§ Order of the Day for the Third Reading read.
§ THE LORD CHANCELLOR
My Lords, I beg to move that this Bill be 436 read a third time. We have had a good deal of discussion about this Bill; hard things have been said about it, and I myself have said some of the hardest. It it not a Bill that any of us like very much, but I think it is only fair to remember that we are getting rid of the Defence Regulations, and that is something we all like very much. Therefore we must be prepared to pay a certain price to achieve that wholly desirable object. As your Lordships know, the Defence Regulations will come to an end on the 24th February.
We had an interesting discussion in Committee on the Bill. Three points were raised. With regard to billeting, I pointed out quite definitely that I knew we could not do away with that provision within the course of two years. There is there a physical limiting factor. There are not, and there cannot be, the necessary number of houses built. Having regard to the number of men who are going to come back from the Forces in the near future, and to the lamentable shortage of houses, if the Minister had the wisdom of Solomon, and if all his labour force, or double his labour force, worked to the utmost capacity, it would be quite impossible to produce a number of houses in the course of two years to make it possible to do away with billeting. I said that then, and I repeat it now.
Then there was a question raised about the Special Constabulary in Scotland. The noble Viscount, Lord Trenchard, and the noble Lord, Lord Saltoun, pressed me about that. There is a clause in the Bill, your Lordships remember, in which we are making it possible for the calling up of Special Constables to be made at an age as low as eighteen. It is quite true that this is the position in England where by Order in Council, you can call up Special Constables at the age of eighteen, and so far as the permanent Police Force is concerned, in Scotland also you can do it. The noble Lords pointed out, I thought myself with great force, that whereas if you take a regular policeman you submit him to some sort of training, if you call up a man as a Special Constable, you may quite suddenly, when he has not had adequate training, call upon him to perform some rather difficult task.
I could not accept any Amendment, but after the debate I did convey to my right 437 honourable friend, the Secretary of State for Scotland, my own personal feeling that he ought to send round an instruction to the various police authorities in Scotland making it quite plain that it should only be in the most exceptional circumstances that they should allow any young man who was of the age of 18 only to enrol and work as a Special Constable. I am glad to say that just before I came to this House this afternoon I got his answer, which does enable me to give that assurance to your Lordships. He says he is quite prepared to issue instructions to Chief Constables in Scotland, when the Bill becomes law, that the power of appointing men between the ages of 18 and 20 as Special Constables is not to be used save in very exceptional circumstances. That is not perhaps quite what the noble Lords would have liked, but it is by no means a bad issue out of this controversy. Then we come to the difficult question of the nurses. I am sorry if I seemed, as I think I was, rather waspish when this question was being raised by the noble Viscount, Lord Swinton. I never like to be.
§ THE LORD CHANCELLOR
The noble Viscount was, of course, only doing his duty. It is perfectly proper that Parliament should be astute to look into this matter to see if we are taking the easy course of keeping on the Regulations instead of taking the much more difficult course of seeing if we can evolve some more satisfactory method. He asked for some figures about which I have taken some trouble, and which I am going to give you, but your Lordships will remember that Regulation 32A (B), which is being carried on in this Bill for a period of two years—we can, of course, abolish it earlier but it cannot be kept on for longer than two years—is being carried on for that period subject to a limitation, that is to say, no new Orders can be made. Therefore we can consider the existing Orders as though they were the Order in Council itself, because there can be no new Orders. The position is this. The Order for England and Wales is dated August, 1941, and the Scottish Order is dated some two years later.
Those Orders, as your Lordships know, only apply to institutions in which recognized rates of pay and conditions of service 438 are being observed, and they do enable the person in charge of a mental institution, or the Board of Control, to dispense with services. Of course, in those institutions where there is a very serious shortage of staff, it is inevitable that applications for release have to be refused, but I am glad to tell your Lordships that it has become now the common practice to give permission to leave in certain cases. For instance, in the case of a woman who took up this work as her war work, and who now wants to leave, because her husband has been demobilized and because she wants to return to her domestic duties, permission is granted for her to do so. There is power, therefore, in hard cases of that sort, to grant permission to leave.
There is this to be said for the existing Order, which, as I have said, cannot be replaced by a new Order. The existing Order only applies to whole-time, and, of course, remunerated staff, who have twelve months aggregate service. As that Order was dated 1941, it is probable that a very large number of nurses—I will deal with the numbers presently—may be said to have deliberately continued their work, thereby bringing themselves within the Order. But I do not want to stress that too far. I do not think it would be fair to do so for these reasons. First of all a great many of these women conscientiously felt it to be their duty, and they were not going to relinquish their duty whatever the consequences. Secondly, many of them must have felt, I think, that probably when the war ended these Orders would also come to an end. So I do not stress that unduly. But the point is there to be met. In the course of the debate I said:We will do the best we can to make the period for which it must stay as short as possible so that it can be measured in weeks rather than in months.I think I overstated it, and that I may have misled your Lordships. Of course, there is no physical obstacle in this case—as in the case of billeting—in the matter of houses. It is simply a question of getting nursing staff to undertake this important but not very pleasant work. It is possible, of course, that we shall get the staff so as to make it a matter of weeks and not of months. On the other hand, I cannot pretend that there is any indication of our succeeding at the present moment.
