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Hospitals (Understaffing)

Volume 465: debated on Friday 3 June 1949

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3.59 p.m.

I propose to raise a point of very great importance, namely, the under-staffing of mental hospitals. I think that we might make it an even larger subject, namely, the general understaffing of hospitals throughout the country. It is a very serious matter today that, because we have conditions of full employment, it is difficult to attract people into the nursing profession. I am very proud of the record of the Labour Government in full employment. I well remember that when hon. Gentlemen opposite were in office we always had about two million unemployed, owing to the disgusting policies which they then pursued. But because of this position of full employment we are faced with the situation in which it is most difficult for us to attract people into professions like the nursing profession.

I am raising today a case which occurred in my own constituency and I hope to be very brief because I know that the hon. Member for Ladywood (Mr. Yates), whose constituent was involved in this case, has some observations to make to the House——

It being Four o'Clock, the Motion for Me Adjournment of the House lapsed, without Question put.

Motion made, and Question proposed, "That this House do now adjourn."—[ Mr. Snow.]

—in the event of his catching your eye, Mr. Deputy-Speaker, upon this case at Rubery Hill Mental Hospital. I have today received a telegram from Mr. David Rhydderch, who is chairman of the mental hospital in question. I think that all the facts about this mental hospital have been in the newspapers, and I want to know whether the Parliamentary Secretary has any statement to make upon the inquiry which the Ministry is conducting into this matter.

I want to refer to the utterly disgraceful allegation which was made yesterday by the noble Lord the Member for Horsham (Earl Winterton). In my opinion, his behaviour was caddish. I think that it is absolutely disgraceful that the noble Lord should have got up in this House of Commons, in relation to an event which took place in my constituency and to a constituent who is looked after so ably by the hon. Member for Ladywood, and made an allegation of murder. Let me say that if he were decent he would have withdrawn that allegation yesterday. I know that he has gone away today, but I am sure he will observe the remarks I am making, and I ask him in all decency to get up and withdraw those remarks at the earliest moment.

On a point of Order. I do not know whether you were listening, Mr. Deputy-Speaker, but I heard the hon. Member use a phrase for which the hon. Member for Wood Green (Mr. Baxter) was made to withdraw from this House a short time ago—that was that he used the word "caddish" in connection with the noble Lord the Member for Horsham.

If I used any unparliamentary expression I, of course, withdraw it, but I do say that the behaviour of the noble Lord was utterly disgraceful, and I think that most of the people in this House agree with me. What right has the right hon. Gentleman to get up in this House and make an allegation against one of my constituents that he has committed murder, without bothering to find out what are the facts relating to the matter? That is typical of the attitude of the party opposite. It is all very well for them to smirk. They are responsible for this very grave situation that we have today.

I believe that it is true that there were 80 mental cases in my constituency left without a nurse during a whole night, but the basic reason for this is that we have not yet provided proper conditions for the nursing staffs both of mental hospitals and of all other hospitals. I am not trying to make any personal observation on this particular case because the Minister is inquiring into it, and I will leave it to my right hon. Friend to deal with it to the extent which he considers it proper to do so. In general—and I know that my hon. Friend will agree—the main point is this: we must provide proper conditions in order to attract sufficient nurses so as to ensure that our hospitals are properly staffed. I have here a letter from a lady who is not politically on our side. I think, however, that the points which she makes are worthy of our attention, and I will quote the letter:
"The first thing that happens in almost every home where a daughter wants to go in for nursing is strong opposition from the parents, of which I am one; and why?—"
She says:
"I oppose my daughter going in for nursing because, firstly, the work is arduous, the hours are long, there is little freedom and little spare time, and by the time the spare time comes they are often too tired to do anything but lie on their beds. Secondly, the tying up of a girl of 19 for some years is all wrong. Suppose she wants to marry? Three of mine have married at 19, 22 and 23 years of age. The latter was doing massage but did not complete her course. Thirdly, living in should be optional and not compulsory. Fourthly, there is often so much dirty work which in a house would be done by a char and could be well done by someone not trained for nursing."
Personally, I consider it absolutely wrong that nurses, particularly nurses in mental asylums who are specially trained for that job, should have to do the work that ought to be done by a char. I hope that the Minister of Health and the Parliamentary Secretary, who is going to reply to this Debate, will have a nurses' charter. I hope that from now on we shall decide, because we have a Labour Government in power and no longer have a Tory Government which exploits and believes in unemployment, to have a real charter for the benefit of nurses and to do everything in our power to attract people to the nursing profession. After all, these are the people on whom we all depend. We are all subject to the vicissitudes of fortune, Mr. Deputy-Speaker, and you, Sir, as well as I, will eventually die. You, Sir, as well as I, will have your final moments perhaps eased by the work of a nurse, by someone who will look after you, help you and smooth that passage over the Styx which comes to us all in due course. We are entitled to remember that benediction passed by our Lord:
"Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me."
We ought to recognise the fact that the nursing profession is a vocation and a great calling, but it is not sufficient for it merely to be a calling. The profession should be provided with proper conditions of employment so that people will want to become nurses. I know that my hon. Friend agrees with me when I say that we in Birmingham are proud of the work done by the Midlands Health Executive in trying to improve the conditions which the party opposite allowed to exist for so many years. We will do everything in our power to back up the Minister, in all the steps he takes, to see that people are attracted to the nursing profession by attractive conditions of employment.

