HL Deb 20 October 1908 vol 194 cc888-913

Order of the Day read, for the House being put into Committee (on recommitment).

Moved, "That the House do resolve itself into the said Committee."—(Lord Ampthill.)

On Question, Motion agreed to.

House in Committee accordingly.

[The Earl of ONSLOW in the Chair.]

Clause 1 agreed to.

Clause 2:

*THE LORD PRESIDENT OF THE COUNCIL (Viscount WOLVERHAMPTON)

moved to amend the provision— 'The Council' means the General Council of Nursing Education and Registration of the United Kingdom, by omitting the words "of Nursing Education and Registration of" and inserting the words "for the Registration of Nurses in." He explained that the object of the Amendment was to confine the character of the Bill to the registration of nurses.

Amendment moved— In page 1, lines 8 and 9, to leave out the words 'of Nursing Education and Registration of,' and to insert the words 'for the Registration of Nurses in.'"—(Viscount Wolverhampton.)

LORD AMPTHILL

said he was quite willing to accept the Amendment.

On Question, Amendment agreed to.

*VISCOUNT WOLVERHAMPTON moved to leave out the words "trained nurse or." The provision would then read— The term 'registered nurse' means a nurse who is for the time being registered in the nurses register.

Amendment moved— In page 1, line 10, to leave out the words 'trained nurse or.'"—(Viscount Wolverhampton.)

LORD AMPTHILL

said that as a similar Amendment stood in his name on the Paper, it followed that he agreed to it.

On Question, Amendment agreed to.

*VISCOUNT WOLVERHAMPTON

then moved a further Amendment not on the Paper to Clause 2. It was to add the words— The term' Local Government Board' means in relation to Poor Law institutions in Scotland and Ireland the Local Government Board for Scotland and the Local Government Board for Ireland, respectively.

Amendment moved— In page 1, after line 12, to insert the words 'the term "Local Government Board" means in relation to Poor Law institutions in Scotland and Ireland the Local Government Board for Scotland and the Local Government Board for Ireland, respectively.'"—(Viscount Wolverhampton.)

LORD AMPTHILL

said this Amendment was designed to render unnecessary several Amendments which stood in the name of Lord Ashbourne. He thought it an improvement on the method proposed by his noble and learned friend Lord Ashbourne for explaining that which it was necessary to explain.

LORD ASHBOURNE

could not accept this statement as to his Amendments. He said he preferred explaining them himself.

On Question, Amendment agreed to.

Clause 2, as amended, agreed to.

Clause 3:

Consequential Amendment agreed to.

Clause 3, as amended, agreed to.

Clause 4:

LORD AMPTHILL moved to substitute "sixteen" for "fifteen," as the number of persons of which the Council should consist. His object was to provide for the representation of Ireland, a matter on which he imagined there would be absolutely no disagreement. Their Lordships would remember that the Select Committee of the House of Commons who considered this question in two successive sessions were very explicit in recommending that the Council should not exceed a certain number. Fifteen was the number they gave; but he trusted that, nevertheless, the Lord President would be willing to agree to the slight increase of one which he proposed, in order to provide, in a manner which he thought would be more convenient than the other method suggested, for the representation of Ireland.

Amendment moved— In page 1, line 19, to leave out the word 'fifteen,' and to insert the word 'sixteen.'"—(Lord Ampthill.)

LORD ASHBOURNE

referred to his Amendment on the Paper also dealing with the number of persons of which the Council should consist. He agreed that it was not desirable to add to the number unduly, and that no increase, should be made which could reasonably be avoided. He was prepared to acquiesce in the Government view to make way for an Irish nurse by reducing the number of English nurses from four to three rather than the proposal to increase the number of nurses from six to seven. The suggestion of the Lord President would work out the same without increasing the number of the Council. In a subsequent Amendment he asked that "eighteen" should be substituted for "fifteen," but he admitted that that number would be one too many, and that he only required seventeen to carry out his object. If the Bill stood as Lord Ampthill and the Government suggested, the whole burden of representation in the case of Scotland and Ireland would be placed upon one nurse from each country. No one had a higher respect for Scottish and Irish female intelligence than he had, but it was hardly reasonable to say that that representation was adequate. The clause provided that one registered medical practitioner should be appointed by the Local Government Board for England. He proposed, in a subsequent Amendment, to provide also for one to be appointed by the Local Government Board for Ireland and one by the Local Government Board for Scotland. He was not concerned as to whether it might be desired to throw over some other members of the Council to make way for these two; but it was not reasonable in so large and important a Council to place the whole burden of maintaining the Irish or Scottish case upon one nurse. He hoped the Lord President would consider the matter.

