HC Deb 02 March 1970 vol 797 cc36-43
The Secretary of State for Social Services (Mr. Richard Crossman)

With permission, Mr. Speaker, I wish to make a statement on further Government measures to ensure that the nursing services are equipped to meet the demands of the present and the future.

I am glad that agreement has been reached in the Whitley Council on higher pay for all nurses in the National Health Service. But I have never considered that pay was the only problem in nursing and, as a matter of urgency, I am now setting up, jointly with the Secretary of State for Scotland and the Secretary of State for Wales, an independent committee with these terms of reference: To review the rôle of the nurse and the midwife in the hospital and the community and the education and training required for that rôle, so that the best use is made of available manpower to meet present needs and the needs of an integrated health service. I am glad to say that Professor Asa Briggs, Vice-Chancellor of the University of Sussex, has agreed to be Chairman of this Committee. The rest of the membership will be announced shortly.

I now turn to participation in management which I believe here and now is the best and quickest way to help the nurses do their job as they want to do it Tomorrow, doctors, nurses and administrators in the teaching hospitals are holding a conference on the meaning and development of multi-disciplinary management and, as far as England is concerned, I shall be promoting similar discussions throughout the service.

Consultation is already proceeding on the implementation of the new nursing management structure in the community services. My purpose is to get the new operational principles and the new nursing management structure firmly established in all parts of the service now in readiness for the organisational changes proposed in the Green Paper.

Against this background of improved pay, urgent study of rôle and training and immediate measures to give nurses their proper place in management I am launching tomorrow a nationwide recruitment campaign which will continue throughout the year. I shall look to hospital authorities to ensure that success in recruitment is not frustrated by lack of funds. I propose, also, to pursue consultations with managements and the professions on all other possible measures that would enable nurses and midwives to use their skills to the full in the service of the patient.

Mr. Maurice Macmillan

I am sure the whole House will be glad that nurses are to get more pay. I hope that the rest of the right hon. Gentleman's statement means that he has fully grasped the urgency of the problem of the shortage of nurses and that this is not merely a productivity exercise to justify the extra pay.

While we welcome the setting up of the committee under Professor Asa Briggs, may I ask whether the Secretary of State can say roughly how long he proposes that it should take before its recommendations are brought forward for possible implementation? Does he think that we can hold the situation meanwhile?

Secondly, would the right hon. Gentleman agree that the problem is not only of recruitment, but of the retention of nurses? Will either the management studies and consultations that he is having or, alternatively, Professor Briggs's committee, consider such matters as making superannuation in the nursing services voluntary? This, I understand, is one of the major advantages which agencies have in attracting nurses from the Health Service; and I also understand that there are now about 1,000 agency nurses in London teaching hospitals.

Thirdly, could the right hon. Gentleman say something about the rôle of part-time nurses and whether he proposes that they should be included, and also the district nurses?

Mr. Crossman

Yes, we shall, of course, consider the part-time and the district nurses with nurses in general.

As for the length of time which the committee will take for discussion, Professor Briggs is hopeful of getting the matter completed in 18 months, which seems to me to be reasonable.

The hon. Gentleman asked whether I thought we could hold the situation. Certainly not by doing nothing for 18 months.

As to participation in management, and recruitment, the hon. Gentleman is right about retention. It was important to see to both. Since 1947, we have not markedly improved our rate of recruitment of student nurses. We need to recruit more and, of course, to retain more at the same time, but to retain we have first to recruit. Part of the consideration of retention will be to consider problems such as superannuation.

The Briggs Committee will be entitled to consider such measures, if that is a serious motive against nurses joining the service, although I should be dubious that that particular measure would be itself a method of improving recruitment.

Mr. Wallace

Is my right hon. Friend aware that his statement will be warmly welcomed by all hospital management committees throughout the country concerned with the problem of nurses? Could my right hon. Friend state whether nurses will be represented on the committee? May I assume from what he has said that regional boards are not to be restricted in nursing recruitment or in nursing establishments on financial grounds?

Mr. Crossman

I thank my hon. Friend. The nursing profession will be represented, although I think that it will by no means be exclusively represented, as we want ideas brought in from the outside.

I shall be discussing on Wednesday with the chairmen of the regional hospital boards the statement I have made, and I shall be urging on them the importance of not letting financial reasons stand in the way, because to maintain the service we really must recruit and hold the nurses. In certain areas we are at the danger margin because of shortage of skilled labour, and I shall be emphasising that it would be a false economy to economise on already over-occupied nursing staff.

Sir J. Vaughan-Morgan

The right hon. Gentleman referred to not holding up the recruitment campaign by stinting funds and also to hospital authorities not being stinted. Will he give an extra allocation for this purpose? In his review of the pay of the nurses, has he been able to get a better salary structure for chief nursing officers and those who come directly under them, so as to make a properly salaried career?

Mr. Crossman

The Whitley Council is still discussing salary structure, but I know that the proposals, as I saw them, included marked improvements here which I think the whole profession, from top to bottom, regards as necessary.

There will be no specific and special grant towards nursing. I am trying to allocate regional board budgets and board of governor budgets according to need.

