HL Deb 02 November 1908 vol 195 cc722-30

Report of Amendments received (according to Order).

Verbal Amendments to Clause 2 agreed to.

LORD AMPTHILL

had three Amendments on the Paper to paragraph (d) of Clause 4. This paragraph provided that the General Council for the Registration of Nurses should, inter alia, consist of— Three registered medical practitioners to be appointed by the British Medical Association, one to be resident in England, one to be resident in Ireland, and one to be resident in Scotland. The Amendments proposed to leave out, in each case where they occurred, the words "be resident," and to substitute in their stead the words "represent the practitioners with a registered address." The noble Lord explained that the proposed new words were designed to meet the views of Lord Ashbourne. But the noble and learned Lord had since expressed himself contented with the wording of the paragraph as it stood. He (Lord Ampthill) did not, therefore, propose to move the Amendments.

LORD ASHBOURNE

, who had several Amendments on the Paper to Clause 11, said that since putting down the Amendments he had read the new clause which the Lord President intended to substitute for Clause 11 now in the Bill. It was obvious that the noble Viscount had applied himself with great anxiety to meet the various points mentioned in the previous debate. Therefore he would not move his Amendments, except, perhaps the one to omit the words "and certify to be wholly or partly maintained out of rates"; but if the Lord President did not see his way to accept that Amendment, he would not feel it desirable to repeat his arguments on that point.

THE LORD PRESIDENT OF THE COUNCIL (Viscount WOLVERHAMPTON)

moved the omission of Clause 11.

Amendment moved— To leave out Clause 11."—(Viscount Wolverhampton.)

On Question, Amendment agreed to.

VISCOUNT WOLVERHAMPTON then moved the substitution of a new Clause 11.

Amendment moved— To insert the following new Clause 11:—Any person who within three years from the commencement of this Act claims to be registered thereunder shall be so registered, provided such person is at least twenty-one years of age and is of good character, and either (1) holds a three years certificate of training from a hospital or from hospitals approved by the Council, or from an institution or institutions which the Local Government Board recommend, and certify to be wholly or partly maintained out of rates; or (2) holds a certificate of similar training as a nurse authorised by the Lords Commissioners of the Admiralty for the sick berth staff of the Royal Navy, or as a nurse authorised by the Army Council for soldiers of the Royal Army Medical Corps; or (3) holds a certificate from the Local Government Board for Ireland, that she possesses the qualifications proscribed for the purposes of Seclion 58 of the Local Government (Ireland) Act, 1893; or (4) produces evidence of training satisfactory to the Council, and has in addition been for at least three years in bona-fide practice as a nurse, or employed as a nurse in a naval or military hospital."—(Viscount Wolverhampton.)

THE MARQUESS OF SALISBURY

moved the omission of "three years" before "certificate" in proviso (1) of the proposed new clause, and the insertion of words providing that the training should be "for such period as may be prescribed by the rules framed under the provisions of the Act." He said that the procedure under the Bill and the reform effected by the Bill constituted a new departure, and there was considerable doubt as to what the period of training ought to be. Since his noble friend introduced the Bill it had been brought to his notice and to the notice of the Government, that in the case of Army and Navy nurses the period of three years was too long. They were trained for a shorter period, and those who were qualified to speak on the matter had assured him that a shorter period than three years was quite sufficient in the case of these male nurses. Therefore the Government had inserted words in the proposed new clause to meet their case. But did not this incident show how careful they ought to be in fixing in an Act of Parliament the exact number of years training to be called for? It was quite true that at the present time there were not a very large number of institutions which trained male nurses. He did not pretend to be very well qualified to speak on the point, but he did not know of any other training schools for male nurses except those connected with the Army and the Navy, but there might be at any moment, and if it were true that a male nurse connected with the Army or the Navy could be trained in two years, that period of training would be sufficient in other similar cases. Therefore, Parliament ought to be very careful about fixing an exact number of years in the Act. But that was not all. One of the greatest hospitals in London, which turned out a large number of highly qualified nurses, was satisfied with two years training. Were they to lay it down absolutely in the Act that the system which prevailed at the London Hospital was not a good system? He certainly did not feel qualified to say so, and he doubted whether the majority of their Lordships felt inclined to say so. Therefore, the better procedure would seem to be to leave the words elastic, so that the period might be inserted in the rules. The rules would come up for review by the Privy Council, and all that could be said against or for such a proposal would be stated before the Privy Council. After that the rules would be laid before Parliament, and it would be competent for their Lordships to say what they thought desirable on the matter. That, he thought, would be a more workmanlike method of dealing with this provision.

Amendment moved to the proposed new clause— In line 4, to leave out the words 'three years,' and in line 5, after the word 'training' to insert the words 'for such period as may be prescribed by the rules framed under the provisions of the Act.'"—(The Marquess of Salisbury.

