HL Deb 21 March 1950 vol 166 cc304-10

2.44 p.m.

Order of the Day for the Second Reading read.

LORD SHEPHERD

My Lords, I beg to move that this Bill be read a second time. In doing so I desire to speak only briefly, because I am well aware of the great interest among all sections in your Lordships' House in the Motion which appears lower down on the Order Paper. The Working Party to consider the conditions under which midwives work and are trained was appointed some little time ago. That Working Party reported on January 28, 1949. In the Report there were no fewer than sixty-three tabulated recommendations but, contrary to general experience, only a small proportion of those recommendations had to be considered in reference to future legislation. By far the greater number of them have been put into operation, are in the process of being put into operation, or, if they are accepted by the Government, will be put into operation administratively. That seems to me a matter which ought to be noted, and one in which we can all take a great deal of pleasure. We find that while there are things still, to be done to improve the profession of midwifery Parliament has done so much of recent years that at this moment there is little pending in the way of future legislation.

It is sometimes said that the profession of midwifery is one of the oldest in the world. Long before there were medical men, in the modern term, there were women who carried out this essential function. But they were untrained, badly paid and almost unrecognised. Indeed, it was not until 1902, during the reign of a Conservative Government, that the first measure was placed upon the Statute Book dealing with the employment of midwives, their education, training and registration. If we really want to applaud ourselves in these days in our modern Parliament, all we have to do is to compare our experience in dealing with the midwife with the experience of the Parliaments immediately before this century began. The Obstetrical Society of London made a survey in 1869, and because of the conditions which they found on that occasion they decided to issue a diploma to midwives who could show a minimum of experience and ability to do their task in child-birth. The diploma could not then be issued in response to training and the passing of examinations. In 1381 the Midwives' Institute (now the Royal College of Midwives) was establishes, and began to perform its beneficent work; and women who were doing the duties of midwifery began to be more experienced and learned in the subject. But a great deal had still to be done, and the help of Parliament was sought. In 1879 and 1884 Bills were drafted, but were never introduced. In 1890, 1891, 1895, 1896, 1897, 1898, 1899, and 1900, Bills were in fact introduced into Parliament but they were blocked, either by interested parties, by lack of interest on the part of Governments, or by sheer bad luck. Every effort had been made during that fairly long period to interest Parliament in this important subject, but almost without avail.

As I have already indicated, in 1902 a change took place and the first Midwives Act of Parliament found its way to the Statute Book. Since that period, especially as a result of the Act of 1936, not only has this profession become recognised but its members are well trained; they are certificated, and are now well employed by public authorities. At present there are 70,000 midwives having their names on the roll, but of these something under 18,000 are practising. Of this smaller number, 5,800 are employed by hospital authorities and 8,200 by local authorities. The remainder are either employed in private maternity homes or, although registered, may not be following their profession at all. It will therefore be seen that the business of midwifery has become a public one. It is now linked up with our health services, and we in Parliament are largely responsible for the future welfare of midwives. Perhaps I ought to add that the figures I have given all relate to England and Wales, as I have been unable to ascertain the proper figures for Scotland and Northern Ireland.

I do not wish to say anything more by way of a preface to this Second Reading. I do not think it is necessary that I should argue the case for the Bill. I believe that the Bill itself is acceptable in all quarters of the House, and I am certain that it will have an easy passage. Perhaps, however, I should say one or two words about the clauses in the Bill, in order that noble Lords may be interested, and perhaps participate in the Bill's remaining procedure in your Lordships' House.

Two working parties were established, one for midwives and one for nurses. The one for nurses was appointed at an earlier date, and indeed its report became known before the second working party was appointed. The nurses' working party recommended that the Central Midwives Board should be amalgamated with the General Nursing Council. They believed that all the nurses in the country, to whatever section they might belong, should be brought under one authority. Consequently, when the second working party was established, the Government, as one of its terms of reference, asked it to express an opinion upon the recommendation of the first board. The working party for the midwives decided that it would be much better that the control of midwives should remain separate from that of the nurses in, general, and the Government have now decided, as will he seen by this Bill, to take the latter view. To that extent there will not be an amalgamation between the midwives' service and that of nursing services in general.

Clauses I and 2 of the Bill deal with that matter. They deal with the reconstruction of the Central Midwives Board, and the Central Midwives Board for Scotland, and with other matters pertaining to them. Perhaps I ought to mention, for the information of your Lordships, that hitherto the Central Boards have been appointed by Order in Council. That originated from the first Act of 1902. The Government have now decided to ask Parliament to change that method and allow such changes in these Boards to be made by statutory instrument. That will expedite matters on occasion, and will at the same time retain the right of Parliament to intervene when changes in the Boards come up for consideration. Before I leave Clauses 1 and 2, I should like to pay a tribute to the admirably efficient work of the present Boards. The revolutionary change which has taken place in the practice of midwifery over the past century, and the high regard in which the profession of the midwife now stands, are due in great measure to the devoted and unobtrusive work of the Central Midwives Boards. Any changes which might be made in their constitution would not imply a reflection on their efficiency, but would be designed to strengthen them, possibly by the inclusion of a higher percentage of qualified midwives who are now limited to five out of a membership of fourteen in England and Wales.

Clauses 3 and 4 of the Bill concern the certification of midwives who have passed their examinations in one of the countries which make up the United Kingdom. A midwife who has gained her experience in England and has been certificated in England but afterwards goes to Scotland to reside will, under rules to be made by the Scottish Central Midwives Board, become eligible for registration and certification in that country. This will do away with some of the cumbersome machinery which now exists between the two. Clause 5 deals with the women who have been trained as midwives in other countries, and who have then come to this country to reside. Where their training is recognised by the Central Midwives Board in this country they will become entitled to their certificate, but where they have been trained in institutions abroad that are not entirely recognised then the Central Midwives Board will be able to authorise further training so as to enable them to become qualified.

