NURSES (AMENDMENT) BILL (Hansard, 23 February 1961)

§ BARONESS ELLIOT OF HARWOOD
My Lords, I rise to move the Second Reading of this Bill, which comes to us from another place, having been put forward by Private Members and supported by all sections of the House. I am grateful, too, because I see that today I am going to have the support of the noble Baroness, Lady Summerskill, who in another place also backed the Bill. I am most grateful to her for having put her name down to support it here.
This is quite a short Bill. The main object is to allow for the change of name from "assistant nurse" to that of "enrolled nurse", and to make some small rearrangements about the elections to the General Nursing Council, and one or two other matters. The assistant nurse is an integral and very important section of the nursing profession. Training is laid down by the General Nursing Council. It fits her for many most valuable and important jobs of work in nursing, and she can relieve the highly expert state registered nurse to perform her own skilled duties, thus utilising the skills of both types of nurses in the great profession of nursing. The assistant nurse works in every kind of hospital—with the chronic sick, in health clinics, in nursing homes, in convalescent homes, Lin tuberculosis hospitals, and in industrial establishments. In fact, throughout the whole of the health and hospital services, 1108 she is part of the team upon which our health services depend—the doctors, the state registered nurses, and the assistant nurses.
An inquiry was carried out, a private inquiry, I think, by the Nuffield Foundation in 1953, which showed the tremendous amount of work being done by the assistant nurses and the need to increase the recruitment of this section of the profession. Since then, with our expanding health service and hospital service, the need is even greater than that found by the inquiry, and it has been decided that it would help in the recruitment of the nurses if the words "assistant nurse" were changed and these nurses were called "enrolled nurses". There will, therefore, be two main groups of nurses: the state registered nurse, with her high qualifications; and the enrolled nurse, 'her training different, but equally valuable to the health service. Clause 1 of this Bill provides for this change.
Clause 2 records 'that the training as between the state registered nurse and the enrolled nurse shall be different and more advanced, as befits the senior partner in the profession. Clause 3 refers to nurses from overseas who may, under this clause, complete their training elsewhere than in the United Kingdom, if they so desire. Clause 4 increases the membership of the General Nursing Council for England and Wales to correspond with the increase in the number of health regions. The South West Metropolitan Areas has been divided into the South West Metropolitan Area and the Wessex Regional Hospital Area. It is therefore necessary to add to the numbers of representatives on the General Nursing Council.
Clauses 5, 6 and 7 all refer to the methods of electing boards and committees. These are rather complicated, but I understand that they sort out the different times at which elections shall take place. Clause 8 regularises the payment of expenses or loss of earnings to members of the General Nursing Council, and various committees of that body. Clause 9 refers to such matters as the administering of oaths, the issuing of writs and the calling of witnesses in cases of disciplinary action.
Clause 10 provides for the appointment of a legal assessor in proceedings before the General Nursing Council, 1109 which proceedings might lead to the removal of names from the roll or the. register of nurses. Such an assessor should be able to advise the parties concerned on any legal matters. He should be a barrister, an advocate, or a solicitor of not less than ten years' standing; and other subsections of Clause 10 deal with the payment of the assessor. This clause arises directly from the Report of the Simonds Commission of May, 1960.
I have been asked to suggest, and I am considering following this up, that the Minister of Health might consider whether, since a great many of the cases which come before the General Nursing Council are of a more or less routine nature., it might be a good plan if the appointment of the assessor need not be obligatory but perhaps could be permissive. In discussing this point with the General Nursing Council, I learned from them that it is only rarely that there arises the type of case which might require an assessor to be present. It might mean that someone would be present on every occasion but would never he called upon, and that is considered to be rather waste both of the time of such skilled person and of money. This is a matter which, perhaps, we might consider at a later stage.
Clause 11 refers to the obligation of a nurse whose name has been removed from the roll to surrender her certificate or badge, or whatever mark of recognition she holds; and, if she does not wish to do so, authorises the General Nursing Council to take proceedings against her. Clause 12 deals with the interpretations of various expressions in the Act, and is purely of a drafting character. Clause 13 refers to certain aspects of the Act in connection with Northern Ireland. Clause 14 is connected with consequential Amendments arising from alterations in the wording of the Act, such as the change from "assistant" to "enrolled" nurse, and one or two other alterations in wording. Clause 15 gives the Short Title, and states that the Act will come into force three months after the date when it is passed.
My Lords, those are the clauses of the Bill, which, as I have said, has been supported in another place by all Parties. I have been brief in describing the clauses of this Bill. I think it is a useful and a practical Bill, which will be agreed to by 1110 all Parties, and one which will be desirable for the General Nursing Council and the profession. I hope that your Lordships will agree to the Second Reading of the Bill without a Division. I beg to move.