*VISCOUNT WOLVERHAMPTON

said the question was, after all, what was the desirable number. The Committee who considered the Bill unanimously recommended that the number should not exceed fifteen, and they coupled with that a strong opinion that it should not be more than eleven. The Government were anxious that there should be full and proper representation on the Council, not only of England but also of Scotland and of Ireland; but he thought that in extending the number to sixteen they would be really going as far as they ought to go in the matter.

LORD ASHBOURNE

wished to know who the sixteenth person was to be. Room was made for an Irish nurse by putting one of the English nurses aside and altering the number from four to three. That being so, where did the sixteenth person come in? He desired to make the number seventeen, so as to provide for one registered medical practitioner being appointed by the Local Government Board for Ireland and one by the Local Government Board for Scotland.

*VISCOUNT WOLVERHAMPTON

said there were to be seven registered nurses elected as the direct representatives of registered nurses. Four were to be elected by the nurses registered in the general register whose registered address was in England or Wales, one by the nurses registered in the general register whose registered address was in Scotland, one by the nurses registered in the general register whose registered address was in Ireland, and one, who should be a past or present matron of a public hospital for the insane, by the nurses registered in the Mental Nurses Register. That absorbed the entire number.

LORD AMPTHILL

held that there was a grave objection to the proposal of Lord Ashbourne. To increase the number of the representatives appointed by the Local Government Board would upset the balance between doctors and nurses on the Council—a matter likely to lead to a great deal of difficulty and jealousy. Under the present proposal it was as evenly balanced as possible. The noble and learned Lord had said that the whole burden of representation would be on one nurse. He thought that hardly a fair statement of the case. They might take it that anybody appointed to a council of this kind would not be a partisan, but would endeavour to be representative of the interests of the whole kingdom. Secondly, there were the three persons appointed by the Privy Council, who might be taken to be impartial and generally representative. Those were his reasons for preferring to adhere to his own proposal that the Council should be increased by one only.

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

My Lords, I think the Committee will agree that, as a general principle, it is desirable that this Council should not be increased in numbers to a greater extent than can be helped. These bodies work more easily and more efficiently when not too large. The noble and learned Lord opposite asked how it was, if we were prepared to agree to the increase from fifteen to sixteen, that we also proposed to substitute three for four in subsection (f). The answer is that if sixteen is agreed to my noble friend would not propose to move the other Amendment, but would maintain the figure at four as it stands at present.

On Question, Amendment agreed to.

LORD STANMORE

called attention to the provision in the clause that three members of the Council should be "appointed by the Privy Council." He asked whether the Lord President could inform him what was the meaning in this connection, of the words "appointed by the Privy Council." Did they mean appointed by the King in Council, or by the Lord President of the Council, or by the vote of the members of the Council?

*VISCOUNT WOLVERHAMPTON

said the appointments would be made in the same way as all other appointments made by the Privy Council—namely, by the Lord President.

LORD STANMORE

thought it would be better that it should be so defined in the Bill.

VISCOUNT WOLVERHAMPTON moved to amend Paragraph (d)— Three registered medical practitioners to be appointed by the British Medical Association, one to be a physician, one a surgeon, and one a general practitioner. by leaving out all the words after "Association."

Amendment moved— In page 2, line 5, to leave out from the word 'Association' to the end of Paragraph (d)."—(Viscount Wolverhampton.)

LORD AMPTHILL

accepted the Amendment, which would, he said, give greater latitude and discretion to the British Medical Association.

On Question, Amendment agreed to.

LORD ASHBOURNE moved to insert in place of the words which had just been omitted, the words "one to be resident in England, one to be resident in Ireland, and one to be resident in Scotland." He understood that these words would be accepted.

Amendment moved— In page 2, line 5, to insert the words 'one to be resident in England, one to be resident in Ireland, and one to be resident in Scotland.'"—(Lord Ashbourne.)

LORD AMPTHILL

suggested that, instead of "resident in," words should be substituted providing that one should be representative of England, one of Ireland, and one of Scotland. There were obvious inconveniences attached to the words "resident in." The Council would probably meet in London, and it might be difficult for a doctor living in Ireland or in Scotland to attend; but there might be in London a doctor who would be regarded as representative of either Scotland or Ireland whom it would be convenient to place upon the Council. The words he suggested—namely, "representative of"—would, of course, not exclude the possibility of appointing a doctor who was resident in Scotland or in Ireland. The words were wider, and gave larger discretion, and he hoped, therefore, that his suggestion would commend itself to Lord Ashbourne.