*VISCOUNT WOLVERHAMPTON

agreed to the Amendment on behalf of the Government.

LORD AMPTHILL

was quite willing to agree to the Amendment, which he fully recognised carried out the noble Marquess' intention of introducing greater elasticity in the Bill. But he was not to be taken, by his acceptance of this Amendment, to be in agreement with thy noble Marquess' next Amendment. He hoped the noble Marquess did not consider that the Amendments hung together.

THE MARQUESS OF SALISBURY

Oh, no.

On Question, Amendment to the proposed now clause, agreed to.

THE MARQUESS OF SALISBURY

moved an Amendment to the same proviso, substituting "named in such rules" for "approved by the Council." He assured Lord Ampthill that, so far as he was concerned, this Amendment by no means hung to the Amendment to which their Lordships had just agreed. This Amendment arose out of an observation made by the noble Lord himself when the Bill was last before their Lordships. On that occasion a noble Lord—Lord Stanley of Alderley, he thought—expressed the opinion that it would be rather rash to allow the inclusion or exclusion of a particular hospital to be entirely at the discretion of the Council formed under the Act. The rejoinder made by Lord Ampthill was that he did not apprehend any such danger, but that if there was such a danger it was met by Clause 10, which constituted the Privy Council the superior authority in matters of this kind. He (Lord Salisbury) pointed out at the time, and subsequent investigation had confirmed his opinion, that Clause 10 would not, as a matter of fact, apply to cases of this kind. If they specially laid it down in the Act that the determination of what should be included or excluded should lie with the Nursing Council, then it would not be necessary for them to make regulations naming these institutions, and it was the regulations and the regulations alone which were subject to appeal to the Privy Council. He suggested at the time that the proper way probably of dealing with the matter was to make the question as to whether a hospital should be included or excluded, one on which the Privy Council should have jurisdiction over the head, if necessary, of the Nursing Council. He had, therefore, in his Amendment included amongst the matters to be subject to regulation the selection of the hospitals which were to be considered qualified as training institutions under the Act. The object of his Amendment was to vest in some authority a power of appeal over a rash or hasty or unfair decision by the Nursing Council. Lord Donoughmore had drawn up an Amendment dealing with the same point, namely, to insert words providing that— If the Council refuse to recognise any hospital or institution as an approved training school for nurses under this Act, the governing body of such hospital or institution, or any person aggrieved by such refusal, may make a representation to the Privy Council, and the decision of the Privy Council shall be binding on the Council. If their Lordships preferred that method of dealing with the point, he (Lord Salisbury) was willing to withdraw his own Amendment. So long as the object was secured, the form did not very much matter. The only difference between the two Amendments was, that under his method the names of the hospitals would not only be submitted to the Privy Council, but would be laid before Parliament, whereas under Lord Donoughmore's method there would be only an appeal to the Privy Council.

Amendment moved to the proposed new clause— In lines 5 and 6, to leave out the words 'approved by the Council' and to insert 'named in such rules.'"—(The Marquess of Salisbury.)

*VISCOUNT WOLVERHAMPTON

said the Government could not accept the noble Marquess' Amendment as they did not possess the machinery necessary for carrying it out. If Lord Ampthill agreed, he was prepared to accept, when they came to it, the Amendment standing in the name of Lord Donoughmore, which gave an appeal to the Privy Council and therefore covered Lord Salisbury's point.

LORD AMPTHILL

was of opinion that Lord Salisbury's Amendment would be quite unworkable. It seemed to him that they might just as well in the rules under the Old-Age Pensions Act insist on a nominal roll of all those who were qualified for a pension, as insist that every institution to be accepted as a training school should be named in the rules under this Bill. During the first three years after the passing of the Act, presuming that the Bill became law, there would be constant applications from institutions to be recognised as training schools. Every time such an application was made it would have to be submitted to the Privy Council, and the rules would require to be reprinted. The rules, he took it, would have to be circulated. There would, therefore, be a constant circulation. He did not think it necessary to assume that the Nursing Council, constituted as it was proposed to be, would come to rash, hasty, or unfair decisions. He would, however, be quite willing to agree to there being a final appeal to the Privy Council. He, therefore, hoped the noble Marquess would withdraw his Amendment in favour of that standing in the name of Lord Donoughmore.

THE MARQUESS OF SALISBURY

thereupon withdrew his Amendment.

Amendment, by leave, withdrawn.

THE MARQUESS OF SALISBURY

then moved his final Amendment to the proposed new clause. He said it was not really consequential. He hoped it would be accepted.

Amendment moved to the proposed new clause— In lines 15 and 16 to leave out the words 'evidence of training satisfactory to the Council,' and to insert the words 'evidence satisfactory to the Council of training prescribed by the rules framed under the provisions of this Act.'"—(The Marquess of Salisbury.)

