§ 4.18 p.m.
§ Amendments reported (according to Order).
§ Clause 4 [Expenditure of Nurse-Training and Hospital Management Committees, &c.]:
§ LORD SHEPHERD moved to leave out Clause 4 and to insert the following new clause:
§ Expenditure on nurse-training by Hospital Management Committees, &c.
§ "4.—(1) Where a standing nurse-training committee is constituted under this Act for a hospital area, expenditure by a Hospital Management Committee appointed by the Regional Hospital Board for the area or by the Board of Governors of a teaching hospital situated in the area, being expenditure—
- (a) wholly or mainly for the purposes of, or in connection with, the training of nurses; and
- (b) of such description as the Minister may specify for the purposes of this subsection;
§ (2) Any question arising under the foregoing subsection whether expenditure is such as is mentioned in paragraph (a) thereof shall be determined by the Minister."
§ The noble Lord said: My Lords, when this Bill came up for its Second Reading it met with a chorus of approval from all sections of your Lordships' House. It was not only generally welcomed but it was believed to be a non-party measure. Notwithstanding one diversion and one Division, I think that those terms could 37 be applied to the Bill at this stage. Good feeling has been maintained, co-operation has been the order of the day, and we all believe now that we have an agreed measure which we can send to another place.
§ In moving the first Amendment, namely, for the abolition of Clause 4 as it now is, and the substitution of the original clause, I think it would be as well if I made a brief statement. The original clause provided that the expenses of hospital management committees and boards of governors for the training of nurses should be met by the standing nurse-training committees out of money provided by the General Nursing Council, who in their turn derived their money from Government sources. The purpose the Government had in mind was to some extent to separate the responsibility of training, at any rate in so far as money was concerned, from the employment of nurses. Secondly, the purpose of putting money through that line was to strengthen the hands of the General Nursing Council and, by the provision of standing nurse-training committees, to provide them with machinery whereby they could keep closely in touch with management committees and boards of governors.
§ For some time there has been a growing feeling that it was essential, in the interests of nurses and of training, that some independent organisation should be mainly responsible for the training schemes and for the approval which followed from them. However, when Clause 4 came before your Lordships' House in Committee, an Amendment was moved by the noble Lord, Lord Luke, to delete the clause, and to introduce a new clause which had for its purpose the taking away of the authority of the General Nursing Council and the standing nurse-training committees for expenditure and transferring that authority to a new independent body, on lines similar to those which we have in the university field. Your Lordships approved the views expressed by the noble Lord, Lord Luke, and, on a Division, carried his Amendment. The Government, or at any rate the representatives of the Government in this House, had to decide what course they should follow after a Division of that kind, creating, as it did, a great change in the Bill. Ministers took the view that it would be better to try to reach 38 an accommodation during the remaining stages of the Bill, so that we could send the Bill to another place as an agreed measure, rather than burke the issue now and allow the Minister to give advice in another place as to the course that should be followed. I think we may congratulate ourselves on the fact that the action taken by Ministers has met with success. General agreement has been established, and a number of Amendments are to come before your Lordships to-day arising out of the discussions.
§ On this issue, this is the line your Lordships are now recommended to take: first to delete the present Clause 4 and put hack the original clause, and then, to meet the views of the noble Lord, Lord Luke, and those who supported him, by creating in the General Nursing Council a statutory committee for the purpose of administering funds for the training of nurses. We have gone even further than that. We have now provided that when disputes arise in the standing nurse-training committees on matters of finance, and indeed on matters generally, there shall be an appeal by those who feel aggrieved to the General Nursing Council, with whom the final word will rest. In coming to this arrangement we think we have strengthened the General Nursing Council and certainly that we have strengthened the standing nurse-training committees. We believe that we now possess the means by which the 600 separate schools for training nurses which exist to-day can he brought into intimate contact, through the standing nurse-training committees, with the General Nursing Council. We are confident that if these Amendments are accepted in another place, we shall have a Bill of first-rate importance to our credit.
§
Amendment moved—
Leave out Clause 4 and insert the said new clause.—(Lord Shepherd.)
§ LORD LLEWELLINMy Lords, we are all indebted to the noble Lord, Lord Shepherd, for dealing with this matter so comprehensively. I think he was right in not confining himself to the Amendment which we are now discussing and informing your Lordships of the situation in regard to the other Amendments. During the Committee stage many of us thought that the standing nurse-training committees were not the appropriate bodies to 39 deal with grants, especially those to the large teaching hospitals, which have always set the pace and standard in regard to the training of both medical students and nurses. We sought for a body akin to that which deals with grants to universities, as the noble Lord has said. That was the purpose of the Amendment moved by the noble Lord, Lord Luke, which I supported and which, on a Division, we put into the Bill.
