HEALTH VISITING AND SOCIAL WORK (TRAINING) BILL

HL Deb 24 May 1962 vol 240 cc1122-62

6.15 p.m.

Order of the Day for the Second Reading read.

LORD NEWTON

My Lords, I beg to move that this Bill be now read a second time. It is a short Bill but it deals with matters of considerable importance. Great emphasis is placed to-day on the value of measures to prevent illness of all kinds and, when people do become ill or disabled or weighed down by social problems, on helping them and caring for them in their own homes. This work falls upon the local authorities who need adequate staff and properly trained staff; and this Bill is concerned with the training of health visitors and social workers, two groups of people who devote themselves to the prevention of illness and to community care.

Your Lordships will be aware that health visiting dates back to 1862, when the Ladies' Sanitary Reform Association of Manchester organised and paid people to make visits; to concentrate on cleanliness, good management and good living; help the sick; and to advise mothers on the care of their children. Down the years responsibility for work of this nature has been placed by Statute upon the local authorities, and the scope of the work has been extended to include the well-being in society of the family as a whole. Among the responsibilities of local authorities to-day are care and after-care for the public in general under the National Health Service Acts and for the handicapped and aged, in particular, under Part III of the National Assistance Act, 1948. Social work is defined in the Young-husband Report as— the process of helping people with the aid of appropriate social service to resolve or mitigate a wide range of personal and social problems which they are unable to meet successfully without such help. Of course, help of this kind has, in some sense, always been available, but it was only in the second half of the 19th century that a systematic attempt was made to enlist the co-operation of those needing help in working out plans to overcome their own difficulties. The pioneers were Octavia Hill, in 1864, and the Charity Organisation Society, in 1869.

This Bill, which is consequent upon the Jameson and Younghusband Reports, is one of the latest developments in the field of what nowadays are called the domiciliary services. Its purpose is to set up two training Councils, one for health visitors and the other for social workers. The Councils will have the duty to provide, or to secure the provision of, further training where they do not consider adequate provision to have been made. Their function, however, will not primarily be to provide training themselves but rather to guide other bodies in its provision. In this task of persuasion, encouragement and enlightenment the Councils will draw upon their own collective wisdom, under the chairmanship of Sir John Wolfenden, and upon that of the expert staff which they will appoint, and they will command authority by their award of certificates to candidates who have completed courses which they have approved. These certificates, in the case of health visiting, will be in the nature of a necessary professional qualification, and, in the case of social work, will indicate a recognised professional competence. They should prove a valuable aid to professional advancement.

It is not fortuitous that these two Councils are being set up by the same Bill. On the contrary, we are forging links between them Which we intend to be lasting, because we follow the Young-husband Report in believing that the rôles of health visitors and social workers will continue to be complementary. The co-operation between these workers which often exists already will become the natural order of things once there is a sufficient number of trained social workers to whom health visitors can refer cases. That is the reason we have provided, in paragraph 9 of the First Schedule, for the Councils to have some members in common. There can, however, be no better guarantee of a close working relationship between them than to provide, as is provided in paragraph 2 of the Schedule, for the Councils to have the same Chairman. Because we cannot envisage a time when association between the Councils will be unnecessary, we have resisted attempts to make it possible for the Privy Council to appoint separate Chairmen.

I come now to the detailed provisions of the Bill. Clause 1 and the First and Second Schedules provide for the setting up of the two Councils. They will cover the whole of the United Kingdom. They are to be called respectively the Council for the Training of Health Visitors and the Council for Training in Social Work. Each is to have a committee to advise on the exercise of its functions in Scotland; similar committees may be appointed for Northern Ireland.

Clauses 2 and 3 describe the functions of the Councils, very much on the lines recommended in the Jameson and Younghusband Reports. They will have the general duty of promoting training by encouraging the provision of facilities for it. They will establish national standards of training by approving courses and awarding certificates. The certificate of the Council for the Training of Health Visitors should take the place of those issued by the Royal Society for the Promotion of Health and the Royal Sanitary Association of Scotland, who have long set the standards for health visitors. The health visiting profession, like many others, is very much in their debt. The Councils will also have the duty of seeking to attract recruits for training courses. To begin with, the Council for Training in Social Work will be concerned only with social work in the local authority health and welfare services, and in similar services run by voluntary organisations. However, the Bill does not limit in any way the fields of social work in which the Council may eventually concern itself. On the contrary, under Clause 3 its functions may be extended to other fields by Order in Council. The courses to be provided may well prove to be suitable training for other forms of social work, and it is hoped that some members of the Council appointed by the local authorities will be people with wide experience.

Clause 4 provides for the Councils to be financed by the Exchequer. The annual sum involved is estimated at about £50,000, but the actual figure will, of course, depend upon the development of their responsibilities and upon the amount of their income from fees for examinations and certificates, and perhaps from publications. The Young-husband Report envisaged the need for research into the social needs of particular groups of people and related matters. Accordingly, Clause 5 of the Bill empowers Ministers and local authorities to undertake such research, where power is not already there, and provides that expenditure incurred upon it by local authorities shall rank for general grant.

The first Schedule describes the constitution and proceedings of the Councils. The membership is broadly based and provides representation for England, Scotland. Wales and Northern Ireland. The local authority associations are strongly represented, having ten members on each Council, but the professional and educational interests together will have a slight majority. So far as the Ministerial appointments are concerned, the interests to be consulted are specified in the case of all but one of the appointments to the Council for the Training of Health Visitors, and in the case of all but two of the appointments to the Council for Training in Social Work. These exceptions will permit necessary adjustments or the appointment of especially qualified individuals. There will be at least one general practitioner on each Council. The purpose is to establish a balance of interests. If, however, the Councils should wish their nets to be cast wider, they will be able, under paragraph 16 of the First Schedule, to appoint advisory committees composed partly of outside persons.

Those, my Lords, are the main provisions of this Bill. It is, as I have said, a small Bill, as Bills are apt to go, but I believe that its beneficial consequences for the prevention of disease, for community care in many forms, and, above all, perhaps, for attention to mental disorders outside the hospitals, will be vastly greater than either its size or the length of the introductory speech which I have thought right to inflict upon your Lordships this evening. I believe that the setting up of the Councils will lead to more people seeking training as health visitors and social workers, so that eventually the local authority services will be fully staffed with trained workers. I beg to move.

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

6.25 p.m.

BARONESS SUMMERSKILL

My Lords, it would appear to those who are unfamiliar with the changing scene in the world of medicine that this Bill is concerned solely with a further contribution to the machinery of the National Health Service and to the administration of our insurance scheme. But it has, in my view, a much greater significance. I should like to emphasise this, in order that the Minister of Health and the powerful Treasury shall recognise that the adequate financing of this measure can yield important dividends in terms both of health and wealth. As the noble Lord, Lord Newton, said, there is an increasing number of patients who are seeking medical advice for complaints in which social factors play a large part. This is reflected in the fact that nearly 40 per cent. of the beds in this country are occupied by patients suffering from some nervous complaint; and one-third of the drugs which are prescribed in this country are prescribed to alleviate symptoms of some nervous disorder.

This new challenge to medicine was referred to by Sir Francis Fraser, Director of the British Post-Graduate Medical Federation. A report of a lecture which he gave to the Royal College of Physicians states that he said: … since the war it had been realised that an increasing number of patients were seeking the help of their doctors for conditions in which emotional or social factors were important or even dominant. He went on: A concentrated study of the social and psychiatric factors of ill-health by the three branches of the National Health Service—hospital, local authority, and general medical practitioner—might be the best way of meeting the challenge. Family doctors, almoners and other social workers could provide much of the evidence required … He then gave a special mention to the local authority, who are responsible for the domiciliary services in which the health visitor and the social worker are becoming an essential part of the team.

