§ 2.57 p.m.
§ VISCOUNT ASTOR rose to move to resolve, That the Regulations dated July 17, 1946, made under the Nurses Act, 1943, a copy of which Regulations was presented on July 22, be annulled. The noble Viscount said: My Lords, I beg to move the Resolution which stands in my name on the Paper. The point dealt with in the Resolution may appear to be small as it affects a relatively small number of people, but I suggest to your Lordships that it is a point of real substance and one which I feel your Lordships, as a revising Chamber, would wish to consider.
I should like first of all to tell your Lordships about the various items of legislation which have led up to the present position. Your Lordships will remember that in 1943 we passed the Nurses Act, an Act which is intended to improve the conditions and safeguard the conditions of the nursing profession, their enrolment, the training, the administration, the rules and so on. In that Act, which was intended to protect the nursing profession and the public from unqualified nurses, and also from people who might come forward with intent to deceive, Section 6 (1) (b) was put in whereby
the Minister may by regulations authorize the use, either generally or by specified classes of persons or in specified circumstances, of specified names or titles containing the word nurse….
Now that clause was inserted with the intention, obviously, that, given a suitable case, it should be utilized. One of the main objects of the Act is to protect those who are duly qualified who wish to employ the title "nurse." The next step took place on May 31, 1945, when the then Minister of Health and the Secretary of State for Scotland brought out regulations under the Act. In these regulations there is one, No. 2 (1) (m) whereby authority to use the term "nurse" in connexion with other words was given to the Christian Science nurses. During the last year that has been the law of the land.
§ I have been asked to say a word about the sort of training which these ladies get. The duly qualified Christian Science nurse is trained in the following: Bed-making, bed-bathing, lifting and turning patient in bed, general care of patient, 822 making bed with patient in it, turning and changing mattress with patient in bed, bed comforts, invalid cookery, bandaging and dressing, first aid in emergencies, communicable diseases and last services. In addition they receive lectures which deal with the ethics and the religious aspect of their work. As regards their standard of education, the student nurses take examinations both written and oral and an educational standard equivalent to that of the school certificate is required. This training takes five years, and the greater part of it is given in institutions. That is to say these nurses have received a full five-years training. I would hike to point out to your Lordships that where they differ from ordinary medical nurses is that they are not taught the medical side of nursing, but apart from that, on the general hygienic side the training which they get is not dissimilar.
§ The Minister of Health and the Secretary of State for Scotland on July 17 this year, published orders whereby this exemption was cancelled. Now I do not want to ask your Lordships to express an opinion either on the methods or the merits of Christian Science treatment and medical treatment. That point does not arise at all. You are not asked to express an opinion on methods or merits, but merely on the question of administering an Act. Christian Science treatment is not illegal; it is recognized by the Public Health Act, 1936. There are numerous orders, but I will refer to only one now. During the last war, the Air Ministry in a pamphlet dated April 5, 1941, dealt with the Christian Science personnel in the W.A.A.F., and it was set out quite clearly there that with regard to the medical aspect of this religion the Service medical authorities did not object in cases of illness if Christian Science personnel asked to be visited by a Christian Science practitioner. Numerous orders as well as Acts of Parliament have recognized this as being a legal form of treatment.
§ To-day, I am fist of all going to move the annulment of these regulations, but before sitting down I hope to submit to your Lordships an Amendment, or an alternative, which I trust may meet with your Lordships' approval. I am going to do so and to urge that you accept this compromise. 823 I think that if we do not repeal this regulation we shall have a law which will be exceedingly difficult to enforce, and I am all opposed to having laws which cannot be enforced. We are also going to have a regulation which will undoubtedly savour of persecution and intolerance. It is very desirable not to have such a regulation. It has been suggested that the titles of these ladies, these Christian Science nurses, should be changed to "aids" or "helpers," and a precedent is quoted from the Nursing Homes Registration Act. When the Nursing Homes Registration Bill was before Parliament it was recognized that it was unfair to expect Christian Science institutions to carry out the medical conditions and provisions of that measure, and that it would be essentially fair to exclude them from the operation of these clauses. But Parliament in excluding these institutions required that they should be called "houses" and not "nursing homes." It has been suggested that on that precedent your Lordships ought to insist that Christian Science nurses should be called something else—"aids" "helpers" or something like that.
§ The cases are not analogous. First, although with respect to the Nursing Homes Act the Christian Scientists did not agree with the provision they did not raise any opposition, because there was nothing in the Church Manual, that is to say their Church Constitution, which specified the designation which ought to be given to an institution. Where nurses are concerned it is different. There is a specific by-law which lays it down that Christian Science nurses shall be called "Christian Science nurses." That is to say it is not subject to amendment within the Christian Science Constitution. I venture to suggest that it would be confusing if every country were to insist that a different designation should be given either to the nurse or the practitioner or the actual place of worship—for some country might say: "These places ought not to be called churches, they should be called halls; those who give treatment ought not to be called practitioners 'but healers'". It would, I suggest, be exceedingly and quite unnecessarily confusing if the Christian Science Church had to have a different designation for its nurses, its healers and its places of worship in different countries.824
§ I have here a copy of the Christian Science Journal which is published in America. It is the official publication which circulates all over the world, and in this journal there are contained the addresses of churches in this country and in every country, the addresses and the names of practitioners who are registered there and qualified nurses. That is an official publication, and it contains only the names of duly qualified nurses or practitioners. I suggest that it would lead to quite unnecessary confusion if each country were to require a different name or designation or title for those who were engaged in treating disease. I hasten to emphasize that I am not asking your Lordships to express any opinion on the merit or value of this form of treatment, but I would merely explain that it is different, and that it is not illegal.
