§ 3.55 p.m.
§ BARONESS SUMMERSKILL rose to call attention to the inadequate salaries paid to nurses and midwives and the existing shortage of recruits to the nursing and midwifery services; and to move to resolve that immediate and substantial increases be made in their salaries. The noble Baroness said: My Lords, it seemed to me that this matter bad been so well ventilated, particularly in another place, and the public 1023 conscience had therefore been roused on what is a moral issue, that my Motion would lapse in consequence of the nurses having secured proper recognition of their work. Unhappily, this has not happened, and the weeks and the months have passed until this injustice suffered by the nurses has become a national reproach.
§ I propose to explain to your Lordships what has been the machinery and how it has functioned in the last few months—indeed, in the last year or two. This machinery has been put into operation before by the Whitley Councils, which are, of course, divided into two: the management side and the staff side. It is the negotiating machinery which the nurses have sought to use and have hoped finally to use successfully. The Whitley Council, about a week previously, offered to improve the salaries within a cost of £10 million, but the sum available immediately was no more than the 2½ per cent. originally offered. It was this suggestion which was put on Tuesday of this week to the staff side of the Whitley Council. As there was no guarantee that the remainder would be paid within a reasonable time, and as the 2½ per cent. which was offered to them had already been rejected, the nurses' and midwives' side of the Whitley Council decided regretfully to go to arbitration. I want your Lordships to understand that this decision was made with great reluctance and only as a means of resolving a deadlock in negotiation.
The noble and learned Viscount's Amendment to my Motion is a little ambiguous at the end, where it says:
and also that the current claim for salary increases may shortly be referred to arbitration.
Noble Lords may think that the noble and learned Viscount is hoping, as I think he is, that this matter will be settled. But your Lordships must know that arbitration is not something which is sought in the first place; it is accepted only finally when the staff side of the Whitley Council, or it may be, at some time, the management side, find that there is complete deadlock and they cannot move the other side to negotiate. Therefore we must not congratulate ourselves and think that, by accepting the Amendment and therefore approving of arbitration, we are being progressive and
helpful in this matter—nothing of the sort; we are accepting something which the nurses and midwives have reluctantly had to accept. Indeed, the secretary of the staff side, who is a Bachelor of Law, said that they regarded negotiation as of great importance, as it offered a discussion of a claim on its merits, and this claim of the nurses and midwives had never been considered by both sides.
§ I must point out to your Lordships that it was on Tuesday that the nurses finally agreed to go to arbitration; but they cannot go to arbitration unless the management are prepared to do so. After many months of negotiations, one would have thought that, perhaps yesterday, the management would have jumped at the opportunity and said, "Very well; we accept". But I say again, this matter cannot go to arbitration unless both sides are agreed. Furthermore, many months may elapse before a decision is made. I would suggest to your Lordships that surely this can only be regarded as a matter of the utmost urgency, for ten months have already elapsed since the first claim was made.
§ I do not need to remind the House of the qualities of these dedicated women, with a long, skilled training, compelled in the course of their work to undertake uncongenial, physically arduous, and sometimes dangerous tasks. The Government have decreed that virtue should be its own reward, plus 2½ per cent. This is a curious doctrine when the Government have encouraged the unvirtuous to reap rewards in many fields. How can one justify giving financial reward in inverse ratio to services rendered? Of course, if the nurses had failed the nation, then the Government might feel justified in punishing them. They are in fact so self-denying that they will consider neither working to rule nor striking. It is against such workers that the Government have elected to make a show of strength.
I am sorry that the noble Viscount, Lord Hailsham, has left the House. He has put the case better than I can. After all, he is a trained lawyer and I do not pretend to have such facility of expression as he has. He told the Westminster Conservative Association at the beginning of May:
Some professions, in particular those which demand long periods of training and a high
degree of personal devotion and self-sacrifice, have been persistently undervalued in the past and must be better valued in the future. This part of the exercise is a difficult one, because in the intermediate phase of the pause it is sometimes they who bear the brunt of the 2½ per cent. But we never intended and never said that 2½ per cent. was to be absolutely rigid; still less, that it was to be permanent. We must get ourselves off this hook as soon as possible.
With all due respect to the noble and learned Viscount on the Woolsack, I think that Lord Hailsham, in endeavouring to get the Government "off the hook" has this afternoon put the noble and learned Viscount on one, as I think he will agree when he examines his Amendment more carefully and hears what the real position is.
§ I would remind noble Lords that the dockers and Service doctors demanded much more than 22½ per cent. In both these cases the guiding light shone quite dimly; in fact it was ignored. These are workers in entirely different fields; but the dockers and the doctors have something in common—a powerful, unified organisation which the nurses do not enjoy. Furthermore, on June 7, the Civil Service Arbitration Tribunal awarded a pay increase of 4 per cent. to nearly half a million civil servants. This will affect the whole staff, from messengers receiving £7 a week to administrative principals receiving more than £2,400 a year. And lastly, salary increases of about 13 per cent. have been awarded by the Industrial Court to hospital almoners and psychiatric social workers. I will tell your Lordships a little later precisely what happened before this award was made.
§ In the light of these awards, your Lordships should bear in mind that the hourly rate of a fully qualified staff nurse in the London area is 5s. It is just about the rate paid to a good domestic help or office cleaner. I would say that in some country areas where your Lordships live it is difficult to find a domestic help even at the rate of 5s. an hour. The noble Lord, Lord Stonham, who is an eminent member of a Regional Hospital Board, will deal with other scales of wages for nurses. The House will agree that it has taken the nurse a long time to protest against the exploitation of her sense of vocation and the failure of the Minister of Health to protect her interests. However, her sense of injus- 1026 tice has led recently to demonstrations unparalleled in the Hospital Service. During the Recess, the Minister of Health had to escape by the back door of a hospital, while in front the nurses displayed banners demanding justice. In consequence, the Minister had to curtail his tour and return to London. In all my experience of hospitals I have never known such a thing. But the significant part of this is that on this occasion sisters and matrons often support their nurses.
§ Your Lordships may have wondered how this demonstration came about. I think it came about because the nurses' representatives, who hitherto had exercised the greatest restraint, told the nurses of the treatment they had received at the hands of the Minister of Health; and when the Minister arrived at their hospital they had already read precisely of his offensive—I say that word deliberately, and I think your Lordships will agree that it is an appropriate word when I tell your Lordships what has happened—treatment of their representatives.
§ I should like briefly to recount the various attempts made by these representatives to arrive at a settlement of their case, and leave your Lordships to decide whether the nurses' patience has been strained to breaking point. The staff side of the Whitley Council decided that there must be a complete revaluation of the nurse. Consequently, a claim was submitted on August 11, 1961, nearly ten months ago. The next day a letter was received by the Whitley Council drawing attention to the pay pause. However, it was understood that the management side would meet the staff side, they thought in November. The staff side waited. Nothing was arranged. November passed; December came. Nothing was arranged in December. January came, and then a letter was sent—five months after the submission of the claim—to state that the management side must obtain the views of the Minister of Health before replying.
§ My Lords, there had been five months in which to do that—five months during which these women were patiently waiting. But while there had been this marking time, a White Paper was being prepared; and, in February of this year, 1027 the White Paper on Incomes was published. The management side immediately announced that, in view of this, they could not offer more than 2½ per cent. The staff side were justifiably incensed. They felt that they had been hoodwinked, because during the five months when negotiations could have proceeded every attempt by the staff side was blocked by the management's alleged unpreparedness. Furthermore, when the White Paper on Incomes was published, the management side interpreted it in the most ungenerous manner, although, according to the Minister of Health, it was not to be put into operation until April. As I have said, a further meeting of the whole Council took place on June 12, when the immediate offer of 2½ per cent. was again made. This was the same offer, and the nurses rejected it. In view of all this, the nurses' organisations feel that the Whitley machinery in the Health Service is urgently in need of overhauling.
§ Perhaps I may just recount a little more history, so that your Lordships will understand the full position—because this is not a sudden decision. In February, 1956, When I was in another place, the Minister of Health was asked to take steps to improve the extremely low salaries in the National Health Service. The then Parliamentary Secretary replied that the Whitley Councils are established on a recognised principle of negotiation of joint councils of employers and employees, and that he was surprised to hear it suggested that the Minister should intervene. He further added that the Minister of Health believed that it would be quite improper for him to intervene in these negotiations.
§ The National and Local Government Officers' Association (NALGO, for short) are demanding a public inquiry into the operation of Whitley Councils. NALGO state that there has been repeated intervention by the Minister in Whitley Council negotiations, and they have thought fit to publish what they call the latest, the clearest and the crudest case of intervention by the Minister in Whitley Council negotiations. I would say, my Lords, that this is related to the increase of 13 per cent. which has been given to the almoners and psychiatric social workers by the In- 1028 dustrial Court. This claim was submitted to the management side in May, 1961—a year ago, well before any announcement of the pay pause. The management side came to the meeting of Whitley Councils in January, 1962, prepared, with Treasury approval, to make an offer to the staff side. This was more than seven months after the submission of the claim. But, my Lords, a few minutes before the meeting took place the chairman of the management side was called to the telephone to be told by the Permanent Secretary to the Ministry of Health that he was not to make any offer to the staff side. The meeting therefore had to be abandoned. This was the reason that the staff side had to go to arbitration. What was the result? They were given a 13 per cent. increase.