An allegation was made by the hon. Member for Solihull (Mr. M. Lindsay) that sane people have been certified by doctors because it was desirable to get them into hospital. That is a disgraceful allegation which is utterly untrue, and the hon. Member, to whom I have written, should be present today to substantiate what he said. The attitude of the Opposition is a matter of party prejudice against the Minister of Health, who has done a wonderful job for the people of this country in spite of the party opposite. We shall get back at the next Election precisely because in these matters we are deeply concerned for the working people of this country, because we want to see them have proper conditions in sickness and health.

I feel that this is a matter of very great importance indeed. It is also a matter of profound political importance, and for this reason. I said 2½ years ago that unless this Government produced a relative wages policy, voluntarily accepted by the trade union movement, the only alternative was direction of labour. As the House knows, I am absolutely opposed to direction of labour in all circumstances. Our policy is a policy of making the job attractive, whereas the Tory policy is mass unemployment, so that people are directed, in effect, by starvation. We do not believe in direction of labour but in making the conditions attractive so that the workers want to go into the undermanned industries. I think that that general proposition must be applied to this very important profession, the nursing profession. I am most grateful that this subject has been raised, and I hope the Minister will be able to say that he will give due consideration to the issue of a general charter for the nursing profession.

4.10 p.m.

I am grateful to my hon. Friend the Member for King's Norton (Mr. Blackburn) for raising this subject, which has arisen out of two Questions which I put in the House just over a week ago, and for kindly permitting me to share some of the time for this Adjournment Debate. I am extremely sorry that the noble Lord the Member for Horsham (Earl Winterton) is not present today. I took the opportunity of advising him last night that the statement he made yesterday would cause the greatest distress among the nursing staffs of the City of Birmingham, and I said I hoped he would see his way clear to withdraw the epithet "murder," which he used most unwarrantably and unjustifiably. I also think it regrettable that the hon. Member for Solihull (Mr. M. Lindsay) is not here, because he gave notice that he would take the Adjournment on this matter and, that being so, in all fairness he should have been here today. I entirely support what my hon. Friend the Member for King's Norton has said about the noble Lord the Member for Horsham.

The incident to which my hon. Friend has referred concerns a former constituent of mine who had the misfortune to have to go into a mental hospital. I would like to quote from a Birmingham newspaper which refers to this incident—the "Birmingham Mail," which is a Conservative organ. It states that the coroner's court were very clear in their decision that the death was accidental—the death being of Mrs. Leah Caroline Walker, a patient in the Rubery Mental Hospital, and formerly of Great Tindel Street, Ladywood. This is the statement made about the evidence given at the inquest by her son, Frank H. Walker, of Castle Road West, Quinton:
"He had visited his mother on many occasions. He had never had any occasion to complain about her treatment or to make any suggestions."
I say that when a son can make a statement like that, it must cause the greatest pain to those responsible for looking after his mother to read a statement by the noble Lord the Member for Horsham that she had been murdered. I sincerely hope that the noble Lord will read what my hon. Friend and I have said, and will think differently about the matter.