Furthermore—and I hope the noble Lord, Lord Amulree, will develop this aspect—the increased expectation of life brings in its train degenerative diseases, and the emotional element in the sickness records calls for some shifting of emphasis in the training of health workers. Indeed, I would say that to-day a regular visit from a well-trained individual in one of these fields, and the establishment of good personal relations, may well meet the needs of many of the unhappy individuals who throng the doctors' waiting rooms and the outpatients' departments of our hospitals to-day, and who consume endless boxes of pills. Successive Ministers of Health—because I am not to-day deploying a new idea—have agreed that we could relieve this pressure, and the expense, by improving our domiciliary services. Consequently, no effort should be spared to strengthen the provisions of this Bill. It may be a small Bill, so far as the number of clauses is concerned, but its provisions are of the utmost importance.

It seems to me 'that there is one major defect in the Bill, but before I address myself to that, I would remind the noble Lord of three points. The representatives of the health visitors and social workers still feel that they have not adequate representation on these Councils. I would remind the noble Lord who is in charge of the Bill in your Lordships' House that when the Bill dealing with the professions supplementary to medicine passed through another place, these professions were inadequately represented. I recall that I pressed on that occasion that they should have adequate representation, and I was rather shocked to find that in another place the representatives of these fine women had not been recognised. Also there still remains a grievance concerning a local authority's power to claim compensation if a woman serves an authority other than the training authority, although the training was organised on a pooling scheme. I think that if the noble Lord makes inquiries he will find there were at least two women who were asked to compensate the local authority because they had married and gone outside that area.

The other point concerns the chairmanship. I was a little surprised that the noble Lord accepted the position with such complacency. The health visitors and welfare workers have not been convinced that it is desirable for the same person to be chairman of both councils. While having the highest regard for Sir John Wolfenden—he is the most overworked chairman, I think, in the whole country—1 personally regard it as an anachronism that a man should be chairman of councils dealing almost entirely with women's work. Florence Nightingale would have been horrified at the mere suggestion and would have vetoed it forthwith. I ask whether your Lordships can imagine that a woman would be put in charge of councils which were concerned almost solely with men's work. There would be an outcry, and quite rightly so.

I come now to the fundamental weakness of the Bill. Not long ago we had a debate focusing attention on the professions supplementary to medicine, and it was revealed that a shortage existed in every one of these professions. Undoubtedly, health visitors and social workers are in some measure drawn from the same category of young women who supply these other professions. Consequently, good candidates are scarce. For this reason I regard the recommendation in paragraph 936 of the Younghusband Report as crucial. It says: We recommend that grant aid from central Government funds should be available to individuals for training in social work in the health and welfare services, as it is already for those who intend to enter the probation or child care services. Then they recommend as a matter of great urgency that the necessary legislation should be introduced. Of course, it is not surprising that the urgency of the matter is emphasised, considering the shortage of these professional people and that fourteen years have elapsed since the appointment of the Mackintosh Committee on social workers and two and a half years since the Younghusband Committee reported. The noble Lord mentioned that a certain period had elapsed, and I am quite sure that he deplores this as we all do.

The Minister of Health in another place seemed to be absolutely unaware of the vital importance of this recommendation on which depends the immediate success of this measure. The Minister insists that these valuable students who offer their services for the National Health Service should try to secure a grant from the education authority. But candidates for social work are often women in their twenties and thirties who have no claim on a given education authority. I would remind your Lordships that the woman with some experience of life is the ideal person, who should have a later training in social work and then be fully qualified to go into the homes of the people to give good advice. If time is lost between an application and a decision from different education authorities, then the candidate, for whom to-day there is fierce competition from industry and other callings, may be lost to the service. Again I would remind your Lordships that in these days of full employment the demand for the services of a reliable woman of integrity is great, and she is not going to wait "cap in hand" week after week for an education authority to consider her request for a grant.

This matter is one of urgency, as Miss Younghusband said. I would ask the noble Lord, if Exchequer grants are made for those concerned with child care, why should they not be made for those training to care for the whole family? How can this anomaly be justified? As I have already said in my opening remarks, it is most necessary now to have our domiciliary services fortified by people who can go into the family and view the conditions, the grievances, from grandmother down to the youngest child.

On Monday of this week, May 21, the Daily Mail reported an interview with the Minister of Health, in which he said: I was a lucky man to come to the Ministry of Health at a critical time, when there was room for big and long vistas. That was a remarkable statement, having regard to his failure to recognise that only an adequately paid staff can ensure the recruitment of nurses from this country in the future. I also found it difficult to reconcile this statement with his attitude towards this Bill in another place. He has a reputation as a tough champion of the Treasury. Well, even his reputation as a tough champion of the Treasury would not suffer if he took a long-term view of the urgency of strengthening the domiciliary service, because only by so doing can he hope to decrease the expenditure on the Hospital Service.

He also told the Daily Mail of his interest in mental health. Is he not aware that the psychiatric social worker is invaluable for collecting case histories? Professor Titmuss, whom we all recognise as a great authority in the field of social work, has said that at the present rate of progress it will take another 53 years before there is an average of one psychiatric social worker to each authority. While the training of a psychiatric social worker may not necessarily come within the province of these councils, nevertheless this is an illustration of the failure to recognise the vital importance of the comprehensive domiciliary service in the practice of medicine to-day. The Treasury is willing to give hundreds of millions of pounds for drugs and the Hospital Service, yet it fails to recognise that an Exchequer grant to the student social worker will accelerate recruitment, and consequently ensure an improved domiciliary service.

I say, again, that this is a short-sighted policy, for the domiciliary service to-day represents a form of preventive medicine, and, owing to the high sense of vocation of the women employed, it is relatively the least expensive branch of the National Health Service. Of course, I welcome this Bill, but I hope that your Lordships will support my plea that it can be strengthened and should be if it is to be successful.

6.40 p.m.

LORD AMULREE

My Lords, the noble Lord Who introduced this Bill said, I think, that part of its purpose was to carry out more efficiently the preventive work and the care and after-care work mentioned in Section 28 of the National Health Service Act. That is some thing we were all extremely pleased to see, and from that point of view one must welcome this Bill. There were, however, one or two doubts that came to my mind as the noble Lord spoke, and I should like to put them forward—not in any sense opposing the Bill, but merely to express another point of view.

The first doubt I had was this. If one really wants Section 28 to work, do we require two Councils? Could not the work be done by one Council? I was for a long time a Member of the Council of the Institute of Almoners, so I have a great deal of respect for their training in the work they do. I wonder whether it is necessary to continue the split between the almoners and health visitors, by having, so far as I can see, in perpetuity, these two Councils. The demarcation of the work between the two bodies has never been laid down very clearly; in fact I doubt whether it can be laid down. They are bound to overlap, to a certain extent, in their work and functions; and, because they are separate and can overlap—this may sound rather paradoxical—a certain number of people may fall between the two bodies, with the result that those who most need assistance may not get it.

I believe that it is very important that there should be a good follow-up system for people who have been discharged from hospital. The same applies to people who live by themselves and who need to be seen in their homes. And this does not always apply only to elderly people; it applies also to middle-aged or even quite young people, if they are living by themselves. It is a very good practice that there should be this follow-up procedure. This is a difficult thing to obtain now, because there are two authorities involved: the hospital authority and the local authority, with its welfare services. From time to time one has seen things go wrong. One has tried in the past to bring these bodies together in order to have one system covering more people than under the present split-up system. I fear—I trust I am wrong—that when this Bill becomes law it may tend to perpetuate the separation rather than to bring the two together.

