§ 5.48 p.m.
§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Glenarthur) rose to move, That the draft order laid before the House on 22nd June be approved.
§ The noble Lord said: My Lords, this order is about the training and employment of men as midwives. It is one of two orders which will lift the present restrictions on training and employment of men as midwives. The other order follows the negative resolution procedure, but I shall speak more of that later.
§ The background is that before 1975, men were barred from the midwifery profession. A midwife was defined as a woman certified under the Midwives Act. The Sex Discrimination Bill in 1974 led the Government to look closely at all areas of employment where some form of discrimination existed. One such area was that of midwifery practice, and the Government sought the views of the statutory and professional bodies concerned with midwifery.
§ The views expressed at that time were that male midwives would not be readily acceptable. The Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists were against the admission of men and the British Medical Association and the Royal College of Nursing had reservations about midwifery for men. In particular, the college said that women should be able to choose the sex of their midwives, and that male midwives would have to be chaperoned.
§ The outcome of this was that the 1975 Sex Discrimination Act, which amended the 1951 Midwives Act, allowed men to enter the profession subject to certain transitional provisions. These were that, until a day specified by order, the training and practice should be restricted to only those centres approved by the Secretary of State. The second order which I have mentioned—the Sex Discrimination (Midwives) (Specified Date) Order—will specify the date when it is proposed that the transitional provisions should end. The Sex Discrimination Act also provided, in Section 20, that the provisions of the Act concerning discrimination in the field of employment and training did not apply to midwives. The order under debate has the effect of ending this on 1st September this year.
§ The background to removing the present restriction is that following the 1975 Act two centres were approved for male midwifery training. In order to be able to assess future developments, these experimental courses were closely monitored and an assessment was made to find out how acceptable male midwives were.
§ The report of the assessment of the two centres was published by my Department in 1982. This concluded that male midwives were generally acceptable. It was however found that certain women preferred to be cared for by female midwives and students, and also 1588 that some women did not wish intimate nursing procedures to be carried out by a male midwife. The report showed chaperoning not to be a major problem; and on competence and practical work, male students were found to be as good as female students.
§ In view of these findings the Government decided to consult widely on the report, and those consulted were asked in particular to express views on the possibility of lifting the present restrictions on training and employment of men as midwives. This consultation showed a broad consensus of opinion in favour of lifting the restrictions, although this was again qualified by the two major considerations which had been expressed by the Royal College of Nursing in 1974. These were that women should be able to choose to be attended by a female midwife if they so wish, and that provision should be made for men training or employed as midwives to be chaperoned as necessary.
§ As a result of this consultation the Government concluded that they should proceed to amend the 1975 Act to allow men to train and practise as midwives on equal terms with women. In addition to agreeing to the preparation of the two orders, the Government agreed that provisions must also be made for women to opt to be attended by a female midwife, and for chaperons to be provided as necessary. Health departments are therefore preparing guidance to health authorities, in conjunction with the orders, to ensure that these safeguards are met. The Equal Opportunities Commission were consulted before the orders were presented to the House. The commission welcome the effect of the orders.
§ I should finally mention one slight problem that has arisen over the proposed legislative changes in respect of male midwives. It does not affect the order that we have under discussion today, but rather the other order—the Sex Discrimination (Midwives) (Specified Date) Order—which it was proposed should be made in conjunction with the amendment of the Section 20 Order to come into operation on 1st September. The specified date order followed the negative resolution procedure, but because of the date of the Recess it cannot lie for the required statutory 40 days; and it therefore cannot be made.
§ However, health authorities will not be debarred from training men or offering employment to a male midwife after 1st September. This will be achieved by using the Secretary' of State's powers under Schedule 4 of the 1975 Act to approve any place which wishes to train or employ male midwives. By these administrative means the Government will put into effect their commitment to introduce the new arrangements on 1st September. The specified date order will be laid again in the autumn to come into operation on 1st January 1984.
§ My Lords, with that explanation, I beg to move.
§ Moved, That the draft order laid before the House on 22nd June 1983 be approved.—(Lord Glenarthur.)