*VISCOUNT WOLVERHAMPTON

said he had no objection to the Amendment, and

LORD AMPTHILL

accepted it.

On Question, Amendment agreed to.

Proposed new clause, as amended, agreed to.

*VISCOUNT WOLVERHAMPTON

moved to leave out Clause 12 in order to insert a new clause.

Amendment moved— To leave out Clause 12."—(Viscount Wolverhampton.)

On Question, Amendment agreed to.

*VISCOUNT WOLVERHAMPTON

moved the insertion of the proposed new clause. He said the latter part of the clause, as well as the provisions of Clause 11 dealing with naval and military nurses, had been drawn up with the advice of the Admiralty and the War Office.

Amendment moved— To insert the following new clause: '12. At the expiration of the said term of three years any person who claims to be registered under this Act shall be entitled to be so registered, provided that such person produces evidence satisfactory to the Council that he or she has been trained in the wards of a hospital or of hospitals approved of by the Council, or in an institution or institutions which the Local Government Board recommend and certify to be wholly or partly maintained out of rates, or has been trained as a nurse under regulations authorised by the Lords Commissioners of the Admiralty for the sick berth staff of the Royal Navy, or as a nurse authorised by the Army Council for soldiers of the Royal Army Medical Corps for such term as may be fixed by the Council, and has passed such examination as the Council may prescribe, or produces a certificate of having passed an examination which the Council accepts in lieu thereof.'"—(Viscount Wolverhampton.)

On Question, Amendment agreed to.

THE EARL OF DONOUGHMORE

then moved his new clause, to follow the last-mentioned clause, and said that as the Lord President and Lord Ampthill had both intimated that they were prepared to accept his Amendment he would not detain their Lordships with any observations upon it.

Amendment moved— To insert the following new clause: '13. If the Council refuse to recognise any hospital or institution as an approved training school for nurses under this Act, the governing body of such hospital or institution, or any person aggrieved by such refusal, may make a representation to the Privy Council, and the decision of the Privy Council shall be binding on the Council.'"—(The Earl of Donoughmore.)

LORD ASHBOURNE

thought the proposed new clause useful and adequate so far as it went, but there was no appeal provided in it against the action of the Local Government Board, who might, quite bona fide, make a mistake. He therefore suggested that the clause should read "If the Council or the Local Government Board refuse," etc. This would give an appeal from the Local Government Board as well as from the Nursing Council. He did not think there would be the slightest inconvenience in this.

*VISCOUNT WOLVERHAMPTON

said the first step the Privy Council would take when an appeal was made to them would be to refer it to the Local Government Board. Therefore, under the noble and learned Lord's suggested Amendment the Local Government Board would be a party to the appeal, and, at the same time, advisers of the appellate authority.

LORD ASHBOURNE

said the Local Government Board had substantial powers of recognising or not recognising institutions, and unless there was an appeal the Local Government Board would be absolutely autocratic.

THE LORD PRIVY SEAL AND SECRETARY OF STATE FOR THE COLONIES (The Earl of CREWE)

I think there is force in what the noble and learned Lord says; but is it not, as a matter of practice, very unusual to give an appeal in so many words from one Government Department to another? I cannot recall any instance in which this is done, and it appears to me that to appeal from the Local Government Board in Whitehall to the Privy Council also in London is a very unusual course. I do not know whether the noble and learned Lord can suggest any precedent.

LORD ASHBOURNE

did not think it was a question of precodont. It was a question of what was obviously for public convenience in administration. There was nothing unconstitutional or illegal in his suggestion.

THE LORD CHANCELLOR (Lord LOREBURN)

What is suggested is an appeal from one Government Department—that is to say, from one Member of the Cabinet who acts with Cabinet responsibility—to the Privy Council. That seems to me a difficult thing to work out; and if it is begun, I do not know where it will end.

LORD ASHBOURNE

intimated that after what had been said he would not move his Amendment.

THE LORD CHANCELLOR

Then I will put Lord Donoughmore's proposed new clause as it stands.

On Question, proposed new clause agreed to.

*VISCOUNT WOLVERHAMPTON

said that his Amendment to Clause 14 was practically consequential on the new provisions of Clauses 11 and 12 with regard to naval and military nurses. He therefore formally moved.

Amendment moved— In page 6, line 23, after the word 'council' to insert the words 'or who have qualified as medical attendants to the Royal Army Medical Corps.'"—(Viscount Wolverhampton.)

On Question, Amendment agreed to.

Drafting Amendment agreed to.

Bill to be road 3a on Tuesday the 10th instant, and to be printed as amended. [No. 219.]

House adjourned at five minutes before Five o'clock, till To-morrow, a quarter past Four o'clock.