HC Deb 16 July 1982 vol 27 cc1350-8

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Brooke.]

4.38 pm
Mr. Peter Hardy (Rother Valley)

The House has many functions. It forms a major part of the legislature, it provides the authority for taxation, and it is the place in which the Government can face criticism and seek to justify themselves, but it has another function as well. It provides a Member with an opportunity to pursue a case where a constituent—or a community within his constituency—faces threats to his liberty and condition or the threat or reality of an injustice.

It is such a case that concludes our week's business. I raise the case of Mrs. Moody. She lives in Rawmarsh in my constituency. She occupied a responsible position with the National Coal Board at Wath main colliery when she was widowed at an early age. She is only 30 years old now. At that point she decided to embark upon a new career. Accordingly, she attended the Sheffield School of Nursing where she qualified as a State enrolled nurse in December 1980.

Prior to that, being a lady of initiative, Mrs. Moody had secured a post conditional upon her completing her course. She expected to start work immediately at the Mexborough Montagu hospital. She was prepared, and had taken every step necessary, to start work immediately. Unfortunately, she could not do so. The problem is that Mrs. Moody was unemployed for several months, through no fault of her own. During the months of unemployment she pursued the problem, she contacted the General Nursing Council and the health authority frequently. Indeed, she incurred approximately £5 expenditure in pursuing the matter. However, she did not receive her State enrolled nurse's number and badge and therefore could not start work.

I did not find out about the case until Mrs. Moody consulted me about a small problem of unemployment benefit and national insurance, which I was able to resolve immediately. I must pay tribute to the officers in our local Department of Health and Social Security and Employment offices, who acted with their normal courtesy and expedition. However, as far as her enrolment number was concerned, my experience was very different. I met with delay, prevarication and deceit. I was given cause to share Mrs. Moody's anger at some of the statements made in the case. Without burdening the House unduly, I propose to refer to some of the many letters that I had to write and some of those that I had hoped never to receive as a public representative.

I wrote to the then Minister of State on 1 March 1981 to complain that my constituent's experience had been grossly unsatisfactory and to suggest that she should be reimbursed in the sum of £645. I do not complain about the Minister's reply. He is in the hands of his advisers and his first response seemed to me to be a reflection of their advice. He referred to the changes in the procedures that had recently been introduced by the General Nursing Council, and that reflected the reply that the General Nursing Council sent to me.

I was not entirely happy and I asked the Minister to look at the matter further. I wrote to him in April, he looked at the matter in considerable detail and wrote me a letter dated 31 July. That reply was interesting, because he pointed out that the Department could not pay the compensation that I felt Mrs. Moody should receive and that either the General Nursing Council or the health authority, as the responsible bodies, could make an ex gratia payment. Quite properly, the Minister did not enter into any argument as to which body should take that action.

I then wrote to the regional health authority and to the General Nursing Council on 24 August. I suggested that one of them should pay the compensation to Mrs. Moody. She was in need of that compensation. She was a nurse who had been unemployed for three months. I suggested that they should pay the difference between the unemployment benefit and her net salary, with £5 to meet the cost of the many attempts that she had made to obtain information and £60 in regard to tax and capital loss.

The area administrator for the health authority looked into the matter. I am satisfied that the information that I have received from that authority has been correct throughout the whole of this sorry tale. It presented the facts and said that it acted swiftly and properly when Mrs. Moody applied for enrolment on 11 December 1980 when she had completed the course. It provided the necessary information to the General Nursing Council to support that application without delay.

On 26 October 1981 the General Nursing Council sent me a reply which leaves much to be desired. I believe that hon. Members are entitled to receive accurate information from bodies, whether public or otherwise. The General Nursing Council said: Unfortunately her School of Nursing sent in their first record of completion of training before training had actually been completed and it was (quite rightly) rejected by the Council's computer system. It was assumed that there was some conversation. So a clear implication that the school of nursing was at fault was made. The letter states that the council could not accept that it was its responsibility that Mrs. Moody was placed at great disadvantage.

I wrote again to the area health authority to suggest that it should pay the compensation since it seemed that the school of nursing was at fault. The health authority took the matter seriously. It made it clear that the information which the General Nursing Council gave me in its letter of 26 October 1981, and therefore the information presented to the Minister, was less than accurate.

