HL Deb 26 May 1977 vol 383 cc1417-20

11.6 a.m.


My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

The Question was as follows:

To ask Her Majesty's Government whether the present priorities of staffing in the National Health Service are meeting the needs of the patient.


My Lords, the Government outlined their priorities (including those for staffing) for the development of the National Health Service in the Consultative Document, Priorities for Health and Personal Social Services in England, issued last year. My right honourable friend the Secretary of State for Social Services is considering publishing revised policy guidance later this year, taking account of comments he has received on the priorities document and other relevant factors, and this will also cover the question of staffing priorities. In addition, my right honourable friend has already asked Health Authorities to reduce their expenditure on management costs by 5 per cent. over the next three years. Subject to this reduction, the Government believe that, given the financial constraints under which the National Health Service is necessarily working, the current overall balance of staffing broadly meets patients' needs. It must, however, be emphasised that the Health Authorities themselves are responsible for determining how to apply locally the general guidance on standards and priorities issued by the Government from time to time.


My Lords, I thank the Minister for that most helpful reply. However, may I draw the attention of his right honourable friend to the very deep distress, worry and concern expressed by the nurses? Between 1972 and 1976, the increase in administrative staff, excluding record keepers and secretaries—who are most important— was 2,144, whereas the drop in the number of nurses trained was 6,511, so that there was an increase of administrative staff and a decrease in the numbers of nurses in training. At their congress in Bournemouth last summer, the nurses called for a review of the number of nurses in training, stating that they were not giving the care that they should and that, particularly in the North—


My Lords, before the noble Baroness goes any further, I must ask her to make her question a short one, and not to read.


I apologise, my Lords. Will the noble Lord bring to the Minister's notice the very real feelings that exist about the nurses, and the fact that the nurses themselves feel that they are not giving a service because of their numbers?


My Lords, two points emerge; the Government are conscious of both. First, I would remind the noble Baroness when she complains about the increase in administrative costs, that this is what we said some years ago would happen when the National Health Service was reorganised. It has happened. We have given guidance to the local health authorities to cut down in this particular field.

With regard to the nurses, we are not unmindful of their views in this matter but, despite what the noble Baroness has said, the fact remains that the nursing strength at the moment broadly meets the needs of patients throughout the country. I do not want to take up your Lordships' time by giving a lot of figures.


My Lords, it is very disconcerting to read of the number of beds in certain hospitals that are not occupied and of certain sections of hospitals that are, according to reports, closed because of the absence of nursing staff. Does the noble Lord not agree that that seems to add some point to my noble friend's Question?


My Lords, the noble Lord must take into account the fact that the Government have encouraged health authorities to rationalise. Instead of having a number of wards with spare beds and a complete group of nurses operating in each ward, the tendency has been to intensify care so that a certain number of wards are kept continuously fully occupied. That means that we can use fewer nurses, but it also means that there are one or two wards where the beds are not occupied because of the rationalisation programme.


My Lords, I take a little comfort from some of the things that the noble Lord, Lord Wells-Pestell, has said, but may I ask two quite simple and, I hope, short questions? First, did I gather from the Minister's remarks that the Government consider that the National Health Service Reorganisation Act was a disaster and, secondly, whether the answer to that be "yes", "no" or "perhaps", when are we to have the report of the Royal Commission on the National Health Service?


My Lords, I do not like to use emotive terms and I am not prepared to say that the reorganisation of the National Health Service was a disaster. What I am saying is that it created certain difficulties which we felt would have been better not created. With regard to the Royal Commission report, I am not able to give your Lordships any indication as to when that may be expected.


My Lords, in considering all these very important questions relating to nursing, how is the noble Lord getting on with all the recommendations made to the inquiry by the Royal College of Nurses? These are very important to nurses, and I should like to know how this matter is getting along.


My Lords, I think the answer is that we shall have to wait until we get the report.


My Lords, does not the length of these exchanges show that we need a debate about the subject?


My Lords, I say to the noble and learned Lord that no doubt that could be arranged through the usual channels, if Members of your Lordships' House felt strongly enough about the matter.


My Lords, while recognising the splendid service of the nurses in most wards—and perhaps I should declare an interest because I may be involved in 20 years' time—is it not a fact that in certain wards, such as geriatric wards, there is a shortage of nurses?


My Lords, there are certain shortages; that we have not denied. What we are saying is that we are hoping that, as a result of our replanning and rationalisation of the use of wards and services, we should be better able in the future to meet these pockets of difficulty. I take some comfort from the fact that the right honourable gentleman, Mr. Patrick Jenkin, when speaking to the American Pharmaceutical Association in New York last week, and as reported in the Daily Telegraph on Tuesday, 17th May, made it clear that he did not side with the view expressed in several submissions to the Royal Commission on the National Health Service, that nationalised health did not work and that Britain should abandon or radically modify it. We share that opinion.


My Lords, is the noble Lord aware that recently there has been an increase in deaths among babies in this country? Is he further aware that a very senior doctor at one of our main hospitals has attributed this in part—or mainly—to the shortage of nurses?


My Lords, I do not think that that is borne out by fact. I have myself replied to, I think. two Questions on this matter in your Lordships' House in the past 18 months, and my recollection is that what the noble Baroness says is not borne out by fact.

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