My Lords, the extent to which ministerial intervention in negotiations and control of management side action takes place can well be seen from the fact (and I would ask those of your Lordships who are familiar with other fields of work to consider this) that there have been 60 separate Health Service arbitrations affecting non-manual staffs. During the same period there have been only three arbitrations in local government; outside this field there has been only one, and that was in the nationalised electricity service. My Lords, it is most unusual for a responsible secretary of an organisation like NALGO to write a letter such as the one I am now going to read. In asking for a public inquiry, he said this:
Staff sides have had to inform the Industrial Court on several occasions that the Ministry has given promise after promise that it will be ready with proposals on a given day, but the promises have not been kept. Ministerial delay and inaction is so constant, and seemingly calculated, that the Whitley Council representatives have been treated in a cavalier fashion and are naturally infuriated with the way their time and travelling expenses have been wasted. At all levels there is profound unrest about the way salaries and conditions of service for health staffs are adversely affected by this strangulation of the Whitley Council.
It will be recalled that a very useful debate took place in this House last January on the shortage of women to serve in professions supplementary to medicine—physiotherapists, occupational therapists, radiographers and chiropodists. Your Lordships listened to the arguments, and generously supported the
Resolution. Proposals far the revaluation of these salaries had been submitted to the management side at various times, going back to November, 1961. Delay followed delay, and finally the secretary of the staff side decided to publish a letter, which he sent to the Minister of Health himself on March 22, 1962. This is what he wrote to the Minister:
Time and again Whitley Council meetings, which management and staff side representatives have attended from all parts of Great Britain, have been proved to be completely useless because your officers were 'not ready' "—
and I may tell your Lordships that the words "not ready" are given in the letter in inverted commas—
to bring forward proposals to the management side on which you are represented. For both sides of the Council Health Service Whitleyism has become a complete farce, and I cannot express too strongly the anger and resentment felt by the staff side and by the professional staffs it represents who are aware of these facts.
My Lords, your knowledge of public affairs is such that you know that secretaries of these responsible organisations have to be tried beyond endurance over the years, not only over weeks or months, before they finally write a letter of that kind to she Minister; and in this case, having told their members what they had done, they were asked by the members to publish it. That is why I am able to read the letter to you to-day.
Undoubtedly the perpetuation of a gross injustice, and the failure to recognise the true value of the nurses' service, must have deterred many young women from entering the Health Service, with the result that hospitals in many areas will continue to be under-staffed. I would say this to the noble and learned Viscount. I realise that he can have no intimate knowledge of this matter; otherwise he would not have allowed his name to be attached to this Amendment—I hope he will forgive me for speaking in this way, but I have been in this world for many years. The Amendment speaks of:
the steady and continuing increase in nursing staffs of all kinds in the National Health Service.…
Of course, when the National Health Service was set up, over ten years ago, all kinds of clinics and little hospitals in country districts were established for the
first time; and if the noble and learned Viscount cares to add up the heads all over the country who have come in over the years, he may find that there are more. But my point, and that of those who understand this question, is that the Service is not adequate, and that, as I shall explain in a minute—and as I explained to the noble Lord, Lord Newton, who has always tried to persuade the House that the Service is adequate—our hospitals can be staffed to-day only with doctors and nurses from abroad, which I say is a most unsatisfactory long-term policy.
I will take up the noble and learned Viscount when he speaks (he must have been very badly advised) of
the steady and continuing increase in nursing staffs of all kinds".
He would agree with me, I am sure, that perhaps one of the most important nursing services is the midwifery service. I have here an example of the kind of letter which is being sent to doctors all over the country—and I read the one that was sent to me. It refers to a hospital on which I served for seven years; a hospital now, I suppose, of about 1,500 beds. It is the North Middlesex Hospital, which serves the congested areas of North London. Two months ago the Secretary said:
It is regretted that a reduction of beds has become necessary. The fundamental reason is a serious shortage of trained midwives, and it is impossible to provide a satisfactory service without an adequate number.
Can the noble and learned Viscount then come to this House and say that the nursing service is adequate, and that this has been well established in all hospitals? He could go back to the Tottenham and Edmonton area many years ago; he could go back to the days of the Poor Law—or perhaps not so long ago as that—and say that there were fewer trained midwives. But the fact is that these hospitals are now having to close their beds, because they do not have these nurses. He may say to me, of course, "Well, here is one hospital." I am very sorry, but I have evidence of a kind that really cannot be dismissed.
This shortage was emphasised last week at the Annual Conference of the National Association for Maternal and Child Welfare. There were, of course,
most eminent gynæcologists and obstetricians there, and they decided that the only solution is to discharge the mother from the hospital after perhaps two days. Mr. H. Francis, Senior Lecturer in Obstetrics and Gynæcology at Liverpool University, warned the Conference last week that, if the number of hospital confinements was cut in this way more women would die in childbirth. He said:
For a woman having her baby at home, the risk of dying is three times greater than if she had it in hospital. Early discharge is the only thing that can be done without undue risk.
Then another doctor added:
Then she is pushed out into another set of hands, often a part-time midwife.
§ My Lords, midwifery is one of the hardest nursing jobs in the country. It demands physical strength; it demands strong nerves; it demands patience; it demands a kind of endurance—if I may dare say so—that many strong men could not give. The underpaid and overworked midwife knows that her services are being exploited, and she has only one course to take, she ceases to practise. For the same reason nurses are reluctant to undertake further midwifery training. That is what is happening in this country.
§ Therefore, when I plead for better conditions, I am not pleading only for the short-term enjoyment by midwives or nurses of extra wages. I am pleading with you to establish conditions of service in this country, so that these fine women will come in and not stay silent. These midwives do not protest; they just feel that they cannot endure it. But it is for us to say that we recognise the importance of this service. I say that this is a grave situation in the world of nursing, and it has come about because the Minister of Health has failed again and again to consider the just and well-deserved demands of the nursing and midwifery services, and, in consequence, discriminates against people whose compassion for the sick renders them defenceless.
§ VISCOUNT MASSEREENE AND FERRARD
My Lords, might I just point out what I consider is rather an inaccuracy? I think the noble Lady compared the sort of Wages paid to 1032 nurses with those of office cleaners. She said that they were both paid 5s. an hour, and it was disgraceful that a nurse was paid the same as an office cleaner. But I should like to point out to the noble Lady that nurses have their board and their lodging provided, and they have a clothes allowance. I consider that it was rather an unfair comparison to make, and I just wanted to make that point.
§ BARONESS SUMMERSKILL
My Lords, I think the noble Viscount has bean misinformed. The 5s. pay is before the deduction for board. I bag to move.
§ Moved to resolve, That, in view of the inadequate salaries paid to nurses and midwives and the existing shortage of recruits to the nursing and midwifery services, immediate and substantial increases should be made in their salaries.—(Baroness Summerskill.)
§ 4.27 p.m.
§ THE LORD CHANCELLOR (VISCOUNT KILMUIR) rose to move, as an Amendment to the Resolution, to leave out all the words after the second "to" and to insert instead: "the steady and continuing increase in nursing staffs of all kinds in the National Health Service; the substantial real increases in their salaries over the last ten years; and to move to resolve that this House takes note of the desire of Her Majesty's Government to see the salary structure further reviewed within the framework of the Government's incomes policy; and also that the current claim for salary increases may shortly be referred to arbitration." The noble and learned Viscount said: My Lords, in rising to move the Amendment which stands in my name on the Order Paper, may I first say one word in congratulating the noble Baroness on the speech which we have just heard? Speaking as head of the legal profession, I would say that she need never worry again in comparing her adequacy with that of the profession to which I belong.
§ I should like to say one other preliminary word, and that is to add to the tribute paid by the noble Lady my own tribute to the nurses and midwives who make such a notable contribution to our health services. In hospitals, where the growing complexity of medical work 1033 makes ever-growing demands on their skill, their devotion to their work and to their patients is as intense and warmhearted as ever. I should not like any of your Lordships to think that that is a mere façon de parler on my part. Like most of your Lordships, I have experienced that care and attention, both in civil and military hospitals, and I make that tribute—I hope the noble Baroness will agree—with the greatest sincerity and with the greatest gratitude on my own part. I would go on and say that the same qualities are also displayed by those employed in the community care services provided by local authorities, which are playing an ever-increasingly important part within the National Health Service. I am sure that everyone in this House would wish to join in expressing our appreciation of the services that they are providing in all these spheres.
Quite contrary to the argument of the noble Baroness, I say—and again I say it with all the weight that I can put to this point—that it is gratifying that the numbers willing to provide these services have not only been maintained but have been steadily growing. There are two points between us, of which that is one: and I hope to show your Lordships beyond any peradventure, by an examination of the whole field and of any part of it about which I am asked, that the increases in the services have been continuous. It is not a question of going back, as the noble Baroness said, to the days of the Poor Law: it is a continuous increase over the last years. To this growth in numbers, which I will speak about in more detail later, the
substantial real increases in their salaries over the last ten years
(to use the terms of the Government's Amendment to the noble Lady's Motion) have, it may safely be assumed, contributed.
§ Let me remind the House of these increases. In 1951, the salary scale negotiated by the Nurses and Midwives Whitley Council for a staff nurse in a general hospital, the basic grade of Registered nurse, was £315 a year on qualification rising to a maximum of £415 a year. For the ward sister, the minimum salary was £375 a year rising to £500 a year. Since then, the Whitley 1034 Council has reached agreement on salary increases to all nursing and midwifery staff from the lowest grades to matrons on no less than six occasions—that is, since 1951. These took effect from June 1, 1952; December 1, 1954; April 1, 1956; July 1, 1957; and the two most recent from March 1, 1959, and December 1, 1960—almost exactly a year before the present claim was put in.