As always, we found the noble Viscount the Leader of the House, who on this occasion was accompanied by the noble Lord, Lord Shepherd, very reasonable. It is no secret that we have had talks on the matter. As a result the Order Paper now contains an Amendment setting up a finance committee of the General Nursing Council, to which all financial matters will be referred, and a further Amendment providing that if either a management committee or board of governors of a teaching hospital are aggrieved by any decisions made by a standing nurse training committee, they have a right of appeal to the General Nursing Council. An appeal on matters of finance will automatically be referred to the finance committee. So far as I am concerned, I think this is a better method than the Amendment which we previously inserted in the Bill. I will he frank about it. It was very difficult to find out exactly how a hospital grants committee should be formed, and who should he on it. I hope that when the General Nursing Council set up their finance committee they will take advantage of the proposal under the First Schedule whereby the Minister is to appoint to the Council three persons with knowledge of hospital administration and finance, and that the Council will make use of these members on their finance committee.
I would join with the noble Lord. Lord Shepherd, in advising your Lordships to go back on the decision that we previously made, to accept the very good compromise that has been worked out in the meantime between us, and so send this Bill forward to another place as a measure on which there is no outstanding disagreement in your Lordships' House. For that reason I would recommend to the House the course just proposed by the noble Lord, Lord Shepherd.
§ LORD WEBB-JOHNSONMy Lords, I would like to make the comment that the Amendment carried in your Lordships' House on the Committee stage was carried because of the anxiety expressed in regard to the position of the teaching hospitals. This anxiety is now largely removed, and I feel that in practice it will be entirely removed, by the Amendments which stand in the name of the noble Lord, Lord Shepherd. Therefore, I would like to express contentment, not only with the Amendment with which we are now dealing but with those which are contingent on its passing, because they all hang together. At the same time, I would like to express my thanks to the noble Viscount the Leader of the House, and to the noble Lord, Lord Shepherd, for the sympathetic consideration they have given to the anxiety expressed, and for their serious endeavour to find a solution which is not only acceptable in this House but which stands a good prospect of being accepted in another place.
§ LORD LUKEMy Lords, I would just like to add my tribute to the noble Lord, Lord Shepherd, and to thank him for what he has said about this. Perhaps I should add something that he could not say—namely, that it would have been better if we had had consulation before and not after the event. However, that is past history. I, too, with the noble Lords, Lord Llewellin, and Lord Webb-Johnson, feel that the three matters now put into the Bill—namely, the appeal, as it were, the new clause setting up the finance committee and the three representatives on the General Nursing Council, will make a great difference. For my part, I am satisfied that the grants committee has now passed into limbo.
§ On Question, Amendment agreed to.
§ Clause 5 [Contributions towards expenses of other persons in respect of nurse-training]:
§ LORD SHEPHERDMy Lords, the next two Amendments are consequential. Perhaps in moving them I may be permitted to express thanks on behalf of my noble Leader and myself for the very kind words that have been uttered. It would, however, be wrong to convey the impression that all the good work has been done on this side of the House. The noble Lords, Lord Cunliffe, Lord Luke 41 and Lord Webb-Johnson have been helpful in the extreme; and, as it were, presiding over what were formerly two hostile forces we have had the independent and sympathetic guidance of the noble Lord, Lord Llewellin. I beg to move.
§
Amendment moved—
Page 4, line 27, leave out ("Hospital Grants Committee") and insert ("standing nurse-training committee for a hospital area").—(Lord Shepherd.)
§ On Question, Amendment agreed to.
§
Amendment moved—
Page 4, line 28, after ("engaged") insert ("in the area").—(Lord Shepherd.)
§ On Question, Amendment agreed to.
§ Clause 7 [Expenses of Hospital Grants Committee]:
§ LORD SHEPHERDMy Lords, this Amendment proposing to delete Clause 7 is in consequence of our reintroduction of Clause 4. I beg to move.
§
Amendment moved—
Leave out Clause 7.—(Lord Shepherd.)
§ On Question, Amendment agreed to.
§ LORD SHEPHERD moved, after Clause 7 to insert the following new Clause:
§ Reference of disputes to the Council
§ ". Any question arising between a standing nurse-training committee for a hospital area and a Hospital Management Committee appointed by the Regional Hospital Board for the area or the Board of Governors of a teaching hospital situated in the area, being a question relating to the exercise by the first-mentioned committee of their functions under this Act, shall, in default of agreement, be determined by the Council."