I feel that one of the most important parts of the Bill is Clause 5, under which provision is made for the carrying out of research. I wonder, however, whether more research should not have been done before the Bill was prepared, in order to find out exactly what is required from these various bodies, and in what way they can best come together to carry out the work laid down under Section 28 of the National Health Service Act. One thing that will assist, I think, is the fact that in many local authorities there has been a merging of the health and welfare committees. Indeed, that merger has now, I believe, been blessed by the Minister of Health himself, and I hope that this will continue. I do not want to give your Lordships a large number of figures, but a certain number of the bigger local authorities have combined their committees and quite a number of them have the medical officer of health to advise the welfare committee. So that local authorities have gone a long way towards bringing both services together under one head and getting them to think alike.

I should like to follow up what the noble Baroness said, because I am worried whether we shall have enough people applying to be trained as social workers. The need is very urgent indeed, and I would put forward two ways in which I think the situation can be improved. The number of people who are destitute (and by that I do not mean poor; because people can be destitute in all sorts of ways—even people with a great deal of money in the bank), and the number of people who require visiting, is growing very considerably, partly because the population is growing older, partly because it is also increasing, and partly also because many more people now go out to work and cannot look after their aged relatives as they used to. This is a trend that I find in the Borough of St. Pancras, where I work.

On looking up the records I found that in 1921, under the Poor Law, the Borough employed fourteen relieving officers. I do not want to go back to that system, but there were fourteen people involved in seeing that people did not get into difficulty. Now we have fifteen health visitors working there whose work is for the most part dealing with maternity and child welfare, though they are supposed to give some of their time to the older groups. In fact they have not a lot of time to give to them. And there are a further six Borough visitors whose work is entirely with the aged. At the same time a certain amount of help comes from the National Assistance Board. The number, therefore, of people who are available for regular visiting is not very large, and I feel it should be increased as soon as possible.

When I heard that this matter was coming up in this House I arranged for a series of about 100 random visits to be made to people who had recently been discharged from my wards of a hospital to find out what they really required. We found that the trouble was not that they were lonely, but that they felt cut off, isolated, and rather frightened that something might go wrong. I think this was due to the fact that there is not a big enough service which enabled them to be seen from time to time, in order to reassure them and to make them feel that, if something did go wrong, they would have somebody to turn to who could bring them some kind of relief.

The noble Baroness asked me to say something about the old people, and this is an important part of the work. If the Mental Health Act is going to be a success at all it will require a large number of social workers. A very great burden is going to be placed on local authorities, and if they cannot fulfil it the idea that it is possible to maintain people in their homes will fade away, and there will be the old demand for people to be admitted to beds in institutions—which is not only a very costly way of dealing with the situation but is not an attractive method and is somewhat inhuman. Therefore, I should like to support what has been said in favour of more money in the way of grants for the training of these workers. If we do not get the money we shall not get the people, and if we do not get the people what we are all saying to-night is a waste of time and we might just as well go away.

I have two further points, one dealing with the training itself. The Young-husband Report laid down a very hierarchial system of social workers. which involved patients being moved from one to another as the severity of their case demanded. I agree there has to be some difference in qualification, but I should like the training to be made as flexible as possible so that one would not have any development of this hierachical system. If you are going to train psychiatric social workers they must have a sound basis of psychiatry; and if you are going to train other social workers I should like them to avoid the tendency, which is arising in the almoner training, to be too "psychiatric" and not enough "social". I should like to see the emphasis laid more on the social work and not so much on psychiatry. That is a matter which we cannot debate here very fully, but I hope that the Training Council will bear that point in mind.

The other point, which I want to raise quite briefly, and which was mentioned by the noble Baroness, concerns the representation on the Council. I agree with what the noble Baroness said: that it is foolish that the people doing the work do not get more representation. It appears to me (I may be completely wrong, and I may have misread the Bill) that there is nobody on the Council who knows a great deal about the work of these social workers. Far more of the people who are going to employ them are there, rather than the workers themselves. That does not mean to say that I do not support this Bill—indeed, I think it could be an admirable measure—but I feel that it has certain defects Which may prove disastrous.

6.51 p.m.

BARONESS ELLIOT OF HARWOOD

My Lords, we have Listened to three very interesting speeches. The noble Lord who introduced the Bill did so very shortly and succinctly. There was the speech of the noble Baroness, with whom I do not always agree, but on this occasion I agreed with every single word she said, and I think it was most brilliantly and beautifully done. And the noble Lord who has just sat down, Lord Amukee, Whose knowledge and experience in medicine is as great as that of anybody in this House, has made several very important points.

I rise to speak in this debate for two reasons: one is that I am, and have been for a great many years, a county councillor and actively engaged in local authority work; and the other is that I have been, and am still, deeply interested in social work and the training of social workers. I think this is a very important Bill and it may have a great influence on the value and effectiveness of the many services provided by local authorities. It arises, as we know, from two very important Reports: the Report of Sir Wilson Jameson on Health Visitors, and the Report of Miss Eileen Younghusband on Local Authority Health and Welfare Services. We are very fortunate in this country, to be able to call on such remarkable people to help us in laying, as it were, the foundation for our legislation by such careful and such excellent Reports. We are deeply indebted to both of these people, to Sir Wilson Jameson and Miss Young-husband, for the way in which they have surveyed the ground and brought forward so many admirable suggestions, which are being embodied in this Bill.

In view of the number of people who are employed in the local authority services, and the number who are still needed, I believe it is most urgent to get this Bill on to the Statute Book. We have a high standard of training for many of our great professions—nursing, teaching, psychiatric social workers and so on—but in many of the welfare services of the local authorities there is a large proportion of people with no social work training at all. Health visitors, on the whole, have more trained personnel than the welfare services of the local authorities, but in both there is a very real shortage of trained people.

In the Jameson Report, there is an estimated need of 11,500 qualified health visitors, of whom 8,000 are working, and there is therefore, a shortage of 3,500. There is also, from the Health Visitors' Association, a demand which I think is a reasonable one, that as the numbers increase and the service becomes more and more valuable and more and more important there is a need for a register of health visitors. We know that they are State-registered nurses and in that capacity they are already registered, but there is this further qualification which they take as health visitors, and this is not registered. In the interests of that profession, and to protect those who take the additional qualification, I think it would be wise to allow them also to be a State-registered service as health visitors.

The Younghusband Report estimates that in the health and welfare services of the local authorities the increased need of trained social workers at the present time is 2,500, with an unspecified number of welfare assistants to help. To cover the shortages of almoners, family case workers and psychiatric social workers, about 800 are needed. Altogether, my Lords, we require in these services about 5,700 trained social workers, plus the 800 I have just mentioned. This is a very formidable total; and there is every reason, therefore, to get ahead with the Bill as fast as we possibly can.

I know from my experience on the county council how much more effective the welfare services could be if we had at our disposal a number of trained people. Parliament, in its wisdom, is continually passing new legislation and putting more work and more responsibilities on to the local authorities. On June 4 in Scotland we undertake to carry out the working of the Mental Health Act—a very great responsibility indeed—and we have practically no trained people, or people with experience in the care of mental health, although we are all most anxious that this idea of community care, which is so excellent, should be carried out. But that is going to be very difficult to do, because we do not have the personnel to help us do it.

