House of Commons Hansard Debates for 3 May 1991

The Minister for Roads and Traffic (Mr. Christopher Chope) : I am grateful for the opportunity to take up the invitation of my hon. Friend the Member for Stafford (Mr. Cash). The Bill is important and my hon. Friend does

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himself a disservice in suggesting that it is unglamourous. The presence of the hon. Member for Lewisham, Deptford (Ms. Ruddock) shows the importance that she attaches to the Bill. Ministers and Opposition spokesmen are not often here on a Friday to discuss such important business.

One of the principal reasons why the Government welcome the Bill is that it will usefully strengthen the powers of traffic authorities in dealing with the temporary regulation of traffic.

Authorities face a growing challenge to manage traffic effectively, particularly as car ownership levels increase and traffic on our roads continues to grow. We should, perhaps, remember that during the 1950s, motor vehicle traffic in Britain doubled. It doubled again in the 1960s and during the 1970s and '80s it doubled yet again. At the end of the last decade the total figure for road traffic was 400 billion vehicle kilometres per annum. National road traffic forecasts suggest that it will continue to increase. Car ownership could increase by between 30 and 50 per cent. by the year 2005. Until cars are used much less than at present, there will be more traffic on our roads. To put that in context, Britain currently has significantly fewer cars on its roads than do many of our European partners. For example, 1988 figures show that, in terms of cars and taxis per thousand population, the United Kingdom came seventh highest among the 12 member states of the European Community and was also behind Austria, Finland, Norway, Sweden and Switzerland. Therefore, contrary to some people's suggestions, Britain does not have more cars on its roads per head of population than any other country in Europe. Indeed, we are well down the league table. With this growth in traffic has also come a dramatic increase in road works, not least because of the need to repair worn-out services and the burgeoning demand for cable communications. This, and the continuing requirement to maintain highways under the pressure of higher traffic volumes, makes it all the more pressing, therefore, that we find appropriate measures for managing temporary works to minimise their disruption to traffic flow. I shall be saying a few words about the Government's proposals on that later, but first I shall return to my hon. Friend's Bill.

It is based on proposals that emerged some years ago from a joint working group between the local authorities and my Department on traffic and parking matters. The Tapwork group, as it became known, produced a report in 1987 with a variety of proposals for improving the law and administrative procedures in traffic and parking. A number of its recommendations have subsequently borne fruit. For example, new procedures for local authorities' traffic orders were made in 1989. In that same year, another private Member's Bill was brought forward to extend the scope of parking equipment available for use by authorities. That passed successfully through both Houses and became the Parking Act 1989. Further recommendations have also been carried into the Road Traffic Bill this Session, which--as hon. Members know--is now in Committee in another place.

The main recommendations on temporary traffic regulation in the Tapwork report contained in B1-B12 in annex B to the report, were well received and are embodied in the measure before the House today. The Bill contains a collection of measures which, taken together, should help to streamline the current procedures and reduce

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bureaucracy. Of course, that means reducing the unnecessary costs which would otherwise be borne by local authorities.

A major component of the Bill is that it will largely remove the involvement of my right hon. Friend the Secretary of State, from decisions on the merits of temporary traffic regulation. That is properly a matter for the relevant local authorities. They can be expected to act responsibly in those matters, just as in matters involving permanent traffic orders, where they have direct responsibility. There has been a progressive devolution of powers over time. It is right to take a further step in that direction. The residual role for the Department will be, first, to provide for continuity, where the traffic authority is proposing to make a permanent traffic order and requires additional time to put the necessary arrangements in place--that is in new section 15(3)--and, secondly, as my hon. Friend has pointed out, in respect of orders affecting footpaths and bridleways where the permitted period of restriction is only six months instead of 18 months, but may be extended by the Secretary of State, on the request of the authority, if he is satisfied that the circumstances warrant it, that is in new section 15(5).