Mr. William Hamilton

Is my right hon. Friend aware that the proposed pay increase for nurses compares extremely favourably with the 2½ per cent. Ceiling which was imposed by the party opposite just a year or two before it left office? Will he give an assurance that this wage increase will not prejudice any future or immediate claims on the question of hours and overtime rates?

Mr. Crossman

My statement was not about pay but about further activities of nurses, but I can only repeat what I said, that the award is for one year. We have not tied people from raising other points when it is finished.

Sir A. V. Harvey

Will the right hon. Gentleman recall that a few months ago the nurses were given an additional food allowance, but it worked out to be taxable, unlike allowances to men and women who work in offices in cities? Will this aspect of the matter be looked at, to see that where nurses are given increases they are real ones?

Mr. Crossman

This aspect has been looked at in this award and due account has been taken of it.

Mr. Arthur Lewis

My right hon. Friend said that the committee will not be precluded from dealing with salaries and such questions as that. Are we to take it that it can look at the whole question of salaries and wages? If not, will he give it permission and, if possible, some idea how to prevent a recurrence of what recently happened when nurses had to wait a long time to get a settlement?

Mr. Crossman

I am sorry if my hon. Friend misunderstood me. What I said was that the committee would not be precluded from discussing superannuation as a bar to recruitment of nurses. I have not asked the committee to study salaries. That has already been dealt with. But I do not exclude the possibility of studying relevant superannuation.

Dame Irene Ward

I agree that the establishment of the committee is a step forward, and I am very grateful for it, but does not the right hon. Gentleman think that 18 months is rather a long time for the committee to take to complete its inquiry, in view of the difficulties of the nursing profession? As the committee will not deal with salaries and pay, which I fully understand, may I have an assurance from the right hon. Gentleman that in future he will cease his ridiculous obstinacy which has caused so much hardship and trouble in the nursing profession?

Mr. Speaker

Order. Every long supplementary cuts out another question.

Mr. Crossman

The second part of the hon. Lady's question is difficult to answer, because I do not recognise the description of my conduct.

Dame Irene Ward

No, but I do.

Mr. Crossman

On the question whether 18 months is too long a time for work of this kind, if we are to do anything serious about the long term, and we must, I think that the period is reasonable, but Professor Briggs has assured me that, if he feels he can, and wants to, produce an interim report, this is not excluded.

Mr. Cronin

I welcome the statement of my right hon. Friend, which will also be warmly welcomed throughout the National Health Service. Is he aware that a substantial number of nurses every year, particularly in the mental health service, are seriously injured as a result of assaults by patients? Will he ask the Briggs Committee to look into the safety of nurses who are looking after mentally deranged cases?

Mr. Crossman

That is certainly part of the work which I hope the committee will cover.

Mr. Orbach

Will the Minister permit representations to the committee from the trade unions concerned, in addition to the Royal College of Nursing? I have in mind N.U.P.E., N.A.L.G.O., and C.O.H.S.E. Secondly, will the committee consider the question of the accommodation of nurses?

Mr. Crossman

The answer to both question is, "Yes, Sir".

Dr. Winstanley

I welcome the statement, both as regards pay and for its recognition that the problem of recruitment and retention of nurses concerns more than just pay. Will the right hon. Gentleman continue this forward-looking approach by stopping people in his Department from referring to the loss of nurses during training through marriage as wastage? Will he introduce a more flexible system so as to make better use of this vast reserve of trained woman-power?

Mr. Crossman

I always have a temptation to become a semantic ameliorist and I will certainly seek to improve the use of language in my Department.

Mr. Ridsdale

I welcome the Minister's statement. Will he look at the position of retired nurses, some of whom are living in great poverty? Although there was an increase last year in public service pensions, much of that increase has been taken up by increased taxes.

Mr. Crossman

I think that the question of the pensions of retired public servants should be seen together and not in isolation, profession by profession.

Mr. Molloy

Is my right hon. Friend aware that the nursing profession knows very well the parsimonious attitude of the Conservative Party when it is in power, and how it takes up the nursing cause only when it is in opposition?

There are two things which my right hon. Friend could do immediately. One is to abolish the fees which the nurses now have to pay to take examinations. The other is to abolish this miserable business of making the nurses pay for their food in hospitals. The abolition of these two things alone could greatly contribute to his recruitment campaign.

Mr. Crossman

It was, of course, the attempt to abolish the payment for food which led to difficulties, but I do not want to get back to that. That, on the whole, is out of the way. Something was done which they wished to have done, and I am sure it is an improvement.

I will ask the committee to look into payment for examinations.

Sir H. Harrison

Will the Minister ask the committee to look at the practice of student nurses in their second year being left all night in charge of large wards? This is a great strain on them and causes those who do not want such responsibility to leave before completing their training.

Mr. Crossman

This is part of the conditions of nurses which the committee should look at. Although I do not admit that this is a prevalent custom, it is a proof of the shoestring on which we are working in terms of nurse power. This is not done because anybody wants it to be done, but because in a particular hospital at a weekend very often there is a desperate shortage of staff. It is for this that I want the recruitment campaign.

Several Hon. Members rose—

Mr. Speaker

Order. Everyone is deeply indebted to the nurses, but I must protect the business of the House.

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