§ What is one of the great dangers that faces this country to-day? Surely, it is laxity in religion. Are you to say that you are going to fine or imprison women who devote their lives to nursing the sick, because they use the title which is laid down in the Constitution, in the Rules of their Church? I venture to suggest that that would not be a fair or wise regulation to pass. Then we are asked, what guarantee is there that if any particular lady takes this title she is, in fact, qualified? We are asked, how can the Minister know that ladies calling themselves Christian Science nurses are qualified? Exactly the same question arose when we were dealing with nursing homes. After the Nursing Homes Registration Act was passed, the Minister of Health wrote a letter, on May 22, 1928, which I will paraphrase. He wrote that it was recognized that it was possible for him to know from a responsible person representing the Christian Science Board of Directors whether a given house was recognized by that Board as a Christian Science house; that is to say, whether it was qualified for exemption. The letter further stated that the Minister did not himself assume any responsibility for any institution, but would grant exemption without further inquiry when he was satisfied that the institution was recognized by the Board of Directors. Exactly the same position would arise in this case. The Minister would recognize that it is possible for a Board of Directors to nominate a person, representing the Board, who will ask for the exemption 825 only of an institution or of individuals who are duly qualified.
§ Now, my Lords, during the last year, Christian Science nurses have had full freedom to use this title. They could advertise in the general Press as Christian Science nurses. They could have cards; they could have name plates. In view of the fact that the Minister of Health proposes to withdraw the permission which has been given, I have been authorized to submit a compromise to your Lordships. It was set out in a letter to The Times of October 22. In this compromise the Christian Scientists do not object to any regulation which would make it illegal for Christian Science nurses to advertise by name-plate, or in the Press, or in any general publication. That is to say, the privilege to do this could be withdrawn. All they ask is that a regulation should be made permitting duly qualified Christian Science nurses to use that title in official Christian Science publications, or in the records of their Church. I venture to suggest that that is a reasonable compromise. What would be the effect? Those members of the public who wanted treatment by medical nurses could get it; those members of the public who wanted treatment by Christian Science nurses could get it. There could be no confusion. Nobody could employ a nurse representing either form of treatment without being aware of the fact.
§ I hope that members of this great and honourable profession, the medical profession—the medical nurses and the doctors—will not refuse to give fair treatment to another set of people who are equally honest, equally consecrated, and also engaged in treating disease. I have suggested a compromise to your Lordships. If the Government, if your Lordships' House, were to accept this, how could we deal with the regulations? The regulation cannot be amended, and your Lordships will notice that I am asking that it be annulled. There are two courses open. One would be for the Government to accept in principle the compromise which I have been asked to submit to your Lordships and to the Government—by withdrawing the present regulations and, as soon as possible, introducing an amended regulation which would not give a general authority to advertise everywhere, but would restrict the use of the title to the official Christian Science public- 826 cations. The other alternative would be to pass this regulation, and for the Government, later on, to introduce an amending regulation. I submit that this latter would be less desirable, because until the amending order was passed the Christian Science nurses would be liable to a fine or imprisonment if they used that title.
§ In another place, when this matter was being debated, the particular compromise which I am now suggesting was not discussed. It was not rejected there. This question is not a Party question. It does not come into Party politics. I suggest to your Lordships that it is essentially the sort of point which an amending Chamber, such as your Lordships' House is, ought to deal with, and I hope very much that it will commend itself to your Lordships. The numbers affected are not very large, but I suggest that the principle at stake is very substantial and important. Great Britain has.prided herself on fair play, on liberty of conscience, on treating all sections of the community alike. In this country, too, we are reluctant to pass laws which it is difficult to enforce, or which savour of intolerance. It is inconceivable that the whole machinery of the law should be set into motion to put in prison a lady who has done five years training, who is consecrating her life to nursing the sick, and who is duly qualified, just because she insists on taking the designation which her Church Rules tells her she ought to take. It is inconceivable that in 1946 we should do that. The responsibility rests upon Parliament as a whole. I appeal to your Lordships, with your tradition of tolerance, with your insistence that you only pass reasonable laws, to support and accept what I venture to suggest is a very reasonable compromise.
§ 3.19 p.m.
§ LORD HORDER
My Lords, may I say a few words on this point? I think that we are all sympathetic with the noble Viscount in standing up for the rights and privileges of women who constitute themselves nurses within a particular religious denomination. The noble Viscount said that this is not a matter of Party politics, but I suggest that it is very much a matter of public polity. For some time we have 827 been trying, and not unsuccessfully, to raise the status of the nurses in this country. They are members of a very honourable profession, rendering great service to the public and private health of the nation. We have certain statutory recognition of two types of nurses. There is the assistant nurse, who has a special role, entitled "assistant nurse." There is the State registered nurse. We have no other category. We are now asked to recognize another category, and we are assured that this category will only advertise itself to the public—for whose security we stand—through the medium of particular journals.
