QUEEN ALEXANDRA'S ROYAL NAVAL NURSING SERVICE (Hansard, 20 May 1971)

§ Dame Joan Vickers (Plymouth, Devonport)

I am glad that we are able to have this debate at such an early hour. I thank my hon. Friend the Under-Secretary not only for replying to the debate but for the considerable interest which he has taken in the Royal Naval Hospital at Stonehouse, Plymouth. He will be pleased to know that excellent progress is being made with the proposed plastic surgical unit and if all goes as planned, this should be finished by April, 1972.

For some considerable time there has been concern about what might be termed misemployment of nurses. In the future, I should like to see the nurses giving their full time to nursing or training for nursing. In June, 1970, the right hon. Member for Coventry, East (Mr. Crossman) wrote to the National Health Service boards of governors of hospitals and management committees and stressed the fact that nurses should not be asked to do housekeeping duties. This matter was then raised also with the Ministry of Defence in July, 1970, having previously been raised in March, 1969, and February, 1970.

As my hon. Friend will know, there is a serious shortage of nursing officers and naval nurses and this has been a matter of concern to Her Majesty's Services for some years. I understand that successive matrons-in-chief have tried to get the system changed; in other words, they have tried to get specially qualified people to do the job of housekeeper. For example, one superintending sister full-time, one sister part-time and three head naval nurses full-time are at present employed to administer the sisters' and nurses' quarters and messes. Two superintending sisters, two head naval nurses and two assistant nurses are allowed, by complement, to do these duties. These are to look after the main messes, which are the sisters' mess and the main nurses' mess. There are three separate houses in 1658 the Royal Naval Hospital, and, outside the hospital, there are the Nelson Gardens sisters' quarters and Wingfield Mansions nurses' quarters.

Naturally, most of these women are not trained for housekeeping work and it is a great waste of both their training and talent to do anything other than nursing. Nursing is a definite vocation. It appeals only to a certain number of women.

With intensive care units in this hospital and with modern surgery, all their skill is needed for nursing. Surgeons may undertake an operation with great skill, but it is usually the nursing care that pulls a very ill patient through. It is tiring and exacting work it needs their full attention, courage and patience.

In May, 1970, the then Minister of Health wrote to all the boards of the National Health Service and asked them to see that the nurses' working conditions were likely to encourage them to stay in the Hospital Service. This criterion should apply also to Service hospitals. Nurses should not have to spend valuable time on chores to be done by other people less qualified, so I am asking the Minister to look into the matter to see whether he can recruit civilians qualified in housekeeping as is done in hostels, some nurses' homes and most civilian hospitals.

There are plenty of these people who would be willing to undertake this type of work and they would relieve the highly skilled and excellent nursing staff to do the job for which they are trained. I am asking for permission for the hospitals to engage two resident housekeepers and three full-time assistant housekeepers. This could lead to a reduction of one superintending sister and three head naval nurses or assistant head naval nurses. This would add no extra expense, therefore, to the upkeep of the hospital and the nurses, in my opinion and theirs, would be much better employed doing work for which they spent years of training. With civilian housekeepers, even this side might be better done because they might be better trained for that type of work.

§ The Under-Secretary of State for Defence for the Royal Navy (Mr. Peter Kirk)

My hon. Friend the Member for 1659 Plymouth, Devonport (Dame Joan Vickers) has raised a point which has been giving my Department some concern for some time. It concerns the welfare of Queen Alexandra's Royal Naval Nursing Service, an order who perform their duties so well that they hardly ever attract the attention of the House. So I am very glad that my hon. Friend has raised this matter, because it enables me to say something about them and about the need to provide them with the very best supporting service possible.

They are of course peculiar to the Royal Navy. They were started by Royal Charter in 1902 by Queen Alexandra herself and they have gone from strength to strength ever since. They are a vital part of the support facilities of the Royal Navy, and we could not carry on without them. Therefore, anything which affects them is bound to be of considerable concern to the Navy and therefore to me.

My hon. Friend raised this matter some time ago with my predecessor and the whole thing has been under consideration for some months. I am glad to have this first opportunity to tell the House what we are doing about the management of the quarters both for officers and for ratings in the Q.A.R.N.N.S. in the various naval hospitals, including the one at Plymouth. This problem does not apply only to Plymouth but to other hospitals as well.

At present the quarters are managed or supervised by members of the Q.A.R.N.N.S. who run the civilian domestic staff and those who originally entered as V.A.D.s have made a particularly helpful contribution in this respect. The V.A.D.s were introduced during the last war largely to take on anything broadly in the nursing field, including the secretarial and housekeeping work. Recruitment to the V.A.D.s stopped in 1960, and the remaining members of the force who applied to the Royal Navy were then absorbed in the Q.A.R.N.N.S.

Their numbers have naturally dwindled and at the moment there are only 11 left. These also in due course will retire. We had to consider what alternative arrangements we could make. We could continue to fill the posts in the nurses' quarters with members of the Q.A.R.N.N.S., including the ex-V.A.D.s 1660 so long as they remained in the Service, but my hon. Friend has pointed out the disadvantages in this course—that once the V.A.D.s had been phased out, one was misemploying trained nurses. Clearly there would be attractions in the long term in making some other arrangement. The "housekeeper" rôle is not popular with fully-trained nurses, as my hon. Friend pointed out, and in view of national shortages, they would be better employed on nursing duties.

Several alternatives are open to us. We might set up a non-nursing branch of the Q.A.R.N.N.S.; the use of W.R.N.S. personnel could be considered; or we might even employ civilian housekeepers or wardens, which, as my hon. Friend said, is now common in National Health Service hospitals. All these possibilities have been looked at carefully and all have advantages and disadvantages.

We hope to take a decision in principle very soon as to whether a new scheme should be introduced, and if so, what form it should take. I am sorry to tell my hon. Friend that I cannot say any more tonight, except to point out that the job goes rather wider than the purely catering and housekeeping arrangements. Ideally, we are looking for, though we may not be able to find, somebody who, in addition to catering and housekeeping, can do general administration, welfare and regulating duties and all the things that apply more to a uniformed service than to civilian hospitals.

It is also a job in which, ideally, the staff should be mobile and ready to fit in with Service requirements. We cannot contemplate a situation in which they would settle down in one hospital, unable to be moved elsewhere. There are, therefore, strong arguments for continuing to provide uniformed staff as opposed to civilians, but there are other factors which will have to be taken into account.

The best I can do tonight is to promise my hon. Friend that she will be informed as soon as a decision in principle has been taken. If the decision is to set up a non-nursing branch of the Q.A.R.N.N.S. its terms of service will probably be similar to the existing conditions in the Q.A.R.N.N.S., but this would have to be worked out in detail once a decision in principle had been taken.

We should naturally be looking for girls or women with some aptitude and 1661 experience for the job, and preferably with some formal qualifications, but this may not be absolutely necessary. I cannot tell my hon. Friend more at this stage. This is a problem and I agree that it has been dragging on for a long time. We want to bring it to a con- 1662 elusion, and I again assure my hon. Friend that I will let her know as soon as a decision has been taken.