§ BARONESS SUMMERSKILL
My Lords, on behalf of my noble friends I am very happy to support the Bill which has been so ably moved by the noble Baroness. It is a little curious to consider that at the begining of the century there was almost a political controversy over the registration of nurses. Indeed, it was your Lordships' House which finally passed the Bill for the registration of nurses, although the Government of that day were not over-enthusiastic about the proposal. The Select Committee which sat in 1908 recommended that there should be a second category, that of assistant nurse, which has been mentioned today. But it has taken, I think, 40 years to persuade the nursing profession particularly that there should be this second category.
To-day we have this opportunity of paying tribute to these magnificent women. They have proved themselves, as the noble Baroness has said, in all kinds of spheres in the world of medicine, but particularly with regard to the aged sick and the mentally sick. To-day we are taking another step, a step which in the field of nursing will be historic. and perhaps many years will pass before your Lordships will have an opportunity to discuss the status of these women. I think Florence Nightingale emphasised the point that technical ability was the most important thing in nursing; but those of us who have been ill know, I am sure, that the qualities of sympathy, understanding and compassion are the hallmark of the dedicated nurse. And among these women we can number the assistant nurses, or enrolled nurses, as they will in future be known.

§ LORD BURDEN
My Lords, before the Minister speaks may I say how wholeheartedly I support this Bill, having had some experience of the admirable work which has been done by so-called assistant nurses, particularly among the old folk? In fact, it is not going too far 1111 to say that it would not be possible for hospitals for the aged to be run without the assistant nurses. I have in mind the great institution of Firvale at Sheffield. My noble friend Lady Summerskill mentioned the mentally sick, but the Bill, of course, does not apply to mental hospitals. The term for assistant nurses in mental hospitals is "nursing assistants" and not assistant nurses; and I think they are outside the scope of the Bill. But I sincerely hope that, as a result of this Bill, all nurses in the nursing profession, including those in mental hospitals—and here I speak with some interest—will be brought closer together, because, after all, they should be members of one unified profession. I should like to congratulate the noble Baroness, Lady Elliot of Harwood, in bringing forward this Bill, and I hope that it will have a speedy passage, unopposed, to the Statute Book.

§ LORD NEWTON
My Lords, as this Bill passed all its stages in another place without any discussion, I am glad to have this chance of stating the view of Her Majesty's Government, which is one of warm welcome for the Bill. I do not think that it is necessary for me to say much more than that to your Lordships, because the Bill has been explained most lucidly by my noble friend and has been welcomed by the noble Baroness opposite and by the noble Lord, Lord Burden. But I should like to associate myself with what the noble Baroness and the noble Lord said about these nurses who, when the Bill reaches the Statute Book, will be known as enrolled nurses. Clause 1, which changes their name, is the most important clause in the Bill. We need more of these enrolled nurses and if this Bill makes it easier to recruit more of them, then I am sure that your Lordships will all agree that it is an attempt which is worth making. I commend the Bill to your Lordships and hope that the House will now give it a Second Reading.