We are led to believe that those journals will only be read by members of this particular body. Surely it is a vital point whether or not those journals are in fact confined to the particular Church which goes by this name of Christian Science, or whether in actual fact they are journals which circulate amongst the public at large. If we could accept an assurance—I do not think we can—that those journals in which the Christian Science nurse advertises herself as a nurse, were confined to this particular religious body, there might perhaps be some sympathy for the noble Viscount's Motion, but I think it is common knowledge that the circulation of at least one of those Christian Science journals is very large and universal, and on that ground I do not think the safeguard for the nursing profession is at all adequate. Therefore I hope that this Motion will not receive your Lordships' support.
§ 3.23 p.m.
THE EARL OF AIRLIE
My Lords, now that His Majesty's Government and your Lordships have had an opportunity of very fully hearing the case regarding the use of the term "Christian Science nurse" as explained by the noble Viscount who moved to resolve that these regulations should be annulled, I am hoping that perhaps your Lordships will appreciate the need at this time, in the common cause of justice, and I might also add, in the interests of common sense, to allow these Nurses Amendment Regulations for Scotland and England to be annulled.
I am intervening in this debate as an ordinary member of your Lordships' House, but I cannot deny the fact that for 828 a long time I have been an adherent of this religion and I have received a great deal of benefit from it. As the noble Viscount said, we are not here to discuss the merits or the methods of Christian Science. That is a matter for another time and another place. But I suggest that we are here to decide upon a matter of principle. There certainly is a principle at stake in this case and a religious one at that. It is from that angle that I should like, if your Lordships will allow me, to say a very few words. You have heard completely explained by the noble Viscount, Lord Astor, the past history of what has happened in Parliament with regard to this matter and I do not propose to repeat it.
But if I may be allowed to do so, I should like to emphasize two or three points. Firstly, it is, I think, fully appreciated by everyone, and certainly by those of the Christian Science movement, that medical nurses are fully entitled to protection, as is also the public from any intention to deceive. I should have thought it was patently obvious, if you make it so clear what your nurses are, by having the prefix "Christian Science" in front of their names, that there could be no intention to deceive, or, if there was an intention to deceive, it could not possibly succeed because one would know perfectly well what one was getting by the very words in front of their name.
But there are two very strong reasons put forward by the Christian Scientists to explain why they are unable to forgo, or do not desire to be forced to forgo, the title of "Christian Science nurse." The first is that nursing the sick is an integral part of the religious activities of this Church. Secondly, that the name or title "Christian Science nurse" appears in the by-laws of the Church Manual dealing with nursing. This Manual is the Constitution of their Church. This Church has branch churches and societies all over the world. Therefore it is patently obvious that it would be quite impossible to alter that Manual or Constitution. As has been stated, this religion and its form of treatment has been lawful in this country for some considerable time and is recognized by Statutes and Administrative Orders and both in another place and in this House. As has been said, these nurses go through 829 a period of, I think it is, five years' training. They are certificated only after a long consecrated training.
On the other hand, in order to meet the objections, of the Medical Nurses Association, a compromise has been offered and, in my humble opinion, a considerable one at that. It has been offered that the Christian Science nurses should forgo the privilege hitherto granted of advertising publicly in the Press, or by name-plate, and that they should confine themselves to registration or advertising in their own particular publications, literature which is actually published in the United States and not in this country at all. The point was dealt with by the noble Lord, Lord Horder, when he asked: Could it be said that this literature was not circulated freely amongst other people? He spoke of a journal. There are three publications. One is the Christian Science Journal, which is entirely composed of Christian Science literature and articles dealing with the Christian Science faith. At the end of those there are certain advertisements of those who are known as "practitioners" and also of "Christian Science nurses." There is the Christian Science Sentinel., and, besides the Christian Science Sentinel, there is an international paper called, the Christian Science Monitor which I presume is the paper to which the noble Lord was referring. As your Lordships will know, the Monitor is a paper of such substance and repute that, apart from anything connected with religion, it is considered to be one of the leading international newspapers in the world, and it has an extremely large circulation. But I would hesitate to agree that, because Christian Science nurses advertise in that paper, it is necessarily going to make it difficult for the medical nurses to be protected.
Like the noble Viscount, I cannot believe that any Government, let alone a Labour Government which, like the whole country and ourselves, put freedom in the forefront of their policy, are going to make themselves responsible for what will amount, I would say, to intolerance at least, though I would put it nearer the word Mark once used, "persecution," if under the amended regulations these nurses will be liable to a fine if they practice their faith according to the Constitution of their Church, a Church which has been legally recognized in this 830 country for some considerable time. In this country we have always believed in freedom in the way in which we wish to approach our God. We do so in the way which helps us most. We have always resisted anyone who has tried to prevent our dealing with these matters in our own way, provided we are hurting no one else. In all humble sincerity, my counsel, for what it is worth—probably very little—would be to leave well alone.
§ 3.31 p.m.