My hon. Friend has already commented on a number of the other provisions in the Bill. I welcome, for example, the provision that will allow a single order to be made covering both local authority roads and trunk roads, with the Secretary of State's consent. That is in new section 14(5). Everyone will agree that it does not make sense to have to proceed with two separate orders on trunk roads and local authority roads, as current law requires.

In the context of provision on alternative routes, the Bill also includes some helpful enhancements. More emphasis is given, in the new section 14(3), to the need to have regard to the availability of alternative routes, whether the temporary restriction is by means of an order or a notice.

New powers are also included in the new section 14(8), which will allow the traffic authority to suspend any free parking place on an alternative route. That might be necessary for a brief period to avoid congestion on that alternative route while additional traffic has been diverted on to it.

Appropriate provision is made in clause 1(3) for the erection of the necessary traffic signs in connection with temporary restrictions. It goes without saying, perhaps, that proper signing is as important for short duration traffic regulation as it is in any other case. Of equal importance is to ensure that works are properly guarded for the benefit of the road user and those working on the road.

I am sure that the House would welcome a little information on the relationship between the Bill and the Government's New Roads and Street Works Bill which is still before the House and has not yet received Royal Assent. That Bill seeks to bring about the long overdue reform of the Public Utilities Streetworks Act 1950. It aims to sort out the present confused responsibility for utility street works by making utilities fully responsible for their own works. It will allow utilities to carry out their own street works much more efficiently. It places a duty on highway authorities to co-ordinate their own and utilities'

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street works, so as to minimise disruption and end the frustration caused when the same stretch of road is repeatedly dug up. Undertakers will be required to co-operate with the authorities and each other in co-ordinating works.

The Bill should help to improve the environment by reducing the amount of street works activity, with its fumes, noise and congestion and by bringing about better quality of work and surface reinstatement. It should also improve safety by means of the new provisions for signing, lighting and guarding works, with the disabled particularly in mind, and by means of requirements for the training of workmen and supervisors. We attach great importance to that. Our intention is to approve a code of practice giving practical guidance to undertakers on how best to ensure that these objectives are met. The code will be based on the revised chapter 8 of the Department's traffic signs manual.

The significant point is this : where it is necessary to restrict or prohibit road traffic for temporary periods, traffic authorities rely on the powers in sections 14 to 16 of the Road Traffic Regulation Act 1984. It is those powers which my hon. Friend's Bill will strengthen and improve. So this Bill is an important adjunct to the Government's wider measure.

As hon. Members will know, where temporary traffic regulation is introduced in connection with road works by utilities, the Government's Bill allows traffic authorities to recover costs from the utilities--both administrative costs and costs of necessary traffic signing. That is a sound principle and one which was acknowledged in the Tapwork recommendations from which this Bill has emerged.

Of course, had my hon. Friend the Member for Nottingham, South (Mr. Brandon -Bravo) been successful with his Bill last Session, there would have been no need for the consequential provisions which now appear in schedule 2 to the Bill. The Government's Bill could have taken everything into account. But it is a tribute to my hon. Friend the Member for Stafford that he has ensured compatibility between his Bill and the New Roads and Street Works Bill. The technical amendments agreed in Committee complete that task. We anticipate that the New Roads and Street Works Bill will be brought into force first. This Bill, if agreed, will then tidy up the drafting by repealing provisions rendered redundant in schedule 8 to the New Roads and Street Works Bill.

The Bill also seeks to provide flexibility on the matter of the permitted duration of restrictions under the more rapid notice procedure. At present, a notice allows a restriction for up to 14 days. That is in the existing section 15(5) of the Road Traffic Regulation Act 1984. The Bill extends this to 21 days, but provides additional circumstances in which a short five-day notice may be used. That includes temporary restrictions for street cleaning purposes and temporary restrictions connected with road works. In many cases, the need for major works in the highway is known well in advance and can be dealt with through the temporary order-making procedure, but the new short duration notice can be useful for unforeseen circumstances.