§ The noble Lord said: My Lords, I indicated that one of the things for which we endeavour to provide in case of dispute locally, is the right of appeal of certain bodies to the General Nursing Council. That is the purpose of this Amendment. It will be noted that the appeal is to the General Nursing Council. I mention that particularly because there was a suggestion that the appeal was to the finance committee. It may of course be to the finance committee ultimately, because when an appeal on finance goes to the General Nursing Council the item will stand referred to the finance committee. I beg to move.
§
Amendment moved—
After Clause 7, insert the said new Clause.—(Lord Shepherd.)
§ LORD LLEWELLINMy Lords, I am obliged to the noble Lord for having had the Amendment drafted in this way, and to those responsible for the drafting for the speed with which they have accomplished it. That has enabled the matter to be dealt with satisfactorily on the Report stage of the Bill. I suppose there will be disputes, both financial and otherwise, which will come under the clause we are now discussing, but only the financial disputes will automatically be referred to the finance committee. The other disputes will be dealt with by the General Nursing Council. I mention that because the noble Lord, Lord Shepherd, omitted to say anything about the one class of appeal. Before I sit down, I would like to thank the noble Lord for his kindly reference to myself.
§ On Question, Amendment agreed to.
§ LORD SHEPHERD moved, after Cause 7, to insert the following new clause:
§ The finance committee
§ ".—(1) The Council shall appoint a finance committee consisting of members of the Council.
§ (2) The number of members of the finance committee and their term of office shall be such as may be prescribed by rules made by the Council under subsection (1) of section three of the Act of 1919.
§ (3) Any matter relating to the discharge by the Council of their functions with respect to the defraying of expenses incurred by standing nurse-training committees shall stand referred to the finance committee and any other matter may be referred by the Council to that committee; and the committee shall consider the matter and report upon it to the Council, and the Council, before taking any action on the matter shall, unless in the opinion of the Council the matter is urgent, receive and consider the report of the committee.
§ (4) The power of the Council under paragraph (f) of subsection (1) of section three of the Act of 1919 to make rules for authorising the delegation to committees of the powers of the Council and for regulating the proceedings (including quorum) of committees shall be exercisable in relation to the finance committee."
§ The noble Lord said: My Lords, the purpose of this new clause is to create the statutory committee of the General Nursing Council to deal with financial matters. I do not think it is necessary for me to discuss it further, because its terms are plain. I beg to move.
§
Amendment moved—
After Clause 7, insert the said new clause.—(Lord Shepherd.)
§ On Question, Amendment agreed to.
43§ 4.50 p.m.
§ Clause 8:
§ The Mental Nurses Committee
§ (3) The Council may pay to the members of the Mental Nurses Committee sums (to be calculated in accordance with directions to be given by the Minister) in respect of any loss of remunerative time and in respect of travelling and subsistence expenses.
§ LORD SHEPHERDMy Lords, the noble Lord, Lord Llewellin, had an Amendment down to this clause to make it clear that the training of mental nurses should be a matter for the consideration of this committee. We are accepting his Amendment in principle, but we have drafted our own Amendments which, from the draftsman's point of view, are more suitable. I beg to move.
§ Amendment moved—
§
Page 5, line 1, at beginning, insert ("The following matters, namely.—
(a)").—(Lord Shepherd.)
§ LORD LLEWELLINMy Lords, although this particular Amendment does not deal with my point, as is obvious from the drafting, the succeeding Amendment, to which the noble Lord Lord Shepherd was obviously addressing himself, fully meets the point which I raised and still have on the Order Paper. I thank the noble Lord for putting down this Amendment, and in consequence I will not move the next Amendment which stands in my name.
§ On Question, Amendment agreed to.
§ LORD SHEPHERDMy Lords, this Amendment is consequential. I beg to move.
§ Amendment moved—
§
Page 5, line 4, after ("question)") insert ("and
(b) any matter relating to the training of persons for admission to the supplementary part of the register containing the names of nurses trained in the nursing and care of persons suffering from mental diseases;").(Lord Shepherd.)
§ On Question, Amendment agreed to.
§ LORD SHEPHERDMy Lords, this Amendment is also consequential. I beg to move.
§
Amendment moved—
Page 5, line 5, after ("question") insert ("as aforesaid").—(Lord Shepherd.)
§ On Question, Amendment agreed to.
44§ LORD SHEPHERDMy Lords, this is a drafting Amendment. I beg to move.
§
Amendment moved—
Page 5, line 14, after ("Committee") insert ("on behalf of the Council").—(Lord Shepherd.)
