HL Deb 30 March 1950 vol 166 cc685-97

5.43 p.m.

Order of the Day for the House to be put into Committee read.

Moved, That the House do now resolve itself into Committee.—(Lord Shepherd.)

On Question, Motion agreed to.

House in Committee accordingly:

[The EARL OF DROGHEDA in the Chair]

Clauses 1 to 4 agreed to.

Clause 5 [Certification in England and Scotland of midwives trained outside the United Kingdom]:

LORD MORRISON

This Amendment, together with the next two Amendments, is drafting, in order to correct an omission to translate the reference to, the Midwives Act, 1902, into a reference to the Midwives (Scotland) Act, 1915. I beg to move.

Amendment moved— Page 4, line 30, at end insert ("the Midwives Act, 1902").—(Lord Morrison.)

LORD LLEWELLIN

I have no objection to this Amendment, and all I would say is that I am delighted to see the noble Lord, Lord Morrison, with us again. Last time we were discussing the Midwives Bill we tried to obtain the figures for Scotland. They were not available, and the noble Lord, Lord Shepherd, said that we could have them on this occasion. I do not know whether it is appropriate, when considering an Amendment which deals with Scotland, for the noble Lord to give us those figures.

LORD SHEPHERD

The figures will be supplied later.

On Question, Amendment agreed to.

LORD MORRISON

This is a drafting Amendment. I beg to move.

Amendment moved— Page 4, line 32, after ("Secretary of State") insert ("the Midwives (Scotland) Act, 1915").—(Lord Morrison.)

On Question, Amendment agreed to.

LORD MORRISON

This is also drafting. I beg to move.

Amendment moved— Page 4, line 35, leave out ("Midwives (Scotland) Act, 1915") and insert ("the said Act of 1915").—(Lord Morrison.)

On Question, Amendment agreed to.

Clause 5, as amended, agreed to.

Clause 6:

Rules as to midwives' uniforms

6.—(1) The power of the Central Midwives Board under section three of the Midwives Act, 1902, to frame rules shall include power to frame rules with respect to the uniform which may be worn by midwives.

5.47 p.m.

LORD WEBB-JOHNSON moved to add to subsection (1) and which they shall have the right to wear should they so desire. The noble Lord said: Your Lordships may think that I have some temerity in rising to address your Lordships about ladies' dress, but this is hardly to be described as a dress: it is a uniform. I should like your Lordships to consider carefully whether it would not be wise to insert in the Bill some provision by which these nurses and midwives, who have striven for a generation for the right to wear a uniform, and the exclusive right to wear that uniform, shall not be prevented from wearing it by some regulation of a local health authority. It is generally agreed that it is desirable that a nurse or midwife should have a uniform which is exclusive, so that it cannot be plagiarised by anybody without committing a misdemeanour. Many nurses who have been deprived of the right to wear a national uniform feel that they are aggrieved, and I have had representations made to me that in the case of midwives we should try to ensure that they still have the right to wear the national uniform should they so desire it, even though they are in the employment of a local health authority.

It may be cited that a nurse who joins the Army, the Royal Navy or the Royal Air Force must wear the uniform of that Force. But that is a national uniform, and what they are being asked in many places to substitute for the national uniform of their profession is a local uniform. Moreover, that local uniform is supplied by the county council. I understand that it costs in each case about £70. It remains the property of the county council, which implies that they are going to use it again if the midwife departs and another one comes. It is not a very pleasing prospect to step into a second-hand uniform. Moreover, each county council may have a different uniform, and in some counties they have put all their domiciliary staff into uniform with only a badge to distinguish between the uniform of a State registered nurse, a State registered midwife, a health visitor, a home help and so on. I feel that these ladies have the right to your Lordships' support, and that is why I have proposed the Amendment. I hope it will receive a good measure of support from your Lordships. I beg to move.

Amendment moved— Page 4, line 40, at end insert the said words.—(Lord Webb-Johnson.)

LORD SHEPHERD

The clause which the noble Lord seeks to amend is similar in all respects to that contained in the Nurses Act of a year ago. If the clause were to be amended as desired by the noble Lord, the conditions under which the midwives would be wearing uniforms would be different from those which apply to nurses. The noble Lord said that he did not wish the regulations of any local authority to prevent the wearing of the official uniform provided by the Central Midwives Board. It is something more than regulations with which we have to deal. The use and the provision of uniforms is a matter of negotiation between the organisations representing nurses and midwives and other persons who are called upon to wear them, and the local authority or other body concerned. The noble Lord in this Amendment is suggesting that, without any consultation, indeed without any official discussion with the organisations with which nurses and midwives are concerned, the local authorities, Parliament should provide an over-riding authority to nurses to wear something different from that provided in the conditions under which they are employed.