I received a disturbing reply from the health authority. Part of the letter read: Inquiries have been made of the General Nursing Council and they admit that certain information given in Mr. Pyne's letter to you dated 26 October is incorrect. For our part, we can confirm that the complete necessary training record of Mrs. Moody was forwarded by our School of Nursing to the General Nursing Council immediately following completion of training. Indeed, we have received from the General Nursing Council a photostat copy of that record dated 11th December 1980. Mr. Pyne—the officer of the General Nursing Council involved in the correspondence— states that 'unfortunately the School of Nursing sent in their first record of completion of training before training had actually been completed …' He has now admitted to … our Area Nursing Officer that this statement is incorrect. This record was dated 11th December, i.e. the date that she completed training and not before and, therefore, there was no reason why the computer should reject the record. Moreover, the General Nursing Council accept that Mrs. Moody paid her fee for enrolment on 11th December and it was cleared by them on 15th December 1980. We therefore have no reason to retract the statement given in my original letter. I accept that unreservedly.

I wrote back to the General Nursing Council to ask it to explain. I received a disgraceful and astonishing reply in a letter dated 27 January and I had to chase the council for the letter. It had informed the area health authority that it would contact Mrs. Moody and me, but it failed to do that. In the letter the council seems to be retreating from the admission that it had made to the area health authority. It said that it was not convinced that Mrs. Moody was actively seeking nursing employment. Mr. Pyne added: Indeed I am led to believe that she very quickly obtained employment outside nursing. The burden of Mrs. Moody's case is that she was unemployed for months and yet the council casts doubt on that and suggests that she acted improperly.

If Mrs. Moody had a lot of money I should have advised her to sue that body for libel. Those people were seeking to transfer the blame and casting on my constituent aspersions that were plainly unjustified.

I sent a copy of that letter to Mrs. Moody. As a sensible South Yorkshire woman, she was not prepared to accept that kind of statement from bureaucrats. She sent a very strong letter. I only wish that it could be read out to the House by a South Yorkshire woman who feels very indignant about such an injustice. Mrs. Moody made the point that she had secured her job at Montagu hospital in September 1980, conditional upon passing and being enrolled. She had not wasted time. She had secured a job and was desperately eager to start it. The very people who prevented her from doing so were those who suggested that somehow she was acting deceitfully. There has certainly been deceit in this case, but it has not come from Mrs. Moody, and I share her concern.

Having been informed of Mrs. Moody's very strong views, in which she criticised bureaucracy and suggested that there might be more chiefs than Indians in some quarters, I wrote again to the General Nursing Council on 8 February. I said that your letter can only be described as quite disgraceful … Your suggestion is really quite indefensible and I regard it as an outrageous attempt to evade responsibility … I believe that the Council should reimburse Mrs. Moody for the financial loss which is involved. May I request that this be paid without further delay and certainly without further prevarication. I concluded my letter with the following words: I await your reply which I trust will contain no further cause for the anger and resentment felt by Mrs. Moody and her Member which previous correspondence has certainly justified. An injustice has occurred and I believe that it should now be rectified by the payment of the appropriate compensation plus interest and the offer of a full apology both in respect of the error and the procrastination. The result was that I received a solicitor's letter. I do not know whether the General Nursing Council felt that a Member of Parliament would quake in his shoes at the prospect of such a letter, but I certainly did not. Although I do not have a particularly and comprehensively good opinion of the legal profession as a whole, one member of it has now sunk very low in my estimation. A Mr. G. V. Bull of Messrs. Wright and Bull—strangely enough, of 23 Portland Place, London W1, the same address as the General Nursing Council—wrote to me in his capacity as the council's solicitor in reply to my letter to Mr. Pyne, the registrar. Mr. Bull said: The facts of this matter are simple. They are indeed simple, but the General Nursing Council has made them complicated. He continued: Your constituent became enrolled on 12 December 1980 but was unfortunately not sent a Certificate of Enrolment until 17 March 1981 in the circumstances already described in your correspondence with the Council, in which it was made clear that the Council cannot issue a Certificate of Enrolment until they have received a record of completion of training from the School of Nursing. Yet the council admits to having received that submission and that it was sent on the date when the period of qualification was completed. Mr. Bull continued: The council regret very much the delay suffered by your constituent and I am asked to repeat, most sincerely, the apologies Mr. Pyne has already given. I am not sure whether they were apologies for the procrastination or for the incompetence. Mr. Bull continued: I have advised the Council that it would not be appropriate for them to meet the demand for compensation which you have made on your constituent's behalf. It is, of course, open to you and to her to take any action you or she thinks fit. Only a few people qualify for legal aid, and Mrs. Moody is not one of them. Nor is she very well off. I told her that I thought that she had a very good case but that I was not a lawyer and therefore could not give absolutely reliable advice. Nevertheless, I thought that she could win a case in court. Like many millions of people in this country, however, Mrs. Moody shrinks from that course of action, as the only people guaranteed to benefit from litigation are the lawyers.

I offered to raise the matter in the House, because I felt that a body should not get away with an injustice to an individual who had done nothing wrong, or get away with imputations of the sort that the General Nursing Council made, or get away scot-free with what was plainly disgraceful incompetence. I passed the matter to the Health Service Commissioner. That seemed to me a sensible arrangement, but unfortunately his terms of reference do not allow him to investigate this case. Perhaps the Minister will consider amending those terms of reference so that any organisation which impinges on the National Health Service can be considered by the Health Service Commissioner.

