Nursing

Baroness Bottomley of Nettlestone Excerpts

Monday 14th May 2018 Lords Chamber

[Baroness Bottomley of Nettlestone (Con)]

My Lords, I feel privileged to follow the noble Lord, Lord Crisp, in his excellent address. Those who have followed him over many years will have noticed his real concern for development. I was always struck by his fascinating book, Turning the World Upside Down, in which he argued that we need to move beyond top-down thinking on international development towards co-development. While richer countries have a responsibility to share knowledge and investment, we must recognise that healthcare innovation from developing countries can be every bit as important for improving outcomes in the developed world.

With his excellent team—it is striking that so many of his distinguished colleagues from the All-Party Parliamentary Group on Global Health are here tonight—he has spelled out so clearly the potential impact of nursing worldwide. Of course, in the UK we have had a growing revolution. During my ministerial days, my excellent noble friend Lady Cumberlege was the one who pushed for nurse prescribing. The noble Lord, Lord Crisp, mentioned nurse prescribing elsewhere in the world. But we have been pioneers in many ways; the noble Baroness, Lady Emerton, was a formidable force in those early years. We can now see how the UK developments are spreading around the world.

I congratulate the noble Lord on his impeccable timing. This debate was delayed. Saturday was International Nurses Day and Florence Nightingale’s 198th birthday. Today marks 137 years since the death of another remarkable woman, Mary Seacole. So he has got his timing right. In Belfast today the Royal College of Nursing is meeting and discussing health in a way that is quite remarkable, from the specifics, whereby those very advanced practitioners can make a contribution, right through to the contribution of nursing in dealing with slavery and sexual trafficking. Now that nurses have come of age, they believe in their confidence and, supported by others, have a voice that must be heard. Having a chief nursing officer reappointed at the World Health Organization, this is a time to speak up and make sure that global impact is really heard.

Education and training are critically important. I have the privilege of being the chancellor of the University of Hull. Professor Julie Jomeen, head of the Faculty of Health Sciences, said:

“We are supporting nurses to become global professionals”.


This is what is changing. Education, training and research are quite remarkable. Through nurse leadership and nurse contribution, we send people on placements to Uganda, Barbados, Finland, Africa, the Caribbean and the Middle East and so forth, and we receive nurses in return from all around the world. This is expanding global outlooks. If you train and learn together, it influences your perspective and view of your professional commitment more than anything else. I am pleased also, incidentally, that the faculty has won a Burdett Coutts award for the STaR project, which tries to ensure that these newly recruited nurses stay in the health service or wherever they are and are prepared for the practice and not just the theory.

We all know that the healthcare challenges of the 21st century are very much the healthcare challenges where nurses excel. In my small contribution, I introduced the Health of the Nation, which was all about prevention and persuasion in dealing with coronary heart disease, stroke, cancers, mental illness, HIV/AIDS, sexual health and accidents. This is not about an operation or a prescription; it is about being close to the patient and the community, staying with them and using persuasion. The modern nurse has not only those skills but, increasingly, the skills of economics, politics and geography, and of beginning to see, in an empowered and enlightened way, the powerful contribution that a nurse can make in so many countries of the world.

Nurse leadership is critical, and we have to ensure that we develop it so that it can make a contribution within the system. It has always been a complex issue in the National Health Service management team. I am sure we can do more to develop the role and its contribution, rather than saying, “Oh, if only we had more nurse managers”.

More than three-quarters of the NHS is female, and the proportion of female nurses is even higher. Women have this huge contribution, not only in the UK but around the world. With our almost uniquely connected position in the international system, we can take real pride. Our international connections, particularly through the Commonwealth, link us to countries where taking the lead on co-dependents can be especially productive. In March, the constitution of the Commonwealth Nurses and Midwives Federation was approved in London. It reaffirms the commitment to maintain, facilitate and develop nursing and midwifery networks across the whole Commonwealth; to help to improve nursing standards across the Commonwealth; to support Commonwealth nurses and midwives; and to develop leadership roles in health policy. Last month, with the CHOGM meeting here in London, we had a further opportunity to make sure that this is fulfilled and delivered.

We know that nurses are more trusted than any other group. It is depressing that, apparently, only 15% of people trust politicians, but 93% of people trust nurses. This gives nurses an authority and position to influence, persuade and lead that few others groups have.

Fifty years ago, the United Nations Secretary-General, Dag Hammarskjöld, said:

“Constant attention by a good nurse may be just as important as a major operation by a surgeon”.


That sounds rather patronising today, when the world has moved on so dramatically. I wanted to take this opportunity to celebrate the individual who will be the next Lord spiritual in our House. On Saturday, Dame Sarah Mullally was installed as the Bishop of London—someone who was Chief Nursing Officer when she was 37 and went to a comprehensive school. She referred to Florence Nightingale’s birthday, saying that Florence was,

“an epidemiologist, a statistician, a social reformer, theologian and nurse. She has inspired generations of nurses. At the heart of what she did was to use the ordinary skills we all possess and can use if we are brave enough, the skill to build human relationships. If we want to improve public health today, if we want to improve the life chances of those who are still left behind and failed by our education system, if we want to reduce the horrifyingly high number of young deaths from knife and gun crime occurring in this wonderful city, we have to build relationships”.

If we take those words and apply them to all the ills, suffering and health problems in so many countries around the world, I absolutely believe that the critical force in ensuring that we deliver those sustainable development goals and promote healthcare for all is the huge, and as yet untapped, power of the nurse. I very much support the noble Lord in his Question.