There is power in new section 15(7) for my right hon. and learned Friend the Secretary of State to alter the number of days--five and 21--if experience suggests that that is needed. That gives a welcome opportunity to fine-tune the arrangements if occasion demands. It would be achieved by means of regulations, subject to the

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negative resolution procedure. That is in line with the philosophy reflected in the New Roads and Street Works Bill-- to ensure that the Government and authorities are not hamstrung by too much detailed legislation which then becomes outmoded over time and which, because it is primary legislation, cannot be amended, even though everyone recognises the need for amendment.

The temporary restriction of traffic is never welcomed by those affected by it, but authorities are under a general duty to assert and protect the rights of the public to the use and enjoyment of the highway and to prevent its stopping up or obstruction as far as possible. The New Roads and Street Works Bill reinforces those duties and provides added incentives for speedy completion of works by public utilities. The Bill ensures that, where the requirement for temporary regulation exists, for whatever reason, there is the necessary procedural and administrative mechanism to ensure its effective application and proper implementation.

My hon. Friend the Member for Stafford referred to the role of the first parliamentary counsel in drafting the Bill and he drew attention to the fact that a couple of amendments were agreed in Committee. In fairness to the first parliamentary counsel, he should not be criticised. The amendments became necesary because the Bill had to be brought up to date to reflect the passage of other Bills and a new schedule was added to the Bill. Every cloud has a silver lining. The fact that last year's Bill did not reach the statute book has enabled this year's Bill to take account of other legislation before the House.

My hon. Friend the Member for Stafford has a distinguished history, not only as an hon. Member, but before he became a Member, of dealing with legislation and drafting Bills. He has demonstrated his expertise once again in the way in which he has successfully steered the Bill through Second Reading, Committee and Report to Third Reading. He hopes, no doubt, that it will receive plaudits when it goes to the other place and that it will soon be on the statute book. It is a great pleasure to know that the Opposition welcome the Bill. I hope that the House will give it a warm welcome later today. I congratulate my hon. Friend the Member for Stafford on the way in which he has handled the Bill and I commend it to the House. 2.1 pm

Ms. Joan Ruddock (Lewisham, Deptford) : I apologise to the hon. Member for Stafford (Mr. Cash) for the fact that I was not in my place when he rose to address the House. I do so only because he has drawn the attention of the House to that fact. He might have noticed that I have been in and out of the Chamber frequently and that I have been here since the start of business this morning. It is due to the ludicrous procedures of the House that I was unable to know at what point the Bill would proceed.

I do not intend to speak for long because I am very much aware that hon. Members who spoke for some hours before the hon. Member for Stafford rose were doing so in an effort to take the maximum time for two Bills to prevent the Pig Husbandry Bill from reaching the Chamber for debate. I regret that very much. I regret, as the hon. Member for Stafford does, the filibustering that caused problems for the precursor to this Bill. I regret that that has happened again this morning and that another worthy measure will not receive proper time and attention in the House.

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As the hon. Member for Stafford and the Minister said, the Bill is important. It contains measures that, although small in themselves, will have considerable consequences. As the hon. Member for Stafford said, it seems that the Department of Transport wished the Bill to be introduced and that, behind the scenes, it has done the work and provided considerable assistance to the hon. Gentleman.

It may sometimes be justifiable to produce such measures and to make them available to those who are successful in the ballot for private Members' Bills. However, I am not sure that the Bill needed to come to the House in its present form. Perhaps it could simply have been subsumed in the procedures on two important transport Bills. The Minister has referred to the Road Traffic Bill and to the New Roads and Street Works Bill. I have been the lead member of the Front-Bench team for the Opposition during the procedures on both Bills. I am glad to tell the hon. Member for Stafford that we have been able to proceed with reasonable consensus on the major provisions in those Bills and that this Bill is complementary to them.

Mr. Cash : Can the hon. Lady tell the House which Opposition spokesman will be handling the Bill in the House of Lords? Lord Brougham and Vaux has kindly agreed to take on the Bill when it arrives in the House of Lords and to put forward our arguments. I hope that there will be no argument at all, but I should like to know whether we shall be able to maintain the same comity and co-operation and that the person who takes the Bill through the Lords is the same as the one who took it through previously, as that will maintain the splendid continuity.