The present position as regards the uniforms was introduced by the Rushcliffe Committee; and, as your Lordships know, Lord Rushcliffe stood very high in the regard of this House by virtue of his association with the Health Services, and in particular with nursing. This was the Rushcliffe Committee's recommendation, and under it local authorities and other persons are now working: Whilst it must be left to the employing authority to say what uniform is required to be worn by domiciliary midwives, the authorities must provide any such uniform, paying full cost. So that what the noble Lord is really proposing here is this: the responsibility for providing the uniforms, and the cost involved in providing them, should rest on the local authority; but that it should be left to another body, the Central Midwives Board, to indicate to those local authorities what their midwives should or should not wear.

When the noble Lord mentioned this to me first, I felt that he had a right to raise a question of this kind, especially if he has been approached by nurses and other persons concerned. But I did hope that he would be persuaded not to press this Amendment to-day, in view of the circumstances which I have related. His proposal is not that all nurses should wear a uniform prescribed by a national body; it refers only to midwives. He is, therefore, seeking a decision which is only a partial one. I have been unable to obtain from the Minister an indication that there would be an immediate occasion on which the noble Lord could raise the matter in general. The Minister, however, has assured me that this subject is really one for the Whitley Council. If it were brought before the Whitley Council, it could not only be fully discussed and dealt with by the Minister, but the nurses, the midwives, the sick visitors and the like would, through the machinery of the Whitley Council, be able to frame their own proposals and endeavour to get a joint settlement. Therefore, I suggest to the noble Lord that he should not press this Amendment to-clay, but should consider the point I have just made and advise his friends that the course I have suggested would be the best. In the circumstances, I am sure that that would be the proper course to pursue.

5.55 p.m.

LORD LLEWELLIN

My Lords, I have listened quite impartially to what the noble Lords, Lord Webb-Johnson and Lord Shepherd, have said. I must say that if the course suggested by Lord Shepherd is followed, I think this Bill is going to make nonsense of itself. In Clause 6 as at present drafted we extend the power of the Central Midwives Board to frame rules, including the power to frame rules with respect to the uniform which may be worn by widwives. From that, I presume that the Central Midwives' Board may prescribe a uniform. It must be a uniform for midwives recognised by the Central Midwives Board. According to Lord Shepherd, if that is done any local authority employing midwives may say, "We care nothing for this uniform prescribed under the Act by the Central Midwives Board; we are prescribing our own." That is going to be the position as outlined by Lord Shepherd. What, therefore, is the good of giving the central body power to prescribe the uniform, if any employing authority may say, "So far as our midwives are concerned, they shall not wear it, and we will not supply it"? That, surely, is an absurd position.

Lord Webb-Johnson's Amendment is quite a simple one. It goes on to say merely that once this uniform has been prescribed, these midwives shall have the right to wear it, should they so desire. I do not see why they should not have that right. After all, what is the use of giving the power to the Central Board to prescribe a uniform and then allowing any employing authority to prescribe any other they like? There might well be a case where the Central Midwives Board prescribed an appropriate uniform and not a single employing authority would provide it That would be a "wash-out" and an absurd thing to happen. I consider that all over the country midwives should have a recognised uniform—and one far better than the dress of the midwives who used to he pictured in the last century, going round with an umbrella and a bag containing various appliances. Now that we want to give midwives a status, it should be recognised, wherever they are, by this uniform. Then, if they are transferred from one county to another, as they may well be, they can wear the same uniform. Surely this would be better than for the various county councils to prescribe a different uniform which would have to be handed in if the midwife left the county, and handed out as a second-hand uniform to the person taking her place. That would be rather a mean attitude towards people who do this extremely vital and important work.

I had hoped that we should have had something much more forthcoming from Lord Shepherd. He gave us an undertaking during the Second Reading of this Bill that he would look into this matter. I thought then that he would be able to come forward at the Committee stage and say "We are giving the power to the Central Midwives Board to prescribe this uniform and, at the same time, we are giving the midwives the right to wear it should they so desire." I am most disappointed, and I think Lord Webb-Johnson is right in the Amendment he has put down.

LORD SHEPHERD

As I indicated, the clause is exactly the same as that with which we dealt last year in respect of nurses. If all the forebodings of the noble Lords have any reality about them one would have expected that since that time they would have arisen in the case of the nurses' uniforms, but, so far as I am aware, no question has been raised at all. What I have suggested is that the noble Lord should withdraw the Amendment to-day and that those interested who have been in touch with him should take the course of proceeding through the Whitley Council. I say that for the very reason that the clause is worded in the way that it is. This clause gives power to the Central Midwives Board to frame rules. It does not say that it may or it must provide a uniform; it says simply that it may frame rules. The rules will in due course have to come before both Houses of Parliament for approval. Obviously, in connection with rules of this character, discussions and negotiations take place, and the proper venue for such discussions is not on the floor of this House, prompted by individuals, but amongst the official organisations of the nurses and midwives concerned. I suggest to the noble Lord that, if he will consider that point for a moment, he will come to the conclusion that I have been rather forthcoming. Although I can give no promise that there will be an immediate opportunity provided by the Minister, I have suggested the course that has been mentioned to me—namely, the course that is always open and by which all kinds of nurses can raise their common problems for joint settlement.

