NURSES ACT 1964 (AMENDMENT) (Hansard, 24 July 1967)

§ Mr. T. L. Iremonger (Ilford, North)

I beg to move, That leave be given to bring in a Bill to make provision for separate rolls of nurses for general and for psychiatric nursing; to make provision for the inclusion of one registered nurse for the mentally subnormal in the statutory composition of the mental nurses committee; and for other purposes. Mr. Speaker, I hope that I shall not try your patience too far if I associate myself very warmly with other hon. Members in wishing joy to you and Mrs. Speaker.

In asking the House for leave to introduce this Bill, the effect of which I shall explain in detail directly, I am asking the House to fire a warning shot across the bows of the Minister of Health, and those who advise him, and the General Nursing Council for England and Wales. I am doing so on behalf of psychiatric nurses, whose views I am convinced generally conform to those expressed to me by many on the staff of the two great hospitals, Claybury and Goodmayes, in my constituency. Many of them are my constituents and I value the advice they give me concerning their patients' and their own needs and interests from time to time. Many of them are constituents of my hon. Friend the Member for Wan-stead and Woodford (Mr. Patrick Jenkin), and I am grateful to him for having agreed to sponsor the Bill should the House give me leave to introduce it.

I can assure the House that I am expressing a view which represents the will of the overwhelming majority of the psychiatric specialists in the nursing profession. This is exemplified by both the quality and the quantity of those who have signed petitions addressed to me and by the fact that in the hospital in my constituency in which staff opinion was systematically canvassed the response was 100 per cent. affirmative, not counting those who were absent or on leave at the time.

I must make one further general introductory point, which is of the greatest importance. Although these psychiatric nurses certainly are most anxious and critical about the organisation of their profession, they are not to be regarded as 8 being, and do not feel themselves to be, in any way an aggressive or bellicose minority, despite the metaphor I used from naval gunnery. They are in no way fractious or perverse.

The legislative proposals which I shall outline are certainly designed to protect their special needs, and must inevitably emphasise the distinction between psychiatric and general nursing. Inevitably also, therefore, the adaptability of the General Nursing Council is called in question. But I know that those on whose behalf I am speaking would wish me to make it clear that they have no antagonism towards the General Nursing Council as such. They merely feel that without the kind of insight and knowledge which only practical experience of nursing mentally-ill and mentally-subnormal patients can give, it would not be possible for the General Nursing Council, with the best will in the world, adequately to perform for psychiatric nursing the special responsibilities which this House has put upon it.

The psychiatric nurses want to make quite sure that any reorganisation or any changes in the composition, functions and powers of the General Nursing Council and the Mental Nurses Committee that may be under contemplation are not in the end made without their special position being fully guaranteed for the future. To that end my Bill would provide for the composition, functions and powers of the Mental Nurses Committee of the General Nursing Council to be as follows.

The composition would be: two nurse administrators—that is to say, matrons, chief male nurses and their deputies—in psychiatric nurse training schools; and four nurse tutors in psychiatric nurse training schools, two of whom being engaged in teaching pupil nurses as opposed to student nurses. The status and identity of psychiatric nurse training schools is a matter which will very much fall to be decided by the Mental Nurses Committee under the terms of the Bill.

Further, there will be two doctors engaged in teaching student or pupil psychiatric nurses, one State enrolled nurse (mental) and one State enrolled nurse for the mentally subnormal, as recorded in the records kept by the General Nursing Council. Next, there 9 will be four psychiatric nurses unspecified, and one hospital administrator in a psychiatric nurse training school.

That makes a total of 15, and of those 15 six will be elected as follows: three registered mental nurses to be elected by their peers, that is to say, by registered mental nurses; one registered nurse for the mentally subnormal to be elected by registered nurses for the mentally subnormal; one State enrolled nurse (mental) to be elected by State enrolled nurses (mental); and one State enrolled nurse for the mentally subnormal, likewise to be elected by State enrolled nurses for the mentally subnormal. The six elected members shall ipso facto be elected to the General Nursing Council.