LORD STANLEY OF ALDERLEY

said the words "representative of" would imply "chosen by," and would give rise to many opportunities of dispute.

*VISCOUNT WOLVERHAMPTON

said his difficulty in reference to Lord Ampthill's suggestion was: Who was to be the electing body? They would have to create some sort of organisation in Scotland and Ireland in order to elect the representative. He thought it would be better to leave it as was proposed by Lord Ashbourne.

On Question, Amendment agreed to.

LORD AMPTHILL moved to increase from six to seven the number of registered nurses to be elected as the direct representatives of the registered nurses. This was, he explained, consequential upon the Amendment which their Lordships had already accepted in regard to the number of the Council.

Amendment moved— In page 2, line 10, to leave out the word 'six,' and to insert the word 'seven.'"—(Lord Ampthill.)

On Question, Amendment agreed to.

*VISCOUNT WOLVERHAMPTON

then moved that this additional member of the council should be elected by the nurses registered in Ireland.

Amendment moved— In page 2, line 15, after the word 'Scotland,' to insert the words 'one shall be elected by the nurses registered in the general register whose registered address is in Ireland.'"—(Viscount Wolverhampton.)

On Question, Amendment agreed to.

LORD BALFOUR OF BURLEIGH

said that in these Amendments the Committee had dealt with the constitution and appointment of the general council. But the clause also provided for the appointment of a temporary council of six, which was to bring the Act into operation. Of these six, two were to be appointed by the Matrons' Council of Great Britain and Ireland, and one by the Society for the State Registration of Trained Nurses; and he desired to know whether the Lord President of the Council had satisfied himself that these bodies were of sufficient standing to be entrusted with these appointments. If such information as he had been able to obtain was correct, these two bodies were practically the same, or, at any rate, they were ruled by the same people.

*VISCOUNT WOLVERHAMPTON

said he had no personal knowledge of the composition of the bodies.

LORD AMPTHILL

said he could answer the question of his noble friend. The Matron's Council was founded in 1894, and its primary object was to bring about a uniform system of education, examination, certification, and State registration of nurses in British hospitals. For years it maintained a committee which laboured steadily with that object in view; and its work increased so much that in 1902 it was decided to form a society having for its sole object the State registration of trained nurses. But until the formation of that society the Matrons' Council was the only body working to secure the registration of nurses, and that in itself, he thought, constituted a sufficient claim why it should be represented on the provisonal council which was to set up the machinery for the election of the general council. He could guess what had suggested the question of his noble friend. There was a letter about the Bill in The Times that morning, which was as well timed as it was inaccurate. There were two flagrant inaccuracies which sufficiently condemned the rest of the letter. These were that the Matrons' Council was to be permanently represented on the general council; and that the Society for the State Registration of Trained Nurses was to enjoy a similar privilege. Their Lordships had the Bill before them, and they could see that these statements were quite inaccurate. As to the membership of the Matrons' Council, it consisted of close on 200 past and present matrons of hospitals and infirmaries, and that did not include several honorary members, representing foreign countries and the Colonies, who had worked for the State registration of nurses. The membership might have been much larger but for the fact that many matrons were the paid servants of hospital committees, who were strongly opposed to the registration policy of the council.

LORD BALFOUR OF BURLEIGH

said that, accurate as was Lord Amp-thill's information generally, his guess in this case was entirely erroneous. His question was not prompted by the letter in The Times, because he had not fallen into either of the inaccuracies which the noble Lord had pointed out. He hoped the Lord President of the Council would satisfy himself of the standing of the two bodies by examining their lists of members before he allowed the Bill to pass in its present form.

THE EARL OF CREWE

My noble friend will, no doubt, take the step which the noble Lord suggests. But I might point out that this is really a temporary provision, and that the whole object of these subsections is to get a generally representative council of that very large section of the nursing body who are in favour of the registration of nurses. There are other nurses who are not in favour of registration, and do not wish to have anything to do with it. They, I suppose, do not desire to be and will not be, represented on this body. I confess it appears to me—and I have some knowledge of the composition of these bodies from having held the office which my noble friend now holds—that, generally speaking, that object of obtaining ladies who are representative of nursing will be very well carried out by the provisions contained in the Bill.

Consequential and drafting Amendments agreed to.

Clause 4, as amended, agreed to.

Clauses 5 to 8 agreed to.

Clause 9:

Consequential Amendment agreed to.