Now I come to one of my criticisms of the Bill. I think that it will not be possible to meet the great urgency which I feel for the Bill by the arrangements that are being made for finance and the grant aid for students. Several training courses are now starting. Four training courses are actually in being, five more are planned to start in the autumn, and two more next year. None of these courses—and this is rather a curious thing—is at the moment being run in, or in conjunction with, the universities. None is in extra-mural departments; they are all in colleges of commerce or technology. Naturally, one has nothing to say against colleges of commerce or technology, but, knowing the kind of training that a social worker requires, it seems to me a mistake not to have included the universities among the centres in which training is given. I believe that one or two universities have offered to do this but they were refused, which seems to me a great pity. They are so obviously the places with the best environment for such training.

Then there is also this problem, which may arise—I do not know whether it has arisen, although I believe it has in one or two places—that, with the desire to get first-class lecturers and tutors for these courses, if they are run in colleges of commerce or technology it will be difficult to get the university lecturers, unless these colleges are able to pay the fees and the salaries of those lecturers at the rate at which a university would pay them. It also seems a pity not to encourage and strengthen the link between the universities and the social training courses, rather than to let this go by default.

I think that the grant aid, which the noble Baroness has mentioned, is the great weakness in this Bill. There are to be no central grants for these students. Applications for grant aid must be made to the local authority through its further education department; and that, as I know—I am chairman of a local education authority—is inevitably rather a slow process. It has to be brought before the further education committee; it then has to go to the education committee; it may possibly have to go to the finance committee, and it may then have to go to the county council. Very often they do not all meet in sequence, and you are definitely slowing down the possibility of getting grant aid for these students quickly.

There is also the point which the noble Baroness made, in that if you are confined to local authority grants you are limiting the scope of recruitment to local areas and local levels. I believe that is a slowing-down process and also a limiting process. Look, for instance, at the Home Office, where I also have some association. The Home Office, knowing they were extremely short of child-care officers and probation officers, immediately organised their own courses; they got their own grant aid direct, and they have been able to go ahead very ably and very swiftly with the training of the personnel whom they want for their work.

When it came to organising the Youth Service with the urgency arising out of the Albemarle Report, what did the Ministry of Education do? They set up their own National College of Youth Leadership, financed 100 per cent. by direct grant. They give direct grant to the students, and any prospective trainee who is any good at all and who passes into the college or into any of the training centres for youth leadership can get direct grant. That is the quickest way to do it, my Lords: that is the most direct way to do it. In that way you will get your students far more rapidly and more effectively than by going through the rather elaborate machinery of the local education authority.

I read the debate held in another place on May 7, and I read the Minister's reply to the point that was made most forcibly by two Members who have worked very hard on this Bill, Dame Irene Ward and Miss Joan Vickers. They both urged the Minister to reconsider this method of grant aiding, but without success. The local authority machinery is all right; it works in the end; it grinds away slowly and it comes out all right in the end. But in my experience that end is generally something approaching two years from the beginning, if you are lucky, and sometimes it may even be longer. So I would urge the Minister most strongly to reconsider the question of these direct methods of grant aid. If the Home Secretary and the Minister of Education can get the direct grant from the Treasury, I cannot see why the Minister of Health should not be in the same position and should not be treated in the same way. If and when the immediate need is met and you want to slow down the training and the recruitment of these social workers, then you can return to the further education plan.

Then there is another proposal which was put up in another place and which I think might also be effective if the direct grant is not available, and that is the question of the pooling grant system. Again, that is successful at the Home Office, for instance, where the pooling of the expense in connection with the training of probation and of child-care officers works very well. One per cent. is taken by the Home Office and used to finance the probation training service, which costs £97,000, and the child-care service costs over £100,000. This pooling system is extremely successful, also, in the financing of health visitors' training.

There will be two streams of people applying for grant aid: the new students who are training for the first time, and for whom direct grant would be by far the quickest and the best way to bring in the new recruits, and those who are already in employment in local authority services but are untrained—and I know that there are a great many of them. They will, we hope, be seconded by their authorities to take a training course under the Younghusband scheme, and their salaries will be paid by the local authority, their employing agency; but without grant aid it will be very expensive for the smaller authorities both to pay the salary of the officer While he is being trained and also to pay for a replacement during the time that he is away from his post with the local authority.

Therefore, a pooling system would help the poorer authorities very much indeed and those who would like to get their personnel trained but who might find it very difficult indeed. It might also help voluntary organisations who would like to take advantage of this social work training and put forward candidates for it. I hope that the Minister will consider some of these points, and will see whether or not it is possible to introduce another system of grant aid.

While speaking about grants I cannot help referring to the sum of money which the noble Lord, speaking for the Minister, has mentioned as being that which will be available for this work: £50,000, £25,000 for each council. This includes expenditure on the office accommodation, the clerical assistance and the executive staff. It seems to me quite impossible. I cannot see how you can possibly run a first-class council—and it must be first-class or it is not worth doing—on £25,000 a year. As I have mentioned, the probation training committee have £97,000 a year at their disposal. I cannot think how two large councils can possibly do an efficient and a first-class job on such a small sum of money. I only hope, as the noble Lord has said to-night, that this amount will be reviewed if it is found insufficient to meet the demands of the councils.

Then there is the question of research, my Lords. This, again, seems to me to be quite inadequately dealt with in this Bill. Research is essential in a service of this kind—just as essential as it is at the Home Office, where the research unit is working and doing first-class work which may well help us to solve some of the very difficult problems in connection with the treatment of offenders. But the research project that is likely to come in this field is going to be absolutely minute. I cannot see how it will even be possible to run a research unit with so little support and so little money with which to do it. Yet research might be one of the best ways of saving money in the end. One can spend money on research, and in other professions, in business or in a variety of fields things are discovered which, when put into action, save hundreds, thousands, perhaps even millions of pounds. I am sure research is essential in this field.

I should like, if I may, to turn for just a moment to the composition of the two councils, to which the noble Lord, Lord Amulree, has referred. I am afraid I do not think that I can agree with the noble Lord, Lord Amulree, about having one council. I think this is a matter for which two councils, as planned, is a better arrangement than his suggestion of one council. But I agree with him, and with the noble Baroness, Lady Summerskill, that having provision for only one chairman written into the Bill is really tempting Providence. In fact, we are lucky, because in Sir John Wolfenden we have a very great man who has interests so wide that he will, with his experience and his capacity, make a good chairman for both councils. But in five or ten years' time, who is to say that the next Minister of Health, or the one after him, will be able to find somebody who will fit the bill as Sir John Wolfenden does? I think it should have been left open for one chairman, if one chairman is found, but it should not have been said that there can definitely be only one chairman. I think this is a matter which we should reconsider.

Another question which Lord Amulree mentioned, and which I think is extremely important, is that the function of these two Councils is to serve as training bodies and recruiting bodies. Yet far the biggest representation on them is the employing bodies, the local authorities. If there are to be training bodies, the most important training bodies in the country to-day are the universities, the social science departments, people who have very great experience behind them in training and in working out different types of social work training.

Yet there is no mention of the Joint University Council being on either of the two Councils. I think this is most unfortunate. I know that in another place the Minister said that they would consult the universities. But they are the most important of all, and just to say that they would be consulted is, I think, quite inadequate. Of course, you would be mad not to consult them; but I think you would be equally mad not to have them on the Council, because they are the people who really have the knowledge and the personnel, and I cannot understand why they are left out. I am sure that if we were discussing in your Lordships' House the training of military personnel, it would be most unlikely that we should leave out a representation from either the Navy or the Army colleges in trying to plan the training of officers. It seems to me just as unfortunate that we should have left out the universities on these two Councils.