439 I now come to several specific matters on which information was sought. The noble Lord wanted to know how many nurses are affected. The pre-war, strength—I am taking England and Scotland together, but I can split the figures if necessary—was 39,500. The present strength is 31,300, so you see that there is a shortage of 8,200. That is over 20 per cent. on the pre-war strength. Of that 31,300 some 18,500 are women—that is to say more than 60 per cent. are women.
Next the noble Lord wanted to know about the number of patients. The number of patients in England to-day is 185,000 odd. I have not got the Scottish figures, but we can make an estimate and I think the total figure for England and Scotland would probably be something of the order of 200,000. So it struck me rather forcibly that a rather large number of nurses—something like 40,000 nurses—is required to deal with something like 200,000 patients. I suppose that this may be accounted for, to some extent, by the fact that a large proportion of the patients are more or less helpless, many are senile, and some, I suppose, are violent and have to be protected against themselves. Probably, also, a good deal of the nursing duty has to be done at night time. The figures show that the number of patients now is rather less than at the beginning of the war because the number of admissions into mental institutions has declined during the war years. I am sorry to say that the number is now increasing. I hope that that is not to be attributed to the Labour Government—but it is a fact. So I am treating it not unfairly, I think, in taking the number of patients to be dealt with as being substantially the same. On that basis your Lordships will see that there is a shortage of rather over 20 per cent. of nurses on the pre-war figures, in spite of the fact that we have been holding these people since 1941.
How many of the 31,300 who are now in this service are affected by this Order? How many had, in September, 1945, completed twelve months' service in the aggregate? I cannot give you the precise figure about that. I could give you the precise figure for Scotland, and from that we can make an estimate taking the same proportion for England. I should estimate that the probable figure is of the order of 25,000 out of the 31,300. That 440 is the estimated number of those affected by the Order. How many institutions are affected by the Regulation? The answer is that there are 278 institutions affected, thirty-eight of which are in Scotland. What about visits? Well, these institutions are all visited by medical and legal Commissioners of the Board of Control. In some sense I have some responsibility for the Board of Control, and therefore, in some sense, this problem weighs upon me. I had not realized it. But it enables me to say with greater force what I am going to say.
I am asked: what steps have been taken to remedy the shortage of nurses? The Government—whether this one or the last one I am not sure—have issued the statement on the "Staffing of Hospitals" which contains a code of conditions of service for nurses including conditions for nurses in mental institutions. The Ministry of Labour are assisting in organizing local recruiting campaigns for the nursing service. The Board of Control have recently issued a circular to mental institutions making certain detailed suggestions for economizing the use of nursing staff. Have nurses wages been made sufficiently attractive? To this, I answer that rates of pay have been Unproved as a result of recommendations of the Rushcliffe Committee. I am told that that Committee are now considering further improvements in scales of pay for mental nurses. The noble Lord, Lord Rushcliffe, I am glad to note, is in his place today and he will correct me if I am wrong about that, but I think it is right. It is already the fact that the lower grades in the mental nursing profession receive £20 a year more than the corresponding grades in general nursing.
The noble Lord then asks: why not till up the shortage by conscription from the general community? I do not turn that down as a possible thing which may become necessary. We cannot allow these people to go on secula seculorum obviously, but conscription is a rather drastic step to take. After all, one man can take a horse to the water but ten men cannot make him drink. If you were to conscript unwilling people as assistants at mental hospitals I do not know what the consequences would be. But I should be very sorry indeed to resort to that experiment save in the very last resort.
Then the noble Lord asked, could not the duration of the regulation be limited 441 to a period of six months? Your Lordships will remember that on December 13 last the Ministry of Labour announced the Government's intention to rescind the Control of Engagements Order which, however, is to be kept in operation until June in the case of ordinary general nurses. I wish that we could do the same for the mental nurses, but we must retain an adequate nursing staff to look after these people who are not able to look after themselves. We cannot run any risks in this matter. I say quite frankly that I agree with every word the noble Lord said. This regulation, this restriction, is repugnant to all of us. Believe me, it is no part of Socialist doctrine—even of the extremest Socialist doctrine—that nurses should be conscripted. Indeed, I can imagine a poster being issued at a General Election—if we keep this thing on—which would be far more effective than the Chinese slavery posters which some of your Lordships may remember. The poster would depict nurses in handcuffs, their hands being bound by a Socialist Government. That, if I may make the suggestion to your Lordships, would be a very valuable poster, from some points of view. Therefore, believe me, in our own interests, apart from anything else, this is a regulation which we want to get rid of at the earliest possible time.