§ Baroness Jeger
My Lords, we appreciate the clear way in which the Minister has dealt with this rather difficult problem and we are roughly in agreement with what he has said. However, I must ask him if he can assure the House that, when he savs that women 1589 will be given a choice, that will be a choice in reality. It seems to me that, if a male midwife happens to be on duty and a female midwife is off duty, the choice will be very unreal for the woman concerned. There may well be circumstances in which pressure will be put on women to the effect that they are being unco-operative in insisting on what the Minister has said is their right.
So I suggest that the practical answer here would be that these schemes should be concentrated in the larger hospitals where there is likely to be a selection of midwives on duty so that if a woman insists on having a woman midwife, the chances of that request being met will be greater than in a small hospital where there may only be a couple of midwives each taking turn and turn about. Those are my main hesitations. I would be glad if the Minister would confirm that in his communications with health authorities he will make it a paramount condition that those rights which he has spelled out in theory will be put into practice.
§ Lord Skelmersdale
My Lords, with great respect it is normal for the Minister to answer the first speeches from the Opposition Front Benches before other noble Lords—
§ Baroness Phillips
Forgive me, my Lords, but I have been in the House quite a while and I do not think that that is correct when we are debating a Motion.
§ Lord Skelmersdale
My Lords, I apologise to the noble Baroness; she is absolutely correct. I was getting confused with the Statements which we dealt with earlier.
§ Baroness Phillips
Thank you, my Lords. Having established that right, I will go on to the next one. I wanted to ask the Minister a question with reference to the chaperon. We went all through this dreary business a long time ago and I thought we had cleared it, but apparently we have not done so and we are now going to rescind various things that were dealt with in great depth a long time ago. I cannot really think that the people whom the Government consulted were very different from the women that we talked to all that time ago.
What is the nature of the chaperon? Is it another nurse? Is it another midwife? Is it a sister? Is it her husband? We are not merely talking about midwives in hospitals. Midwives go out into the rural areas. As I recall, the chaperon was one of the greatest stumbling blocks when we debated this previously. If the Government are going to spend double the money in order to have a minder, in order to have two people present, it is not quite in keeping with their policies in relation to some other aspects of the National Health Service. I should like to know the nature of the status of the chaperon.
§ Lord Somers
My Lords, before the noble Lord replies, I should just like to raise one point. The noble Lord says that there has been general agreement that this would be a desirable change. I wonder whether 1590 that general agreement has been that of women, because they are the people who are chiefly concerned.
§ Lord Glenarthur
My Lords, I am grateful for the comments of the noble Baroness, Lady Jeger, and the noble Baroness, Lady Phillips. As regards the choice in reality, which was referred to by the noble Baroness, Lady Jeger, I can confirm that will be a choice in reality. I have every confidence that health authorities will act responsibly about this very important matter of choice.
The guidance being prepared by health departments will instruct health authorities to ensure that women are able to choose to be attended by a female midwife if they so wish. The fact remains that there are not very many people involved with it at the moment. Of the 28 who qualified at the two midwifery centres to which I referred in my opening remarks, only two male midwives are practising in the country at present. Therefore I do not think that the situation is quite as serious as the noble Baroness made out.
The noble Baroness, Lady Phillips, was concerned about chaperonage. I do not really see that the cost problem which she mentioned really is a problem. I do not see chaperonage costing very much at all. There are often many student nurses or other midwives in attendance in hospital wards and delivery rooms and I envisage that the number of occasions when a member of staff has to be assigned specifically to chaperon will be the exception rather than the rule. The costs should, therefore, be minimal and no special provision is being made for them. I hope that that answers the point that was raised.
The noble Lord, Lord Somers, raised a point which I did not quite catch. If he could repeat it I will do my best to answer it.
§ Lord Somers
My Lords, I merely asked whether the general agreement which the noble Lord mentioned on the desirability of this change, was chiefly that of women, not of men.
§ Lord Glenarthur
My Lords, as I understand it, the survey was conducted at the hospitals where male midwives have been practising, and husbands were consulted and found this agreeable.
§ On Question, Motion agreed to.