Nursing and Midwifery (Amendment) Order 2008

My Lords, I, too, apologise for my rather breathless arrival in the Chamber; I had not realised that we had such a speedy Minister. The present situation is clearly unsatisfactory. I think that everyone agrees that 12 elected nurses and 11 lay members have proved to be a very cumbersome NMC. I think that there is general agreement that it should be reformed, and the Royal College of Nursing is very supportive of that. I have a few comments and questions. First, a general comment: why does the new council have to be entirely appointed? I am seriously worried that everything in this country is run by quangos that have members appointed by the Appointments Commission overseen by the Privy Council, which is presumably overseen by the Government. I think I said a few weeks ago that the health service is a rather Stalinist organisation. It feels like that when everything is appointed and there is no element of election or the professions being able to choose their own representatives. I share the reservations of the noble Baroness on the Conservative Benches but urge the Government to take heed of this warning. We must not have an all-appointed country. They are keen on talking about devolving responsibility and power downwards yet they devolve that responsibility to bodies that have been appointed by themselves, directly or indirectly. That concerns me. Secondly, there will be seven professional members on the new NMC. Will the Government ensure that there are general nurses, midwives and perhaps community nurses represented on the NMC? Community and district nurses in particular are going to be extremely valuable in the health service in the years to come because patients are admitted to hospital for a much shorter period. They should get representation on the NMC. I have some concern about stopping the elections. It may be two or three years before the new council comes into being. Again, my democratic soul rankles at the fact that elections will be stopped. If we decided to change the way we elected our MPs, would you really tell all the MPs that they could stay on for a couple of years or so until the new system came in? I think not. It is better to have people elected even if only for a short time before the new arrangements come into play. There is a valid concern from the midwives, too—that they may lose the Midwifery Committee, one of the four statutory committees that exist at the moment. How will the council consult midwives if the committee goes? The midwives are hugely important. Let us face it: they are the branch of nursing that brings the next generation into the world. There could not be a more important group. They really must be consulted by the NMC. I hope the Minister will tell us that there will still be a Midwifery Committee. I welcome the provision for the NMC to make temporary changes to register nurses in emergency situations. Nurses are extremely well qualified and talented people, capable of all sorts of duties that at the moment they are not allowed to perform. I do not have many reservations about that; it is an excellent thing. Should a national emergency occur, there should be this immediate upgrading to do jobs that are needed in the community. On the whole I welcome the revision of the NMC but hope I can have some assurances on the points I have raised.