Nursing

Baroness Cox Excerpts

Monday 14th May 2018 Lords Chamber

[Baroness Cox (CB)]

My Lords, I also warmly congratulate my noble friend Lord Crisp, not only on securing this debate and his comprehensive introduction but on his phenomenal commitment to the Nursing Now campaign and the Triple Impact report, in which he was so ably assisted by my noble friend Lady Watkins of Tavistock.

I declare an interest as an honorary vice-president of the Royal College of Nursing—the RCN. I also had the privilege of being involved in work for the Triple Impact report. It is many years since I was registered to practise in the UK, but I maintain a passionate commitment to nursing, especially through my involvement in a small NGO, the Humanitarian Aid Relief Trust, or HART. It was established to provide aid and advocacy for people suffering oppression, often in conflict or post-conflict regions not reached by major aid organisations, for security or political reasons. We work with local partners and always give them the dignity of choice, asking them to identify their priorities for aid, which is often the provision of healthcare—in very challenging situations.

Time permits me to give just two examples to illustrate the achievements of nursing in such challenging situations. First, in northern Uganda, while the notorious rebel Lord’s Resistance Army was still inflicting its reign of terror, we in HART visited and established a partnership with local people desperate to help orphans for whom there was no one to provide care. A key professional was the senior nurse, Pius. In addition to providing clinical care for orphans, including those with HIV, he also runs the local clinic, where he is confronted with massive clinical challenges, such as a lady who was eight months pregnant and had cerebral malaria. It was the rainy season and the nearest hospital was 40 kilometres away and inaccessible. Pius therefore carries full clinical responsibility in that area. When we invited a medical colleague with a special interest in tropical diseases to sit with Pius for a clinic, he said that Pius’ work was superb and could not be better. That initial programme has grown over 10 years from care for 39 orphans to provision of holistic nurse-led health care for over 600 HIV positive children and their families.

The second brief example comes from the little-known historically Armenian enclave of Nagorno-Karabakh, which was subjected to attempted ethnic cleansing by Azerbaijan in the early 1990s but gained a ceasefire in 1994. When we asked the Government there for their aid priorities, they identified help for people with disabilities, as there was no effective provision in the former Soviet Union, where disability was still massively stigmatised. Our partner, Vardan, was given a bomb-damaged building, from which he developed a now internationally recognised centre of excellence, staffed by nurses. The member of his nursing staff with responsibility for treatment of pressure sores initially had to contend with horrific cases. One patient with fungating sores was suicidal. Marietta treated him so successfully that he recovered and began to make exquisite wood carvings, achieving self-esteem, financial provision for his family, and happiness.

These examples illustrate the competence and achievement of so many nurses—I could give so many other examples—working in very challenging situations in remote areas, sometimes in conflict or post-conflict situations. We celebrate their achievements perhaps particularly appropriately today, on International Nurses Day.

I therefore also greatly appreciate the work of the RCN, with its support for and participation in a number of nursing alliances in Europe and the Commonwealth, which not only seek to influence European and global policy but also spread learning and experience between nursing organisations; for example, the development of advanced practice on nurses’ key role in tackling antimicrobial resistance, and on addressing the health of the health workforce.

One example is RCN co-operation with the Zambia Union of Nurses Organization on its implementation of the WHO safe surgery checklist, and raising the profile of the profession in Zambia. This work and its visibility as an organisation that seeks to improve practice means that it is increasingly a partner of choice for the Zambian Ministry of Health. It has also helped it to build its own membership as a professional nursing association as well as a trade union.

The RCN also provided background to the Nursing Now campaign by undertaking research on key trends in nursing and identifying the areas that make a significant difference to nurses being able to achieve positive changes for health, including education, professional regulation, workforce resources, a pleasant working environment and nurses’ ability to influence and improve health policy. The RCN has committed to continue to raise the profile of this significant and global initiative.

I am delighted that the Triple Impact report and the Nursing Now initiatives have helped to highlight the fundamental importance of nursing here in the UK as well as in developing countries, where they are often the only providers of healthcare for large populations. As I have indicated, I have seen many inspirational examples of nursing practice in remote and very challenging situations, and I hope there will be a greater opportunity for a two-way programme of professional visits: for nurses from those areas to come to the UK to benefit from clinical updating in the latest developments, and for UK nurses to visit their colleagues in those remote situations, where they will benefit from the inspirational resourcefulness and professional competences of colleagues.

I therefore conclude by asking the Minister whether Her Majesty’s Government will provide adequate support for these two-way professional training programmes, which will help nursing, as the primary provider of healthcare around the world, to continue its vital contribution to the well-being of people globally.