§ On Question, Amendment agreed to.
§ LORD SHEPHERDMy Lords, during the Committee stage a number of appeals were made to us about the expenses which were to be paid to persons who were attending committees on nurse-training business. We have given consideration to those matters, and we have thought it wise to bring the Bill into line with the provisions of the National Health Service (Amendment) Bill. I think that will satisfy those who were in doubt as to whether we were covering the whole of the legitimate expenses. I beg to move.
§
Amendment moved—
Page 5, line 21, leave out from first ("of") to end of line 22, and insert ("earnings they would otherwise have made or any additional expenses (including travelling and subsistence expenses) to which they would not otherwise have been subject, being loss or expenses necessarily suffered or incurred by them for the purpose of enabling them to perform duties as members of the Mental Nurses Committee").—(Lord Shepherd.)
§ LORD LLEWELLINMy Lords, in my view it is quite right that the Nurses Bill should follow the same lines as the National Health Service Bill. I am glad that these Amendments have been put down in order to meet this point, and bring the two matters completely in line.
§ On Question, Amendment agreed to.
§ Clause 9:
§ Registration of Nurses trained abroad
§ 9.—(1) A person who proves to the satisfaction of the Council that he has been trained either generally as a nurse or as a nurse of some special class in a country or territory outside the United Kingdom in accordance with a scheme of training recognised by the Council as being satisfactory for the purposes of this subsection, that he underwent his training in an institution so recognised and that he is of good character shall, on making an application in the prescribed manner and on payment of such fee, if any, as may be prescribed, be entitled to be registered in the part of the register appearing to the Council to be appropriate to his case.
§ LORD SHEPHERDMy Lords, there are several Amendments to Clause 9. The intention is to ensure that nurses trained abroad who are admitted to the Register 45 shall have passed any examinations forming part of their training. The Amendment has been made at the request of the General Nursing Council to make it abundantly clear that no nurse trained abroad who has failed to pass an examination forming part of her training, shall have any title to be admitted to the Register. It may be that in some countries there are forms of training which the General Nursing Council would regard as satisfactory but which do not involve the taking of an examination. The Amendment would not preclude the admission of nurses who had completed training of this kind. I beg to move.
§
Amendment moved—
Page 5, line 28, leave out from ("that") to ("in") in line 30, and insert (", in a country or territory outside the United Kingdom, he successfully completed his training either generally as a nurse or as a nurse of some special class").—(Lord Shepherd.)
§ LORD LLEWELLINMy Lords, I think these are better words than those we had before. They seem to me to meet the case which one used to hear—and perhaps one hears of it to-day—where, as one of their qualifications, certain Indian students who had been to one of the universities used to put "failed B.A., Oxford" This Amendment means that if there is an examination which has to be taken nurses will have had to pass it, and will not he able to rely upon that old recommendation of failing to pass.
§ On Question, Amendment agreed to.
§ LORD SHEPHERDMy Lords, this Amendment is consequential. I beg to move.
§
Amendment moved—
Page 5, line 39, leave out ("has been trained") and insert ("successfully completed his training")—(Lord Shepherd.)
§ On Question, Amendment agreed to.
§ LORD SHEPHERDMy Lords, I beg to move the next Amendment.
§
Amendment moved—
Page 5, line 42, leave out ("he has been so trained") and insert ("his training was")(Lord Shepherd.)
§ On Question, Amendment agreed to.
§ LORD SHEPHERDMy Lords, the next two Amendments are drafting. They are merely to change the order of the words as they appear in the clause. I beg to move.
§
Amendment move6—
Page 6, line 2, leave out ("if they are satisfied that he is of good character")—(Lord Shepherd.)
§ On Question, Amendment agreed to.
§
Amendment moved—
Page 6, line 3, after ("may") insert (", if they are satisfied that he is of good character,")—(Lord Shepherd.)
§ On Question, Amendment agreed to.
§ Clause 10 [Closing of parts of the register]:
§
LORD SHEPHERD moved, after subsection (2) to insert:
(3) No request undo, the last foregoing subsection shall be made by the Council with respect to the supplementary part of the register containing the names of nurses trained in the nursing and care of persons suffering from mental diseases unless the Council are satisfied that means exist whereby members of the public can readily ascertain whether a registered nurse has been so trained and no such request shall be so made with respect to the supplementary part of the register containing the names of nurses trained in the nursing of sick children unless the Council are satisfied that means exist whereby members of the public can readily ascertain whether a registered nurse has been so trained.