My hon. Friend said he had received a telegram today. I, too, have received a telegram from which I would like to quote. It is from the Chairman of No. 6 Group, Hospital Management Committee, Birmingham, and says:
"I wish to protest at the unwarranted misrepresentation of the truth regarding unfortunate incidents at this hospital on May 3rd after the inquest held under the direction of His Majesty's coroner, sitting with a jury, had brought in a verdict of accidental death, and said there was no evidence to prove that the patient had been attacked. Earl Winterton's statement has caused very great distress among our staff, who have most conscientiously and loyally carried out their nursing duties. In the circumstances I am entitled to ask, on behalf of the staff, for a withdrawal of his completely wrong statement."

As there are some right hon. and hon. Members sitting on the Opposition Front Bench, I think it would be appropriate if they would get up now and say that they realise that a serious mistake was made by the noble Lord the Member for Horsham (Earl Winterton), and that they themselves feel—I am sure the noble Lord, if he were here, would agree—that his allegation ought to be withdrawn.

I am sorry, but knowing nothing about this case I could not possibly intervene in this matter.

This unfortunate woman, as I have said, lived in Great Tindel Street, Ladywood, in the heart of my constituency. I remember calling the attention of the Birmingham City Council, 21 years ago, to the fact that 45 people were living in a 10-room house. If anyone is justified in using the word "murder," I say that many hundreds of my constituents were murdered because of the social conditions which were permitted by the party to which hon. Members opposite belong.

I wish to congratulate the staffs of our hospitals in Birmingham. They are entitled not to unwarrantable slurs of this nature, but to distinguished service medals for the way in which they have shouldered, and are shouldering, a burden which they themselves cannot control.

As to the general problem, my hon. Friend and I both have hospitals in our constituencies, which deal with the chronic and aged sick such as the one in Selly Oak, and there are mental hospitals in our constituencies, too. The problems of staffing are interwoven. I have seen beds touching each other in the Dudley Road Hospital. That was before 5th July when the National Health Service Act came into operation. Only a short time ago I discussed this matter with a medical superintendent. He asked me how I thought he could take my constituents who were ill in Ladywood. It is a grave responsibility for any medical superintendent to take in patients where there is not the staff or accommodation for them.

In regard to mental hospitals, the medical superintendent has no alternative but to accept patients who are certified. Never at any moment did I make a statement in this House which could have been calculated to give the impression that any of those patients that went into hospital had not been correctly certified. Looking at that problem there is undoubtedly a very great problem. The number of nursing hours in Rubery should be 6,000 per week, but we can only provide for 3,000. For that we do not attack our staffs or our medical superintendent. We give them the greatest praise for what they have done.

In conclusion, may I say that the kind of statement that appeared in the "Daily Express," attributed to the chairman of the hospital concerned, saying that old people, who have nothing wrong with them except old age, are being admitted as voluntary patients to mental hospitals under the National Health Act——

He has entirely denied it. He actually made a statement to the Press, and I have here the statement as published in the "Birmingham Despatch" in which he denied the charge made by the hon. Member for Solihull. In fact he has been accused of giving information and he said of the hon. Member, "I do not know him, I have never spoken to him nor written to him, and if that is typical of his contributions in the House of Commons I have no wish to meet him." I should have thought that the hon. Member for Solihull would have had the decency to withdraw so that the City of Birmingham might have had the truth.

This is an issue which is of the greatest possible importance. My hon. Friend the Member for King's Norton and I, together with my other colleagues representing Birmingham, stand together on this particular issue of chronic and aged sick, because we feel that it is one for the most careful examination and wide inquiry. We shall want to know who is responsible for giving the information which was supposed to have been given to the hon. Member for Solihull. I thank my hon. Friend for permitting me to speak in this Debate, and I hope the Minister will be able to probe the matter fully so that he will be able to bring a report to the House at an early date.

I myself did not hear any of the remarks to which reference has been made, but I learn that my right hon. Friend the Member for Horsham (Earl Winterton) left this morning on an official delegation for Denmark. It was, therefore, quite impossible for him to be here this afternoon. The report of this Debate will be brought to his attention.

We are very grateful to the right hon. Gentleman for having made that statement. We all respect the noble Lord. We realise he could not have meant to make the statement which he did yesterday, and we are very grateful to the right hon. Gentleman for having gone as far as he could towards withdrawing this allegation.