I met Mrs. Moody and told her that I understood her reluctance to enter into litigation and expressed the hope that one day we should have a society where people could more readily pursue the course of justice without Members of Parliament having to raise cases in the House—in this case, much later on a Friday than we normally sit. I agreed to raise the matter in the House.

Earlier today, we discussed the National Health Service dispute, and I shall not trespass on that subject, but whatever our conflicting views the Minister will accept that nurses are not particularly well rewarded. They are certainly esteemed—unless, of course, they become rebellious—but they are not well rewarded. I see no reason why a nurse in my constituency should forfeit £700 because of public—or semi-public—incompetence.

Today, Mrs. Moody is employed at the Rotherham district general hospital. She is one of a team led by Dr. Bardhan, who has been at the forefront of the clinical development of fibre optics. Mrs. Moody is a pleasant woman with a happy manner. She is most suitably employed, because she can encourage people who need cheering when they visit the day clinic for what can be a stressful experience. She will save many of my constituents from stress and anxiety. I only hope that the community can provide some recognition for her anxiety and stress and the grossly unsatisfactory treatment she has received from bodies which should know better. I hope that, somehow or other, the body concerned can be prevailed on to treat my constituent decently. At any rate, Mrs. Moody now has the satisfaction of knowing that her case has been aired in Parliament. Further, I hope that people in the public sector or the private sector who feel that they can deceive Members of Parliament and seek to frighten them from pursuing cases involving their constituents' welfare will be discouraged by this debate.

4.57 pm
The Minister for Social Security (Mr. Hugh Rossi)

I apologise for the absence of my hon. and learned Friend the Minister for Health, who has direct responsibility for this subject, but he had a prior commitment, and I have offered to stand in his place.

I am grateful to the hon. Member for Rother Valley (Mr. Hardy) for raising the problems that his constituent, Mrs. Moody, had in obtaining her enrolment certificate from the General Nursing Council. I was, nevertheless, very sorry to learn of the difficulties that Mrs. Moody had experienced and of the fact that this had consequently delayed her in taking up her position as a State enrolled nurse at Montagu Hospital, Mexborough. I always regard it as being of the utmost importance that this House pays cognisance to the plight of individuals whose rights are seemingly hampered by problems of administration. The hon. Gentleman put his case forcibly on behalf of his constituent. Although what I and my hon. Friends can do is very limited in such cases, I am sure that the hon. Gentleman's words will be heeded by those to whom they are directed.

The House will realise that the General Nursing Council is a statutory body which is responsible for the regulation of the nursing profession in England and Wales and is, therefore, responsible for the matters that we are debating. I rely on the council officers for the information which has been supplied for use in this debate. They have been most helpful to my Department, and I regret that the hon. Gentleman should find it necessary to use terms such as "prevarication" and "deceit" about them. However, he has put his case and produced the evidence in support of it.

I begin by examining the general provisions which govern the inclusion of any nurse on the roll controlled by the General Nursing Council. The council has carried out that statutory obligation since 1919, and it should be remembered that it has to cope with processing many tens of thousands of applications each year.

To be eligible for acceptance for inclusion on the roll, each pupil nurse must have passed the appropriate written assessment, together with three hospital-conducted practical tests to assess practical nursing competence. The pupil nurse must also have completed the statutory 24-month training period. Finally, he or she must have paid the statutory enrolment fee. Any nurse who applies for enrolment and who fails to satisfy any one of these conditions may not be included by the General Nursing Council on the roll.

If all the conditions are met, then the effective date of enrolment is either the date on which the enrolment fee was paid, or the day after the date of either completion of the statutory training or the date of success in the last qualifying examination, whichever is the later.

In Mrs. Moody's case, her effective date of enrolment was determined by the date of completion of her statutory training, which was on 11 December 1980. Her effective date of enrolment was, therefore, 12 December 1980.

It is, of course, of concern that it should take the General Nursing Council over 12 weeks to notify an applicant of her acceptance on to the roll. As we know, the facts of Mrs. Moody's application were that her application for enrolment was made on 11 December 1980 and notification was not issued to her in writing until 17 March 1981. Unfortunately, her application was made at a point when the council was changing over from a batch computer system to an on-line computer system for processing the applications.

The change-over caused some confusion among some training schools, which were required to submit information in a form somewhat different from that which they had been accustomed to supplying. That led to teething troubles and a logjam in the issue of certificates. However, I must point out that the notice was issued to Mrs. Moody on 17 November 1980 with the results of her assessment for enrolment, and it stated: Your Certificate will normally be issued between 6–8 weeks after receipt, by the Council, of your Application Form. So she was put on notice that there would be some delay.