VISCOUNT SAMUEL

I do not know whether it is intended to press this Amendment to a Division. If not, I need not take up your Lordships' time when there is another debate to come after this. But, if there is any possibility that there may be a Division, I think I ought to say a word or two in deprecation of that course. I submit to your Lordships that this is not a matter about which this Committee, after a debate such as we have had, can come easily to a conclusion. If the detail of the many considerations on the one side or the other had been examined first by a Committee of your Lordships' House, hearing various parties and being able to report and to advise the House, well and good; but that has not been done. We have heard contrary views expressed this afternoon. I think that any one of your Lordships who is not familiar with the details of the case would find it difficult to say at the moment which way he ought to give his vote.

The noble Lord, Lord Llewellin, said that as it stood this clause made nonsense and would not work. On the other hand, the spokesman of the Government says that it merely applies to midwives what is already the law in precisely the same terms with regard to nurses. If that is so, how is it that the Nurses Act has not been made nonsense of in the same way? Prima facie one would imagine that, if this House and another place legislated in certain terms last year or recently with regard to nurses, when a precisely similar case comes forward with regard to midwives they would not wish to act inconsistently in the one case as compared with the other. Furthermore, the noble Lord, Lord Shepherd, in charge of the Bill has said that in the normal course this is the kind of subject which would be referred to the Whitley Council, in which both the employing authorities and the nurses and midwives could have their views expressed and considered. I confess that for my own part it would seem better that the Committee should leave the matter to be dealt with by the machinery already provided rather than this afternoon, merely on the strength of the debate that we have had, come in deus ex machine and decide this matter offhand without sufficient information 'to justify our doing so.

LORD LLEWELLIN

This seems to be a very simple point which does not need a great deal of investigation by a Committee hearing evidence. If you give power to the 'Midwives Board to prescribe a rule setting forth what a midwife's uniform is, will that midwife afterwards have the right to wear it or will she not? It is a very simple point that we are discussing. I should have thought it did not need much intricate knowledge of the subject. I am always with noble Lords opposite when they go back to tradition. They say that because this matter was not in the Nurses Act therefore it may be wrong to put it into the Midwives Bill. I should have thought that this was not one of the matters that was best left for discussion by the Whitley Council. It is true that they go into conditions of pay, working hours and conditions of service, but I do not know that they have any power to tell any council—

LORD SHEPHERD

Will the noble Lord not appreciate this point: that amongst the terms of service, including salaries, hours of work and conditions of employment, the uniform is part of the bargain made by the local authority with the nurses? It is not a small matter. Indeed, I think the noble Lord, Lord Webb-Johnson, in my hearing indicated that the cost of a nurse's new uniform in these days is in the region of £70. You have only to total that up in the light of the number of nurses and midwives employed to realise that quite a large sum of money is involved. I would plead with the noble Lord to accept the advice that we have given and allow this matter to go before the Whitley Council, instead of deciding it in this Committee over the heads of the local authorities.

LORD LLEWELLIN

May I finish what I was saying? So far as I can see, the Bill gives the midwives concerned only the right to wear the uniform. It does not enforce the financial obligation on the employing authority to provide it—that may well be a matter for the Whitley Council—but it does give the nurse the right to say: "If I want to wear the uniform of my calling, then I can wear the prescribed uniform." It does not necessarily say that the employing authority have to pay for it. I agree that that is a matter to be decided on the Whitley Council.

LORD WEBB-JOHNSON

Naturally, I give sympathetic attention to the noble Lord, Lord Shepherd, and I understand his difficulties, but I feel that I should be as justified in pressing him to accept my Amendment as he feels in pressing me to withdraw it. I feel that, if there is a

future discussion on the whole general question, the position of myself and my friends will be stronger if it is already on the Statute Book that midwives shall have this permission. It is only permissive that she shall be allowed to wear it should she so desire. In regard to the nurses, also, I should like to inform your Lordships that this is raised because of the experience of the nurses in finding that, although after a struggle for a generation they obtained a national uniform, many of there employed under local authorities are not allowed to wear it. They have to wear the local uniform. In regard to the expense, that is already accepted by those local health authorities, the county councils. When they ordain a uniform they pay the cost of it. They could easily save expense by giving a uniform allowance. As a nurse or midwife arrives under their employment, she will arrive already equipped and will have only an allowance for maintenance. I feel that I must persist in my Amendment.

VISCOUNT SAMUEL

Does the noble Lord contemplate that within the same town there should be some widwives wearing one uniform, the national uniform, and others wearing the local uniform?