4.20 p.m.

I am very grateful to my hon. Friends for having raised this matter. It is of the utmost importance that the allegations that have been made and the innuendoes that have been put forward should be cleared up. They have caused the greatest distress throughout the country in the nursing profession, particularly in the mental hospitals. I should like, first of all, to say something about the matter which has been referred to, the death of a patient in the Rubery Hill mental hospital, to which both my hon. Friends have referred.

I have myself examined the depositions that were made to the coroner in the inquest on this case. It is true that the ward in which the patient was receiving attention had no full-time attendant that evening, due to shortage of staff, but it was visited on many occasions during the evening, so that there was, in fact, a nurse in attendance most of the night. There is nothing at all in the evidence to suggest—and I have examined it most carefully—that this old lady was involved in the incident which did occur between two other patients in the ward that evening. She was seen by a nurse immediately after that event took place and appeared to be perfectly all right then. The coroner sat with a jury, who returned a verdict of "Accidental death." I would strongly support the comments of my hon. Friends that remarks of the character which were made, apparently without reflection at all, by the noble Lord the Member for Horsham (Earl Winterton)—I appreciate that he is not able to be here this afternoon—were utterly without foundation, were irresponsible, and were mischievous in the effect that they have had throughout the country. I can well understand the bitter feelings of the nursing staff and of the management of that hospital.

I would say a further word with regard to the question that was raised about wrongful certification. It was the hon. Member for Solihull (Mr. M. Lindsay) who raised that matter. There is still no evidence whatever of this having happened. The names of some old people who, it is alleged, have recently been admitted to one of the Birmingham mental hospitals, are now being obtained by my right hon. Friend so that a detailed investigation shall be made in each case. It is most reprehensible that a charge of this character should be made, impugning the conduct of the medical and legal professions. Wholly irresponsible statements of that kind ought not to be made by hon. Members of this House without the most careful and searching investigation. It suggests that some hon. Members opposite are so anxious to cause trouble in the development of our Health Service that they will lend themselves to this kind of remark.

My hon. Friend the Member for King's Norton (Mr. Blackburn) raised a wider aspect of the matter, the important question of the staffing throughout the country. He mentioned not only mental hospitals but general hospitals as well. We are well aware that we are suffering from a general shortage of nurses especially in the mental hospitals and among the female nurses. I would assure him that we are doing our utmost to try to overcome that very serious difficulty. We appreciate that nurses, both in the mental hospitals and in the general hospitals, have suffered under real difficulties such as bad accommodation—appallingly bad in some cases. So far as pay is concerned, improvements have already been announced for general nurses. The position of the mental nurses is now under consideration by the Whitley Council and any recommendation that it makes will be retrospective to 1st February. I am sure that this will be a further encouragement to nurses to undertake this very important, strenuous, difficult and highly necessary job of work.

Can my hon. Friend tell me if the report is to be long delayed?

I certainly hope not. There is no reason why it should be long delayed, and I am most anxious that we should receive it very soon. Hon. Members know that there is before another place at this moment a Nurses Bill which opens out the way to general improvements in the whole organisation of the nursing profession. That will act as a great encouragement to young girls to enter the nursing profession, assured that this very fine and rewarding service will be made much more attractive to them than it has been in the past.

I am very grateful indeed for the opportunity which has been given for this Debate to take place this afternoon, because it is most essential that the facts about the matter should be known not only here but throughout the country. I would just like to add that my right hon. Friend himself strongly encouraged the non-certification of old people, and in an instruction which he issued to regional hospital boards back in November, 1947, he stated that:
"It is now commonly accepted that it is undesirable to certify old people, especially those over 70, suffering from mental infirmity if certification can be avoided."
The instruction went on to say that except where it was essential to certify because the patients were too difficult to manage without this step, accommodation should be found for them outside the mental hospital service. We are fully aware of all the difficulties of accommodation which exist at the present time. We are doing our utmost to overcome them, but it does not help in those efforts to have the sort of irresponsible remarks thrown across the House to which we have been subject during the last week.

Question put, and agreed to.

Adjourned accordingly at Twenty-eight Minutes past Four o'Clock, till Tuesday, 21st June, pursuant to the Resolution of the House yesterday.