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Clause 15—(List Of Certain Nurses Not Registered Or Enrolled)

Volume 388: debated on Wednesday 7 April 1943

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I beg to move, in page 10, line 8, to leave out "form and keep a list."

I wonder, Major Milner, whether you would permit this Amendment and the next—in line 10, after "Act," to insert: "cause to be entered on the general register the names "—to be discussed together, as the subject matter is the same.

If the Committee are prepared to agree, I think that would be a convenient course.

This is the most important Amendment I have down to-day. I want to argue it first of all upon its morality. In 1919, under Dr. Addison, as he then was, as Minister of Health, the register was open. Nurses who had passed the prescribed examinations and had attained the qualifications were given a period within which to get on to the register. Some failed to take advantage of the provisions of the Act and never became State registered nurses. One can easily imagine many reasons why that should have happened. In 1919 a large number of nurses were out of the country. Many got married and thought they would never want to take up the profession again. Others found a place in industrial or commercial undertakings. For various reasons many of them came back into the profession and found themselves unable to use the term "State registered nurse," although they possessed all the qualifications. The importance of being on the State register is recognised by everybody who has read the Rushcliffe Committee's Report. I would like the Committee to be satisfied, on the ground of the equity and the justice of the claim, that no one would be injured by a qualified woman being put on the register. I know that the Ministry of Health has taken the line that the register is closed to them and why should the Minister keep on opening it, but in this situation we can afford to be generous. It is easy to argue that you should permit this class of nurse to come on the register.

Next I argue on the ground of expediency. In the Bill there are to be the State register, a supplementary register, a roll and a list. If we can reduce them by one, it will be a good thing. Rubbing that list out would be a good thing, because these people are a dying quantity, and in the process of time they will go out of existence. The list at the moment is nothing more than a device to prevent qualified nurses from losing their title of "nurse." People will only be called "nurse" in certain conditions, and these people would be left out who have not registered unless they were on this list. I am not so sure that getting this type of nurse on the list will not do more harm than good to her and that we are not, by Act of Parliament, proposing to stigmatise her as occupying an inferior position. When you want to appoint a high nursing officer you look at the "Nursing Times" or at any of the nursing papers, where the advertisements always say "State registered nurse." You cannot get these highly qualified women—some of them have specialised in certain departments of nursing—because we have decided that the State registration is the qualification that must be obtained. You have not got too wide a field from which to choose, especially in war-time. There is every reason why you should widen that field.

I suggest that on the grounds of expediency it would be a wise thing to give these nurses a chance to get on to the register. I have looked at this thing from every standpoint. I have argued it with Ministry officials, and I have not yet found a valid argument against it. What I have found is that the General Nursing Council does not like it, that the General Nursing Council is opposed to the reopening of the register. If I appeared to be critical of the General Nursing Council on a previous Amendment, that was due to the fact of the rigid attitude they had adopted in regard to this matter. Some of these nurses went through almost as bad a time in the last war as these nurses are going through now. Many of them did not get on the register through the fact of that war. It would be an act of justice and certainly an act of statesmanship of great help to those who take an interest in this work, and are administering the work, and who want all the help they can get, if the Minister would say, "We are prepared to reopen the register," notwithstanding that formidable body the General Nursing Council. I know how difficult such bodies can be. Having won his way to the extent he has on this Bill up to now, I hope that now, instead of standing up to Parliament, he will stand up to the General Nursing Council and give me my Amendment.

I would like to add a few words to the appeal made to the Minister by my hon. Friend the Member for South Tottenham (Mr. Messer). All my life I have been up against the idea of building a wall around either a profession or a trade. I came across it in my very early days in the building trade, when certain trades made the conditions of entry into that trade so difficult as to make it almost impossible for others to come in, and I remember in those days the horror with which they were viewed by what I was pleased to call at that time people of the upper classes. Every effort was made, and ultimately those efforts succeeded in breaking down that barrier round the trades.

I remember following the last war the same kind of period regarding the time when an application could be made for a pension by those unfortunate fellows who were wounded or had disabilities of one kind or another in the last war. I remember the seven years period after which no application could be made for a pension. Ultimately, because of pressure from outside, as in the other case I have mentioned, that barrier of time was broken down. Here is a profession, and it is not the only profession in regard to which the moment some people get into it their object appears to be to prevent anyone else from coming in. It is bad for the profession and bad for the country. Surely it is not unreasonable to say to the Minister that the only thing that ought to be necessary in this regard is that the person should be qualified. Is it not wrong that a qualified person, because of reasons that have already been given, and which I need not elaborate—many good, cogent reasons—did not at an earlier time obtain registration, are therefore to be barred from registration for the rest of their lives, and are to be barred from the opportunities that may come to them, and which they may need, at some time in the future because of not having a registered title? I appeal to the Minister not to put up this barrier which is sought to be put up in this profession by certain people who have got in and wish to prevent others from coming in. It is not unreasonable to open the profession to qualified people. That is the only thing you need worry about. Are they qualified? If they are, give them permission to come in, with the same opportunities for employment in all the spheres of nursing which those on the register are permitted to apply for to-day.