§ VISCOUNT BUCKMASTER
My Lords, it was not my purpose to address your Lordships on this matter, but, having heard the noble Lord who has just spoken say he has seen much good done by Christian Science, I think I am entitled to say that I have seen much harm done by it He also stressed that this clause was a question of persecution. I am concerned with protecting the public and protecting the great body of nurses. The noble Lord, Lord Horder, has told your Lordships, that nurses deserve in every way the protection we can offer. We should do all we can to raise their status, to improve it, and to safeguard it, and I strongly urge your Lordships to resist any proposal to annul these regulations.
§ 3.32 p.m.
My Lords, I suppose, as we are all giving a declaration of faith, I may say at once that I am an anti-Christian Scientist. At the same time I should like to say to your Lordships that I think there is some real substance in the Motion the noble Viscount has put before you this afternoon, and for this reason. In the regulations paragraphs (a) to (p) all seek to prevent anybody holding herself out to the public for what she is not. In certain circumstances she can hold herself out as a student nurse, a pupil assistant nurse, a maternity nurse, a registered nurse, or a trained nurse, and so on. Now that is very proper. In the regulation that is before your Lordships this afternoon, however, an attempt is being made to prevent somebody from holding herself out to the public for what she is. That is a point on which your Lordships should at least reflect before you come to a decision.
One cannot, after all, impound every word in the English language and prescribe by regulation that it can be used only in certain sections. "Nurse" is one of the oldest of words, so let me take 831 a more modern word—"accountant." There are any number of people who describe themselves as accountants, and some of them I have known could not even write an account of income and expenditure correctly. I am satisfied that a great deal of money is lost by innocent and ignorant persons in this country through going to people who describe themselves as accountants to get their affairs audited. Yet it has never been suggested that nobody can use the word "accountant" except a chartered accountant or an incorporated accountant, even though such a restriction would protect the public. Unless His Majesty's Government are prepared to go the whole hog and give the people that protection as well as this, I really think it might be wise to make some concession to the noble Viscount who moved the Motion.
§ 3.34 p.m.
§ LORD TEVIOT
My Lords, I intervene for a few moments with great regret as I have a complete appreciation of the earnestness with which my two noble friends have put forward this Motion. I would like to inform the House, however, that in the two and a half years in which I was chairman of an inter-departmental committee on the subject of dentistry, this question did arise. The question was whether one was entitled to describe the ladies as dental nurses, and we came to the conclusion, after many discussions on the subject, that we could not so describe them. I think the word "nurse" does convey to all of us a certain meaning, and I am afraid it is certainly not the one my two noble friends have put forward. We know perfectly well, in our own minds, that if you send for a nurse it conveys to one something that is of the greatest possible importance. We in this House and Members in another place probably would be all right, but there are many people in the country who are not so familiar with all these questions as we are. I ask your Lordships to consider very carefully before adopting the suggestion made by my two noble friends.
§ 3.36 p.m.
My Lords, I would like to support this Motion, and with your Lordships' approval I will for one moment refer to the debate which took place in another place on this very subject. In my view the debate that took 832 place then was much too long, with the consequent result that a large number of irrelevancies were introduced which did no good to anybody but did a great deal of harm to a large number. In a debate on this kind of subject, it is, to my way of thinking, more than ever important and essential that the subject be approached dispassionately, without bias and with as open a mind as possible, because, although on the face of it it is entirely a question of nomenclature, without a great deal of care it is too easy to introduce into the debate questions of religion which must always be difficult and may easily and unnecessarily wound the susceptibilities of a great number of individuals. It is, therefore, pertinent to to-day's discussion in this House to consider why the irrelevancies arose elsewhere. I have considered this point and I have come to the unfortunate conclusion that the irrelevancies were introduced as a result possibly of a subconscious fear that any mention of Christian Science might introduce prejudice.
If we are to solve these problems in your Lordships' House to-day it is quite essential that all suggestions of fear or prejudice should be at all costs avoided. The subject must be approached absolutely clearly with an open mind. What is this problem? We have a medical nursing profession seeking to safeguard its status from, shall we say, charlatans or other individuals who style themselves nurses but who are not properly qualified or trained. That is a perfectly reasonable desire—the desire of one honourable profession to safeguard its members. On the other hand, we have the Christian Science nurses and they are, I submit, an equally honourable profession also, having undergone five years of training before they are qualified, whose members are similarly endeavouring to safeguard their position. There are the two groups of individuals each trying to safeguard their members' status. As the noble Viscount who raised this Motion has already mentioned, the 1943 Act permits certain use of the term "nurse" in certain circumstances. It might be of interest to your Lordships to know that it permits the use of the word "nurse" in the case of a children's nurse. The 1945 regulations made under that Act also admit the use of the word "nurse," in some grouping or other, to various other categories of individuals.