§ The revision of salaries in 1959 was the result of a review of the salary and grading structure of all nursing and midwifery staff employed by hospitals and local authorities, and produced substantial salary increases ranging up to 24 per cent.—and 24 per cent. is a considerable increase. The salaries as so increased—that is, after the increases of up to 24 per cent.—were further increased by 5 per cent. in December, 1960. So, if I may quantify that, the salary scale for the staff nurse—£315 a year and rising to £415 in 1951—is now £525 a year on qualification rising to £656 a year. This represents an increase of 67 per cent. at the minimum of the scale and 58 per cent. at the maximum. Now I turn to my other category. For the ward sister, the 1951 salary scale—£375 a year rising to £500—has become £656 a year rising to £840, an increase of 75 per cent. at the minimum of the scale and 68 per cent. at the maximum.
§ I think it is always necessary, when one quotes figures with regard to wage or salary increases, to try to look at the real increase; and, therefore, as your Lordships will see, I have put it in my Amendment, and I hope your Lordships will bear with me while I give it to you, because it might be thought, unless I did so, that the gains have been lost as a result of the fall in the value of money. But, in fact, in the ten years from October, 1951, to October, 1961, the Ministry of Labour's Retail Price Index rose by just under 38 per cent. Thus, during a period in which retail prices, as measured by the Index, increased by some 38 per cent., the pay of the staff nurse and the ward sister—the two grades in which the largest proportion of the trained nurses in hospitals are employed—rose by between about 58 per cent. and 75 per cent. That is to be compared with the 38 per cent. My Lords, these increases represent between 15 per cent. and 27 per cent. more than was 1035 necessary to maintain the purchasing power of their salaries in 1951.
§ LORD STONHAM
My Lords, would the noble and learned Viscount allow me to interrupt him? I do not dispute any of the figures which he has just quoted, but I think he should make allowance for the fact that the subsistence charges have also been increased; because the noble Viscount, Lord Massereene and Ferrard, was under the mistaken impression that the salaries were plus the cost-of-living allowances, the cost of board and lodgings, whereas they are inclusive.
§ THE LORD CHANCELLOR
I anticipated that that point might be put to me, and therefore I should like to deal with it. I do not know whether the noble Lord, Lord Stonham, is just raising the point or whether he purports to base anything on it, but I can give him the figures. I think he will find, as a human being, great comfort in the figures I give him, but he will not find much comfort if he is suggesting that they have any adverse effect on my argument. The position is, as the noble Lord, Lord Stonham, has said, that there is a residence charge which covers full board; lodgings, normally in the nurses' home; personal laundering; and the use and the laundering of uniform. I asked for information on this point. I hope your Lordships will forgive me for the increased length of my speech, but the noble Lord, Lord Stonham, has raised the point, and I therefore deal with it.
In 1951, a student nurse, first year, had a net salary of £100; a nurse in her third year, £125; a staff nurse, at minimum £195 and at maximum £295; a ward sister, at minimum £245 and at maximum £370. Now the corresponding figures for 1962 were, instead of £100, £171; instead of £125, £208; instead of £195, £345; instead of £295, £476; instead of £245, £451; and instead of £370, £635. The percentage of these increases, dealing with it, as Lord Stonham would prefer, on a net basis, is 71 per cent., 66 per cent., 77 per cent., 61 per cent., 84 per cent., and 71 per cent. I am very glad the noble Lord raised the point, because I had taken the trouble to find out about it, and it shows that the increases on the net figure are even higher in percentage than those which I have already quoted.
§ LORD STONHAM
My Lords, the point I was trying to make was that in 1951 the board and lodging charge against the staff nurse was £120. It is now £180, which is a 50 per cent. increase, against the 38 per cent. increase in the cost of living which the noble and learned Viscount has quoted.
§ THE LORD CHANCELLOR
My Lords, I do not think the noble Lord could have been listening to what I said. I deducted the residence charge, which was £100 in the first case in 1951, and £128 in 1952, and similarly so in every other case. I did not read to your Lordships every figure after subtracting it from the sum, but I did take them all into account. The position is that after that has been done, the increases in net salary are higher, on a percentage basis, than if you take the gross amount. That is the point that I am making. I am not going to use adjectives. I have put before your Lordships these percentages. I have dealt with these percentages in relation to the cost of living. That is the first point. Perhaps I am using one adjective when I ask your Lordships to say that my Amendment is right in saying that these figures which I put before you are substantial increases in the real amount of the salaries. Let me put it another way: that whereas for the ward sister at her maximum in October, 1961, an increase of £189 over the October, 1951, salary would have sufficed to give her the same purchasing value, the actual increase was £340; for the staff nurse the corresponding figures are £157 and £241. That is the position.
Again I am anxious that I should speak with studious moderation, for two reasons. One I made plain to your Lordships, and that is the gratitude that I still feel, and which most of your Lordships feel, for what nurses have done for one's self. The second is that there is now an intention to take this matter to arbitration, where the arbitrator may have to consider it. While, of course, it is perfectly right, and I am not questioning it, that your Lordships have the right to discuss any question that you think of public importance, I am very anxious that my words should be moderate because the matter is going to be dealt with by arbitration, and I shall try to put it as moderately, as factually, and as objectively, as I can.
1037 I think I have said that it may safely be assumed that the increases in salaries which I have been describing have contributed to the growth in the numbers of nursing and midwifery staffs employed in our health services. But I do not mean for a moment to imply by this that pay is the only thought in the minds of those who choose a career in these professions. We all know that there are other important influences, and not least their wish to serve their fellow citizens. But, my Lords, pay is undoubtedly an important factor, and the fact that there has been over the whole period to which I have been referring a steady upward trend in all branches surely bears out the view which emerges from the figures that I have just put before the House: that there cannot be the serious inadequacy of financial reward that some have claimed. I would agree with the noble Baroness that it is difficult to find a reliable yardstick against which the adequacy of the totality of the number of nurses and midwives employed can be realistically assessed. I do not suggest that every hospital has all the nurses and midwives it would like: nor do I suggest that nowhere could additional staff be usefully employed. But what is undeniable is that over the whole country the total number of nursing and midwifery staffs employed shows a steady and continuous expansion. The latest total for nurses and midwives employed in the hospital service—namely, in March, 1962—is the highest ever recorded.
My Lords, before I make a speech like this I am, of course, provided with hundreds of figures dealing with every possible aspect of the matter. I am not going to inflict them on your Lordships, because it is very difficult to pick out great columns of figures, especially when somebody reads them; and your Lordships have them in front of you. I will try to select what I think are the most important figures, and then I will deal specifically with the point that the noble Baroness chose as the spearpoint of her attack, the midwifery service, and will fight her on her own ground on this point. I want to give a general picture, in which there is no militancy at all, but simply an attempt to give the picture as a whole.
Registered nurses employed whole-time, again taking the period since 1951, 1038 have increased by 23 per cent., and part-timers—and they are very important, as everyone will realise—by over 120 per cent. Student nurses have increased by 8 per cent. Pupil nurses have increased by over 150 per cent. Other nursing staffs have increased by over 50 per cent. for whole-time staff, and nearly 150 per cent. for part-timers. Midwives employed whole-time have increased by 12 per cent., and part-timers by nearly three-quarters. The noble Baroness took mid-wives, and gave me the impression (I hope I have not been under any misapprehension) that she thought we should have to go well into the quite distant past before figures could be produced of increases. I will take first whole-time certified midwives. On December 31, 1951, there were 5,372. On March 31, 1961, there were 5,919. On March 31, 1962, there were 6,010. The change, as you can see, between March, 1961, and March, 1962, was 91, and the increase between September, 1961, and March, 1962, was 114.
Let me put it another way, because the noble Lady was anxious that I should take recent years. Let me put it on a percentage basis. Taking 1951 as 100, in 1959 there were 102.2; in 1960, 106; in 1961, 109.8 and in 1962, 111.9, which I have rounded off and called 112. If you take the same percentage figures—I think that is easier than trying to carry numbers—part-timers on March 31, 1962, were 173.4, compared with 100; in pupil midwives, Part I, 136.4, and Part II, 167.5. These are the best figures that can be obtained. We know the feelings of the noble Baroness, and I can understand them; but when she quotes particular examples, like a letter written by somebody in circumstances the whole of which we cannot know, we have to look at the whole picture, which shows the increases I have just mentioned. I agree that these increases have not been enjoyed equally by all types of hospital. Psychiatric hospitals, on the whole, have not fared quite so well as others, but even there the broad picture is still one of general expansion. I will not trouble your Lordships with the details, which I have here.
There is one other point about which I was concerned and which I had investigated. There is a fall of 2¾ per cent. in the number of student nurses training for the register from the peak 1039 at September, 1959, but even now the number is still higher than ever recorded before 1958. A minimum educational standard is to be applied from the beginning of next month to applicants who wish to train for the Register, and some facilities previously used for training nurses for the Register are to be switched to the training of nurses for the Roll. As I have said, the number of student nurses is rising steadily and this trend is likely to go on.
It might be said that some of the increase has occurred in the ranks of the nursing staff who are neither registered or enrolled. But let us take the number of qualified nurses, which has reached new heights. In December, 1951, it was 69,037, and in March, 1962, it was 90,406. Giving only the first two digits, the numbers rose yearly—69, 77, 82, 85, 86, 90. That is a steady and substantial increase. I think that everybody will agree that qualified nurses are essential for good nursing services, but I am sure that those nurses themselves would be the first to recognise that the other nursing staff have a valuable supporting rôle to play given training on the job and the necessary supervision. The most striking increases have taken place among part-time staff. This is, in part, a consequence of the trend to earlier marriage. It is not peculiar to nursing, but is found in many fields. It is, I suggest, a trend to be warmly welcomed. In this way hospitals are able to draw on a valuable reserve of skill and experience that has been built up in the past.
