that, throughout the passage of the Bill, the hon. Ladies on the Government side had made a contribution. On this subject they know what they are talking about. The conclusion which I have reached is that hon. Gentlemen opposite are silent because they do not know what they are talking about. So far, we have not had any contributions from hon. Gentlemen opposite. Hon. Ladies opposite know what they want and are prepared to ask for it.

Miss Pitt

My hon. Friend the Member for Manchester, Wythenshawe (Mrs. Hill) was quite right in anticipating that I would tell her that there was no need for the Amendment, as I have already told her in private correspondence. There is nothing to prevent the Health Visitors Council from maintaining a register in the sense of a record of the health visitors to whom it has issued its certificate. Indeed, I am quite sure that it would choose to do that. If that were all my hon. Friend had in mind—it is all that her Amendment asks for—then I say that that is almost certain to happen. That I believe meets the point made by the hon. Member for Willesden, West (Mr. Pavitt). Evidently, he is mainly concerned with maintaining a register of health visitors who receive the appropriate certificate.

9.45 p.m.

From the speeches made by my hon. Friend the Member for Wythenshawe and my hon. Friend the Member for Plymouth, Devonport (Miss Vickers), however, it is evident that although it is not covered by their Amendment they want to go further and to have powers so that the General Nursing Council may take disciplinary action. I am sorry to tell them that their Amendment would not provide for that. It would not, therefore, achieve their object. In any event, if their anxiety is to protect the title of "health visitor", it would be necessary to have supplementary powers to take disciplinary action.

Since however, the first object of my hon. Friends is to secure that a register is kept, I can promise them that that is possible without any Amendment. To go further and to provide the council with all the disciplinary powers of other professional bodies would go a long way beyond the scope and purpose of the Bill.

Dame Irene Ward

The argument of my hon. Friend the Parliamentary Secretary is extraordinary. I am prepared to see the Amendment in the Bill as it has been put down. If it meets the wishes of the women public health officers, why cannot my hon. Friend give them the satisfaction of embodying their suggestion in the Bill? As she says, they are entitled to keep a register without having the fact written into the Bill. Is there any reason why it should not appear in the Bill, plainly stated as in the Amendment?

The title of the Bill is "Health Visitors and Social Workers Training Bill", yet in the text of the Bill there is no mention of the bodies concerned. There is no indication that my right hon. Friend the Minister wants to build up, as he ought to be doing, the status and position of health visitors and social workers. It is extraordinary that there has been no emphasis upon this. The only people who are mentioned in terms are the employers, who are, of course, the local authorities.

If women public health officers wish to have this provision in the Bill, there is no reason to prevent its inclusion. It would indicate to the country—I hope that people will study the Act from time to time—that a register of health visitors is to be kept. That in itself would be an indication of the position of health visitors concerning the general organisation of their services and powers.

What my hon. Friend the Parliamentary Secretary has said is nonsense. She is putting ideas into my head which I certainly do not have. I see no reason why she wants to do that. I am quite capable of putting my ideas forward. There is no reason for her to indicate to me what I am thinking or want, because I do not think or want it. All I want is the Amendment in its simple terms embodied in the Bill, so that at least we have it there and people will know that the health visitors have a register.

If someone reading the Bill sees that the health visitors have a register, it is an indication to him that he can study it. If there is no register, no names may be available to local authorities or to other individuals interested in the work done by health visitors.

It is most ungracious of my hon. Friend not to accept the Amendment. The Bill does absolutely nothing that anybody wants except the Minister and the Parliamentary Secretary. It is most extraordinary that this quite simple little Amendment should be rejected and that things should be put into my mouth with which I am not concerned at all.

Miss Herbison

I support the Amendment. In dealing with points raised by the hon. Ladies the Members for Manchester, Wythenshawe (Mrs. Hill) and Plymouth, Devonport (Miss Vickers), the Parliamentary Secretary said that the Amendment did not give health visitors any powers of disciplinary action, and so on. The Amendment does not ask for that. The health visitors are merely asking that a register should be kept. They are not asking much from the Minister.

The hon. Lady the Member for Tynemouth (Dame Irene Ward) used the word "ungracious", and that is perhaps the correct word to use in this context. The Amendment does not ask for a great deal, and it might be gracious of the Parliamentary Secretary if, even at this stage, she would say that she was prepared to accept this simple Amendment.

Mr. Powell

The debate has shown that the intention of the Amendment is that there should be a register of those who have received the certificate of the council. It is from no wish to frustrate anyone's desires that I must tell the House that there is no doubt at all that the council has the power to maintain such a register. I should think that there is no doubt at all that it will do so, and I should also have thought that it was somewhat derogatory to the council, which my hon. Friend the Member for Tynemouth (Dame Irene Ward) wants to build up, to write into the Bill—I do not think these words would do it with sufficient precision—a requirement that it should maintain a register.

I hope that the House will take it that the desires of those concerned can be met within the Bill as it stands and, so far as one can see, undoubtedly will be met, and that it would be better that these words should not be written into the Bill.

Amendment negatived.