833 It has been argued that the title of "Christian Science nurse" is so distinctive as to guard against any possible public misconception as to what they are. I, for my part, entirely support that view. I do not see how there can be any misconception. However, if His Majesty's Government are not prepared to accept this point of view, I still cannot think it is beyond the wit of man to devise some compromise that will enable us this afternoon in your Lordships' House to solve this problem. The noble Viscount who moved this Motion has already suggested a compromise, and it is one that I would whole-heartedly support. I do not wish to keep your Lordships over long, but I would just like to repeat it in my own words. I would like to put it in this way. If the Minister insists on retaining the 1946 regulations, the regulations which prohibit the use of the term "Christian Science nurse," perhaps he would undertake to introduce a specific reference in some new regulation so that, first of all, in so far as the profession of Christian Science nurses is referred to in the books of the Church of Christ, Scientist, and in so far as individuals are described in the various manuals and journals published and printed, not in this country but in the United States of America, there shall be no interference with the distribution of those publications in this country and, secondly, that the individuals themselves shall not lay themselves open to prosecution for having their names published in those papers. I believe that an assurance to be followed up by a regulation on those limes would meet the case and both sides could go away feeling satisfied. As the noble Viscount who moved this Motion has already said, such a compromise would, I believe, meet the wishes of the Christian Science Church in this country.
In suggesting that I appreciate that it is not an inconsiderable concession on the part of the Christian Science Church, and I believe that it is only asking on the part of the medical nurses for a very small concession to come so far to meet us. I am fully convinced that unless something on these lines is done, unless some concession is made to the Christian Science nursing profession, the motives of His Majesty's Government, however impartial and sincere they really are—and I myself am fully convinced that they are impartial and sincere—will be 834 misconstrued not only in this country but also in the United States of America, on the Continent, and elsewhere. There will be suggestions of prejudice and intolerance which, in my view, would both be unfair to His Majesty's Government and would do injustice to the good name that this country has always had for freedom of thought and worship.
§ 3.44 p.m.
§ LORD ALTRINCHAM
My Lords, the noble Viscount, Lord Astor, who moved this Motion said very truly that it is not a question of Party politics. I do not speak as a member of a Party; I speak only for myself and as a member of your Lordships' House. I intervene because I feel very strongly that this is a question of principle which is at issue on this Motion to-day. I am a very recent member of your Lordships' House, but in the short time in which I have had the privilege of being here I have learnt to respect your Lordships' judgment very deeply, particularly on a question of this kind, and it will be a matter of great interest to me to see how your Lordships decide upon this question this afternoon.
I only wish to make my own contribution as best I can, and I do feel very strongly about it. Nobody could go further than I do with the noble Lord, Lord Horder, in his desire to protect the nursing sisterhood in this country.
§ LORD ALTRINCHAM
To protect the public. I entirely accept the correction. On second thoughts I do not think it is a correction, if I may say so with great respect to the noble Lord. You are protecting the nursing sisterhood when you are protecting the public. You are protecting the nursing sisterhood against competitors who may deceive the public by appearing to have qualifications which they have not. That is the object. My own feeling is that nothing we can do is more worthy of doing than to establish the position of that trained profession in this country and to increase its appeal, for it is greatly in need of recruitment at the present time. No one feels that more strongly than I do. However, I do not believe that any profession gains by intolerance. I think one has to be perfectly clear about this. There is a great deal of intolerance about at the present time; 835 closed shops are being heard of in every quarter, and I do not think these are of real assistance to the organizations or professions which insist upon them. They are the sign of a temper in the modern world which is a dangerous temper and a temper very unlike that which we ought to cultivate in this country, where we have a great tradition of tolerance, where as a matter of fact a conscientious person of whatever type, a man with religious convictions however peculiar, has a protection and respect which he receives nowhere else in the world.
The first question is this. Is it possible that the compromise which has been suggested is such that the public can in any way be deceived? The proposal is that the title of "Christian Science nurse" shall be used only in the Christian Science journals. I understand that is what my noble friend proposed. There are three such journals published in the United States of America, the Christian Science Journal, which is a purely religious and technical journal, the Christian Science Sentinel, which I understand is also technical, and the Christian Science Monitor, which, owing to its excellence and impartiality, has a world-wide circulation well outside the Christian Science field. It is only the publication of the Christian Science Monitor which can possibly mislead anybody. I do not think anybody who is not a Christian Scientist would take the other publications.
Is it seriously contended that a member of the general public who happens to get into his or her hands a copy of the Christian Science Monitor and see nurses advertised as Christian Science nurses is going to be led to believe that they are any other than what they say they are—namely, Christian Science nurses? I cannot believe it is necessary to inflict that disability upon those who are, trained in nursing which is recognized by their own religion in order to protect trained medical nursing sisters. It seems to me that we must guard against creating an offence which everybody will regard as against common sense if it occurs. Apparently it will be a serious offence if anybody whose name appears in the register in one of the three Christian Science journals should come to this country. Anybody whose name appears in those journals coming to this country 836 will have committed an offence. I cannot believe that that is a reasonable proposition. Here are nurses in the United States of America who are registered in conformity with the laws of the United States of America who, if they come to this country, are guilty of this offence because their names appear in that register and are advertised in these Christian Science journals. I cannot believe that that is a proper thing and I, for my part, very strongly support this Motion.
The noble Lord, Lord Buckmaster, said that Christian Science had done great harm. I do not speak as a Christian Scientist—I am a member of the Church of England—but I am bound to say that I have seen much good done by Christian Science as I have also seen some harm done. On the whole I have seen more good than harm done. In any case, this is a recognized religion. It is not for us to discuss the merits of Christian Science; it is for us simply to discuss fairness and tolerance towards what is a recognized faith in this country.