All the figures that I have given relate to England and Wales, but the picture for Scotland is broadly the same, and although the figures relate only to the hospital services, the picture in the local authority services is again of an upward trend, if somewhat less spectacularly so. Surely the figures I have given of the amount and higher proportion of increases prove beyond dispute, and more effectively than any arguments or comparisons, that conditions in the nursing profession taken as a whole—pay, conditions, work, and opportunities—are attractive to a large and increasing number of our young women and young men. And this is in a period of as full employment as this country has ever known, so far as I know its history.
1040 My Lords, it was against this background and in the context of the principles set out in the Government's White Paper, Incomes Policy: The Next Step, that the nurses' pay claim had to be considered. The White Paper pointed out that the objective must be to keep the rate of increase in incomes within the long-term growth of national production. That is only explaining what an incomes policy is. I do not care what their politics may be, any Government one could contemplate in this country, whether they be Labour or Conservative, if they found that the country as a whole was doing what we did in 1960–61, paying increases of wages and salaries of £1,600 million a year when the increase in national production was only £600 million a year, would have to take action; and it could take action only by means of some incomes policy, while at the same time trying to increase the size of the national cake it proposed to split up. I should have thought that this was too clear for any argument.
I would remind your Lordships that there are two effects if we fail to do our duty in this way (because it is not only a matter for the Government; it is also a matter for every man and woman of good will), two effects which are inevitable, unavoidable to everyone. First of all, there is the increased cost of exports, which would price us out of markets that we have or might have. Secondly, at home the greatest unfairness is caused between different sections of the community, because inflation bears hardest on those on fixed incomes, not on those whose incomes have steadily risen, and on pensioners.
The noble Lady made a point which (if she will allow me to say so, and I do it with the greatest good temper, as she knows) had a specious attraction but not a real one. She quoted other wage settlements that have been made in the public and private sectors. Your Lordships know that we live in a free society. We cannot place a ukase on employers throughout the private sector to take the course which we think is right in a free society. You are bound to have these limitations, and to have certain settlements which conflict with the general view. But what unutterable cowards and fools we should be if we allowed setbacks of that kind to deflect us from the general path which we must follow of countering 1041 inflation: and, as I say, I defy anyone to put their hand on their heart and say that you could, with these increases of £1,600 million as opposed to £600 million, counter inflation without some form of incomes policy. That is the Government's view, and it is the view set out in the Paper to which I referred.
That means that national production is rising at the moment; and I hope it will increase. But at the moment it is somewhere about 2½ per cent., and that seems likely to be the rate, because it is about 2.4 per cent. for 1962—though I hope we shall see an increase there and that the National Economic Development Council will show the way of avoiding difficulties in getting that increase. But in the present phase, having passed from the pay pause on April 1, increases in wages and salaries should be kept within that figure The White Paper also made it clear that certain criteria which had been used up to that time should be subordinated to the need for the considerations which were set out in the Paper.
The noble Lady and I join issue (and when I use these terms the noble Lady will not misunderstand; when I say we have our fight and we join issue, she well knows that I am putting it rhetorically in order to underline the point) on the Tightness or otherwise of my colleagues in asking the Whitley Council to have these matters in mind when they dealt with the claim. I respectfully disagree that it was wrong. I think it would be entirely wrong if a Government did not say to the management side when considering a claim, "You must have in mind the general national position". We have moved out of the 19th century. In the 19th century, of course, the position was that the workman tried to get as much out of the master as he could, and that was a matter between them. To-day, if we are going to make any effort to avoid inflation, we must always be conscious of another chair in these discussions: it is a chair which is often empty in some people's minds, but one that is notionally occupied in this country by people who on the whole are interested in stopping the inflationary process and its bad results. I venture to say that when the management side have to consider a claim it is right to ask them to have in 1042 mind the general national considerations and the way the Government have suggested that inflation can be prevented.
The management side considered it and came to the conclusion that they would not be justified in offering an increase in pay to nurses and midwives in excess of 2½ per cent.; and this was the offer they made on February 13. The staff side rejected this offer on March 13, but made no further move apart from the organisation of public protests. Your Lordships have heard the noble Lady's explanation of that. But, at any rate, that is what happened. On May 14 the chairman of the management side took the initiative, with the Government's warm approval, and wrote to the chairman of the staff side proposing that the two sides should resume contact and consider together how the present pay structure should be improved. The noble Lady referred to this as the interview at which the £10 million offer was made without anything definite being said as to dates. What was suggested was that the two sides should resume contact and consider together how the present pay structure should be improved, the point being made quite clearly and frankly that, while any agreement that resulted would no doubt have to be implemented by stages, it would be well worth while to study what improvement could be made within various limits of costs and what relative order of priority should be placed on them.
If your Lordships will forgive me, this is pure arithmetic, but I think it is essential for your Lordships to understand the position. Two and a half per cent. equals roughly £3⅓ million—one may disagree about the fraction, but that is roughly so. So that taking the figure of £10 million mentioned by the noble Lady, that would have to operate in three years to use the £10 million. There would be 1962 and 1963, and then early in 1964 there would be a final figure. So that, as a pure matter of arithmetic, the time in which it would operate would be something like 21 months. And, of course, that means that any agreement which resulted as to a review of scales would have to be implemented by stages, but, I should have submitted, not over a very long time, and it surely would be worth while to study what improvements could be made within various limits of 1043 costs and what relative order of priorities should be placed on them.
This is not the case of a simple judgment of Solomon, which we are all inclined to think comes into arbitration, where you take the figure of payment and the figure of the employer and add the two together and divide by two—I do not say that this happens, but sometimes results look as if that simple method of approach has been followed. Here is a case where we have innumerable different scales. What is terribly important—and it is one of the great problems in employer-and-employee relationships to-day—is to know, if I may put it in this way, whether the concertina is properly opened between the different scales: whether you ought to pull it wider between two scales or to narrow it between two others. Therefore, I ask your Lordships to say that it was a reasonable course to consider the improvements that could be made in the scales and what the relative order of priorities should be.
The negotiating committee of the staff side met the management side on June 12 for a further examination of the proposal. The management side explained that what they had in mind was that the two sides of the council should consider together how a sum representing an amount substantially in excess of 2½ per cent. of the total annual salary bill could be distributed to best advantage between the different grades. As I say, they could not say at this point at which stage a new agreed pay structure could be introduced within the cost limit they had in mind. I have taken the noble Baroness's figure and shown that when that would occur would depend on the development of the economic situation and of Government policy. But the cost limit they had in mind was one which they understood was likely to be capable of implementation in a reasonably near future period, as I have explained. Meanwhile, the offer of an immediate 2½ per cent. increase was included in the total cost limit, and would represent the first step.
Given this salary structure and all the circumstances I have mentioned, this proposal appeared to the Government to be a fair and constructive approach within the framework of their policy, and both sides seemed to be agreed that 1044 there were points in the pay structure where substantial improvement and realignment was justified. The approach of the management side would have ensured that the two sides could get together and pool their views about improvements and priorities, with the assurance that an agreement could be implemented fully in the not too distant future, in accordance with the development of policy.
The negotiating committee of the staff side apparently did not feel able to recommend to the full staff side, which met two days ago, that the proposal be accepted. The Government have learnt that the full staff side have decided to reject the management side's proposal, and that the current salary claim may shortly be referred to arbitration. It has been open to the staff side at least as early as March 13, when they rejected the management side's offer of a 2½ per cent. increase in pay, to take their claim to arbitration with the consent of the management side, which would not have been refused, and to leave the decision to the Industrial Court where the only limitation, which still applies, is that the terms of reference be so drafted as to secure that any increase in pay awarded cannot be operative before April 1, 1962, which is at the end of the pay pause.
As I have said, as the case is now likely to be going to arbitration—and I cannot see why it should take many months—the House will not expect me to say more. I regret, despite what the noble Baroness has said, that if the decision was to be to seek arbitration, the staff side should have delayed it so long, although I pay attention to what the noble Baroness said. I want to make this clear, because I think it is important that everyone should understand it. Awards of the Industrial Court are not in themselves binding on the parties to a dispute, but when parties have agreed to submit the dispute to arbitration they would normally expect to abide by the result. This is very important. Assuming that there is an award to the nurses and the Whitley Council accept it, the Government have already made it clear that my right honourable friends, the Minister of Health and the Secretary of State for Scotland, will implement it. I invite your Lordships now to show that you 1045 agree that the facts fully justify the terms of the Government Amendment.
I have tried to state all the points with the most studious moderation, especially as the matter seems to be going to arbitration. I claim that I have made the four points contained in the Amendment. I have shown that there has been asteady and continuing increase in nursing staffs of all kinds in the National Health Service".I have demonstrated that there have not only been substantial increases in the last ten years but that the real increases are substantial. I have shown our support of the management side and our own desire that the salary structures should be reviewed, and that this could be done within a reasonable time.
I think it is right that your Lordships should take note of the fact that the current claim will shortly be referred to arbitration. The Industrial Court will have to consider the matter. When the factual contents of the Amendment are so fully justified, I strongly suggest that your Lordships should accept the Amendment and so take note of the fact of our desire that the salary structure should be reviewed, and that questions of amount will be decided by arbitration, in which case my right honourable friends will implement the result. I accordingly ask your Lordships to accept the Amendment. I do not think the noble Lord, Lord Stonham, would wish me to read the words again.
Leave out all the words after the first ("the") and insert ("steady and continuing increase in nursing staffs of all kinds in the National Health Service and the substantial real increases in their salaries over the last ten years, this House takes note of the desire of Her Majesty's Government to see the salary structure further reviewed within the framework of the Government's incomes policy; and also that the current claim for salary increases may shortly be referred to arbitration".—(The Lord Chancellor.)