That leaves nine other members, and they are to be appointed by the Minister of Health to make up the balance of the total membership of 15 which I have specified. They are to be so selected for appointment by the Minister as to ensure that not less than four of the 15 are engaged in training student or pupil nurses in hospitals for the mentally subnormal, the care of the mentally subnormal being a growing section of the psychiatric specialisation which is in danger of becoming the Cinderella of the whole profession. Finally, it shall be stipulated that no person shall be co-opted to the Mental Nurses Committee.

The functions and powers will be as follows. The Mental Nurses Committee is to be responsible in psychiatric hospitals for the training of student and pupil nurses, for laying down the syllabus for and method of conduct of nursing examinations and appointing the examiners, and for the registration and enrolment of nurses. It will nominate ex-officio representatives on to the disciplinary, the finance, the education, the examinations and any other appropriate committee of the General Nursing Council, and it will have an absolute right of veto so that the separate parts of the register and roll reserved for psychiatric nurses shall not be abolished without the full agreement of the Mental Nurses Committee. Further, it shall have a mandatory function in all matters relating to the training, examining, registration or enrolment of nurses for patients with mental disorders; that is to say, all such matters shall be referred 10 to this Committee for final decision. I should explain that this shall be not merely a consultative function or status in the sense of a sham guarantee which can be overridden, but shall enable the Mental Nurses Committee to have the final deciding voice in all such matters.

Those are the terms of the Bill. I hope that the House will give me leave to introduce it. I hope that its terms will be studied sympathetically and with profit by those responsible for the future organisation of the nursing profession, and, accordingly, I beg leave to introduce the Bill.

§ Mr. Laurence Pavitt (Willesden, West)

I oppose the Motion. I share many of the views put by the hon. Member for Ilford, North (Mr. Iremonger), and I readily endorse his aim of trying to do something for psychiatric nursing. What is more, I share his concern for Goodmayes Hospital, where I was recently the guest of honour at a dinner of the Confederation of Health Service Employees and of the mental nurses engaged at that hospital.

But I ask the House to reject the Bill for these reasons. The Bill is badly timed. It is inadequate. In the present state of negotiations, it will create a good deal of uncertainty if it is allowed to proceed further. Negotiations have been proceeding for some time on this and other nursing matters. I realise that the Bill will die a natural death because of the Parliamentary timetable, but the arrangement whereby we are to come back again in October for the conclusion of the Session will entail a fairly long period of uncertainty and, in the present state of negotiations, this cannot be in the best interest of the nursing profession as a whole or of psychiatric nurses in particular.

The General Nursing Council is in negotiation about this matter, and it has already put forward proposals to the Minister. Discussions are going on with a view of subdividing the present roll into three sections, not two, as suggested by the hon. Member for Ilford, North—one for general nursing, one for mental illness, and one for mental subnormality. This is neither the time nor the place to go into the merits of having one, two or three rolls, but it is obvious that, as 11 negotiations are in train, if we try to jump the gun in the way proposed, the profession will be precluded from pursuing the sort of discussions which, perhaps, would lead to a more satisfactory conclusion. It is better not to discuss reorganisation of this kind in isolation from the rest of the problems of the nursing profession, and, in particular, from the pressing problems within psychiatric nursing itself.

The hon. Gentleman's Bill is concerned not so much with status as with constitution, but the whole question of status needs to be answered before one changes the membership of any council, and this matter also is at present under review. The General Nursing Council has responsibility for the whole of the nursing profession. I submit that, rather than give leave to introduce the Bill at this stage, in its half-baked condition, the House would do better to allow full consideration to proceed among the people concerned, not only with the General Nursing Council, the Confederation of Health Service Employees and the National Union of Public Employees but with all others who have an interest in wishing to benefit and improve the welfare of psychiatric nurses. One hopes that the Minister will eventually reach a comprehensive solution and not have piecemeal legislation of the kind proposed. For all those reasons, I ask the House to reject the Bill.