Finally, as to the question of the use of the word "nurse," that word is a very old and a very broad noun in the English language. Are we now going to be told that children's nurses are not to call themselves nurses? If they are not to be called "nurses," what are they to be called? Am I not to have a nursery in my house without getting a certificate from the Minister of Health? Is this where we are getting to? Is the shop to be closed to that extent? All this business about words is really only a cover for a form of professional intolerance which I do not believe accords in the least with the spirit of the nursing system in this country, and which can only do it harm. I therefore beg His Majesty's Government to accept this compromise.
§ 3.52 p.m.
§ LORD LLEWELLIN
My Lords, I hope your Lordships will forgive me if I intervene for a moment, largely for the reason that I take a slightly different view of the matter from that taken by my noble friend who has just addressed you. I do not believe that all that is said will happen if this regulation continues to be a regulation will really happen at all. First of all, let me disabuse the mind of my noble friend who has just sat down in regard to the children's nurse in the nursery. In the Statute—and a regula- 837 tion cannot upset a Statute—it is provided that… nothing in this subsection"—that is, the subsection under which this regulation is made—shall prevent a children's nurse from taking or using the name or title of nurse, unless the circumstances in which, or the words or letters in combination with which, the name or title is taken or used are such as to suggest that he is something other than a children's nurse.The "he" sounds rather odd to me, but the Interpretation Act, of course, provides that "he" may also mean "she."
§ LORD ALTRINCHAM
If my noble friend will allow me to say so, I was well aware of the passage which he has just read to the House, but one of the noble Lords who addressed the House on this subject said it was important that there should be no use of the word "nurse" outside the properly trained medical nursing system.
§ LORD LLEWELLIN
I beg my noble friend's pardon, but I thought it was just as well to make it clear that this did not affect the position of the children's nurse. It is worth while to see also what this section of the 1943 Act does. It says:As from such date as the Minister may by order direct, any person who, not being a duly registered nurse under the principal Act"—that is the 1919 Act—or a duly enrolled assistant nurse, takes or uses the name or title of nurse, either alone or in combination with any other words or letters, shall be liable on summary conviction to a fine …It is not the case, as one noble Lord said, that sentence of imprisonment can be imposed. Later on, in paragraph (c), of Section 6, subsection (1), it is said:a person shall not be guilty of an offence under this subsection by reason only that, without objection by him, other persons use the word nurse in addressing or referring to him.Let us take the case of the Christian Science Monitor, which publishes something about somebody who is called a Christian Science nurse. Let us take, first of all, an American subject. The Christian Science Monitor publishes that and the person to whom it refers takes no objection to it, but because of this proviso in subsection (c) that person is not liable to be prosecuted. Nor do I believe that you could bring home to any 838 British subject who was described as a Christian Science nurse in a paper published abroad that an offence under this section had been committed. Therefore, whether or not the Government accept the compromise suggested, I believe it will be quite all right for a Christian Science nurse still to be so described in newspapers published abroad. I do not see that there is any way in which you could bring home an offence to them.
On the general subject, what was this Act of 1943 intended to do? Under the Act of 1919 it was made illegal to call yourself a registered nurse if you were not a registered nurse; but the phrase "registered nurse" was too long, and an attempt was made by the 1943 Act to give some definite status to a person who was called a nurse. I think it was right to do that then: and I think it is right to insist upon doing it at a time when there is the greatest difficulty, as most noble Lords—or at any rate all those associated with hospitals—will know, in getting a sufficiency of properly trained nurses for our hospitals. The more you do to raise the status of the nursing profession, the more likely you are to get the recruits who are necessary for the hospitals of this country.
I think nobody will disagree with the noble Viscount who introduced this Motion when he says that this is a matter into which he thinks this House may wish to go. It is, if I may say so, a very right and proper matter for this House to go into; but it is one thing for this House to go into the subject and another thing to take the view that it should go into the Lobby in support of the noble Viscount. I am not in a position—why should I be?—to advise any noble Lord as to what he should do. This is a matter which cuts across Party politics, but as my noble friend has spoken from these Benches, perhaps your Lordships will allow me to say—and I know this for a fact—that had my noble friend the Leader of the Opposition been in the House this afternoon, he would have advised that it would be unwise to defeat the Government on this particular issue.
§ 3.59 p.m.
§ VISCOUNT ADDISON
My Lords, we have had a very interesting and very sincere discussion, and I propose now to state the views of the Government upon this matter. In the first place, I should 839 say that on a Motion of this kind, under the proceedings of Parliament, a compromise is not possible. Your Lordships have either to vote for it, or against it. That is the way in which these orders are dealt with in Parliament. If the regulations were annulled, then it would be possible for the Minister or the Department to bring forward modified regulations, but your Lordships cannot amend them. So far, therefore, as the regulations are concerned, you must either approve them or disapprove them. Therefore I am afraid that on those grounds there is no possibility of meeting the noble Viscount's suggestions.