§ 5.17 p.m
§ LORD STONHAM
My Lords, I am sure your Lordships are most grateful for the long speech we have just heard from the noble and learned Viscount, and for the many interesting figures that he quoted in the course of it. I feel myself that it is quite impossible to take in the significance of the very large num- 1046 ber of figures in the course of the speech, particularly when so many of them are quoted as percentages. I must confess that since almost my first day in another place in 1945 I have had a healthy disrespect for the Parliamentary use of percentages. I remember the late Willie Gallagher, the one Communist Member of Parliament we then had, getting up in the House and drawing the attention of the House to a 100 per cent. increase in his Party, which then numbered, in all, two. But it was 100 per cent. increase. Therefore, when any percentage increases are quoted in Parliament, I always ask myself the question: Where do you start from? Where do you go from? That is extremely important in the case of the nurses, because statistics can be made to prove anything, even the truth. I think the speech of the noble and learned Viscount proves beyond question that the Government are not aware of the value of the nurses, despite the warm tribute which the Lord Chancellor paid to their services.
I should like to deal with some of the figures of the nurses' salaries which were quoted, and not to deal with them in percentages but to say precisely what they are. The figure quoted by the noble and learned Viscount for staff nurses in 1951 was £315, which he made clear meant £195 a year after they had paid for their board and lodging—less than £4 a week. That is where they started in 1951. When you start adding on percentages you ask yourselves: what do they get now? A staff nurse to-day gets £525 on starting, which means that when you deduct £180 for her board and lodging, she gets £6 10s. 0d. a week. A staff nurse has had to do her three years' student nurse training; she has had to do her midwifery course, and she is in a position of very great responsibility.
I was at a hospital this morning and a staff nurse was in charge of a ward of 24 beds because they simply did not have a sister. That particular hospital is five ward sisters short. They are at present irreplaceable, and there is no one old or experienced enough among the staff nurses to be upgraded. That is a position of very great responsibility. Today, after all those 69 per cent. increases they have had since 1951, a staff nurse is getting £6 10s. 0d. after the deductions 1047 for her board and lodging. Of course, that is a staff nurse.
If you go to ward sisters, they were getting £375 gross in 1951—round about £5 a week after paying their board and lodgings; £5 a week for a woman with all that experience; probably 35 years of age, 15 years in nursing, and utterly responsible, particularly to-day with many of our house physicians and junior medical staff really needing the experienced ward sister to prevent some of the mistakes that would otherwise arise. These women have the lives, literally, of some 20 to 25 men or women in their hands; and, as I say, we were paying them about £5 a week in 1951, and today they are paid, after their board and lodging deductions, £451 a year—less than £9 a week. It is quite impossible to get unskilled female labour in a factory at that price.
My noble friend Lady Summerskill quoted a figure of 5s. an hour. The noble Viscount, Lord Massereene and Ferrard, who is not now in his place, queried it. He just could not believe it. I think it is true. When they are paid 5s. an hour there is £180 a year board and lodging allowances to come off, which brings it down to about 3s. 3d. an hour. You just cannot get ordinary domestic staff for that kind of wage. This, of course, is after allowing for all the 61 per cent., 68 per cent. and 79 per cent. increases since 1951. Before anybody starts talking in terms of percentages, ask where you start from. We all remember the story of the chap in Chorlton-cum-Hardy asking the way to Runcorn and villagers saying, "If I were going there I wouldn't start from here". The fact is that when you are discussing fair salaries you do not start from a 1951 basis; you start with the value of these incomparably valuable people and ask yourselves what is a fair salary.
Let us go a little lower down the salary scale to student nurses. Whatever their colour, it is certain we could not possibly even begin to think of running our hospitals without these first-class nurses, under training and doing their three years. These 18 to 20-year olds get today, after all the increases and after deducting their lodging allowances, from £171 to £208 a year—£3 5s. to £4 a week. These are educated girls. Of 1048 course, they have to satisfy educational standards. Many girls are in fact rejected because they are not up to necessary standards. Indeed, when the new regulations come into force we shall be demanding a higher level of educational qualification. These are educated girls under discipline, undergoing hard and difficult training, and they can really do it only if they are dedicated.
The justification for saying that the Government do not know the value of our nurses, although they know their price, is that nurses have been disgracefully exploited in the matter of salary, and it is utterly useless and, indeed, less than fair to quote percentage increases in the last ten years unless you make it perfectly plain that ten years ago those salaries were virtually on a semi-voluntary basis and were not really salaries. I could go on and say that some of the consultants at some of my hospitals used to get 10 guineas a year, but that was merely an honorarium. What we have to look at is the position to-day and it does not matter what standards you take or what kind of comparison you make, our nurses are disgracefully underpaid and it is a real scandal. It is all very well assuming that all these women are dedicated, that they do not strike, that they do not charge for overtime and that no matter what we do to them they will still go on nursing. That is true; but we should not take advantage of that. Do not think, either, that a little more prosperity will not improve their morale. It will. It is quite true that prosperity alone does not make people happy, but it is surprising how it helps. I think that the noble and learned Viscount entirely failed, abysmally failed, to answer my noble friend's point about the salary scales.
Then there was the second point about the steady and continuing increase in nursing staffs. You must relate that to the duties and to the jobs. I am not going to quote the figures, but I can say this: that almost twice as much work is being done in hospitals as when the National Health Act came into operation. Not only that, but we are constantly harassing our staffs to reduce the turnover interval, to reduce the bed state, the average number of those staying in bed, and in all kinds of ways to increase efficiency. This puts more and more work on the staffs. But the noble and 1049 learned Viscount said to my noble friend that she should not take an isolated case and quote that as if it represented the national picture. But, of course, she was quoting from a meeting of an association and merely giving some example.
The noble and learned Viscount knows that I am one of those people who, in a voluntary capacity, stand as employers of these nurses and of the ancillary staffs, and I assure him that we feel this position very keenly indeed. So far as numbers of staffs are concerned, this has been going on for years. Let me tell him of some of the expedients. He took great pleasure in the fact that we have so many part-time nurses coming back; nurses who have been trained, got married and come back part-time. I take pleasure, too; but we are going to all sorts of steps to encourage them back simply because we cannot get enough female staffs in geriatric hospitals and hospitals for the chronic sick. In another of my hospitals which has 320 beds the matron has just come back from her second visit to Ireland in twelve months in order to try to get staff. She has spoken to girls in high schools and convents. There have been advertisements in hotels. Arising out of all this we hope to get six nurses. We adopt all expedients of that kind.
Then there is the overwhelming fact, which the noble and learned Viscount did not even mention, that I should think 33⅓ per cent. of hospitals would have to close down to-morrow but for the nurses coming in from the Commonwealth. Indeed, it is curious that this debate should coincide with the commencement of the operation of an Act next Sunday when, to a large extent, that flow will, in my view, considerably diminish, because although they can be brought over specially, I do not think the numbers will be anything like the same as they would otherwise be without the Commonwealth Immigrants Act. It does not matter at which branch of nursing you look midwifery or other branches, the shortage of nursing tutors is absolutely chronic. Our difficulty with nursing tutors is that, because of the low salary scales there is a very real shortage in relation to need. It is idle and irrelevant to quote the fact that there are more nurses now. You might just as well quote figures for food in the world when there are millions 1050 more mouths to eat it and millions more stomachs to fill. The only relevance with regard to nursing staff is need, and the need is at present very much greater than supply.
The noble and learned Viscount referred to the Government's desire to see the salary structure reviewed within the framework of the Government's incomes policy. He went to great lengths to explain exactly the relationship between the 2½ per cent. which was offered and the total of £10 million which might be added over the next two and a half years. But I would submit that it is not fair, and indeed, quite irrelevant, to try to relate nurses' pay to a national wages policy.
The noble and learned Viscount, the Lord Chancellor, said you cannot have a wages policy unless there is some relationship between increases in salaries and increases in national production. That is a sentiment to which I would largely subscribe if there were any way of measuring the contribution made to national production by our nurses. But I submit that there is none. Therefore, it is quite irrelevant. I do not say that they do not contribute to an increase in production, because they put back into production men and women who might otherwise be dead or lying on their backs. Of course, they help to increase our productivity. But to suggest, for example, that unstaffed beds, beds which we have not got nurses to work, are an economy is not true. Of course they are not. We still have to run the hospitals and incur expense whether we have enough nurses or not.
The Lord Chancellor said what cowards and fools we should be if we did not stand firm against inflation; and there springs to the mind a picture of this army of Florence Nightingales advancing on the thin red line of the Government, and challenging them with their white aprons and curved caps. But, my Lords, is that an argument to which we can seriously subscribe? These nurses have been underpaid just so long as there have been nurses. They were grossly underpaid ten years ago, and they are still grossly underpaid, despite the 68 per cent. increase they have had since 1951. We are asked to believe that a reasonable increase of salary for them would be a breach in the incomes 1051 policy; that it would lead to gross inflation. It would not. We have had speeches from the Benches opposite on questions of this kind. There have been speeches by the noble and learned Viscount the Leader of the House, who only the other day said that the Conservative Party is, and must remain, the Party of the trained and qualified man and woman. We are merely asking them to prove that. We are merely asking the Government to give evidence of this desire to see nurses' salaries suitably improved. We are only astonished that they have managed so manfully to repress any desire to see fair play.
The final point I want to make is on this question of arbitration and the instructions which were given by the Minister of Health to the management side of the Whitley Council. The noble and learned Viscount the Lord Chancellor said, "I do not agree that the Minister was wrong to ask the management side to bear in mind the facts of the Government's economic policy or the facts of the economic situation and their wages policy. "He does not agree. Let us see just precisely what happens. The staff side make a claim and it is considered by the management side. What is the constitution of the management side of the Whitley Council? Five of the members are from the Ministry of Health and Department of Health for Scotland. When the Minister asks them to have regard to these facts they hear their master's voice. Ten of these members represent Regional Boards in England and Wales and Scotland, the Association of Hospital Management Committees and Boards of Governors of Teaching Hospitals; and eight represent local authorities, such as the London County Council, and the local authority associations.