At that time, with the introduction of the revised computer-based system which caused considerable difficulties, it was taking the council on average the best part of 10 weeks to issue enrolment notifications. That lengthy period was exacerbated by the particularly large number of applications being made at that particular time.

Although, on the face of it, it would seem a simple task for the council to check that the written exam and practical assessments had been passed, that the training period had been sucessfully completed, and that the correct enrolment fee had been paid, in practice that was not so. Delays in the submission of completed training records, in particular can, and do, often contribute to the time taken for processing enrolment applications.

In the particular case of Mrs. Moody, her training centre at Sheffield had correctly completed and submitted her training records to the council at the end of her training course in December. That is the one stage in the processing of her application where, unfortunately, the recorded facts have let us down. Neither the health authority nor the General Nursing Council can adequately show either when those records were despatched or when they were received. It was, however, as a result of an inquiry to the council at the beginning of February 1981 that a duplicate of the training record was submitted by the training centre, and that record is shown to have been received by the council on 9 February 1981. That information was fed into the council's computer on 20 February 1981, and it was only then that all the necessary satisfying conditions for Mrs. Moody's application for enrolment were met.

My hon. Friend's inquiries of the General Nursing Council have resulted in my being advised that Mrs. Moody was apprised of her enrolment and SEN number by telephone on the occasion of her telephoning the council at that time. I am told that she was informed by the council that possession of her number would provide her with satisfactory evidence for her to approach the new employing authority—Rotherham area health authority—with a view to taking up her appointment as an SEN with it at Montagu hospital, Mexborough. Again, my information is that Mrs. Moody was not prepared to accept this telephone notification and preferred to await her written notification of enrolment. It is, I understand, common practice among employing health authorities to accept such telephone details of enrolment on registration because of the very point about which the hon. Gentleman protests—that is, the time needed by the council to issue notification.

I know of nothing to suggest that Rotherham would not have acted on such information if it had been given to it. As it was, Mrs. Moody's written notification was despatched to her by recorded delivery on 17 March 1981, and I understand that she took up employment at Montagu hospital 13 days later. The hon. Gentleman will notice that I have been at some pains to emphasise the fact that there is and always has been an inherent time lag in processing nurse applications to enrolment of registration. I use the expression "time lag" deliberately as it is only the period of time over and above the norm that can be fairly regarded as delaying an individual's appointment in relation to other pupil nurses at the time.

In the case of Mrs. Moody's application, she was informed that this time lag for enrolment would normally be in the region of six to eight weeks. As it was, over 13 weeks elapsed in her case. The actual delay therefore amounts to a period of between five and seven weeks.

On the possibility of the employment of Mrs. Moody in the Health Service during the period from 12 December to 29 March, my hon. Friend has been informed by the Sheffield health authority that Mrs. Moody was advised by her training centre that she could have remained employed by it after the end of her training period. The normal practice would then have been for her pay as an SEN to be predated in clue course to her effective date of enrolment. Mrs. Moody, however, having made arrangements to commence work at Montagu hospital when her enrolment came through, preferred, I understand, not to take advantage of this option.

I should like to take this opportunity to inform the House that, largely due to the introduction of new technology and the concerted efforts of the council's own staffs to streamline procedures, the time lag between the receipt of applications and the issue of certificates is now on average between three and four weeks.

The hon. Gentleman has called into question the possibility of compensation for Mrs Moody for the period during which it is claimed she was deprived of employment. This is not really a matter on which my hon. Friend or the Secretary of State can directly intervene. These are matters that fall to be decided between the General Nursing Council and the health authority. I hope that they will pay clue heed to all that has been stated on Mrs. Moody's behalf during the debate. If they do not, I can only repeat the advice already given to the hon. Gentleman by the former Minister of Health, my hon. Friend the Member for Reading, South (Dr. Vaughan). There is always recourse to legal action if Mrs. Moody feels that her rights have been infringed and that she can recover by way of damages the losses that she feels others have caused her to suffer. Beyond that, I am afraid that I am not in a position to help the hon. Gentleman. These are matters that are outside the ability of Ministers to deal with.

Mr. Hardy

It seems to me that some of the information that the Minister has obtained and given to the House in good faith—I do not make any charge against him—has come from the General Nursing Council and it continues to arouse my considerable doubts. The story about Mrs. Moody being told on the telephone is, in my view, completely inaccurate. I shall ask Mrs. Moody to write to me again. I have discussed this matter fully with her. I believe her word implicitly. I have had ample grounds to doubt that of the General Nursing Council.

The Question having been proposed after half-past Two o'clock and the debate having continued for half an hour, MR DEPUTY SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at eight minutes past Five o'clock.