§ The noble Lord said: My Lords, during the debate on the Committee stage fears were expressed, chiefly, I think, by the noble Lord, Lord Webb-Johnson, about the position of specialised training. As your Lordships will remember, the Bill provides for a general training with certain specialised training, and it also provides that at some time if the Council think proper, portions of the register for specially trained nurses would cease. We have gone closely into the matter, and have produced this new subsection which we hope will meet the difficulties which were then expressed. We desire, in particular, to make it clear that the training of sick children's nurses is not to he discontinued.
§ I would also draw your Lordships' attention to the fact that there is nothing in this Bill which will prevent the General Nursing Council, in the keeping of its Register, attaching to the names of the registered nurses the special qualifications which they earn. Moreover, the General Nursing Council will have amongst its members representative; of the specialised trained nurses, and they will watch closely that the General Nursing Council will not go wrong in dealing with these matters. If the General Nursing Council desire to 47 close a part of the Register because it is no longer required they must satisfy themselves that there will be means of identification of the registered nurses afterwards. We can take it for granted that the specialist nurses on the Council will see that that is done. Further, the General Nursing Council, even though they may take action having themselves been satisfied, must then satisfy the Minister; and I presume that the Minister of Health, like all good Ministers, will cause some inquiry to be made before he comes to a decision. I hope, therefore, that the new subsection will meet the difficulties that have been expressed. I beg to move.
§
Amendment moved—
Page 6, line 23, at end insert the said subsection.—(Lord Shepherd.)
§ LORD WEBB-JOHNSONMy Lords, your Lordships will remember that in the Committee stage I moved an Amendment which, by your leave, I withdrew, setting out in detail the proposals of the General Nursing Council in regard to post-graduate specialist training. It was obvious from the discussion that there were certain difficulties in this matter, and certain anxieties in regard to people hunting for a row of letters after their names. I am therefore very relieved that the noble Lord, Lord Shepherd, is moving this new subsection to Clause 10, because I think it safeguards the position of the General Nursing Council. It is only on the initiative of the General Nursing Council that any supplementary part of the Register can be closed, and if they are not satisfied that satisfactory means exist for the public to ascertain whether an individual nurse has specialised training they need not make any move in the matter at all. I am grateful to Lord Shepherd for the sympathetic attention that has been given to this matter, and I am content with this clause as it will now stand.
§ On Question, Amendment agreed to.
§ Clause 11 [Provisions relating to the approval of training institutions]:
§
LORD LLEWELLIN had given notice to move, in subsection (2) after "Chancellor" (where that word first occurs) to insert:
of which a copy shall at the same time be served on the Council.
48
The noble Lord said: My Lords, this is a small matter. I put down my Amendment to ensure that if there was an appeal a copy of the notice should be served on the Council, as well as on the Permanent Secretary to the Lord Chancellor. The noble Lord has put down an Amendment in words which are perhaps more appropriate than my own. I thank him for putting down that Amendment, and wish to inform the House that I do not intend to move mine.
§
LORD SHEPHERD moved to add to subsection (2):
It shall be the duty of a person who serves a notice under this subsection upon the Permanent Secretary to the Lord Chancellor to serve at the same time a copy thereof on the Council.
The noble Lord said: My Lords, in view of the remarks just made by the noble Lord, Lord Llewellin, it is hardly necessary for me to say anything. I therefore beg to move.
§
Amendment moved—
Page 7, line 21, at end insert the said words.—(Lord Shepherd.)
§ On Question, Amendment agreed to.
§ Clause 13 [Admission to the list of persons whose due admission was prevented by war circumstances]:
§ LORD SHEPHERD moved to leave out Clause 13, and insert the following new clause:
§ Admission to the register of persons included in the list, &c.
§ ".—(1) The Council shall make rules providing for the admission to the register, on payment of such fees (if any) as may be prescribed, of—
- (a) persons whose names are included in the list; and
- (b) persons other than as aforesaid who hold certificates issued by institutions which appear to the Council to be satisfactory for the purposes of this provision stating that they completed before the beginning of July, nineteen hundred and twenty-five, a course of training in nursing in the institution and who satisfy the Council that they are of good character and have adequate knowledge and experience of nursing.
§ (2) A person whose name is included in the list shall, on being admitted to the register, cease to be included in the list, and it shall be the duty of the Council to make the requisite alterations therein."