That is a total of 23 on the management side of the Whitley Council—five from the Ministry of Health, eight from the local authorities, and ten from the management side of hospitals. The Minister conveys advice to them, and we all know (this is the case with so many Whitley Councils) that, whatever the management side engaged in the industry think, if the Ministry representatives say, "There is not going to be an increase, because the Minister has said so", it does not eventuate. That is the truth. That is a really dreadful fact.
1052 Let the noble and learned Viscount the Lord Chancellor be in no doubt what we in the hospital world think about the nurses' claim. I have in my hand—and this has now been going on for a couple of years—a minute of a meeting held last month, of my regional branch of the Association of Hospital Management Committees, who run the hospitals. It says:The Chairman reported that the Council of the Association have given consideration to this question …that is, the nurses' pay claim… and representatives on the Whitley Council are to press the claims of the nurses, which we strongly support. It was noted that the Council have made recent representations to the Ministry for a revision of salaries and wages of all grades of nurses and medical auxiliaries.I can assure the Lord Chancellor that I know of many cases of hospital committees which have met and had this matter under painful consideration in a voluntary way and have passed resolutions demanding considerable increases. And I am quite sure that the Lord Chancellor himself knows that, too.
§ THE LORD CHANCELLOR
The noble Lord asks that I should be in no doubt. May I take it that the noble Lord is wanting the whole 33 per cent. of the claim and the whole £43 million? That is what he is asking for now, is it?
§ LORD STONHAM
I do not agree that all nurses' salaries are capable of the same percentage increase. When the noble and learned Viscount asks me if I am asking for the whole 33 per cent. as an overall figure, my own view is that the matter needs proper review, and that some grades in the nursing profession ought to have larger increases than others—indeed I mentioned one just now, the nursing tutors. But I certainly think an increase of the order of 33 per cent. would be justified.
The final point therefore is this. This matter is now going to arbitration—at least I hope it is. From the Lord Chancellor's reply, I believe and understand that it is. As he rightly said, both sides have agreed to accept the verdict of the Court, and in his closing remarks he gave an assurance that the Government would respect any award that was made. 1053 The important thing, however, is this: have any instructions or directions at all been given to the management side of the Whitley Council in this matter; and, if so, will they be withdrawn before this question is considered by the Industrial Court? I feel that, whatever the final award may be, the only one that would give satisfaction to the nurses, and to the public (and in this issue the public are at one with the nurses), would be one where they felt that an entirely impartial, unfettered body had considered the evidence and come to a verdict and a decision free from any strings. I hope, whatever the outcome of the vote to-night, and whatever your Lordships may decide to do about the Amendment, that all of us would agree that the time has now arrived—in fact, it arrived a long time ago—when this matter should be decided by right of a just verdict, with no pressure from anyone.
§ 5.40 p.m.
§ THE EARL OF ALBEMARLE
My Lords, the reason why I ask your indulgence for a few minutes is because I feel extremely strongly—I have a strong protest in my heart and mind—about the attitude of the Government in forcing into the same mould as negotiated trade union agreements the claims of the nursing and healing vocations. The Government must be aware that the general conscience of the community is disposed to follow the teaching in the story of the Good Samaritan. I would suggest that that puts the Government into the wrong Lobby on this subject. There can be no question that the salary structure needs revising, and that not enough people are going into these vocations. Therefore, I hope that something may come out of arbitration. But there has to be considered, and I hope will be considered, the shortage of nurses which exists in some fields and in some hospitals.
What is the reason? The major cause is not, I think, that the salaries are small. The reason for there being insufficient recruits and of those offering service is that this is a hard and exacting life and the conditions do not measure up to what people would wish them to be. With the ever-increasing age of the population, inevitably there is a greater number of aged to care for. This 1054 last is not the preferred branch of nursing. The care of children and of those acutely ill who may by devotion be brought through, and where the results can be seen are, naturally, more rewarding. A woman's intuition and sympathy, even among the untrained—I refer to the auxiliaries that I am hoping will be mobilised in a way that is not done now—cam often bring a patient through after the physician and the surgeon have done all they can. I am sorry for the length of my remarks. I wanted only to show that I thoroughly disapprove of the nurses and the vocations to do with nursing being put within the Government's income policy. I think it is really quite immoral.
§ 5.43 p.m.
§ LORD AMULREE
My Lords, I must apologise, before opening my speech, for not having heard the beginning of the speech of the noble Baroness. Unfortunately, I was detained elsewhere. I hope that in what I am going to say I shall not overlap what she has already said, but I want to say a word or two in favour of the nurses' claim. I am not really particularly worried about the state of affairs of the student nurses. They do not get a great deal of money, but they are young women in training and, as one might say, they do get paid enough to keep themselves going. It has been said that hospitals could not run if they were not there. That, of course, is entirely true. But then, most of their training must be of a practical nature; it must be taken in the hospital wards and cannot be given in the lecture room.
The people for whose plight I feel extremely sorry and for whom I wish to speak, are the nurses who have passed their training and become staff nurses and ward sisters. Their figures of salary have been given; we know what they are. I agree with the noble Lord, Lord Stonham, however, that although on paper the increase has been quite substantial, it all started from a pitifully small beginning. The amount that they get now is not sufficient to be compared with the amount of work and great responsibility which they need to carry. Quite a number of these women are now expected to live outside the hospital. Some of them prefer to live outside, perhaps because the nursing quarters are 1055 not large, or they prefer to be at home. It is not easy for a person of that training and doing that kind of work to live comfortably on the maximum salary of £656 a year. The responsibility that these women carry is enormous.
The same applies to the ward sisters. They are paid a little more, it is true; but even then, their maximum salary is not large, and again the responsibility which they carry is very large indeed. The noble Lord, Lord Stonham, referred to the fact that it is now more important than hitherto that we should retain these good sisters, because there are a lot of young house doctors who come here from foreign countries who do not speak good English. That, indeed, is true. But I can assure him that it was exactly the same in my young days, when I was a student. Whilst working in the wards in one's first years one relied very greatly upon the advice of these nurses.
There is one anomaly which I do not understand—namely, why is it possible for a nurse going into the administrative side of the profession to earn more money than the ward sister, or even a deputy matron in a big hospital? The maximum salary for a deputy matron in a hospital of 500 beds—I am sorry to quote more figures at your Lordships—is £1,097, with a reduction of £245. I saw an advertisement yesterday in one of the nursing papers for a sister to be employed on the administrative side at the maximum salary of £1,290 a year. I cannot see why there should be this anomaly between a sister who is really in charge of patients in a ward and one who is, I was going to say, merely doing administrative work, and whose responsibility is not quite so great as that of the former.
I have come across another point in regard to nurses from the Commonwealth. We get quite a number coming over here to do post-graduate work in our hospitals. When they arrive here a fair proportion go into commerce. I can think of one who went into a big multiple store because the pay she was getting as a nurse was not so good as that which she got in the multiple store. I know that one swallow does not make a summer, and that hard cases make bad law; but I think we ought to take into consideration the fact that these nurses 1056 come over here to gain experience, and they consider that they do not get enough to live on. I can never understand why nurses in Canada, and trained nurses from this country who go to Canada, are paid the equivalent of £105 a month while working in hospitals there. I know that the cost of living is greater in Canada than it is here, but I was there myself about six months ago and I do not think it is double what it is here; so it looks as though nurses are doing far better in countries like Canada, and that the rate of pay is more substantial than it is here.
There has been a certain amount of talk to the effect that hospitals would not run if it were not for the nurses coming from the emerging countries, the Commonwealth and other places. I think that is probably true. But surely one of the things we have always rather prided ourselves upon is that people come to this country to be trained, and to say that if it were not for them the thing would break down is the wrong way to look at it. We ought to encourage more of these people to come here and be trained and to take the fruits of their training back to ther own countries. Therefore, the argument that we rely on nurses from other countries does not seem to be very sound.
It is quite true that the total number of young women entering nursing has gone up, as the noble and learned Viscount showed in his interesting figures, but I think it is also true that the work has gone up. And whereas in the old days nurses worked a two-shift system, they now work a three-shift system, which means that the number of nurses needs to be increased by a third in order to make this work. Although the numbers have gone up they have not gone up to the total number required. This is particularly true in the type of work in which I am interested, namely, the work of the geriatric departments and what used to be called the old chronic sick wards. But I doubt very much whether pay has a lot to do with it. I think that quite often the work is not of great interest and young women just do not want to go into it. I would blame the excessive educational standard demanded by some of the nursing bodies rather than the actual poorness of salary. However, I should like to see 1057 an increase in the pay of these trained people—not to increase the numbers coming in, because I am doubtful whether that would be so; but to see a just appreciation of the sense of responsibility which they bear in the very important work that they carry out.
I am pleased to see that the nursing profession is going to arbitration before the Industrial Court. I do not share the doubts that have been expressed about what will happen there. I have had comparatively long experience of the Industrial Court because my father was its first President, and I am quite convinced that if the nurses go there for arbitration they will get a perfectly fair, just and honest result, which, I am very pleased to hear from the noble and learned Viscount, Her Majesty's Government will implement when it is known.
§ 5.54 p.m.
§ LORD AUCKLAND
My Lords, this debate has been a very interesting one. The noble Baroness, Lady Summerskill, made a persuasive speech, but I think my noble and learned friend has answered it convincingly to at least some degree. What rather worries me is the use of this adjective "substantial". Personally, I do not like the use of the word, either in the terms of the Motion or in the terms of the Government's Amendment, because I do not think in either case it has been proved.