I wish to support the Amendment. A day or two ago I met in the Lobby two charming nursing sisters, one with a caressing Irish accent which would bring tears to the eyes of the most flinty-hearted Minister or civil servant. They were experienced nurses with the highest possible qualifications, who had served in the last war, and since then had spent many years in India. I understand that they are working for the country now. They said that because when they were very young and thoughtless and admittedly had many happy things to occupy their minds at that time, they omitted to register. It was a mere formality which they did not think of at the time. They feel now that they have been penalised under this Bill and graded below nurses who have no higher qualifications and less experience than they have. One has written me a letter, in which she says:

"This is our grumble. We feel a great injustice will be done to the fully qualified general trained nurse who trained in a recognised training school and through various reasons did not register during the period of grace. After all it was only a technical fault and we feel we ought to be given the opportunity of having our names put on the Register with the same status as those with the same qualifications now on the Register. Many of us served the country well in the last war and are doing the same in this and the Government are needing the skilled nurse, who is always willing to come forward, but we do feel we have been penalised too long for our youthful omission."
The Minister, I am sure, is always willing to listen to an appeal, and I hope he will allow these nurses to be put upon the register. There is no reason why they should not be put on, and nobody is going to suffer an injustice if they are put on. The country wants their help at the present time, and I plead with the Minister to agree to accept the Amendment moved by my hon. Friend.

The hon. Gentleman seems to be under a misapprehension in one or two matters. First of all, if the charming ladies to whom he refers are as highly and fully qualified as he would suggest, I do not understand why they did not take advantage, not of the first period when they should have registered, but of the longer period extending to as far as 1925, when the last war had been over for seven years, which was allowed in which to take the necessary steps. I would remind the Committee that that period of grace was given in order to bring in people who had found it difficult to come in particularly because of the war, or particularly because their circumstances had changed. But the standards were not as high as the standards now demanded for those who are State registered nurses. Secondly, since that period there have been many nurses who omitted to take advantage of the period of grace who have taken the additional training necessary in order to get on to the register in the normal way of passing the State examination. I cannot understand, since many have done that who were in exactly the same position as the charming Irish lady, why she and her friends should not do the same.

To take the second point, that the prejudice against the case in favour of this Amendment is that the General Nursing Council do not like it, I would say that my hon. Friend makes a very partial statement there. The fact is that the whole profession is against re-opening the register in the way he proposes. [Interruption.] No, the hon. Member is quite wrong. If he will apply to the Royal College of Nursing, he will find that they are equally opposed to the reopening of the register in this form as are the General Nursing Council. I do not want to delay the Committee longer to put up an argument that may be more powerful to my hon. Friend than he found the official argument, but I would recommend him to do this if he has not already done it: he will see the case for the special list which is meant to meet hardship set out in paragraph 20 in the Report of the Committee on Nursing Reconstruction, set up at the behest of the Royal College of Nursing and presided over by Lord Horder. The arguments were weighed, and if the Committee will look at that long paragraph they will be convinced that the profession is right from the point of view of not letting standards down. They might in any case not have been qualified for the general register at all—it might be a supplementary register for some, of them who might not have been qualified to come on to the general State register. I regret I am not able to accept the Amendment.

Will the Minister give some reason why there is any necessity at all for a time limit? He has not said one word to show that a time limit is an advantage.

It is quite clear that we were doing two things. Setting up a register by the overwhelming demand of all concerned and with the assent and consent of Parliament as a whole, we were first of all putting on the register some with qualifications not so high as would be required by the terms laid down for all future entrants. It would be dangerous to re-open what Parliament has decided in general terms as long ago, as 1919 from the point of view of keeping the standard up.

I am rather surprised that the Minister has become so heated. There seems to be an undue exaggeration on his part as to what is asked in this Amendment. We know quite well that women who were definitely continuing in the nursing profession had abundant opportunity—as a matter of fact, I think the opportunities were generous—in that they could get in on a status lower than that demanded at present. That is all true. There is no question or dispute on that. The Minister and the Committee know that many women, trained nurses, happily married, had families of young children, and finished with the profession and were thankful that they were finished with it, as conditions had been so bad that they did not want to be reminded of nursing again. We are now passing further legislation on the question of nursing, and there has been another war, commencing in 1939. The best service that many of these women—with their children now grown up—could give would be in the profession for which they were trained. What the Mover of the Amendment is asking is that for a period at any rate there should be willingness to consider applications. I do not think there will be a very considerable number, but it it not merely for the women's sake but because of the urgent need for qualified and experienced nurses that it should be considered. I do not think it would mean very great labour.

We are not asking that the standard should be lowered. They can set what standard they like, and say that any woman who has had the necessary training and can prove her qualifications can come in. It is a very small thing to ask, and it would placate members of the profession who are opposed to this. At the same time, it would meet the problem of providing a few more qualified nurses and give them the status they are entitled to by their qualifications, instead of condemning them because they did not avail themselves of the period of grace. They did not then picture themselves coming back to the profession. Now they are needed because of the war, and the need may become far greater yet.

Discussions have taken place to meet the very point which has been put. We have arranged to have a special list. These people will have the right to use the word "nurse," and they will go on with their work; but if they want admission to the general register, surely they must conform to the standards which have been applicable since the period of grace expired.

According to Clause 6, they will not, because they will not be registered; they will not be enrolled.

Under the regulations, under Clause 6, Sub-section (1), proviso (b), they will be entitled to.

Amendment negatived.

Motion made, and Question proposed, "That the Clause stand part of the Bill."

Can the Minister tell us what will be the position under this Clause of male nurses? That does not seem quite clear, especially in view of the discussion we have had on Clause 13, where it has been necessary to alter the description of "sister tutor" to something else. It is true that nurses are mostly females, but there is a valuable group of men who have served in the Army, the Navy or the Air Force, who are excellent nurses and whose position does not seem quite definite—at any rate, about whom I feel some doubt.

That category of nurses is included. Again, there is no difference between male and female. "Nurses" includes both.

Question, "That the Clause stand part of the Bill," put, and agreed to.

Clause 16 ordered to stand part of the Bill.