§ The noble Lord said: My Lords, during the Committee stage there was some discussion, initiated by the noble Lord, 49 Lord Webb-Johnson, on this clause, concerning persons who, although they had had training prior to a given date, had failed to make the necessary application in time for enlistment. A suggestion was made that we should reopen the lists to give these nurses a further opportunity to get on to them, so that they could take their proper place in the nursing profession once more. We have given consideration to the points put forward and in this Amendment we are going a little further than requested. We are going to provide opportunities whereby nurses who are on the list, or would have been on the list if they had made their applications soon enough, can now become registered, if they make their applications and satisfy the authorities. I beg to move.
§
Amendment moved—
Leave out Clause 13 and insert the said new clause.—(Lord Shepherd.)
§ LORD WEBB-JOHNSONMy Lords, it looks again as if we are going to part in complete amity. I should like to reiterate my thanks, not only to the noble Lord, Lord Shepherd but to those who have agreed to this Amendment; and not only for covering the point which I raised but for adding lavish generosity to the gift.
§ On Question, Amendment agreed to.
§ Clause 14 [Registration, &c., fees]:
§ LORD SHEPHERDMy Lords, the Amendment standing in my name on this clause is consequential on the new clause. I beg to move.
§
Amendment moved—
Page 5, line 36, leave out subsection (3).—(Lord Shepherd.)
§ On Question, Amendment agreed to.
§ Clause 16 [Allowances to members of the Council and the Assistant Nurses Committee]:
§ LORD SHEPHERDMy Lords, this is an Amendment that has already been accepted in principle in an earlier part of the Bill. I beg to move.
§
Amendment moved—
Page 9, line 18, leave out from second ("of") to end of line 19, and insert ("earnings they would otherwise have made or any additional expenses (including travelling and subsistence expenses) to which they would not otherwise have been subject, being loss or expenses necessarily suffered or incurred by them for
50
the purpose of enabling them to perform duties as members of the Council or of the Assistant Nurses Committee, as the case may be").(Lord Shepherd.)
§ On Question, Amendment agreed to.
§ 5.8 p.m.
§ Clause 20 [Interpretation]:
§
LORD LLEWELLIN moved to add to the definition of "registered mental nurse"
and includes registered mental deficiency nurses.
The noble Lord said: Your Lordships will see that in Clause 20 there is a definition of registered mental nurses. Some people are anxious whether the term "registered mental nurse" includes a registered mental deficiency nurse. I think it should. If the definition does in fact include registered mental deficiency nurses, I should like to have an assurance from the noble Lord that it is so. I beg to move.
§
Amendment moved—
Page 11, line 5, at end insert the said words.—(LordLlewellin.
§ LORD SHEPHERDMy Lords, this Amendment is unnecessary—for this reason. The object of the Amendment is to ensure that the definition of registered mental nurse includes registered mental deficiency nurses. The Parliamentary draftsman advises me that they are so included as the Bill stands. The principal Act provide; for one supplementary part of the Register only for all nurses trained in nursing mental diseases; and both mental nurses and mental deficiency nurses are registered in this part. The definition, therefore, covers both types of nurse. There has been a good deal of misapprehension on this point, and I desire to take this opportunity of snaking it clear so that that misapprehension need not arise in the future.
§ LORD LLEWELLINMy Lords, in view of that clear explanation from the noble Lord, I beg leave to withdraw my Amendment.
§ Amendment, by leave, withdrawn.
§ First Schedule [The General Nursing Council for England and Wales]:
§ LORD SHEPHERDMy Lords, in paragraph 2 (1) of the First Schedule, there is a provision for the election of nurses to the General Nursing Council, nominated from the fourteen areas into which the country is to be divided. As 51 the paragraph stands, although the nominations will come from the areas, the election will be by the nurses in the country as a whole. There has been a feeling that in the future, with the development of the standing nurse-training committees and therefore the building up of regional feeling, there will be a desire that the nurses now to be nominated regionally shall be elected regionally. We have been confronted with some difficulty, however, because there is no machinery at present existing for the purpose. Moreover, there are so many difficulties to be met, the end of which we cannot at present see. The Minister has therefore agreed to submit Amendments the first of which terms the nurses who will elect on the national basis "general electors." Then, to paragraph 4 of the Supplementary Provisions to the Schedule, there is an Amendment to provide that if in future the General Nursing Council find it possible and desirable to change the basis of election they can do so under the powers given to them. I beg to move the first Amendment.
§
Amendment moved—
Page 12, line 20, at end insert ("(which persons are hereinafter referred to as" general electors")").—(Lord Shepherd.)
§ LORD LLEWELLINMy Lords, if I may say so, we have no objection to any of these Amendments. They have been well described to us by the noble Lord, and I think they are an improvement.
§ On Question, Amendment agreed to.