LORD WEBB-JOHNSON

I envisage the possibility that the noble Viscount has put before us; but there would still be a recognisable badge of office, though in order to recognise a midwife in the local authority uniform the inquiring person, at any rate at my stage of life, would have to put on his glasses and gaze at some part of her torso to ascertain whether she was a midwife, a nurse, a health visitor, a home help, or what you will.

On Question, Whether the proposed words shall be there inserted:

Their Lordships divided: Contents, 29; Not-contents, 14.

CONTENTS
Salisbury, M. Amherst of Hackney, L. Hawke, L.
Brocket, L. Hindlip, L.
Bathurst, E. Broughshane, L. Kinnaird, L.
Buckinghamshire, E. Clydesmuir, L. Llewellin, L.
De La Warr, E. De L'Isle and Dudley, L. Lloyd, L.
Fortescue, E. [Teller.] Derwent, L. O'Hagan, L.
Onslow, E. [Teller.] Fairfax of Cameron, L. St. Just, L.
Gage, L. (V. Gage.) Sempill, L.
Bridgeman, V. Gifford, L. Tweedsmuir, L.
Long, V. Hampton, L. Webb-Johnson, L.
Wolverton, L.
NOT-CONTENTS
Jowitt, V. (L. Chancellor.) Bingham, L. (E. Lucan.) Holden, L.
Burden, L. Kershaw, L. [Teller.]
Alexander of Hillsborough, V. Chorley, L. Lucas of Chilworth, L.
Stansgate, V. Darwen, L. [Teller.] Morrison, L.
Henderson, L. Shepherd, L.
Adams, L.

On Question, Amendment agreed to.

Resolved in the affirmative, and Amendment agreed to accordingly.

Clause 6, as amended, agreed to.

6.18 p.m.

Clause 7 [Information as to midwives]:

LORD SHEPHERD

This is really a drafting Amendment, although it affects a rather important point. Under the Bill midwives who gave notice to practise during the month of January, 1950, would not be registered at all; so we are extending the period to thirteen months in order to enable that to be done. I beg to move.

Amendment moved—

Page 5, line 22, at end insert: ("Provided that, in relation to the year nineteen hundred and fifty-one, this subsection shall have effect with the substitution for the reference to twelve months of a reference to thirteen months.")—(Lord Shepherd.)

LORD LLEWELLIN

There is no objection whatsoever to this. If it had not included January, of course, it would have been a straight twelve months every time.

Clause 7, as amended, agreed to.

Clause 8 agreed to.

LORD SHEPHERD moved, after Clause 8 to insert the following new clause:

Allowances to members of the Boards

".—(1) The Central Midwives Board may pay to the members thereof sums (to be calculated in accordance with directions to be given by the Minister) in respect of any loss of 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 that Board.

(2) This section shall apply to Scotland with the substitution, for references to the Central Midwives Board and the Minister, of references respectively to the Central Midwives Board for Scotland and the Secretary of State."

The noble Lord said: This clause is similar to that which appeared in the Nurses Act last year. It is to enable loss of earnings to be met, together with any additions to normal travelling and other expenses. I beg to move.

Amendment moved— After Clause 8, insert the said new clause.—(Lord Shepherd.)

Remaining clauses agreed to.

First and Second Schedules agreed to.

Third Schedule [Enactments Repealed]:

LORD MORRISON

Like the last three Amendments that I moved, this Amendment is drafting. Before I move it perhaps the Committee would permit me to answer the question which was asked by the noble Lord, Lord Llewellin, as to the figures for Scotland. In so far as I have been able to ascertain any figures, they show that there are 19,000 midwives on the Scottish roll. Of that total 2,400 are practising, 750 being employed in hospitals and 1,350 by local authorities. That is the best information I have been able to get. This Amendment, as I have said, is drafting. The first part of it repeals a provision in the Midwives (Scotland) Act, 1915, which is now replaced by paragraphs 1 and 2 of the First Schedule. The second part of the Amendment repeals a provision in the 1915 Act, which will be replaced by the proposed new clause after Clause 8. I beg to move.

Amendment moved— Page 10, line 12, column 3, at beginning insert ("in section three, the words from 'the Board may act' to 'from their own number' and the words from 'and the members shall be paid' to the end of the section.")—(Lord Morrison.)

LORD LLEWELLIN

I am very much obliged to the noble Lord for having obtained those figures. I believe that my noble friend beside me is doing a quick calculation and is working out that Scotland has its fair proportion of midwives.

LORD SHEPHERD

The last Amendment is consequential on the adoption of the new clause following Clause 8. I beg to move.

Amendment moved— Page 10, line 22, column 3, at end insert ("Section four.")—(Lord Shepherd.)

Remaining Schedule, as amended, agreed to.

House resumed.