Moreover, I share the view taken by the noble Lord, Lord Llewellin. It does not appear to me to be a compromise at all, even if we could apply it, to do something or other which would affect something that was printed in a newspaper in the United States. Quite frankly, it has nothing to do with the point at issue. We are not considering that. We cannot control what they print in the newspapers in the United States, and I am quite sure nobody on either side of the House would be rash enough to suggest such an undertaking, so we can rule that out. That is not a compromise at all; it is just impracticable, that is all. It will not work. Let me say again that it is not a question of religious controversy, or the interfering or seeking to interfere with anyone's convictions at all. Neither of those considerations comes into the matter. The thing which really matters is: how are we to act with regard to the promotion and safe-guarding of the interests of the profession of nursing? That is really what we have to decide.
As the noble Lord, Lord Llewellin, said, the Act of 1943 was passed because after the Nurses Registration Act, which I myself passed through Parliament early in 1919, there were difficulties which arose, and consequently this excellent Bill of 1943 was passed to regularize and improve the position, as was only right. The idea was that gradually we were emerging, shall I say, from the period of our history in which Mrs. Gamp was recognized as a nurse. Gradually the profession has become one in which a standard of training is required, a standard of certification is required, and the Nurses 840 Registration Act was to set up a register of those who were so qualified. The whole effort has been gradually to raise the standard of the profession of nursing.
The noble Lord said that Christian Science nurses were not taught the medical side of nursing—I took down his words. Well, I am not concerned with what they are taught other than that, and it is entirely for those who have this faith to decide what they would wish them to be taught. But here we are concerned with establishing and trying to enhance the profession of nursing, which is something ancillary to and a part of medical treatment. That is what we are driving at all the time. Therefore, from our point of view, the noble Lord undermines his own case when he insists that these ladies do not receive medical training. It only goes to show that if we agree that people should describe themselves as nurses who have not had a medical training, we should to that extent be leading the people to think that they are qualified persons so far as medical training is concerned. They are not qualified persons, and in that sense we are not doing good to the nursing profession.
I would like your Lordships to get, shall we say, some sense of proportion in this matter. I have here a document which tells me about it, and it says that there are understood to be seventy Christian Science nurses in this country. Some were originally hospital trained and were converted to Christian Science; twenty-seven of the seventy have received their diplomas in the United States, and the others are not accounted for. Let us not get the thing out of proportion. It is not a large number of people with whom we are concerned. But of course, as the noble Viscount quite properly said, it is not a question of numbers but a question of principle, and you are not entitled to treat people hardly even though there may be few of them. That is perfectly right, and I entirely support that. On the discussion in another place when it was proposed to annul the Regulation it was defeated by 245 votes to 43, so that the proposal received very little support. The fact is that in our view it is not right that any particular set of people who are not nurses, whatever may be their personal religious convictions, which have nothing whatever to do with the issue, should describe themselves as nurses.
THE EARL OF AIRLIE
They are not nurses; they describe themselves as Christian Science nurses, which is a very different thing.
§ VISCOUNT ADDISON
No, it is not. That is my point. It is misleading the people to think it is something identical—
§ VISCOUNT ADDISON
With the greatest respect to the noble Earl, I listened to him with much patience and I did not interrupt him, and I must ask him to do the same for me. The connotation of the word "nurse," as we are trying to build up the standard of training and the quality of the profession, indicates somebody who has had a proper training as a nurse to help in a hospital. In our view it is not in the interests of nursing that other persons, whatever may be their religious denomination, should describe themselves as nurses, because if we accept this with regard to Christian Science nurses we cannot stop there. I do not see why you should not have Salvation Army nurses, who are just as much entitled to describe themselves as nurses and advertise themselves as nurses, or Presbyterian or Anglican nurses, and so on. You do not refer to Christian Science doctors or Methodist doctors. Doctors have a medical qualification and that is the thing which is the test of their being entered on the Medical Register, and the same applies to nurses.
I am sorry to say that with the greatest possible good will to try and meet the noble Viscount we cannot possibly agree to his suggestion. We want to advance the reputation of the profession of nurses. Call it a "closed shop" if you like, I do not mind. The medical register is a "closed shop." I am a member of that profession myself, and I should be the first to protest against anybody coming into that profession calling himself properly trained who had not been properly trained. It is a "closed shop" and so it ought to be. It is a closed shop in the interests of the community. That is why Parliament made it a "closed shop," and there is nothing to be ashamed of in that. If they had not made it a "closed shop," we very soon should have, and that applies to any profession in which, in the interests of the public, 842 it is deemed that a certain training should be required. That is really the root of the whole matter. I am sorry that we cannot make an exception, but in our view this regulation should be supported, and I hope that the House will support it.
§ LORD ALTRINCHAM
May I ask the noble Viscount one point. The noble Lord, Lord Horder, as I understood him, attached importance to the fact that under this regulation the name of a Christian Science nurse could not be entered in the Christian Science Monitor. I understood him to say that it would be an offence for the name to appear. The noble Lord, Lord Llewellin, said it was not an offence under this regulation, so apparently Lord Horder's argument falls to the ground. May I know which of those two arguments is in fact sound?
