NURSES, MIDWIVES AND HEALTH VISITORS BILL (Hansard, 2 April 1979)

§ Lord WELLS-PESTELL
My Lords, I beg to move that this Bill be now read a third time.

§ Lord WELLS-PESTELL
My Lords, I beg to move that this Bill do now pass.

§ Baroness YOUNG
My Lords, I do not think it would be right to let the Bill pass without making one or two comments about the particular circumstances in which we find ourselves today. This Bill 1727 is not a party political Bill in any sense. But it is one which has raised very real issues of principle between different medical organisations, the nurses, the midwives and the health visitors. I think it only right to tell the House that today I have received no fewer than two telephone calls and three telegrams expressing concern about Clause 4 of this Bill and the way that the midwives are being treated.
One of the telephone calls was from Miss Dent of the Royal College of Midwives, who is still very concerned about the scope of Clause 4. We did discuss this matter both in Committee and on Report, and the noble Lord, Lord Wells-Pestell, has been good enough to write me a further long letter about the provisions of Clause 4. I am glad to be able to confirm to the House and to put on the record that it is a fact that the council will be required to consult the midwifery committee on any proposal which affects midwifery education. This was a matter on which I was not quite clear on Report, and I am glad to have it on the record that that is the meaning of Clause 4.
The difficulty in which I find myself, and one which I think is shared by the midwives' profession, is that, since Clause 4 was originally added to the Bill in another place and amended on Report, this House has added Clause 8 with regard to health visitors. Clause 8 is worded somewhat differently to Clause 4. If we look at Clause 8(3), it is clear that the council shall not act on any such matters before receiving a recommendation of the joint committee. It therefore makes a much stronger claim for the joint committee than for the midwifery committee, which, under Clause 4(2), the council must consult, but of course the council does not have to act upon the consultations.
The noble Lord, Lord Wells-Pestell, has been good enough to explain the reason for this difference: it is that the committees are different in that the health visitors committee's position is unique as a first committee, and it is quite clear that its parent bodies have to wait for its advice, whereas the position of the midwifery committee is that it is a separate committee; the council will consult it but it does not have to take its advice, except in the case of its own practice, which is set out in 1728 Clause 3, under which the midwifery committee has the right to make or amend its rules. I do see that there is this difference.
It is to me personally a matter of regret that there is still some unhappiness on this point. We are too late in the proceedings to be able to put this right. I have made this statement in some detail this afternoon because I know that the noble Lord, Lord Wells-Pestell, is himself concerned about this. I feel it right to express my own concern about this unresolved matter, and I should like to hope that in the subsequent carrying out of this Bill these very real fears may at least be met in some administrative way. This is not, it seems to me, a party political matter in any sense. I think the difficulty arises that if more powers are given to the nurses and health visitors the midwives feel disturbed, and the same applies the other way round. It is very much a balance of powers between the three groups of people. As they are all so important to our national life and as their education is so important, it does seem to me somewhat unfortunate that one party to this Bill is not completely happy about its terms.
As I say, I believe that at this stage it is too late to do anything. I and my colleagues regret that we are in the position of not having the time to go into this matter as thoroughly as we should have liked. We accept, with our colleagues in another place, that it would be wrong to hold up this Bill which the nurses and the other professions clearly would like, and on balance we feel that it is better to let the Bill go on to the statute book even in its present state than to seek to amend it further. If the noble Lord feels that he can say anything on this point about the midwives, I think it would be helpful to have it on the record so that they may have the opportunity to study the record and see the interpretation the Government puts on this matter.

§ Lord WELLS-PESTELL
My Lords, I am very grateful to the noble Baroness, Lady Young. We were concerned, as she knows only too well, to see whether there was anything in the point that she made at the last stage of this Bill. As the noble Baroness quite rightly says, I did take advice on this. A very long discussion took place and it resulted in a further letter to the noble Baroness. I 1729 have had an opportunity over the weekend of looking at that letter. I do not really think there is anything between us at all. I am quite sure in my own mind that this arises as a result of a certain misunderstanding on the part of the midwives.
It is very often not appreciated by people outside Parliament that you can give committees of various bodies certain powers and authority without necessarily having to use the same phraseology. For example, if we look at the top of page 3 of the Bill, under Clause 3 we see the words: The Council shall consult the Finance Committee on all financial matters", and there it is left, simply because "consult" can mean only one thing; it means consultation. It is perfectly true that, in the last analysis, the Central Council is the supreme body, but the Central Council must be the supreme body. I should like to make the point clear. As I have said, I have explained to the noble Baroness that, although she was quite right that the particular provision then under discussion, namely, Clause 4(3), did not relate to midwifery practice—and she accepted that—all other matters affecting midwives were covered elsewhere. The noble Baroness conceded that that was so.
Clause 4(2) requires the council to consult the midwifery committee on: all matters relating to midwifery". I do not think that there can be anything more embracing than that. I repeat that it says: all matters relating to midwifery". Thus the committee will certainly be able to play its part in the formation of policy in respect not only of midwifery practice, but of matters of midwifery education and training. As I have said, we use the word "consult" in the Bill to mean precisely that, bearing in mind that in the last analysis the council is the supreme authority. With that explanation, I beg to move that the Bill do now pass.