Clause 9, as amended, agreed to.

Clause 10:

Drafting and consequential Amendments agreed to.

LORD ASHBOURNE moved to add a new subsection providing that the council might appoint three or more members to act as a committee for Ireland and for Scotland, respectively, and might authorise each such committee, subject to revision or approval by the Council, to transact any business of the Council concerning Ireland or Scotland, respectively, which the Council might think it expedient to delegate to such committee. He hoped the Amendment would commend itself to the Lord President for he had been informed that these committees would be a great convenience.

Amendment moved— In page 5, line 11, after the word 'Act,' to insert 'The Council may appoint three or more members to act as a committee for Ireland and for Scotland, respectively, and may authorise each such committee, subject to revision or approval by the Council, to transact any business of the Council concerning Ireland or Scotland, respectively, which the Council may think it expedient to delegate to such committee.'"—(Lord Ashbourne.)

*VISCOUNT WOLVERHAMPTON

opposed the Amendment. He said the proposal was both unnecessary and inexpedient. He thought it undesirable to set up statutory committees who would require separate officials. The clerical work could be perfectly well done in the central office in London, and there was nothing to prevent the Council appointing sub-committees to report on specific points, which would be preferable to a statutory delegation of functions. Uniformity of regulations and procedure was desirable for all parts of the United Kingdom.

LORD ASHBOURNE

said that after the Lord President's statement he would not press the Amendment.

Amendment, by leave, withdrawn.

THE MARQUESS OF SALISBURY

understood that some little difficulty would arise under the Bill in respect to the nurses attached to the Admiralty and the War Office. He believed the matter had been brought to the attention of His Majesty's Government by those qualified to speak upon it, and he would like to ask the Lord President whether it had been considered and what arrangements they proposed in order to meet the difficulties that had been brought to their notice.

*VISCOUNT WOLVERHAMPTON

said that the view of the Privy Council was that the provision in Clause 10, to the effect that— No rules made under this section shall have effect until the same shall have been approved by the Privy Council, and the Privy Council may approve, the rules, either without or subject to, such modifications as the Privy Council think proper. constituted ample protection to both Army and Navy nurses. He understood that it was probable that on the Report stage the Admiralty and the War Office would desire to insert additional words in order to guard against any possible defects in the procedure. Those Amendments would, of course, be very carefully and favourably considered. It was desirable that no rules made under the Bill should have the effect of law until they had received full consideration at the hands of the Privy Council, who would hear representations from public departments and localities with respect to any specific regulation to which they objected.

THE MARQUESS OF SALISBURY

felt sure it would be a source of satisfaction to their Lordships to understand from the Lord President that the intervention of the Privy Council under this clause would not be a formal matter, but that they would exercise effective control of all the regulations under the Act. As it was the intention of the Government to raise the specific matter at the next stage of the Bill, he would not now trouble their Lordships further with regard to it.

Clause 10, as amended, agreed to.

Clause 11:

LORD ASHBOURNE

said that Clause 11 as it stood provided that— Any person who within three years from the commencement of this Act claims to be certified thereunder shall be so certified provided such person is at least twenty-one years of age, and either: (1) Holds a three years certificate of training from a general hospital approved by the Council, or from a Poor Law institution recommended by the Local Government Board, and is of good character; or (2) 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, and is of good character. He moved to insert, after the word "hospital," the words "or from hospitals." If the provision were confined to a three years certificate from one hospital only, a large number of the best Irish nurses would be excluded.

Amendment moved— In page 5, line 16, after the word 'hospital,' to insert the words 'or from hospitals.'"—(Lord Ashbourne.)

*VISCOUNT WOLVERHAMPTON

accepted the Amendment.

On Question, Amendment agreed to.

LORD ASHBOURNE moved to delete the words "a poor law" and to insert in their place the word "an." This would leave the Local Government Board a wide and unfettered discretion. The Lord President had an Amendment on the Paper to leave out the words "a Poor Law institution recommended by the Local Government Board" and to insert the words "an institution which the Local Government Board recommend and certify to be wholly or partly maintained out of the rates." He hoped these words would not be added, as they might exclude some first-class institutions which obtained nothing from the rates.

Amendment moved— In page 5, line 16, to leave out the words 'a Poor Law,' and to insert the word 'an.'"—(Lord Ashbourne.)

LORD STANLEY OF ALDERLEY

said the two points were quite separate. He therefore hoped the Committee would deal with the noble and learned Lord's Amendment apart from the question of the rates.