Those of us who are connected with the hospital world, either as a profession or as members of hospital boards, as in my case, recognise the justice of the nurses' claim. I have taken some trouble, prior to this debate, to talk to a number of hospital nurses, sisters, matrons and student nurses, and I so much agree with the noble Lord, Lord Amulree, when he says that basically the present salaries of student nurses are reasonably adequate. I use the word "reasonably" because it must be remembered that some of these young girls support widowed mothers, and their salaries—ranging from £228 to £336, less something like £130 for board and lodging—are by no means large, bearing in mind the fact that they have a lot of responsibility and are frequently called on, without further remuneration, to work overtime. It is only natural that there will be some kind of friction when a student nurse's sister, who is 1058 perhaps two or three years younger than herself, works in an office or a shop and earns perhaps twice as much as her relative.
Only the other evening, at my own request, I received a small deputation of staff from a hospital in Surrey to discuss this whole problem. They discussed it frankly, and we had a most useful discussion. It was agreed then that, as I have said, the present salaries of student nurses were reasonable, but the noble Lord, Lord Amulree, was so right when he mentioned the case of the sister and the staff nurse, and of course the matron. The maximum that a sister earns is, as I understand it, £840 per year. Deducted from this is £205 for board and lodging and other expenses. When I discussed this matter with a hospital nurse it was suggested that some of them do not mind paying the board and lodging charges, because this leaves them free to complain of any anomalies which might arise, although I doubt whether that view is universally shared. I have always been a reluctant supporter of this business of board and lodging charges. After all, in the Armed Services a soldier or airman or sailor does not pay for his accommodation. He receives his food and his uniform as part of his payment and it is arguable that those who work in hospitals should be in the same category. But, in fairness, I should state that that view is not universally shared in the profession. I put it forward as a point in this debate.
As the noble and learned Viscount rightly said, the nursing profession received pay awards in 1959 and 1960 and, in the present situation, I think the pay pause has been justifiable. I very much regret the fact that the Service doctors received the enormous increase which they did, and it is quite understandable that the nursing profession should have been angered by this. But I feel that the figure of 2½ per cent. in itself was—I would not go so far as to say an insult but in the circumstances it was rather tactless. I think that, in view of the two previous increases, it might almost have been better to have offered no increase at this stage, but a firm promise of a reasonable increase at such time as the pay pause is brought to a conclusion. I cannot help feeling that, psychologically, that would have 1059 been very much more advantageous than this present set-up.
The hospital matron is I think the one grade to which attention should be directed here. The average salary of the hospital matron, is, I believe, something not very much over £1,000 per year. Perhaps those who are more expert on these matters than I am will correct me if I am wrong. That is without the deduction for accommodation, et cetera. I really do suggest that that is a most inadequate remuneration; and, while it would be out of order to presume to make any suggestions to the arbitration court, I think it is to be hoped that it will give very careful consideration to the senior grades, if and when any increases are allowed. It should be said, in fairness, that the hospital to whose staff I spoke took no part in the recent demonstrations either in uniform or out of uniform. They have behaved with the utmost decorum. Some of them are here to-day listening to this debate, and I certainly hope that for their sakes the award will be swift.
My Lords, this debate has centred largely around pay. The terms of the Motion are directed towards the shortage of nurses, and there is no doubt that in certain parts of the country—in the Midlands and in East Anglia, particularly—there is a shortage. While it is recognised that recruitment of nurses is on the increase, there is also some wastage through marriage and sometimes through the fact that some of them do not like the discipline, and sometimes, possibly, through the pay problem. It would be interesting and informative to hear from the Government figures of those who may leave after perhaps two years of training or even less. I think that when we are considering recruitment of nurses these points must not be overlooked.
I have stressed before and I stress again the importance of comfortable, modern accommodation for these nurses. The ten-year hospital Plan is a bold document and doubtless the Minister, who has done so much for our hospitals—we must be fair—will have borne in mind the importance of decent accommodation and reasonable standards of food. Some of the nurses' homes in these hospitals really are very decrepit 1060 and depressing, and a nurse who has worked long hours, and perhaps a lot of overtime, likes to go somewhere where she can meet her friends or spend her off-duty time as she wishes, with a reasonable standard of comfort. While I think that pay plays a vital part in this problem of the nursing profession, the problems of accommodation are certainly not unimportant.
My Lords, there are, of course, some nurses who leave the profession because the discipline is too strict, but I think any nurse, in whatever grade she is, will recognise the necessity for reasonable and just discipline; and certainly in hospitals to-day matrons are by and large humanitarians who do not prevail unfairly on their staffs. I would end by hoping that this arbitration will be empowered to act quickly, and that the nurses, particularly those in the senior grades, will be recompensed suitably.
§ 6.6 p.m.
§ LORD CITRINE
My Lords, although my name is not down on the list of speakers I hope, by the indulgence of your Lordships, to be able to take part in this debate. Whatever one may think about the merits of the Amendment, I think none of us could withhold our admiration for the skill with which its merits were advocated. I found myself many times, in my young days, sitting in the Law Courts listening to advocates, and when the advocate for the plaintiff had sat down I felt that an unanswerable case had been made out—until I heard the other side. I am quite sure that did it fall to the noble and learned Viscount the Lord Chancellor to advocate the case of the nurses, he could have made out to-day a case as convincing as the one that is put to us. That is a tribute to his skill, I hope, and is not intended for any ulterior meaning.
There seems to be a completely direct contradiction between the terms of the Amendment and those of the Motion. I think it has been shown by the noble Lord, Lord Stonham—and the same point struck me—that the apparent contradiction is not so real as it appears at first sight. To say that there has been a steady increase in staff does not in the least prove that there is no shortage. As has been properly said, staff should be measured against the duties they have to perform; and I suppose 1061 that at some time or other there will be some move made in the building of new hospitals and still further nurses will be required. Also, in regard to the question of salaries, the fact that, between particular periods, increases have been given which exceed the increases generally granted throughout industry is no proof that the salaries themselves are adequate. As the noble Lord, Lord Stonham, said, everything depends upon the base from which you start. These are questions of fact, and it is very difficult to resolve the truth of those facts on ex parte statements, no matter who makes them or how authoritative he is.
I would have said that the Amendment itself shows that the Government realise that the salaries paid to the nursing staff are not adequate. It asks us to take notice of the Government's desireto see the salary structure further reviewed within the framework of the Government's incomes policy;…Reviewed in what direction—downwards? There is no suggestion of that. If it is not downwards, then surely it must be upwards. So, if one takes the narrow point of the accuracy of the reference, it is clear that the Government themselves are satisfied that existing salaries should be increased.
I am very well aware of the limited scope within which the Government consider that that increase should take place. The noble and learned Viscount the Lord Chancellor was very emphatic on that point; and he went on to expound the Government's incomes policy, which is, of course, mentioned in the Amendment. Personally, I have some concern about this Amendment. I have no doubt at all as to where the public stand. If it had been the custom in this country to take a referendum of the public on particular measures, I feel confident that the public would be found behind the nurses in the claim that they are making. But, of course, this Motion is being put in the House of Lords; and, without any disrespect to any Member of this House, we cannot disguise the fact that there is a permanent preponderance of Government supporters sitting on the Benches opposite. That position is irremedial in present circumstances, until some measure of reform of this House takes place; but I firmly believe, judging by the speeches which 1062 have been made, that if this issue were left to a free vote of the Members of this House, the Government would find many of their supporters going into the Lobby to defeat this Amendment and to carry the Motion.
What I was particularly surprised about was the extent to which the noble and learned Viscount the Lord Chancellor brought out the general range of the Government's incomes policy. It is common knowledge that we have been overpaying ourselves as a nation, not for one or two years but for at least half a dozen years: but that applies to all sections of the community. It does not apply only to wage earners and salary earners: it applies to everybody who is receiving income; and it would be far more convincing to me personally, and to the many trade unionists in the country, were there clearer evidence of the Government's readiness to tackle the problem in regard to sections of the community other than those of the wage and salary earners. As one who has been brought up in the sphere of voluntary negotiations—and we have many times portrayed the freedom of our system of collective bargaining in this country as an example to the whole world, and as a system which is in itself the real answer to the settlement of salaries by Government decree and by State intervention—I say that that system has been put very greatly in danger by the Government's policy.
I have the White Paper here, and in substance that White Paper either eliminates or whittles down every one of the customary arguments which are put in wage negotiations: the cost of living, increased productivity in particular industries, trends of profits, shortage of labour, comparisons with incomes in other employments. All of these are challenged or given diminished importance. I would ask the noble and learned Viscount the Lord Chancellor to tell me what is left. What becomes of the system of incentives we have built up? In almost every industry in this country where it is possible to measure work accurately, there are in operation systems of incentives of a bonus or a piecework kind, or something of that nature. What becomes of that system if the people employed in the particular trade, undertaking or industry, know in advance that, irrespective of how well 1063 they work, how hard they work, or what may be the profits resulting to their company as a consequence of their work, they will receive no more increase than the 2½ per cent. forecast—forecast, remember, not proved—in the country's general productivity? That, to my mind, is a staggering blow at the system of wage payments. It seems to me to destroy the system of incentives in firms and industries generally.
This policy presses hardest on the weakest people. The dockers were able to defend themselves, and they were ready to do it; but the nurses have a different sense and a different environment. Their work brings them into closer relationship and contact with great suffering and distress and human problems, and I think that they, together with most people, would regard it as unthinkable that they should use their economic strength to force an issue with the Government. That same kind of reasoning can be applied to many sections of the community. In fact, the more peaceably-inclined people are in industry, the less they have been accustomed to resort to strikes, of the more likely they are to be hit by this policy. I repeat: I think it has done irreparable harm to the system of free negotiation.
