§ LORD GREVILLE asked His Majesty's Government what steps the Minister of Health is taking to see that the civilian staffs of hospitals be made a reserved occupation owing to the serious depletion of staffs already taking place. The noble Lord said: My Lords, I shall be extremely brief in the remarks I propose to address to you on this question. I think your Lordships will all agree that the hospitals of this country are doing national war work of great importance, and to carry out their work the machinery necessary to run the hospitals must be in full working order. Naturally, owing to the calls of the various forces of His Majesty's Government, we have lost a good many people. There are also other calls, especially in the women's department, and we are losing our staff at such a rate that the question may arise that we shall have to close wards in our hospitals. That, I think your Lordships will agree, would be a very lamentable state of affairs.
§ The staff of a hospital can be divided roughly into three parts. First of all there are the medical men, and may I say how greatly I welcome the action of the President of the United States in allowing young doctors to come over here to help our very much overworked doctors? Then there is the nursing staff. The nurses are reserved and cannot leave their work. And next we come to the lay staff. People on the lay staff, with very few exceptions, are not reserved and that is where we are feeling the pinch. First of all, there is the Secretary Superintendent's department. That really is the mainstay of the administrative side of the hospital. Those on that staff deal with all accounts and all correspondence; they keep an enormous number of records and have to attend to insurance matters affecting all the staffs of the hospital. Then there is the Steward's department, which is a very important department. The Steward has to deal with all the food, all the supplies, cleaning materials and everything required for the hospital, and naturally he has to have a certain staff. Then we come to the engineering staff. They have to deal with all the boilers, with the stoking and with electrical work which is always increasing in a modern hospital.
§ There are also the foreman and his staff, who have to deal with all repairs. 32 In the hospital with which I am connected we had an instance of the importance of that last Wednesday, when most of our windows were blown out. Owing to the black-out they had to be replaced very quickly. The foreman, who is responsible for all the cleaning, must have quite a large staff. Then we have the porters, who can be divided into two divisions. First, there are the skilled porters. By those I mean men who work in the operating theatres and the surgeries. They are all men who have been with us for some time and have a knowledge of doctors' ways and their duties. They are not easily replaced. They certainly cannot be replaced at a week's notice. Secondly, there are the ordinary porters who are responsible for moving patients from the wards to the operating theatres, for any transfers that take place and for the reception of incoming patients. To give an instance of what their work means, I may say that last Wednesday, as a result of the raid, the porters were on duty from 10.30 to 7 o'clock the next day. They were so overworked that I had to get up some of the stokers to help them. These men also are very difficult to replace if they are called up on His Majesty's Service because of the higher wages paid for fire spotting, demolition and other work. If we had to raise the minimum wage to any wage that would attract porters to the hospital, it would cost £1,600 a year extra. I understand that my Committee are considering that matter to-day at the hospital.
§ Then we come to the female lay staff. They include the almoners, who are reserved, masseurs, X-ray experts, registrars and office staff. They are all skilled and are not easy to replace, because many of the clerks have to work in various medical departments and must know certain medical terms and certain medical usages. Then there is the domestic staff. Of course the kitchen staff is very important and must be maintained. We must also have maids to work in the dining rooms and bedrooms and do the rougher work in the wards which nowadays we do not ask nurses to perform. It is very difficult to keep these people. They are being attracted away by higher wages. Only last Saturday, seven went off in a body from the hospital with which I am connected to one hotel in London and we are absolutely unable to replace them. The only people reserved, apart from nurses and 33 doctors, are potters over thirty, pharmacists at twenty-five, and the assistant secretary at thirty.
§ Some time ago—I think it is nearly two years ago—I drew the attention of the Minister of Health to the likelihood that we should be very short of lay staff in the hospitals. I am afraid that that had very little effect In fact the Minister seemed rather inclined to brush the matter aside. What I would like very humbly to suggest to the Minister of Health is that he should approach the Minister of Labour, because with all these registrations going on now of both men and women, I should think there would be very many unsuitable for munitions work or for such services as fire fighting and A.R.P. who would be willing and anxious to work in the hospitals. There must be a great many women who have done domestic duties in their own homes who could do similar duties in the wards and other places. The same consideration applies to many men who are now registering. There must be many men over forty who are capable of doing ordinary porter's work and other work in the hospitals. I think if the Ministry of Health could arrange through the Ministry of Labour to have attention drawn to these vacancies in hospitals, we should probably be able to keep our staffs going. I also think that work in hospitals should be made a reserved occupation so as to prevent these people leaving their work and causing great difficulties in the hospitals.
§ The object of my addressing your Lordships to-day is to put before the Ministry of Health the situation which is to be found, I think I might say, in all hospitals. We all have great difficulty in replacing lay staffs. There is one other matter which I should like to mention. Although I have not given him notice of it, I feel sure that my noble friend, with his usual courtesy, will approach the Ministry of Health with regard to it. I refer to the delay in opening country branches of London hospitals. We were approached by the Ministry of Health before Christmas and asked if we could start 100 beds in the country. We said that we would be delighted to do so. It was a question which had been on our minds, the keeping of so many nurses and other staff in London in these dangerous days, for if anything happens you have nowhere to go unless you make 34 arrangements beforehand. Mot long afterwards I got in touch with the member of the Ministry who had approached me. He said that he had no further information, and could not do anything about it, and that it had gone into the hands of the Ministry of Health. So, if the noble Lord, Lord Croft, will approach the Ministry and let us know when we are likely to be able to take over and staff these hospitals in the country, I shall be greatly obliged. I think in these days it is a very urgent matter.