*VISCOUNT WOLVERHAMPTON

said that Lord Ashbourne's Amendment was exactly similar to the first part of his (the Lord President's) subsequent Amendment. He therefore accepted it.

LORD AMPTHILL

could not agree to the Amendment, the effect of which would be that any institution could be recommended by the Local Government Board.

THE EARL OF CREWE

We have not reached that point yet. We are on the Amendment of Lord Ashbourne to leave out the words "a Poor Law," and to insert the word "an." I think if the noble Lord would agree to postpone the discussion until we come to the Amendment of my noble, friend the Lord President it would be far more convenient, because the two points overlap.

LORD ASHBOURNE

said the only question was whether the Lord President would think it desirable to press for the addition of the words "and certify to be wholly or partly maintained out of the rates." He ventured to hope he would not. Surely the Local Government Board might be trusted in the matter.

LORD STANLEY OF ALDERLEY

hoped that, as a matter of order, the Committee would follow the advice of the noble Earl the Lord Privy Seal, and dispose of the non-contentious Amend-meat first. The further point as to the introduction of the rates would arise on a subsequent Amendment.

LORD AMPTHILL

said that the only object in putting in the words "Poor Law institution" was to indicate that the Local Government Board should confine their recommendations to institutions over which they had a certain amount of control. The effect of Lora Ashbourne's Amendment would be to leave it open to the Local Government Board to recommend institutions with which they had nothing whatever to do.

THE EARL OF CREWE

I may say that we do not propose to agree to what the noble and learned Lord (Lord Ashbourne) suggests—namely, the omission of my noble friend's words when we come to them. We do not think it would be reasonable to do what would be in effect turning the Local Government Board into the council; that is to say, to allow it to certify institutions of all kinds with which it has no sort of connection. I do not know whether Lord Ampthill is prepared to agree to the modified form of Amendment suggested by the Lord President, but if he is he will be able to allow the noble and learned Lord's Amendment now before the Committee to pass, because it is really part of our Amendment. Of course, if he objects in toto to any change in the Bill, he would be right in speaking now in order to express his views.

LORD BURGHCLERE

thought there was a good deal of point in Lord Ampthill's contention, because if the Committee accepted the Amendment of Lord Ashbourne as it stood and did not eventually adopt the Amendment of the Lord President they would be placed in a position of great difficulty. He therefore suggested that Lord Ashbourne should withdraw his Amendment and allow the Lord President's Amendment to be moved in the form in which it stood on the Paper.

THE LORD CHAIRMAN

I take it that Lord Ashbourne will withdraw his Amendment.

LORD ASHBOURNE

Very well.

Amendment, by leave, withdrawn.

*VISCOUNT WOLVERHAMPTON

then moved to leave out "a Poor Law institution recommended by the Local Govern-met Board" in order to insert "an institution which the Local Government Board recommend and certify to be wholly or partly maintained out of rates."

Amendment moved— In page 5, lines 16 and 17, to leave out the words 'a Poor Law institution recommended by the Local Government Board,' and to insert the words 'an institution which the Local Government Board recommend and certify to be wholly or partly maintained out of rates.'"—(Viscount Wolverhampton.)

LORD ASHBOURNE

intimated that, as the Lord President and the Leader of the House held that it was desirable that these words should be inserted, and as the noble Lord in charge of the Bill agreed, he would not press his opposition.

LORD STANLEY OF ALDERLEY

regretted the insertion of the proposed words for the reason which Lord Ampthill had given for supporting their insertion. He thought there ought to be some body superior to the Council in order to secure that a proper hospital should not be boycotted on account of professional jealousies.

LORD AMPTHILL

said that Clause 10 established the Privy Council as the authority superior to the Nursing Council, and in any case it was best not to anticipate that unfair and invidious distinctions would be made.

THE MARQUESS OF SALISBURY

hardly thought Clause 10 covered the point. No doubt Clause 10 gave the Privy Council a general power to control the regulations made under that clause; but Clause 11 contained a specific enactment which no regulations made by the Privy Council would be allowed to overcome. There certainly ought to be some authority with the right of jurisdistion in the case of institutions rashly or unfairly excluded by the Nursing Council. He suggested that the noble Lord in charge of the Bill should consider whether the Privy Council should not be inserted in place of the Local Government Board.

On Question, Amendment agreed to.

Amendment moved— In page 5, line 17, after the word 'institution,' to insert the words 'or institutions,' and after the word 'Board,' to insert the words 'of England, Ireland, or Scotland.'"—(Lord Ashbourne.)

*THE LORD CHAIRMAN

Is this a consequential Amendment?

