§ Lord MolloyMy 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 they will make a statement about alleged poaching of National Health Service nurses by private institutions.
§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Elton)No, my Lords, we are not aware that any does take place.
§ Lord MolloyMy Lords, is the noble Lord aware that those who represent the interests of nurses, like the Confederation of Health Service Employees and the Royal College of Nursing, are aware that this is an example of frustration for British nurses? It is confirmed by advertisements in the Nursing Times. There are pages of advertisements from overseas organisations offering jobs to British nurses to leave this country and give their services elsewhere in the world. Would the noble Lord please be prepared to consider his reply and examine what I have said?
§ Lord EltonMy Lords, nurses are free to seek employment wherever they choose. Being the major employer of nursing staff, the National Health Service is bound to lose some qualified staff to posts abroad. The department does not collect information on the number of nurses who leave the National Health Service to seek employment abroad. However, the General Nursing Council for England and Wales provide details of the number of nurses who apply for verification of their qualifications to be sent to a registered authority in another country. There were 4,523 of these in the year to March 1981. They do not of course include nurses taking up employment in a country which does not require verification of qualifications.
§ Lord Boyd-CarpenterMy Lords, is it not an appropriate tribute to the standard of British nurses that they should be so much in demand abroad? Is it not also slightly offensive to them to suggest that they can be poached like pheasants?
§ Lord EltonMy Lords, whether the term is culinary or sporting, the Government remain of the opinion that the standards are indeed high and welcome the fact that the private sector is beginning to contribute to this.
§ Lord Wells-PestellMy Lords, is it not true that the conditions of employment and the facilities—and sometimes better pay—tend to attract nurses from the National Health Service into private medicine? Is not the solution to get the private hospitals to run, and pay for, their own nurse training?
§ Lord EltonIndeed, my Lords, the Government think that still more can be done in the way of involving the private sector in the training of nurses, though in fact a good deal is being done. It is not our impression that the standards of remuneration and conditions of service are so very much better in the generality in the private sector than they are in the National Health Service.
§ Lord WigoderMy Lords, are there not at the moment something over 200,000 qualified nurses employed in the state sector and a mere 6,000 in the private sector? Is not the total number of nurses in all parts of the country at the moment desperately seeking work in excess of 15,000?
§ Lord EltonMy Lords, the private sector is a very small part of the health services. The level of trained nursing unemployment is below 1 per cent. of the whole.
§ The Earl of OnslowMy Lords, is it not rather odd to think that the party opposite are encouraging private education in nursing; and, secondly, is it not interesting that they do not complain when state-educated engineers work in the private sector? Are they honestly expecting that they all have to work in the state sector?
§ Lord EltonMy Lords, the study of the parties opposite is a matter of continuing fascination to me, but I would not seek to explain it to my noble friend.
Lord Wallace of CoslanyMy Lords, is the noble Lord aware that I would readily agree with him that it is not possible to stop nurses applying for a job wherever they want to go? Secondly, does he not agree that the high standard of nursing in Britain is entirely due to the state system of nurse training paid for by public money? Therefore, under those circumstances, would he not agree with me—I mentioned this in the recent debate—that so far as the private sector in Britain is concerned they should at least pay some token sum towards the training incurred at the expense of the British taxpayer?
§ Lord EltonMy Lords, I said that such a scheme had not passed beyond the possibility of being considered. The noble Lord will be aware that, for instance, at the Royal Masonic Hospital there is the training of both state registered and state enrolled nurses, and at St. Andrew's Psychiatric Hospital there is training of registered mental nurses, so the private sector is not doing nothing. I hope, as does the noble Lord, that it will do more.
§ Baroness TrumpingtonMy Lords, am I right in saying that if nurses by their free will choose to work in private institutions they will not get pensions, whereas those who work in the health service do get pensions? So what one loses on the swings may be gained on the roundabouts.
§ Lord EltonMy Lords, the question of pensions in the private sector varies from institution to institution.
§ Lord BrockwayMy Lords, arising from the Minister's answers, would he not agree that the deprivation of nurses in the National Health Service is due to the fact that because of their lower scale of wages they are attracted to three other spheres: not only overseas and the private hospitals but to the nursing agencies? The National Health Service has to pay higher wages to nurses from the nursing agencies than it does to its own staff at the cost of its revenue.
§ Lord EltonMy Lords, as I said earlier, the question of the conditions of service and remuneration of nurses in the private sector is very much a matter for them, but I understand that many independent sector establishments and organisations base their pay scales on Whitley rates and that in a large number of cases no additional financial payments are made. Indeed, the annual salary received by a qualified nurse in the independent sector can be less than she would receive in the National Health Service. Comparisons such as this are difficult to make because of the other terms and conditions of service which might be involved.
§ Lord MishconMy Lords, would the Government care to take a leaf from the Metropolitan Police and print the percentage of coloured people among the serving nursing profession?
§ Lord EltonMy Lords, I think that by any stretch of the imagination that is another question.
§ Lord KinnairdMy Lords, from the nurses' point of view—because this is a Question about nurses—might I ask the Minister whether it is not possible that some nurses might prefer to work for private institutions?
§ Lord EltonMy Lords, we return to the point at which we started—that the nurses have freedom to work where they wish to do so.
§ Lord MolloyMy Lords, is the noble Lord aware that the point of raising this Question in the beginning was the grave apprehension experienced by those who represent British nurses? Because, as the noble Lord, Lord Boyd-Carpenter, quite rightly said, the British nurse, male or female, is held in high regard throughout the world, therefore, that must mean that their standard of training, whether for SEN, state registered nurse or state certified midwife, reflects a great deal of credit on those who train them in the National Health Service and—
§ Lord MolloyMy Lords, is the noble Lord aware that there is a strong feeling that poaching is going on by people from foreign nations? Would he not at least be prepared to consider perhaps talking to the representatives of our nurses, the Royal College of Nursing and the Confederation of Health Service Employees—
§ Lord Molloy—so as to understand what the problem is and how it affects the National Health Service?
§ Lord EltonMy Lords, if I can give a brief reply to that rather long question, the Government always have the interests of nurses very close to them and wish to be well informed as to what those interests are.