TUBERCULOSIS VISITORS (HEALTH AND CHEST CLINICS) (Hansard, 26 May 1976)

§ Mr. Anthony Steen (Liverpool, Wavertree)
I beg to move, That leave be given to bring in a Bill to make provision for improving the status of tuberculosis visitors working within health and chest clinics; and for connected purposes. Would it be in order, Mr. Speaker, to wait until the Chamber clears a little before I present my Bill?

§ Mr. Speaker
I ask right hon. and hon. Members, if they are leaving the Chamber, to do so quietly because the hon. Member for Liverpool, Wavertree seeks to address the House.

§ Mr. Steen
One of the important tasks of the House, as you have heard this afternoon, Mr. Speaker, is to champion the rights of the individual and to protect minority groups from being trampled on by the big battalions. I take it that no hon. Member will disagree with that. If that is the case, how does one reconcile that basic principle with the discrimination that is currently practised against the tuberculosis visitor if she does not possess a health visitor's certificate?
There are 140 tuberculosis visitors. Most are experienced State registered nurses usually with other qualifications as well, such as State certified midwives, certificates in tropical diseases and qualifications of the Royal Institute of Public Health and Hygiene. However, fewer than six of those tuberculosis visitors hold a health visitor certificate.
The tuberculosis visitor's job is to detect and monitor and help those who have tuberculosis. The visitors work from chest clinics and are part of the National Health Service. Chest physicians tell me that they are invaluable and indispensable and play an important part in the life and health of the country.
The House may be surprised to learn that the number of tuberculosis cases in Great Britain is starting to rise again. In 1975 there were 12,323 outbreaks. That is why it is so repugnant that the Government have passively accepted Halsbury's odious distinction between the tuberculosis visitor with the health visitor certificate and the tuberculosis visitor without it. If a nurse has the health visitor certificate, her status is enhanced 471 and she is raised in pay and pension rights to the equivalent of Ward Sister 1. If she does not have the health visitor certificate, she is demoted to the bottom rung of the nursing ladder, to staff nurse. Whereas in 1970 the tuberculosis visitor without the health visitor certificate was on an intermediate scale between staff nurse and sister earning £180 less than the tuberculosis visitor with the certificate, in 1975 Halsbury shot up the differential to £1,248 while downgrading those without the certificate. If the tuberculosis visitor has the health visitor certificate, not only is she paid more, and gets a higher pension, but she is three grades higher than her colleague doing identical work in the same office, in the same area, who takes on the same responsibilities. If the tuberculosis visitor has no health visitor certificate she is on the same rung as the nurse who has just qualified. In fact, she is back to where she started 20 or 30 years ago.
Everyone is agreed that Lord Halsbury got it badly wrong and that the tuberculosis visitor without the health visitor certificate should be upgraded, although not necessarily to the same level as those with the certificate, because everyone recognises that the health visitor certificate—an eight-month course—is a valuable and additional training; but she should at least be placed on the same band as other community nurses such as the district nurse and the district midwife. In this way the distinction between those tuberculosis visitors with the health visitor certificate and those without it would be narrowed, their status restored and the financial differential reduced to £300.
I am glad to say that the Edmonton chest clinic has found a way around this anomalous situation. Since January 1976 it has got rid of its tuberculosis visitors. Instead, the two tuberculosis visitors without the certificate it employs have been upgraded to district nurses. But they are actually carrying out identical work although with a few extra jobs thrown in for good measure. Their salary scale now goes up to £3,552, but a few miles away, at the health centre at Hackney, there are still tuberculosis visitors doing identical work whose salary scale goes up only to £2,646. I believe that that is totally wrong.
472 What is so mean and hurtful is that the Department of Health obviously thinks that it can get away with this, because it takes the view that nurses will not take industrial action as they are not part of one of the strong unions. Although NALGO has expressed support and concern, it is odd that the other heavyweight unions do not appear to have the interest or gallantry to take up this cause and to resist the fundamentally wrong and unacceptable principle of actually downgrading a group of workers and reducing both their status and their salary and pension rights.
Since I introduced a previous Bill on 27th April, dealing with the one other anomalous group who have been downgraded—the school nurses without the health visitors certificate—hon. Members will be surprised to learn that I have received but one letter from the Department of Health on the subject and that was yesterday from the Minister of State regretting that he was unable to attend the House this afternoon to listen to my Bill. I thank him for that courtesy. It was good of him to let me know this, and I will excuse his absence if he will tell me what he is doing to put this matter right.
I take it that the Minister is not contending that the tuberculosis visitors without the certificate are not doing their job properly. I presume that he is satisfied that the 100,000 people who have contracted tuberculosis in the last 10 years received proper treatment. I also presume that he is not disregarding 30 or 40 years' experience in nursing and saying that it is less relevant than an eight-month training certificate. If that is the case, why is he remaining silent? Is he just plainly indifferent to the plight of these ladies? Does he realise that a good number of them, in the course of their work, have caught tuberculosis themselves and have suffered considerably?
I presume that his officials have exploded the myth that the health visitor certificate does not mean that a tuberculosis visitor does any different work when she is acting as a tuberculosis visitor. All it means is that a nurse with it is eligible to take on other work. It is also fair to say that those tuberculosis visitors, who have had a lifetime of experience tend to act as mentors to those young 473 girls, often with the health visitor certificate, who have recently joined the service.
Last July, at Question Time, the Minister acknowledged there was an anomalous situation and that it was causing a great deal of unrest. He said that he would review the matter. It has also been discussed by the Whitley Council which is responsible for assessing the salary and status of nurses. The Staff Side asked for the matter to go to arbitration. The Management Side has repeatedly turned down that request. Who are the Management Side of the Whitley Council? They are the Government in sheep's clothing.
How can this Government, so full of high principles and lofty words, reject the pleas of 140 devoted nurses who have given a lifetime of service to this country? How can a Government committed to the spirit and principles of equal opportunity, and the rights of each individual, turn a blind eye to the plight of the tuberculosis visitors?
My Bill will put right this deep injustice. So long as it continues it should deeply embarrass each one of us on all sides of the House. We are all collectively responsible and we must all be deeply ashamed.