VISCOUNT MERSEYMy Lords, I rise to support my noble friend in what he has said, but in doing so I feel very like a minnow following a Triton, in view of his knowledge of the London hospitals. To my mind the really important members of hospital staffs in this connection are the engineers and porters and permanent lay staff. Most hospitals now supply the nucleus of an A.R.P. and Emergency Centre which does work in connection with any incident which happens in the neighbourhood and, if we are deprived of the physically strong porters and engineers, men who know about the management of electric light, men who very often come from the Services, there is a risk of bringing the whole of the work of a hospital in an emergency to nothing. The question of the nursing staff is of course much more difficult. I think that if the Ministry would arrange for the engineers and porters and the male lay staff to be exempted, they would be doing something which would benefit the whole of the local community.
§ THE JOINT PARLIAMENTARY UNDER-SECRETARY OF STATE FOR WAR (LORD CROFT)My Lords, I was not sure whether the noble Lord, Lord Greville, by his question, was referring to the question of the male staffs of hospitals or to the more general question of providing for the essential staffs, both male and female. He has now made it clear from his remarks that he is covering the wider aspect of this question. Taking first the question of recruitment for the Fighting Services, the Minister of Health has had fully in mind the difficulties in which hospitals are placed in maintaining adequate male staffs, especially as the hospital facilities of the country have been greatly expanded under the Emergency Hospital Scheme. He has kept in touch 35 with the British Hospitals Association as well as the Minister of Labour on the problem. But he has been bound to recognise that the need for men in the Forces at present is so great that the voluntary hospitals must make their contribution equally with local authorities, and that both must look to the employment of women substitutes wherever possible as a solution of these difficulties.
The noble Lord was, I gather, not really stressing the question of the medical staffs. Special arrangements are already in operation for them through the machinery of the Central Medical War Committee. As to administrative staff, the noble Lord will see from the revised Schedule of Reserved Occupations published just before Easter that hospital secretaries are reserved at the age of twenty-five until Stage B is reached, when the reservation age is raised to thirty, rising again at Stage C to thirty-five, whilst for other administrative and clerical staffs the reservation age remains at thirty until Stage C, when it rises to thirty-five. This gives a very considerable measure of protection to the hospitals and should allow ample time to train women substitutes or older men. Individual cases of difficulty can still be considered on their merits. Similar consideration has been given to the subordinate grades. Without going through all the occupations concerned, it may be mentioned that hospital porters remain reserved at thirty while hospital orderlies are still reserved at the same age and will only be recruited below that age if required for similar work in the Forces.
Turning to the wider problem of retaining adequate staffs, and especially nursing and domestic staffs, at the hospitals, both the Minister of Labour and the Minister of Health are fully conscious of the vital importance of hospital staffs in deciding on the steps to be taken to mobilise the man- and woman-power of the country. Reference may be made to the Minister of Health's statement on the nursing problem in another place on April 3. He then described the appeal which had been made to the women and girls of the country to come forward for nursing duties, and said that the appeal would be specially brought to the notice of young women in the age groups now registering with the Ministry of Labour. 36 This registration system will also be used as far as possible for meeting the needs of those hospitals that are particularly short of domestic staff. Special arrangements have been made for the hospitals to notify their needs locally to employment exchange managers. Officials of the Ministry of Labour will then, when interviewing women who are available and suitable for this type of work, place before them the important part which domestic work in hospitals plays in the national effort. At the same time, women who are already employed in hospitals will be encouraged to stay there rather than to transfer to other occupations which may appear to them to be more attractive. The Government feel sure that they can rely, without resort to compulsory powers, on the patriotism and good sense of the women, and that the great majority of them will realise that this type of hospital work, although it may not be very spectacular, is nevertheless of the greatest importance to the country at the present time.
With reference to the question of the delay in opening country branches of the London hospitals, to which my noble friend referred, I will certainly convey his request for information to my right honourable friend, and will inform him at the earliest possible date. I am grateful to the noble Viscount, Lord Mersey, for emphasizing the point, which he thinks of great importance, and supporting the view of my noble friend Lord Greville with regard to engineers and porters. I will see that his views also are conveyed to my right honourable friend.
LORD GREVILLEMy Lords, I beg to thank the noble Lord, Lord Croft, for his reply, which I hope will relieve some of our difficulties. I should like to point out, however, in view of the Minister of Health's suggestion that we should employ more women, that we cannot fill the vacancies for women which we have now, and that is why some of those who are now registering might be allocated to the hospitals. It would be difficult to replace the men in the hospitals by women; stoking, repairs to buildings and electrical work are not suitable for women. I would again thank the noble Lord for his very courteous reply.