§ LORD SHEPHERDMy Lords, I beg to move this Amendment which, coupled with the next one, provides that three persons skilled in finance and hospital administration shall be added to the General Nursing Council. I beg to move.
§
Amendment moved—
Page 13, line 6, leave out ("and").—(Lord Shepherd.)
§ On Question, Amendment agreed to.
§ LORD SHEPHERDMy Lords, this Amendment is consequential. I beg to move.
§ Amendment moved—
§
Page 13, line 14, at end insert ("and
(e) three shall be persons appearing to him to have had experience of the control and management of hospitals").—(Lord Shepherd.)
§ LORD LLEWELLINMy Lords, perhaps I might say a word here, because this Amendment adds to the Council three persons who appear to the Minister "to have had experience of the control and management of hospitals." We think that it will be a considerable improvement to this measure to have these persons statutorily included, as they now will be. As I have said before, we very much hope that the General Nursing Council will take advantage of having these experienced people and will admit them as members of the finance committee of the Council.
§ On Question, Amendment agreed to.
§
LORD SHEPHERD moved to add to paragraph 4:
(", and the said scheme may provide that the system in accordance with which the election of the fourteen nurses mentioned in head (a) of sub-paragraph (1) of paragraph 2 of this Schedule shall he conducted shall be either—
The noble Lord said: My Lords, this is the further Amendment to which I have just referred, providing for regional elections if in the opinion of the General Nursing Council they appear desirable. I beg to move.
§
Amendment moved—
Page 13, line 18, at end insert the said words.—(Lord Shepherd.)
§ LORD CROOKMy Lords, on Second Reading I drew attention to some of the difficulties which I anticipated in this regard. I should like to thank the noble Lord for the Amendment he has moved, and to express my support of it.
§ On Question, Amendment agreed to.
§ LORD SHEPHERDMy Lords, the purpose of this Amendment is to make sure that when a casual vacancy occurs in the membership of the General Nursing Council the person appointed to succeed shall come from the same area or be under the same dispensation as the one who has departed. I beg to move.
§ Amendment moved—
§
Page 13, line 27, at end insert—
("(2) A person appointed to fill a vacancy occurring in the place of a member that was originally filled by a nurse elected for one of the areas into which England and Wales is divided under sub-paragraph (2) of paragraph 2 of this Schedule shall be a person who would be qualified for election for that area if an election were to take place on the date on which he is appointed, and a person appointed to fill any other vacancy shall, if the place vacant was originally filled by a person required by the foregoing provisions of this Schedule to be a person of a particular class, himself be a person of that class.")—(Lord Shepherd.)
§ LORD CROOKMy Lords, on Second Reading I directed attention to the fact that the Bill as then drafted did not contain the provision as in the 1919 Act. I asked the Government to look into the matter. I should like to thank the noble Lord for the consideration he has given to this matter, and for putting this Amendment down on the Order Paper. May I add that I have not risen upon earlier Amendments or during Committee stage to do what I should like to do now?—namely, to thank the noble Lord for his courtesy and co-operation in accepting so many of these points which are now embodied in these provisions of the Bill.
§ On Question, Amendment agreed to.
§ Second Schedule [Standing Nurse-Training Committees]:
§
LORD LLEWELLIN moved to add to the list of members to be appointed to a standing nurse-training committee:
(h) persons appointed by the Minister after consultation with the Queen's Institute of District Nursing.
The noble Lord said: My Lords, as your Lordships will see, the Second Schedule deals with the constitution of standing nurse-training committees. There are persons to be appointed by the Regional Hospital Board for the area; persons appointed by boards of governors of teaching hospitals situated in the area; persons appointed by the Council; persons appointed by the Central Midwives Board; persons appointed by the Minister after consultation with the local health authorities in the area (which will, of course, partly cover the point I am raising); persons appointed by the Minister after consultation with the local education authorities in the area; and persons appointed by the Minister after
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consultation with such universities as he thinks fit.
§ The purpose of my Amendment is to suggest that persons should be appointed by the Minister after consultation with the Queen's Institute of District Nursing. I think that everybody who has anything to do with hospitals and nursing realises what a great work the Queen's Institute have done in training district nurses. I appreciate the difficulty of including the Institute in this measure under such a designation because, although they have been doing this good work for a long time, there is no guarantee that the Queen's Institute will continue for ever. So perhaps it is rather difficult to include them. They have done extremely valuable work in the training of district nurses. I hope that, if not in this form in some other form, that very valuable body of persons, the district nurses, may have some membership of, and in the same way have some say on, these standing nurse-training committees. I do not know what the country districts and also many of the town districts would do without their district nurses. They probably teal with more people, and perhaps help to prevent more illness, than many other nurses, despite the great work that those nurses always do.