I have said that I have round that this business is, in some sense, operated under my control. But whether it is or whether it is not my colleagues would always readily let me look into it. I would undertake, therefore, that when June or July comes, I will personally make a full statement to your Lordships in which I will review all the relevant acts and circumstances, and I will put your Lordships into possession of every single piece of information that comes to me. I wish I could say more, but quite frankly I think that if I said more than that I might be in danger of making promises I could not satisfy. I very much hope that with that explanation your Lordships will allow us to have this Bill read a third time, a Bill which is, after all, going to put an end to these Defence Regulations.
§ Moved, That the Bill be now read 3a.—(The Lord Chancellor.)442
§ 6.20 p.m.
§ LORD RUSHCLIFFE
My Lords, since the noble and learned Lord on the Woolsack has referred to me I should like to say this. Personally—and I speak for myself and for nobody else—I am very glad that this matter has been ventilated here today and the other day because it is just as well that this country should know the tremendous debt we owe to these men and women—they are mostly men, but perhaps it is about half and half—who are performing this valuable service. It is perfectly true that the conditions and the salaries and the pay of all classes of nurses have been very considerably improved lately and indeed they well deserve it. But I might point out this. I think perhaps that the conditions are at least as valuable as an improvement in pay, but it must be remembered that as you lengthen the holidays to which the nurses are quite properly entitled and as you quite properly diminish the hours of work, so you need more nurses to make up what would otherwise be a deficiency. It is not generally known that the present number of women entering the nursing service is larger than it has ever been, but the demand on their services is so much greater that there is still a tremendous shortage of nurses, both men and women.
I think and believe that this improvement in recruitment has been due at any rate to some extent to the improvement in their conditions, and what the noble Lord said is perfectly true that the whole question of the mental nurses is being considered by a sub-committee of the main Committee of which I am Chairman. I hope it may be that the result of their recommendations may attract more recruits to this important branch of the nursing service. The noble Lord told us the other day that he had consulted, I think, the Home Secretary and he had been advised that it was absolutely essential that this present arrangement should continue for a number of months at least. I venture to think that if he had consulted the Minister of Health he would have got exactly the same answer, because I believe it is absolutely essential that the public service should have the services of these men and women for some little time ahead. I welcome the suggestion that the noble Lord has just made 443 that in the course of this year, say within the next seven or eight months, he will be able to come here again and tell us what the position is with regard to these nurses and indeed of the other matters referred to.
§ 6.24 p.m.
§ VISCOUNT SWINTON
My Lords, I think the whole House will be deeply indebted to the Lord Chancellor for the very full particulars he has given to your Lordships. It does seem at the moment to be an absolutely insoluble problem. No other nurses are being held and we have not got to extend this to other forms of nursing which I suppose present greater attractions. Yet we must find a solution which prevents us from holding these people indefinitely in what must seem to all of us a most unattractive yet onerous and self-sacrificing employment. It is one to which people ought to go if they feel they want to do so, but I can imagine that even the most kindly hearted and equable persons might find that the work got frightfully on their nerves. Quite frankly I cannot criticise or obstruct if I cannot suggest a constructive alternative, and at the moment I do not see one. There may be some consideration as to whether the numbers look to be high. I should be grateful if the Lord Chancellor would go into that because his figure was five to one. It means one trained person to five lunatics. I do not know if some form of dilution could do something to that. I cannot oppose this for the time being, but I am perfectly certain that after what the Lord Chancellor has said everything will be done and I am very glad that he is going to follow this up himself. For my part I readily accept the offer he has made that he will be able to tell us how far we have gone.
§ 6.27 p.m.
My Lords, I should like to associate myself with what the noble Viscount has said, I had an opportunity of saying a few words on this particular matter on another occasion, but I appreciate very much indeed the extremely courteous and helpful way in which the Lord Chancellor has dealt with the situation. I should only like to add my voice to that of Lord Swinton in saying how much we welcome the steps he proposes to take and to give the House more information later in the year.
§ 6.29 p.m.
My Lords, I should not like the Bill to pass without thanking the noble and learned Lord on the Woolsack for the very sympathetic way he met with the Amendment moved by my noble and gallant friend Viscount Trenchard and myself in the Committee stage. I realize some of the difficulties he had to encounter, but I honestly think that having got the Chief Constable not to enrol special constables under the age of twenty without some special sanction is a very big gain. I cannot imagine any Secretary of State who is not in grave terror of Parliamentary criticism in relaxing that rule at a time of civil unrest.
§ On Question, Bill read 3a, and passed.