§ VISCOUNT ADDISON
That question would be more properly addressed to the noble and learned Lord on the Woolsack. We cannot prevent anybody printing something in a United States paper. We cannot be responsible for that. What we are responsible for is what British citizens do in this country.
§ VISCOUNT SAMUEL
If a Christian Science nurse, resident in this country and practising here, were to pay for the insertion of an advertisement in the Christian Science Monitor, which circulates in this country, would that be an offence or not?
§ THE LORD CHANCELLOR (LORD JOWITT)
You may ask the question, but, not having heard the argument, I am much too wise to answer.
§ 4.11 p.m.
§ VISCOUNT ASTOR
My Lords, may I deal with one or two of the points which have been raised, more particularly as I think that some of the arguments which have been used are based on misunderstanding? The particular point which we have had before us just now is, I think, going to be a point of very real substance. Are these ladies, whatever they may be—English, Scottish, Welsh, but, at any rate, all British—who are nursing in this country, going to be fined and, if they do not pay the fine, put in 843 prison, because they advertise their names and addresses in the Christian Science Journal, which is an official publication? It seems to me that that is a point of real substance.
§ VISCOUNT ASTOR
I merely wanted to put the question because some of the speakers, judging by their remarks, seem to think that we were dealing with allusions to nurses in the Christian Science Monitor, which is a daily paper. Such allusions would not be a crime, I agree. But if duly qualified nurses, who have been trained and are practising here, think it necessary to carry out the rules and regulations of their Church and advertise in their own official publication, then I venture to suggest that it is a very serious step to make them liable to fine and imprisonment for obeying the rules and regulations of their Church.
That is one point which I wish to put before your Lordships. Another arises in this way. The noble Viscount, Lord Addison, said that if you allow the designation "Christian Science nurse," you might just as well have a "Salvation Army nurse" or a "Presbyterian nurse." Now there are two forms of treatment. This is not the occasion to go into the matter in detail, but I think I can summarize it by saying that one form, the Christian Science treatment, depends entirely upon prayer and does not include the use of medicine. Christian Science treatment is entirely spiritual
§ treatment; it does not use drugs and medicine. With regard to "Salvation Army nurses" or "Presbyterian nurses," the form of treatment which they would be helping to administer does not exclude the use of drugs, so that their case is entirely different. If later on some other set of people came forward and were able to make out as good a case, it might well be that you would wish to make an exception in their case.
§ But I do want to point out the fundamental difference between healing which depends entirely on spiritual methods, healing by prayer, and healing by the use of physic and medicine. I repeat that Christian Science treatment is not illegal. It is not proposed to pass a law to prohibit lectures on Christian Science or to prohibit worship in Christian Science churches. I can understand, though it would be unwise, that you try to pass a law to make this entirely illegal, but I cannot understand the logic of passing a regulation which is merely going to make it difficult for people belonging to a particular denomination to carry out the rules and regulations of their own Church whilst it is not illegal in this country. I feel that this is not a question of numbers; it is not a question whether the number is seventy more or less; it is a question of principle. I hope, therefore, that enough of your Lordships will support us in the Division.
§ On Ouestion, Whether the said Resolution shall be agreed to?
§ Their Lordships divided:—Contents, 11; Not-Contents, 55.845
|Airlie, E. [Teller.]||Ailwyn, L.||Harris, L.|
|Iddesleigh, E.||Altrincham, L.||Rochdale, L.|
|Boyle, L. (E. Cork and Orrery.)||Saltoun, L.|
|Astor, V. [Teller.]||Dunmore, L. (E. Dunmore.)||Somers, L.|
|Jowitt, L. (Lord Chancellor.)||Brentford, V.||Ebbisham, L.|
|Mersey, V.||Faringdon, I.|
|Salisbury, M.||Samuel, V.||Gifford, L.|
|Simon, V.||Hatherton, L.|
|Beauchamp, E.||Wimborne, V.||Henderson, L. [Teller.]|
|Howe, E.||Hindlip, L.|
|Inchcape, E.||Aberdare, L.||Holden, L.|
|Lucan, E.||Addington, L.||Horder, L.|
|Manvers, E.||Chatfield, L.||Inman, L.|
|Munster, E.||Cherwell, L.||Kenilworth, L.|
|Vane, E. (M. Londonderry.)||Chorley, L. [Teller.]||Lawrence, L.|
|Yarborough, E.||Darwen, L.||Llewellin, L.|
|Denham, L.||Lucas of Chilworth, L.|
|Addison, V.||Derwent, L.||Marley, L.|
|Morrison, L.||Queenborough, L.||Shepherd, L.|
|Mottistone, L.||Quibell, L.||Terrington, L.|
|Mountevans, L.||Raglan, L.||Teviot, L.|
|O'Hagan, L.||Ravensworth, L.||Waleran, L.|
|Pakenham, L.||Rea, L.||Walkden, L.|
|Pethick-Lawrence, L.||Rochester, L.|
§ Resolved in the negative, and Resolution disagreed to accordingly.
§ VISCOUNT ASTOR
My Lords, in the circumstances I do not propose to move 846 the Resolution in my name relating to the Nurses (Scotland) Amendment Regulations.
§ House adjourned at twenty-five minutes past four O'clock.