There is a case, as Lord Amulree, has said, for including more professional people on those Councils. On the Health Visitors' Training Council, the two important organisations, the Health Visitors' Association and the Royal College of Nursing Health Visitors' Council, are not mentioned by name. I believe that, as paragraph 5 of the Schedule says that eight of the members after consultations with the Minister of Health, shall be health visitors, naturally those two organisations should be consulted. I think it is a pity not to have specified that members of these two big professional organisations should be on the Health Visitors' Council. There is also the question as to whether only one representative from Northern Ireland, when they, too, have a branch of the Royal College of Nursing Health Visitors' Council over there, is enough.

With regard to the Social Work Training Council, I have already mentioned the fact that the Joint University Council is not represented on that body, but there is not in fact a single organisation with experience of social work training mentioned among the long list of organisations. The British Medical Association is mentioned, as is the Association of Medical Officers of Health; but there is no mention of a single organisation of social work training. I think that is a great pity. The Councils should, if they are to be effective, really be training bodies and recruiting bodies, but they are in fact, as described in the Schedules, really employing bodies. This quotation from the Jameson Report, in Paragraph 374 on page 141, is, I think, very apposite: The constitution of the central bodies should adequately reflect the interests surrounding Health Visiting. It will clearly be necessary that employing, professonal and educational interests should be represented. The general balance of representation should be such that professional and educational interests—the Health Visitors' organisations, the training centres and the universities—should together be in a slight majority. That comes direct from the Jameson Report.

My Lords, I hope that the Minister will reconsider some of these points now that the Bill has come into your Lordships' House. Personally, I hope that this Bill will be a non-controversial one, because I think all of us, on both sides of the House, are anxious to see the Bill go through and become a really important addition to our social legislation. Training is essential for all professions. People have fought for the training of nurses since the days of Florence Nightingale, and for the training of teachers, too. Nobody wants the sick and ill to be nursed by untrained people, or our children to be taught by untrained teachers. Many of the problems which have to be dealt with by the health visitors and the health and welfare services are immensely complicated and difficult. The noble Baroness, Lady Summerskill, described, I thought most excellently, many of those problems. We must recruit for the service people of wide knowledge, understanding, and the temperament for this kind of community and family service. This Bill will, we hope, help to provide such people and to raise the standard of our welfare services throughout the country. But this will not be done unless there are some changes in the administrative structure of this Bill to make it correspond to the needs of to-day.

7.17 p.m.

THE EARL OF FEVERSHAM

My Lords, I find myself enjoying the comparatively rare experience in your Lordships' House of agreeing with all the points of substance which have been raised on both sides during the short debate on an important Bill. So I would hesitate to take up the further time of your Lordships by re-echoing the points and the observations which have so lucidly and clearly been made by the noble Baroness, Lady Elliot of Harwood, and others, were it not for the fact that I want no opportunity to be lost to convince my noble friend Lord Newton, and for him, in turn, to convince our right honourable friend the Minister of Health, that due weight and consideration should be given to the unanimity of opinion and expression of your Lordships' House. At the same time, I should like to pay some tribute to my right honourable friend the Minister because it is during his industrious term of office that this Bill sees the light of day.

I am not going to follow the noble Baroness, Lady Elliot of Harwood, into that part of her speech where she dealt with the clauses relating to health visitors, but I want, quite shortly, to say a word or two about those clauses which relate to social workers. First, I should like to emphasise again that we should urge upon the Government the most pressing need to promote as soon and as effectively as possible the establishment of adequate and well-trained health and welfare services in all and every one of the local authorities.

When your Lordships' House was discussing the Mental Health Act, it was then declared that the Minister would circularise 145 county boroughs and counties requesting them to submit schemes on what they were going to do to implement the intentions of that Act. That has been carried out. Local authorities have submitted their schemes. But one wonders whether the intention of the Mental Health Act can be implemented unless the Minister is going to pay due attention to the points which have been rightly emphasised in this debate. I refer particularly to the suggestions first put forward so concisely by the noble Baroness, Lady Summer-skill, and others who have spoken.

In a field where there is a severe shortage of vocationally minded people, if all demands are to be fairly served it is essential that there should be equal attractions. The health and welfare services of local authorities are, we know, the Cinderellas of the social work field. The Joint Training Council for Social Work say: In every other branch of social work, including medical and psychiatric social workers, as well as youth leaders, child care and probation officers, a grant in aid is available from central funds at the professional training stage. We urge that social workers taking this course should not be made practically the only exception to a well-established rule. By comparison with the provision available in these other fields I have mentioned, there is now, under this Bill, a positive deterrent to those employed by local authorities and engaged in welfare and health duties. People will not be recruited to these services, nor will those at present employed by local authorities be seconded by their employers to a Younghusband course for a period of two years.

In my estimation, these facts will be disastrous in the implementation of the Mental Health Act for five years—possibly for ten years—because every local authority, in these days of great shortage of recruits in the whole field of social services, must rely upon those persons of goodwill who already have some considerable experience. It is particularly over this point that this Bill stops short and defeats its purpose. If the poorer local authorities have to pay the full cost, they will naturally ask themselves what priority they can give to this work compared with all the other priorities in their budgets. They will ask, "How can we guarantee that staff trained with our money, out of our rates, will stay with us?" Your Lordships will appreciate, as many are members of local authorities, that the answers will vary in almost every local authority area.

We all know that it is this sort of problem that every local authority has to face. Some are better equipped than others; some grasp their opportunities for training their staffs; some give priority to other things. So that there is no certainty at all that any particular local authority will endorse a training application. I think that this is particularly true of local authorities which, because they have no further education courses within their areas, have to send their students outside, and so have to bear the full cost. This makes a difference of several hundreds of pounds.

To-day we are finding a ridiculous situation, in more than one place. I am told on good authority (I have had this from the Association of which I am Chairman; I refer to the National Association of Mental Health) that at the North-West Polytechnic, in London, there are in the same building two courses for social workers, one where central grants are available to the students of the child-care officers course and the other where students of general social work are not eligible for any central grant. This sort of situation is not limited to London. Exactly the same conditions prevail in Birmingham, at the College of Commerce. Can one think of a more ridiculous situation than having personnel, in all probability with a strong vocation, though taking a different slant of their social service, going to the same educational institution where one set has the advantages of a central grant and the other is denied them? I can think of nothing, in this second half of the twentieth century, that is more likely to lead to a continuance of the failure to get recruits than this sort of situation.

What are the alternatives? They have been fully enumerated by my noble friend Lady Elliot of Harwood and others. At this time, when the Bill has been through another place, one wonders whether it would be possible for the Government to change their minds and provide central grants, as in the cases we have all quoted, or at least give due cognisance to the suggestion that a common pool should be established for training purposes. That common pool would be contributed to by every local authority. I hope that in due course my noble friend on these Benches will move an Amendment to this effect. I know that there is a precedent for this. I understand that the expenditure on the training of midwives and health visitors is pooled and reallocated. In one local authority with which I am closely connected—1 refer to the Borough of York—I am told that they are training midwives and receive back from the pool a sum of £5,315. If it can be done in respect of one category of social work, I have not yet read in the Reports of another place, or in any other direction, a reasoned and logical answer why it cannot also be done in this case.

I think that it is necessary to say a word on the financial proposal to create an equalisation fund, which will have as its source contributions from every local authority and will be administered to enable a two-stream channel to operate. It would provide the finances to enable a poorer local authority to send to one of the Younghusband courses, to which the noble Baroness, Lady Elliot of Harwood, referred, an employee seconded, but who would not go to such a course if that local authority had to bear the full burden of paying for it. On the other stream, the equalisation fund would assist those areas that may require a far higher preponderance of personnel in these fields in their recruitment and their training grants. I hope that my noble friend Lord Newton will explore whether something of this kind cannot be done. The consensus of opinion that has been given, I think by every one of your Lordships who has spoken, is that social workers themselves, and local authorities, in the absence of a direct grant to provide vocational training, would find it best and fairest if there were to be pooled contributions for all local authorities.