On Question, Amendment agreed to.

LORD ASHBOURNE

desired before the Committee passed from Clause 11, to ask the attention of the Lord President to one particular matter. There were, he said, a number of nurses in Ireland at the present moment who had worked for some considerable time under the certificate of the Local Government Board. Clause 11 was framed with a view of saving the status of existing nurses, and he would be glad if the Lord President would consider before the next stage of the Bill whether words could not be inserted which would save the right to go on the register of nurses at present certified by the Local Government Board.

*VISCOUNT WOLVERHAMPTON

assured the noble and learned Lord that the point should receive consideration before the Report Stage.

LORD AMPTHILL

said the Committee had been rushed into an acceptance of the last Amendment, moved by Lord Ashbourne, on the assurance of the Lord Chairman that it was consequential. It was consequential, but consequential upon an Amendment which had been withdrawn—that was, so far as the first part of it was concerned. As to the second part of the Amendment, inserting, after the word "Board," the words "of England, Ireland or Scotland," that matter had been disposed of by the definition clause carried on the Motion of the Lord President of the Council. Lord Ashbourne's Amendment, therefore, was not necessary, but he (Lord Ampthill) had no opportunity of intervening before it was passed.

THE LORD CHAIRMAN

It can be put right on Report.

Clause 11, as amended, agreed to.

Clause 12:

LORD ASHBOURNE

said he understood that the principle of his Amendment to this clause was accepted by the Lord President. It was really consequential.

Amendment moved— In page 5, line 25, after the word 'hospital,' to insert the words 'or of hospitals.'"—(Lord Ashbourne.)

LORD AMPTHILL

, in expressing his agreement with the Amendment, explained that though they seemed trivial these words met an important case. The tendency of hospitals was to specialise, to have special hospitals for special diseases, and the consequence was that a fully-trained nurse had to undergo her training at more than one hospital. The provision as it stood might be read to require that she must have a certificate from one hospital only. The words which their Lordships had already inserted in the Bill and which it was now proposed to add in Clause 12 met this difficulty—a difficulty, which he understood, would arise more particularly in Ireland.

On Question, Amendment agreed to.

Consequential and drafting Amendments agreed to.

Clause 12, as amended, agreed to.

Clause 13:

Consequential Amendment agreed to.

Clause 13, as amended, agreed to.

Clause 14:

Consequential Amendment agreed to.

Clause 14, as amended, agreed to.

Clause 15:

Drafting Amendment agreed to.

LORD AMPTHILL

said the clause provided for the payment by every registered nurse of a fee of 2s. 6d. before 13th January in each year, and if a nurse made default, his or her name "shall" be removed from the register, but "may" be restored in certain circumstances. He moved to substitute "may" for "shall" in the first case and "shall" for "may" in the second. He pointed out that no latitude was given in the case of a nurse living abroad. He thought the removal of a name should be discretionary and the restoration of the same obligatory.

Amendment moved— In page 6, line 17, to leave out the word 'shall,' and to insert the word 'may,' and in line 18, to leave out the word 'may,' and to insert the word 'shall.'"—(Lord Ampthill.)

LORD BALFOUR OF BURLEIGH

thought that if the restoration was to be made, as declared in the clause, on proof that the failure to pay was due to inadvertence or mistake or on other satisfactory explanation, it should remain discretionary.

LORD AMPTHILL

said he was going to ask their Lordships, without notice, to leave out the last sentence of the section.

THE EARL OF CREWE

I do not feel sure that that would be quite a safe course to take, because it might almost involve the restoration of the name of a nurse whom it was undesirable to restore for other reasons. I think it would be far better to change "shall" to "may" in the first case, but to leave "may" in the second case.

LORD AMPTHILL

expressed his willingness to bow to the opinion of the Lord Privy Seal in the matter, and amended his Amendment accordingly by deleting the second half.

On Question Amendment, as amended, agreed to.

Clause 15, as amended, agreed to.

Clause 16 agreed to.

Clause 17:

LORD AMPTHILL moved to amend the provision enacting a penalty in the case of anyone not registered under the Bill who, after the commencement of the Act, knowingly used the title "registered nurse." He moved to substitute for the words "after the commencement of this Act" the words "after the publication of the first Annual Register of Nurses." The expression now in the clause was a little vague, and he thought it would be an improvement to define more accurately the precise moment of time.

Amendment moved— In page 6, line 37, to leave out the words 'commencement of this Act,' and to insert the words 'publication of the first Annual Register of Nurses registered under this Act.'"—(Lord Ampthill.)