The noble and learned Viscount the Lord Chancellor spoke, as he described it, in terms of studied moderation. I would ask him what more he could have said if he had appeared on behalf of the management side of the Whitley Council before the arbitration board or tribunal. What other points could he have put forward? I do not know them. Every argument that could be used against advancing the salaries of the nurses beyond the 2½ per cent. which the Government themselves have put forward was used in the course of his speech this afternoon. I say that as one with the deepest respect for the fairness of the noble and learned Viscount. I have sat in this House and admired on many, many occasions during the course of debates the way he has tried always to put the case fairly. But he was an advocate to-day, and an advocate against the nurses. I say that with, I hope, the same studied moderation that he himself used in the course of his case.
1064 If the Government really desire to see the salary structure overhauled, what are they waiting for? Why do they not do it? If I were an employer and thought that my employees deserved an increase, I should give it—and that is the position I think that the Government imply in their reference to a review of the wages and salary structure. Now this claim is going to arbitration, and surely it is an extraordinary position that, before the arbitration court hears a word from the parties concerned—and, after all, they probably know a great deal more about the inner things than we know in this House, and perhaps will be given wider opportunities in the nature of things for putting their case than is possible in a debate of this kind—here we are, more or less trying to lay a setting in which that arbitration should take place. I know that is not our intention, but we are doing it, and that provides for me a very serious dilemma. That is why I have concern about the Amendment.
I have concern, too, about the Motion itself, and while I would not wish to incur any misunderstanding on the part of the noble Baroness who moved the Motion, I have some doubt about the wisdom of its timing—not of its merits, but of its timing. I am afraid that what may happen if this Amendment is carried is that the whole system of arbitration will be still further prejudiced in the minds of working people. It is already very widely suspected, and its fairness is being impugned on all sides. It will be argued by many people not as familiar as we are with the manner in which arbitration tribunals strive to be fair and to give a balanced judgement that they are in fact obeying a Government instruction. I know that when I was a local official of a trade union in my early days I could never appreciate the niceties which existed between the Government of the day and a special body called the Committee on Production, which was set up during the First World War to deal with wages claims. It seemed to me to be evident that when a Government laid down a policy, that policy would find its way into the decisions of arbitration tribunals. I am certain to-day that there are thousands upon thousands of people who think in that vein. Therefore, I regard it as very unfortunate that, instead of leaving the matter to the arbitrator to determine, if 1065 I can so put it, the Amendment loads the dice against their being able to give that objective consideration.
The noble Lady who moved this Motion has always been on the side of the underdog. Whatever it is, she courageously advocates the cause, whether it is popular or unpopular, and I hope she will not misunderstand me in what I have said. I have expressed my doubts about the timeliness of the Motion and the Amendment: but there they are on the Order Paper, and I am faced with that dilemma. I will vote against the Amendment, and, if the opportunity occurs, for the Motion. I beg of the Government that they will give the Members of this House an opportunity freely to express their views in the Division Lobby, and not on a Government Whip.
§ 6.24 p.m.
§ THE LORD CHANCELLOR
My Lords, if I may reply now on the Amendment, the noble Baroness can then reply to the whole of the debate. I thought that was fairer. I have already spoken after the noble Baroness, and I thought it was fairer that she should speak after me. Does she agree?
§ BARONESS SUMMERSKILL
My Lords, I have never learned that a woman's last word is always successful, but I will try this time.
§ THE LORD CHANCELLOR
My Lords, I have intruded on your Lordships' time for so long that I do not want to do it again. I want to say only one word about what the noble Lord, Lord Citrine, has said. It is a very difficult point indeed, when a matter is of great public concern and of great public interest, and there are going to be proceedings about it in some forum outside the courts of law, to know what is the proper thing to do in Parliament. I realise the doubt that he has expressed about the Amendment; indeed, he was good enough to say the same about the timing of the Motion, although he did not disguise his views. I say only this: that if that view were to commend itself, and the noble Baroness were to inform me that she would in any case not press the Motion to a Division, I would not press the Amendment to a Division, and we would leave the matter without its being 1066 divided upon. I will not go further than that. I think that noble Lords will agree that that is as far as I can go. But, of course, unless it is on that understanding, with the Motion couched in such critical terms, I must go on with my Amendment and have that established.
I want to say only one other word to my noble friend Lord Citrine. He asks how collective bargaining, as we understand it, is going to continue. Of course, the clearest answer to him would be if we managed, by the efforts of the N.E.D.C. and of everyone, to increase the size of the "cake". Because with every increase in the size of the "cake", the amount of hundreds of millions available in a percentage of the gross national product increases, and allows more room to manœuvre on the various lines that he mentions. I am speaking very roughly, and my noble friend Lord McCorquodale of Newton will probably correct me if I am wrong; but, speaking from memory, I think the position is something like this: that 2½ per cent. of the gross national product gives something like £6,700 million a year. If you increase your rate of increase in the national product by 4 per cent., you would be giving yourself £1,000 million or more within which to manœuvre your various pay increases. That would be my general answer, but some day we will have a debate or a discussion with my noble friend Lord Citrine.
Again, I will not go into detail with the noble Lord, Lord Stonham. I said that I would not go into detail in answering the noble Lord, and I know that he will not hold it against me. He has very fairly put all his argument on the basis of the amounts after payment of full board and lodging, personal laundry, and use of uniform. We have both stated our points of view, so I do not think that your Lordships would be greatly helped if I went into the matter again. I should like to make only one point; and it is purely a debating point without any merits, and I make it simply because I enjoy making it and because I think the noble Lord, Lord Stonham, will enjoy my making it. He said that what makes the difference is Where the salary started from. I should only like to say to him, with all the good will in the world, that in my speech the salaries started from the point where 1067 the Labour Government left them in 1951.
The noble Earl, Lord Albemarle, is now here. He said flatly that we should have left the nurses out of the incomes policy. I want him to consider only this: that an incomes policy is not for the benefit of any one group or of any collection of groups; it is for the benefit of everyone in the country. I believe—and I hope he will consider this: I ask for no more—that everyone ought to make his contribution.
My noble friend Lord Amulree made a most interesting speech. Again, I hope he will forgive me for not going into the detailed points now, though I should like to consider them. I should also like to consider the points which were raised in the most interesting and thoughtful speech of my noble friend Lord Auckland. I am not quite sure that I have in mind the figures which he thought would be helpful, and therefore I think it would be better if I read his speech in Hansard and then wrote to him about it, rather than gave him figures out of my head. I am sure that the noble Baroness and I, although we disagree on many points, will agree on one thing. We are both very grateful for the quality of the debate to-day, and that makes us all the more grateful to the noble Baroness for having initiated it.
§ 6.30 p.m.
§ BARONESS SUMMERSKILL
My Lords I do not intend to keep the House much longer. I think it is significant the Government decided that the nurses had such a strong case that they had to ask the noble and learned Viscount the Lord Chancellor to bowl against me. I never thought the time would come when he would reply to a debate of this kind. I think that the noble and learned Viscount was less than fair when he charged me with quoting one hospital. I am much too old a Parliamentarian to do such a thing. I would remind him that I quoted a famous surgeon at a conference of the Maternity and Child Welfare Association last week, when he deplored the fact that the midwife service was so inadequate.
The noble and learned Viscount raised the argument, which I anticipated he would raise, that the service could not be inadequate because so many nurses have 1068 entered it. But he was including all the Commonwealth and foreign students in this country. We know that the hospitals could not keep functioning if this flood of student nurses did not come here, but that has happened only in the last few years. Therefore, I would ask the noble and learned Viscount, who is very fair, if he would deduct these immigrant figures, when he would find that the totals were much lower. But the real test of the Hospital Service is not the number of nurses but whether the service is adequate. Many noble Lords can vouch for the fact that in their own areas there are many vacancies. I am sure that all your Lordships have made up your minds.
Finally, may I say a word on the point of my noble friend Lord Citrine about timing? Those who know hospitals and nurses will know that through the years matrons and sisters have said to the nurses, "My dears, this is not the time. Have patience". The nurses have had patience. This Motion has been on the Order Paper for months. When I opened the debate I said I had thought it might not be necessary ever to raise the matter in your Lordships' House because it would have been settled. But the time has come when the nurses' case should be put boldly in your Lordships' House. Their world is not removed from that of your Lordships. As the noble Earl, Lord Albemarle, has said, many noble Lords have been in bed and have been able to evaluate the services of nurses and decide what is their real worth. I leave it to your Lordships. When noble Lords go into the Division Lobby to-night I hope that they will realise that the nurses of the country are hoping that this House will support their case.
§ VISCOUNT ALEXANDER OF HILLSBOROUGH
My Lords, I would just like to say to the noble and learned Viscount that we value the offer he made just now, but I do not think that we could possibly accept it, not only because of the general case which my noble friend Lady Summerskill has put, but also because we have had this matter on the Order Paper for weeks It is not a question of right timing, if I may say so to my noble friend Lord Citrine. We were persuaded by the Government to give way weeks ago, because they 1069 specially wanted another noble Lord to raise the general question of world and Commonwealth birth control. We have not been responsible for the timing of this Motion at all, and therefore cannot possibly give up our right to challenge an Amendment which strikes us as being so inadequate.
§ THE LORD CHANCELLOR
My Lords, I would not have made this offer had it not been for the speech of the noble Lord, Lord Citrine. The noble Lord carries enormous weight with the
§ Resolved in the affirmative, and Amendment agreed to accordingly.