As the noble Baroness and every other speaker has said, we do not consider that that is the best method, but at least it would show the earnestness of the Government to be fair to the welfare services; and it would show what has been shown before, both in the training service instituted many years ago (in which I played some part) for the probation service, and by the Children's Act, 1948, that the Government were anxious to stimulate the setting up of essential new services. Also, it would show a desire to ensure efficient services in all local authorities, rich or poor.

I do not want to detain your Lordships much further, but in the area of which I have particular knowledge—I refer to the provisions of the Mental Health Act—I entirely agree with the noble Lord, Lord Amulree, that that Act cannot work without the proper application of these fundamental community services. The noble Lord will know, as I think I I know, that the hospital services are going forward in a dynamic way, but that the lack of adequate community services is blunting the effect and causing people to be sent back into hospital as re-admissions. It is no use my right honourable friend the Minister of Health and, through him, the Regional Hospital Boards, claiming that the average stay of patients in mental hospitals is being reduced, if it is misleading the public about re-admissions.

I can only reiterate what I said in your Lordships' House in moving the Motion during the debate on the Young, husband Report in February two years ago. Many of the public have been alarmed by the idea that the Mental Health Act will throw on to the community a large number of mentally sick people who need special care. The only way to reassure them is to provide a social works service—a service to which they can turn in the knowledge that effective help will be given. Even with its deficiencies, this Bill makes an improvement possible, but it could make it certain. So I add the plea, as a layman, to the view of almost every expert in the field, and that is to plead with the Government that they do not baulk at the final hurdle and ruin the whole concept and effectiveness of this Bill. Without adequate finance, which appears to mean a simple pool, the Bill is sure to flounder and to fail.

7.35 p.m.

THE EARL OF IDDESLEIGH

My Lords, I have had the honour of sitting in your Lordships' House for about 35 years, and I do not remember ever hearing a Government Bill receive quite such sharp criticisms from all sides of the House. At this late hour, it would be quite otiose for me to repeat the criticisms that have been so ably given by the noble Baroness, Lady Elliot of Harwood, and by the other speakers who have, on most subjects, shown a very high degree of unanimity. The fact is that many of your Lordships are closely connected with social work and admire the social workers. In this Bill, Her Majesty's Government have managed to hurt and annoy the social workers, and our speeches have reflected their bitterness.

I will venture to quote from a letter signed jointly by the representatives of the Association of Psychiatric Social Workers and the Institute of Almoners. They say: The under-staffed and under-paid social workers find it bitter to realise that the Ministry of Health places so little value on the welfare and casework services which the Bill is designed to promote and which the public has a right to expect. Another body, the Institute of Almoners write: Social workers fervently hope that the House of Lords will show the same informed and realistic attitude to this issue as was demonstrated in their first debate on the subject and that there may yet be time to make the Bill a living force in the social services of the country. These ladies, whom we cannot sufficiently admire, are placing great reliance upon us. I think we can promise the noble Lord, Lord Newton, a long and energetic Committee stage.

7.37 p.m.

BARONESS SWANBOROUGH

My Lords, I realise that the greatest pleasure will be given by the shortest possible speech, so I will only reiterate what everyone has said: that is, that the greatest of hopes come from every one of us for the Government to make adequate financial provision, so that the social workers, and all that that term comprises, should have real backing in the endeavour they are making to get the perfect training. Those of us who are in any way connected with the social services of this country are very jealous of the pattern we have set up. It is a pattern that can be a model for the rest of the world, and it would be foolish of us if we were, by skimping as to training, to vitiate the example which we are able to give to other countries in the methods we have evolved and the pattern that has come from those methods. But to attain the pattern, a standard of training, both as to technical skill and as to professional ability, is of paramount importance; and I think this is because of something which has not been mentioned so far; namely, that ultimately the influence of such training forms the character of the nation. That character is in itself a strength which we cannot over-emphasise in the pattern it can give to the world.

People who qualify in social service in all its various forms have a very special make-up. Their outlook is certainly dedicated, and their ability is strengthened by their own personal endeavour and without experience they cannot carry on the work at all. I, personally, think that if we are to have first-class standards of training for people who carry responsibility, it is necesesary to see that these standards are matched by a level of remuneration which is sufficiently good to make those doing the work feel that they have a salary which is sufficient for them not to be looking at their pay packets with apprehension It should also give the certitude that they are recognised as having responsibility in their own field and in the carry through of such responsibility.

All of us who are deeply concerned in having a really good welfare service for those who require it—and I would emphasise that this is really the reason we are all so interested in this service—look at the problem with the knowledge that the commodity supplied to the consumer must be in the right shape; and as the consumer in this case is, of necessity, a person who is usually in difficulty in order to qualify as a consumer, it is necessary that the help to that consumer be of the right calibre. The old person who is labouring under a great disability, the middle-aged woman suffering from marital distress, the sick, the lonely and the dispossessed, do not want to be handled by those who are academically proficient but by those Who are experienced and informed. They, the consumers, are not preoccupied with methods or legislative machinery. Standards of training and qualifications pale to insignificance before their need for human understanding and dextrous handling of situations beyond their own control.

We, who spend our lives in the social services, are clear that training is of paramount importance, but training without experience is of no value to anybody at all, and that is Why most of us who are connected with these fields of work would like to see that 50 per cent. of the training given by the training Councils would, in fact, be practical and would actually be on the ground. The Bill before your Lordships is undoubtedly a step forward in the right direction, but the Bill is of little value unless the country itself recognises that the social worker has a definite responsibility and should receive an adequate salary for the job. But we must understand, all of us, that no restrictive practices in welfare work should take place, because of standards of training that we are all advocating, and the volunteer should be welcomed to play his or her part alongside the professional, although each lin their own sphere and each with their own job to fulfil.

Volunteers working on a modern basis—and I speak naturally on behalf of the service with which I am associated—expect in their work for local authorities, whoever their local authority may be, to work to the officer who is qualified to hold that post. The volunteer today accepts that, as a principle of thinking to-day, charitable patronage has gone and statutory aid is here; and voluntary service to-day consists in integrating volunteer service into statutory aid. This leads to a standard of service on the part of volunteers working to the officer of the local authority. Such an officer, with accepted training and adequate responsibility vested in the post, is, I presume, the ultimate object of this Bill.

We are in no danger in this country of being short of people to do the job from the point of view of volunteers to help the professional; we are in no danger in this country of not having enough people ready to try out new schemes, but I am fearful that the love of the hallmark—a hallmark sometimes of doubtful quality—which is worshipped in other lands might possibly, by mistake, be adopted here. I am in favour of well-trained social workers, but I want to urge safeguards against a situation which has come to pass in the North American Continent, where voluntary participation in the welfare of the community has been frozen out because of professional views. This has led to impossible situations which are now the subject of much thought and discussion in the endeavour to rectify what has happened. I do not believe that this can happen here, but I do believe that we must watch and be careful. I would therefore urge that the Training Councils give to the professional social worker a type of training that includes information and experience of the work done by voluntary workers, because in this country so great a part of the auxiliary social service work is done on a voluntary basis.

Anyone in social work to-day realises that a knowledge of legislation and an understanding of day-to-day machinery, both of central and local government, are essential in the job, whether the worker be a professional or a volunteer. There could be no doubt whatsoever that this statement could be checked by asking those who are at the receiving end of the social services whether experience in handling and the knowledge which comes with handling are of paramount importance. This stock in trade can be learned, I contend, in the school of life, even better than from textbooks, and I would suggest for your Lordships' consideration something which would be completely new in the field of social service but which, through its careful planning and ultimate structure, could be yet another lead from this country to the world.