§ I would like to ask the noble Lord his intentions with regard to giving district nurses some sort of say or representation on these standing nurse-training committees, and to inquire whether it would not be useful, without including them in the Statute, to ensure that the Queen's Institute, which have clone such valuable work, are consulted. I hope the Ministry will take occasion to use their services for consultation as well as rely upon them to train these nurses for the common good. For those reasons I beg to move my Amendment.
§
Amendment moved—
Page 14, line 18 at end insert ("( ) persons appointed by the Minister after consultation with the Queen's Institute of District Nursing.")—(Lord Llewellin.)
§ LORD CROOKMy Lords, I should like to support the noble Lord, either in the Amendment which he has moved or in extracting from the Government some statement as to the way in which they can utilise the services of this magnificent Institute. On other occasions I have spoken 55 of the difficulties through which they have been passing, owing to the takeover on July 5 last, and also of our lack of knowledge in regard to their future. It may be that the noble Lord, Lord Shepherd will tell us that it is not easy to make this addition to the Statute, but I hope that at any rate the other appeal made by Lord Llewellin, to utilise their services, will receive some response from the Government.
§ LORD SHEPHERDMy Lords, the noble Lord, Lord Llewellin, read out the composition of the standing nurse-training committees, and he indicated the manner in which the committees are to be peopled with representatives. Noble Lords will have gathered that every organisation or body mentioned in the list is a statutory authority, and therefore an authority which has some real claim, because of its functions, to representation on that committee. The Government feel that if they open the doors to a professional organisation like the body mentioned by the noble Lord we should be landing ourselves in considerable difficulty. The Minister agrees that the Royal College of Nurses is a body that must be consulted. Indeed, there must be the closest co-operation when things in which there is a mutual interest have to be performed.
§ LORD LLEWELLINI do not want to interrupt the noble Lord, but did he mean the Queen's Institute of District Nursing?
§ LORD SHEPHERDYes. That is essentially a body that must be consulted, not merely by the Minister but, I should hope, by the General Nursing Council. We on our side of the House have a very great admiration for this Institute and the work they are doing. Every day I see one of the nurses trained by this Institute visiting a neighbour's house, in all kinds of weather; and my admiration is boundless because of the zealous way in which the duties are carried out. However, I am sorry that I cannot accept the noble Lord's Amendment, although the Government will do everything they can to encourage the consultation of which I have spoken.
§ LORD LLEWELLINMy Lords, in view of that undertaking to take them 56 into consultation as much as possible, I shall not press my Amendment. I see the difficulties of including in a Statute a voluntary body like this, because of course they might cease to exist, and then the Minister would not be able to appoint a person after consultation with them. When the noble Lord was speaking I was in some doubt as to whether one could describe a board of governors of a teaching hospital as a statutory body. I have a little doubt as to whether they are a statutory body, but they are likely to continue, I suppose. I see the difficulty about including this particular body in the Statute, but I hope—as I know will be the case—they will be taken into consultation as much as possible. I ask leave to withdraw my Amendment.
§ Amendment, by leave, withdrawn.
§ LORD SHEPHERDMy Lords, this is a drafting Amendment. I beg to move.
§
Amendment moved—
Page 14, line 31, leave out ("sub-committees") and insert ("any sub-committee").—(Lord Shepherd.)
§ On Question, Amendment agreed to.
§ LORD SHEPHERDMy Lords, this is similar to the other Amendment relating to the payment of expenses. I beg to move.
§
Amendment moved—
Page 14, line 32, leave out from second ("of") to ("as") in line 33, and insert ("earnings they would otherwise have made or any additional expenses (including travelling and subsistence expenses) to which they would not otherwise have been subject, being loss or expenses necessarily suffered or incurred by them for the purpose of enabling them to perform duties as members of the committee or sub-committee, as the case may be.").—(Lord Shepherd.)
§ On Question, Amendment agreed to.
§ Third Schedule [The Hospital Grants Committee]:
§ LORD SHEPHERDMy Lords, this Amendment is consequential on the reinsertion of Clause 4. I beg to move.
§
Amendment moved—
Leave out the Third Schedule.—(Lord Shepherd.)
§ On Question, Amendment agreed to.
57§ Fifth Schedule [Enactments repealed]:
§ LORD SHEPHERDMy Lords, this is consequential on the new Clause 8. I beg to move.
§
Amendment moved—
Page 17, leave out lines 50 to 56.—(Lord Shepherd.)
§ On Question, Amendment agreed to.