On Question, Amendment agreed to.

Consequential Amendment agreed to.

Clause 17, as amended, agreed to.

Clause 18 agreed to.

Clause 19:

Consequential Amendment agreed to.

Clause 19, as amended, agreed to.

Clause 20:

LORD AMPTHILL

had an Amendment on the Paper to Clause 20. The clause provided that— Before suspending or removing any nurse's name from the register on account of breach of any rules or misconduct, the Council shall send to such nurse a statement in writing by registered letter, of the breach or misconduct imputed to him or her, and shall afford the nurse an opportunity of giving an explanation in writing or in person; and the Amendment proposed to add at the end of the clause the words— And of being legally represented if he or she so desires. He said that on further consideration, he was very much inclined to ask their Lordships' permission not to move this Amendment. It had been represented to him from various quarters that it was desired, both by doctors and nurses, that a provision of this kind should be inserted; but he now felt that the point was amply met by the right of appeal accorded in Clause 21, and it seemed to him very possible that an addition of this kind to the clause might suggest the employment of counsel and be a very considerable embarrassment to the Nursing Council. If, therefore, their Lordships had no objection he would not move the Amendment.

LORD ASHBOURNE

, who had a similar Amendment on the Paper, said that unless he heard some further reason from the Lord President of the Council he would move his Amendment. He did not wish to encourage the incurring of legal costs, but it might happen that a nurse's character and status were at stake, and she might be ruined if she had not an opportunity of making her case. It might be that she was unable to do it herself, and there should be a provision that in such circumstances she might have the benefit of professional assistance. He, therefore, thought it reasonable to insert the proposed words.

Amendment moved— In page 7, line 35, after the word 'person,' to insert the words 'or by legal representation if he or she so desires.'"—(Lord Ashbourne.)

*VISCOUNT WOLVERHAMPTON

said the Government took the view which Lord Ampthill had expressed, that the insertion of these words would considerably add to the cost of the procedure and involve a sort of legal trial in every case. Moreover, the Bill already provided for an appeal to a proper Court, where the matter would be fully considered.

LORD ASHBOURNE

intimated that he would not press his Amendment.

Amendment, by leave, withdrawn.

Clause 20 agreed to.

Clause 21:

LORD ASHBOURNE moved to amend this clause, which ran— Any registered nurse aggrieved by a decision of the Council removing his or her name from the register within three months from the notification of such decision may appeal therefrom to the High Court of Justice in England and Wales, and to the Lord Ordinary officiating on the Bills in the Court of Session in Scotland, and such appeal shall be final. He proposed to insert, after the word "therefrom," the words "according to his or her registered place of residence, either" and to insert, after the word "Wales," the words "or to the High Court of Justice in Ireland." This was a matter of machinery, and his Amendment provided that regard should be had to the registered place of residence.

Amendment moved— In page 7, line 39, after the word 'therefrom,' to insert the words 'according to his or her registered place of residence, either,' and after the word 'Wales,' to insert the words 'or to the High Court of Justice in Ireland.'"—(Lord Ashbourne.)

LORD AMPTHILL

was disposed to accept the Amendment if the noble and learned Lord persisted in it, but ventured to suggest a difficulty that might arise. A nurse who had given her permanent residence as in Ireland, but who happened for the time being to be attending a case in England, would be compelled, under Lord Ashbourne's Amendment, to appeal to the High Court of Justice in Ireland. In such a case the provision would constitute a great inconvenience.

LORD ASHBOURNE

said the Amendment had been drafted after full consideration and on the advice of a high legal authority.

*VISCOUNT WOLVERHAMPTON

recognised the difficulty to which Lord Ampthill had called attention, and asked whether it would not meet the case if an alternative were given to the appellant to go to any one of the three Courts. It would obviously be unfair to compel a nurse who was at the moment living in Ireland, but whose registered address was in England, to come over to England to maintain the appeal, and vice versa. Perhaps the noble and learned Lord would consider the point. He was sure their only desire was to do what was right in the interests of those concerned.

LORD BALFOUR OF BURLEIGH

said that as the clause stood the nurse might appeal to the High Court of Justice in England and Wales and to the Lord Ordinary officiating on the Bills in the Court of Session in Scotland. The whole drafting of the Clause required reconsideration.

*VISCOUNT WOLVERHAMPTON

expressed the opinion that an appeal to the County Court would meet the case.

LORD STANLEY OF ALDERLEY

thought the Lord Pesident's previous suggestion—namely, that the appellant should have power to go to any one of the three Courts—the right one. He hoped that on Report the Lord President would deal with the matter in that way. The residence of the nurse was not a material matter.