Clause 6 of the Bill deals with uniforms. An official uniform is to be provided, but the wearing of this uniform will not be compulsory upon midwives themselves. It may be that occasionally, in localities where patriotism is strong and where colour schemes are believed in, uniforms may be established by county councils or by borough councils and the like. The penalty for wearing a uniform without the proper authority to do so will be severe, and will protect this profession from persons who might like to become midwives without having secured the necessary qualifications. Clause 7 deals with the roll of midwives. There are over 70,000 enrolled at this moment, and the Central Midwives Board is compelled to publish this roll once every five years. Since only between 17,000 and 18,000 of these women are at present in practice, it is considered a waste of time and money for the full roll to be published. However, the roll will be kept at the headquarters of the Board so that it may be examined by interested parties. As hitherto, the local authorities will supply the Central Midwives Boards with the names of practising midwives, and it will be the duty of the Central Midwives Board to publish those lists every year—a list of 17,000 instead of 70,000.

Clause 8 enables the local supervising bodies to provide residential accommodation for pupil midwives. We believe that to be a good step in the proper direction. Clause 9 exempts midwives who are in practice from jury service. In Clause 10 there is a provision for minor amendments to the Bill which, at the appropriate time, will facilitate a consolidation measure so that the law relating to midwives can be made clear and simple. I beg to move.

Moved, That the Bill be now read 2a.—(Lord Shepherd.)

2.58 p.m.

LORD LLEWELLIN

My Lords, so far as I can see, there is no objection at all to this measure. After all, Clause I merely does away with the reference to the Privy Council, and leaves the matter in the hands of the Minister, but either House of Parliament can still deal with it by negative Resolution if they do not like the constitution of the Board. I think that is a step to which we can all consent. I agree entirely with the reciprocal arrangements made between this country and Scotland, on the one hand, and Northern Ireland on the other. I think these clauses, including Clause 5, are sensible. I am a little astonished that there is not that reciprocal arrangement between the Ministry of Health and the Scottish Office or the Government of Northern Ireland which would have enabled the noble Lord to give us the figures for Scotland and for Northern Ireland to-day. We are entitled to the figures for Scotland, for this Bill deals equally with Scotland as with England.

With regard to Clause 6, I think it is a good idea that midwives should have a distinctive uniform and not merely a badge as they used to have in times past. But I hope it will be a distinctive uniform, and not a kind of county council uniform which may be adapted to anybody doing any kind of service in the county council. With regard to Clause 7, I think it is right that the Central Midwives Board need not publish every five years this huge list, which includes many midwives who have now ceased to practice but are still qualified; but we should have a live register published every year. With regard to Clause 8–the provision of accommodation—where there are enough students for a midwives' course it is obviously appropriate that some kind of accommodation should be provided for them. I hope it will not be done when there are only one or two; but when there are sufficient to justify hostel accommodation then I think it quite right that the local authority should have the power to provide it. As to Clause 9–exemption from jury service must say that I think that this ought to have been provided for a long time ago. There are plenty of people available for calling up for jury service without taking midwives away from what is, after all, essential work.

In short this measure, which found mention in the King's Speech, seems to comply with the basic principle underlying that Speech, in that it is a completely uncontroversial measure. It might indeed hardly justify mention in normal times in the gracious Speech from the Throne. We are grateful that we have not got more contentious legislation than this coming along. As this is one of the major Government measures to be introduced in this Parliament, it is for those of us who think it is a proper one to greet it and welcome it and to express the hope that all future measures introduced in this Parliament will be as non-contentious and as pleasant in their character as the one we are now discussing.

3.2 p.m.

LORD WEBB-JOHNSON

My Lords, I should like to say a word of welcome and of greeting to this Bill. I do not wish to discuss any of the clauses in particular, but I would ask the noble Lord, Lord Shepherd, to give serious and sympathetic consideration between now and the Committee stage to the wording of Clause 6. I was glad to hear the noble Lord say that the wearing of the proposed uniform would not be compulsory, but I was rather disturbed to find that some local authorities might prevent midwives from wearing the uniform which is recognised as the uniform of their profession. I hope that at the Committee stage the noble Lord will be able to assure your Lordships on this point.

While the midwife has secured under the Bill a uniform which she may wear, hope that she will also secure the right to wear that uniform and not be liable to a requirement to vicar one prescribed by a county council or other authority.

LORD SALTOUN

My Lords, could the noble Lord in his reply explain for the benefit of laymen, the expression, "not entirely recognised"? Does it mean societies whose certificates exempt the holder from perhaps preliminary examination, or that they are not recognised at all?

LORD SHEPHERD

The reference I made was to midwives who come to this country from abroad. Some of the institutions in which they are trained have been recognised as giving a certificate worthy of the name, whereas in other cases there has not been the same confidence in the training given to these women. These women, as I have said, will not be entirely shut out, as they will he given an opportunity of further training. In reply to the noble Lord, Lord Webb-Johnson, I shall be pleased to give consideration to the point raised by him, and to talk with him on the matter between now and the Committee stage.

LORD CLYDESMUIR

My Lords, may I echo the plea made by my noble friend Lord Llewellin, that we should at sonic stage have the comparable figures for Scotland?

LORD SHEPHERD

Yes, certainly.

On Question, Bill read 2a, and committed to a Committee of the Whole House.