If knowledge and experience can qualify a young entrant into this field, why should not someone who has worked for many years, and is prepared to face a special test by a panel of examiners, call upon her experience and knowledge to satisfy the examiners as to her competence to hold a diploma, too? Should not an apprenticeship served in the maelstrom of helping human beings count in the nature of a credit towards a qualification? Is it right that man-made laws should endow with a special virtue a young thing, with a period of book learning and a time of field work, yet exclude another Who has spent years of his or her life in this same sphere, and has achieved in a far harder school, at greater expense to herself, those things that should count as credits towards the (ultimate? My suggestion is that a woman, widowed or in similar circumstances, could, having given a certain set number of years of consecutive work, be entitled to be examined and tested; and that, if such a test showed that her knowledge of theory and practice came up to that set in the papers for the social service worker, she should receive a diploma or certificate and rank as a professional.

I suggest this because in the field of social service there are many people who, for one reason or another, have not qualified originally and have worked in the field of social service for a variety of reasons. It may be that they are doctors' wives, or parsons' wives; or it may be that they are interested in one particular line of work but have not been able to leave home. They have worked hard, and in due course have suddenly needed to acquire professional status, often to earn their living. If such people were precluded from joining the ranks of the professionals it would be a great loss to the nation, because they would have to leave the field of social service. If my suggestions were carried to their logical conclusion it would mean that the number of professional social workers in the country would be strengthened in practical ways and that the establishing of late entrants would be a new and sensible way of using the skills and abilities generated through long years of service to the community.

7.50 p.m.

LORD NEWTON

My Lords, I was very surprised to hear the noble Earl, Lord Iddesleigh, say that he never remembered in a great many years of service in your Lordships' House a Bill being so severely criticised as this one. I find it very hard to understand how he thinks that. Indeed, I should have thought the criticisms earlier this afternoon to which the Transport Bill was subjected were rather more severe than the criticisms your Lordships have addressed to me this evening. From the speeches to which I have listened I am happy to believe that your Lordships will give this Bill a Second Reading this evening.

What I found particularly instructive and interesting about the comments your Lordships have made—and I recognise that all of your Lordships who have spoken are great experts in this field-was that really many of them were not so much criticisms of the Bill, although of course there were criticisms of omissions in the Bill, as divergent opinions about the nature of social work and "what it takes", if I may use a colloquialism. None of your Lordships took up what I might call extreme positions on this, but I recognise that there can be two extreme schools of thought. For instance, on the one hand it can be claimed that social work is so specialised that the training of the social workers must be dominated by the professional interests, and to hang with their employers the local authorities! On the other hand it can be argued that social work is not an esoteric profession, or at any rate ought not to be, and that experience of life is as valuable as theoretical training. As I say, none of your Lordships has taken up an extreme position, but I noticed divergent views upon this fundamental question of what the nature of social work really is.

As I listened, particularly to the speech of the noble Baroness, Lady Swanborough, I was driven to ask myself this question: am I—a person who was an MP. for nine years and dealt with thousands of personal problems of constituents, including advising husbands on how to cope with their recalcitrant wives and vice versa—am I or am I not capable of being a social worker without two years' training in a college of further education? Your Lordships have not collectively given me an answer to that question. I have some faint hope that the noble Baroness, Lady Swanborough, might say, "Yes"; she shakes her head; then I am quite certain that none of your Lordships would say anything but, "No".

However that may be, the real point is that we want more health visitors and social workers, and they must be capable of doing their jobs. The Government have been advised by two expert bodies on how to set about attaining this objective. This Bill is the result. It is designed to meet the interests of all concerned, the professions and what the noble Baroness, Lady Swanborough, called the consumers; and I take it that she would mean that the consumers are both the patients, if I may call them that, and also of course the employers, the local authorities. So much for the general principles underlying the Bill.

I should like to come now to the main points which have been raised in this debate. The first was the question of the chairmanship of the Councils. The noble Baroness, Lady Summerskill (and perhaps I should say she told me she would not be able to stay for the end of this debate), felt that there ought to be separate chairmen of the two Councils and she also said that in any case there should not be a male chairman. I think perhaps she was forgetting that among social workers the distribution between the sexes is fairly even. On the other hand, the noble Lord, Lord Amulree, even went so far as to suggest that perhaps there ought not to be two Councils and one chairman but one Council for both health visitors and social workers. That shows how there can be divergence of expert opinion on these matters.

I explained in my opening speech why the Government think it is right that the two Councils should have some members in common and that there should be one chairman, and I do not think I need say very much more about that. The arrangement provided for in this Bill seems to me to be a compromise between the two points of view of the noble Baroness, Lady Summerskill, on the one hand, and of the noble Lord, Lord Amulree, on the other.

My noble friend Lady Elliot of Harwood, in her very interesting speech, raised, among other things, the question as to whether or not the estimated cost of expenditure by the Councils, which is put at £50,000 a year, was adequate; and she suggested that it was not. I would emphasise that this figure is just an estimate and we shall have to see how the thing works out when the Councils have been set up and start work. But the position is, that the balance of their expenditure—that is to say, the balance when regard has been taken of any income they have made—shall be met by the Exchequer, whatever it amounts to. That seems to me to be fair enough.

I come now to the question of grants to students. Many of your Lordships argued, and with great force, that they ought somehow to be paid from the centre. There is no dispute between any of us about the desirability of suitable candidates getting adequate grants. Perhaps I should first say something briefly about the position of health visitor students, because they were referred to particularly by the noble Baroness, Lady Summerskill. Most of them are sponsored by local health authorities at a salary varying from full salary to around three-quarters of the salary, and most have a contract to serve the authority for varying periods up to two years.

The noble Baroness, Lady Summer-skill, disliked this system and she mentioned specifically that she knew of two cases of students who had completed their training as health visitors and were required to compensate their local health authorities because they ceased to work for them. These matters were raised in another place on the Committee stage and my honourable friend the Parliamentary Secretary undertook to look into the question of these contracts of service and to discuss the matter with the authorities concerned and to give appropriate advice. Since then, information has been sought about the practices of local health authorities and the results are now being studied, and that includes the two cases specifically mentioned by Lady Summerskill.

I now turn to the position of social worker students, and, as I said just now, there is no dispute between us about the desirability of suitable candidates getting adequate grants. But the question is where the grants are to come from. It is the view of Her Majesty's Government, as it has always been, that the arrangements for giving these grants should fit in with the general pattern of grants for further education, because one cannot get away from the fact that training to be a social worker is a form of further education and there is prima facie every reason why this, like other branches of further education, should be treated in the same way and why the local authorities should exercise their responsibility in respect of students on these courses as on other courses.

Several of your Lordships mentioned exceptions to this rule: the case of youth leaders, those being trained to undertake child care and those being trained to go into the probation service. So far as youth leaders are concerned, the arrangement there is for a Ministry of Education grant for a limited period of five years, and for one course which is run at the Leicester College of Youth Leadership which is provided by the Ministry of Education. So far as the Home Office grants for child care are concerned, these were instituted as a result of the Curtis Report, which called for emergency action; and so far as training for probation work is concerned, the probation service is run by probation committees, which consist of magistrates, and not local authorities, and my right honourable friend the Home Secretary is in fact the probation authority for the Metropolitan magistrates' courts area. Whether you take the view that those are special cases, or whether you take the view that they are not special cases but rather anomalous, they are at any rate exceptions to the general rule that financing students for further education is the responsibility of the local authorities, and in the view of Her Majesty's Government there is no case at all for saying that student social workers should be treated as an exception.