LORD ASHBOURNE

thought it would be wiser to leave the words out at this stage, and consider the matter further before Report.

Amendment, by leave, withdrawn.

Drafting Amendment agreed to.

Amendment moved— In line 2, after the word 'Scotland,' to insert the words 'and to the High Court of Justice in Ireland.'"—(Viscount Wolverhampton.)

LORD BALFOUR OF BURLEIGH

questioned whether the word "and" in the Amendment should not be "or."

THE EARL OF CREWE

I think "and" is used before in the clause, and erroneously. It should be "or" in each case.

*VISCOUNT WOLVERHAMPTON

I will carefully consider the drafting before the Report stage.

Clause 21, as amended, agreed to.

Clause 22 agreed to.

Clause 23:

Amendment moved— To leave out Clause 23."—(Viscount Wolverhampton.)

On Question, Amendment agreed to.

Clause 24 agreed to.

LORD AMPTHILL moved the addition of the following new clause: "This Act shall not be construed to affect or apply to the gratuitous nursing of the sick by friends or members of a family, and also it shall not apply to any person attending the sick for hire, but who does not in any way assume to be a registered nurse under this Act." He was doubtful as to the expediency of introducing this clause, and he was not satisfied with the wording, but it had been strongly desired by some members of the medical profession and by authorities in Ireland. He did not think there was anything in the Bill to suggest that gratuitous nursing would be affected, but he invited an opinion from the Committee.

Amendment moved— To insert the following new clause: 'This Act shall not be construed to affect or apply to the gratuitous nursing of the sick by friends or members of a family, and also it shall not apply to any person attending the sick for hire, but who does not in any way assume to be a registered nurse under this Act.'"—(Lord Ampthill.)

THE EARL OF MAYO

suggested that better words would be: "This Act shall not apply to or affect nursing of the sick by any person not registered under the Act, and who does not in any way assume to be a registered nurse." There was a strong feeling in regard to nursing by nuns in hospitals. It was a delicate subject to approach, but he thought that words should show that the Act cast no slur on nurses not on the register.

*VISCOUNT WOLVERHAMPTON

was inclined to think that danger of a misunderstanding of the Act as interfering with gratuitous nursing was imaginary. He could not consent to the Amendment without further consideration.

THE EARL OF MAYO

agreed with the Lord President that the danger was, perhaps, imaginary, but said that imaginary dangers in Ireland very often worked against the beneficial operation of an Act of Parliament, and they wished to avoid that in this case.

LORD BURGHCLERE

thought it was a matter that might be dealt with in the definition clause.

THE MARQUESS OF LANSDOWNE

So far as I am able to understand the subject before us, these words are really quite unnecessary, and I should venture to suggest that they were not only unnecessary but somewhat misleading. There is nothing in the Bill, as I find it, which could possibly affect or apply to gratuitous nursing by members of a family or others, and if we insert these words we suggest that there is something in the Bill which it does not contain. My noble friend was, evidently, by his language, not much enamoured of his own Amendment, and I venture to advise him not to press it.

LORD ASHBOURNE

said the Bill was popular with nurses, but to avoid mistaken ideas getting about, it would be well that words should be introduced making it abundantly plain that non-registered nurses were absolutely free to follow their calling.

THE EARL OF CREWE

I have no objection whatever to this matter being considered again on Report, but I find myself in general agreement with the noble Marquess on the Front Opposition Bench. It seems to me that the insertion of words of a kindly and consoling character, to reassure people who do not read the Act of Parliament and do not know the law, is a practice which ought as far as possible to be avoided, and I hope the matter will be allowed to drop.

Amendment, by leave, withdrawn.

LORD AMPTHILL

also had the following new clause on the Paper— Nothing contained in this Act shall be considered as conferring any authority to practise medicine or to undertake the treatment or cure of disease. He said it was of the same character as the clause which had just been under discussion, and was for the purpose of addressing what the noble Earl the Leader of the House had called kindly and consoling words to the medical profession. His own view was that the clause did not seem necessary, and as he took it that that was the sense of the Committee he would not move it.

Title:—

Amendment moved— In page 1, to leave out the words 'qualifications of trained nurses, and to provide for their registration,' and to insert the words 'registration of nurses.'"—(Viscount Wolverhampton.)

On Question, Amendment agreed to.

Standing Committee negatived: The Report of Amendments to be received on Monday next, and Bill to be printed as amended. [No. 210].