There is no doubt that the local authorities are alive to the need for developing the community care services with trained staff. There was a good response to the pioneer courses. My noble friend Lord Feversham instanced as one reason why he disliked the prospect of grants being paid by the local authorities that they would be saying to themselves "What are our priorities to be in our budgets?" I should like to say to my noble friend that even Ministers of Health and Chancellors of the Exchequer ask themselves what the priorities are to be in their budgets. So that did not really seem to me to be a particularly strong argument.

THE EARL OF FEVERSHAM

My Lords, if I may interrupt my noble friend, may I say that the has misunderstood my intention. It was that, quite clearly, the well-established committees of any local authority are more likely to persuade a council of that authority to give them a larger share of the block grant than the committee of a new service; and it is the new service which wants particular stimulation when it comes at the present time.

LORD NEWTON

I listened to my noble friend, but if I misunderstood him I apologise. Let us look at it like this. I realise that all your Lordships who have stayed to the end of this debate are enthusiasts about social work. There are enthusiasts also for all the other forms of further education which it is the duty of local authorities to finance. I think we should leave it like this: that the position will be closely watched, as my right honourable friend the Minister of Health has said that it will be, and that my right honourable friend the Minister of Education is ready to take up with local education authorities individual cases of difficulty, and is also ready to issue guidance to local education authorities on further education grants for both health visitors and social workers. I should also like to remind your Lordships that in another place my right honourable friend the Minister of Health said that there are many ways in which pressure can be brought to bear upon local authorities that do not discharge adequately the duties which are placed upon them by Statute.

BARONESS ELLIOT OF HARWOOD

My Lords, I wonder whether I might just say one word about the emergency aspect, because 5,700 people are required to make this service really effective. That is a great many people, and, as the noble Baroness, Lady Summerskill, said, competition at the moment for people in all professions is so great that unless the Minister of Health really puts his back into this effort and works hard for it, we shall not get the 5,700 people.

LORD NEWTON

My Lords, I do not understand why my noble friend imagines that it is only my right honourable friend the Minister of Health and herself, and people who think like them, who are conscious of what she is calling an emergency. The local authorities are the employers of these people when they are trained. They are what the noble Baroness, Lady Swanborough, called "the consumers." I should have thought they were in a position to recognise the situation as well as anybody.

BARONESS SWANBOROUGH

My Lords, I may have been foolish, but when I said "the consumers" I meant the patient, the receiver of the social service workers' efforts, and not the local authority.

LORD NEWTON

My Lords, I recognise that. But it seems to me that the local authorities, who are the employers, are also the consumers of the services of these people when they have been trained. But I do not want to make overmuch of that.

My noble friend Lord Feversham asked me why expenditure on social work training cannot be pooled, in the same way as local health expenditure on health visitor training is pooled. I should like to attempt to give him the answer to that. It is a fairly complicated one. The position is that employing authorities incur substantial expenses in seconding nurses for health visitor training, because this is the normal entry into the profession. Also, some of these same authorities are themselves incurring expense in providing the training courses. This is pooled. Social workers, on the other hand, will be largely recruited after having been fully 'trained. The employing authority will not have to pay secondment costs for all recruits; nor will the local health and welfare authorities provide the courses. These will be run by the local education authorities as part of their normal further education activities. The expense of seconding existing staffs is not, in the view of Her Majesty's Government, such as to warrant a pooling arrangement.

The other matter of some substance which was raised in the debate by the two noble Baronesses, Lady Summer-skill and Lady Elliot of Harwood, was the question of professional representation on (the councils. The Jameson Report recommended that the professional and educational interests—that is to say, the health visitor organisations, the training centres and the universities—should together be in a slight majority. This kind of majority is provided on both the Councils, and I shall try to explain how that works out. The Council for the Training of Health Visitors has 31 members besides the chairman. Of the professional and educational interests, 8 are to be appointed after consultation with health visitor organisations, 6 after consultation with universities and other training bodies, and 2 after consultation with the General Nursing Councils. This makes 16. Of the interests other than professional and educational, 10 are to be local authority members and 3 are to be medical members. This makes 13. Of the unidentified members of this council, there will be one Northern Ireland member and one member to be appointed by the Health Ministers without consultation. These add up to 2. So, even if it turns out that neither unidentified member belongs to the educational or professional group, that group will still have a slight majority, one, over the remainder—that is to say, 16 as against 15.

The Council for Training in Social Work has 32 members besides the chairman. Of the professional and educational interests, 10 are to be appointed after consultation with social work organisations, and 7 after consultation with universities and other training bodies. This makes 17. Of the interests other than professional and educational, there are to be 10 local authority members and 2 medical members. This makes 12. Of the unidentified members, there are to be 1 Northern Ireland member and 2 members appointed by the Health Ministers, without consultation. That makes 3. Here also, even if it turns out that no unidentified member belongs to an educational or professional group, that group will nevertheless have a slight majority over the remainder—seventeen as against fifteen.

My noble friend Lady Elliot of Harwood made certain recommendations about the bodies that she thought ought to be consulted. I think she even suggested that certain bodies ought to be specifically written into the Bill as being entitled to have members on the Councils. I do not think I can do more than say that her observations have been noted by me, and no doubt will be noted by my right honourable friend. But I suggest that it would not be right to tie my right honourable friend's hands too tightly in this matter.

There are two other "mall points to which I think I ought to reply before I sit down. The noble Baroness, Lady Summerskill, complained that candidates aged twenty or thirty have no call on the local education authority for grant. That, however, is not the case. There is no age bar, and the local education authorities can make their grants to candidates of any age, provided that they are resident in their area. Then my noble friend Lady Elliot of Harwood complained, I think, that no courses for training in social work had been started in the universities. There are the pioneer courses which my right honourable friends, the Ministers for Health and Education, promoted in advance of this Bill and in advance of the setting up of the Training Councils. Apart from this, I do not think it unreasonable that the Government should have followed the recommendation of the Younghusband Report that the two-year general training in social work should be given outside the universities, mainly in colleges of further education.

My Lords, I hope that I have answered the speeches reasonably adequately. I do not expect to have satisfied your Lordships completely, but at any rate I hope you will feel that I have dealt sufficiently with your comments. I trust that you will now feel able to give the Bill a Second Reading.

LORD HENDERSON

My Lords, may I say just a word, before the Question is put, I did not interrupt the noble Lord when he was speaking, but he did take up the comment of my noble friend Lady Summerskill, about there being two chairmen, instead of one, for the two Councils. He cited the noble Lord, Lord Amulree, as seeking one Council, and he seemed to brush aside the suggestion made by my noble friend on that basis. He forgot to mention that the noble Baroness, Lady Elliot of Harwood, also supported Lady Summerskill in that suggestion. My noble friend went one stage further. Having asked for two separate Chairmen, she then made the point about these being women's organisations, and said it was curious that they should always have male Chairmen. I should have thought that the suggestion made by Lady Summerskill would have enabled there to be one male Chairman and at least one female Chairman. I hope that the noble Lord will bear that in mind when this debate is over.

LORD NEWTON

Perhaps, with your Lordships' leave, I may reply to the noble Lord, Lord Henderson. I did not, of course, seek to suggest that the solution propounded by the Government was the right one, because Lady Summerskill was on one side of the scales and the noble Lord, Lord Amulree, was on the other. I recognise that the point was also made by Lady Elliot of Harwood. The reason why I cited both Lady Sum-merskill and Lord Amulree was in order to show that there are divergent expert opinions on this matter. I did not go into it further, because I hope I explained with reasonable care in my introductory remarks why the Government have put into the Bill the provisions they have.

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

House adjourned at sixteen minutes past eight o'clock.