Ms. Ruddock : I undertake to speak to my colleagues in another place to signal our attitude and to say that I hope that the same attitude will be demonstrated there.

The Bill is complementary to other Bills on which we have been prepared to co-operate. Indeed, I hope that we have added to and improved those measures. As the hon. Member for Stafford and the Minister said, it is important to restrict traffic temporarily because of the increasing number of necessary road works. That is why we support the Bill. We supported a similar Bill introduced by the hon. Member for Nottingham, South (Mr. Brandon-Bravo) and we regret that that Bill fell in the way that it did, making it necessary to use the valuable time of the House again. The filibustering was unnecessary. We welcome the Bill and I congratulate the hon. Member for Stafford on his success in bringing the Bill thus far.

Mr. Cash : We very much appreciate the attendance of the chief Opposition spokesman on transport on this important occasion. He pays considerable attention to these matters. Furthermore, when one sees him on television--

Mr. Deputy Speaker : Order. I do not see that that has anything to do with Third Reading.

Ms. Ruddock : I fear that the hon. Member for Stafford is getting anxious because we might finish consideration of the Bill rather early and the Pig Husbandry Bill may receive another hearing. The hon. Gentleman should not try to help his hon. Friends who wish to frustrate that measure by adding to the time taken for debate on his Bill. If he presses me, he might find that I am not so keen on his Bill. I was about to conclude.

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Mr. Chope : Does the hon. Lady accept that the Government are not against the Pig Husbandry Bill and also that the Government closely considered the options for incorporating the provisions of the Road Traffic (Temporary Restrictions) Bill into another Bill? Obviously, if that had been done, we should have saved time. Will the hon. Lady accept that it was because we were unable to do that that we decided to support this private Member's Bill?

Ms. Ruddock : I am happy to accept the second statement that the Minister made. Whether or not the Government are for the Pig Husbandry Bill, on occasions like this, there seems to be an understanding with the Government which is demonstrated by the length of the Minister's speeches-- not the Minister present now, however. I shall not allow that to happen any more by allowing further interventions. I shall sit down after congratulating the hon. Member for Stafford on his success thus far. I hope that, with our support, his Bill will reach the statute book.

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Pig Husbandry Bill

Order read for consideration, as amended (in the Standing Committee).

Order read for resuming adjourned debate on Question, That the order for consideration of the Bill be discharged and the Bill withdrawn.

Question again proposed.

Sir Richard Body (Holland with Boston) : I beg to ask leave to withdraw the motion.

Motion, by leave, withdrawn.

Bill, as amended (in the Standing Committee), considered.

Mr. Deputy Speaker : With amendment No. 5, it will be convenient to consider amendments Nos. 1, 6 and 2. Not moved.

With amendment No. 3, it will be convenient to consider amendment No. 4. Not moved.

Consideration completed.

Third reading what day?

Sir Richard Body : Today, Sir.

Mr. Deputy Speaker : Queen's consent? Not given. Third Reading what day?

Sir Richard Body : Friday next.

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Nurse Prescribing Bill

Order for Second Reading read.

2.9 pm

Mr. Dudley Fishburn (Kensington) : I beg to move, That the Bill be now read a Second time. This is an unusual occasion--

Sir Richard Body (Holland with Boston) : On a point of order, Mr. Deputy Speaker. I wonder whether the Question on Queen's consent, in respect of my Bill, may be put again now that a Privy Councillor is here. I am gratified to see that my right hon. Friend the Minister of State, Privy Council Office is in his place.

Mr. Deputy Speaker : I regret that we cannot go back.

Mr. Fishburn : It is unusual for a 10-minute rule Bill to reach its Second Reading. Ten-minute rule Bills usually serve the purpose of presenting a particular aspect of policy that needs the spotlight of attention, but today's Second Reading gives the Bill a glimmer of the light of seriousness.

The Bill will enable nurses--29,000 community nurses, in the first instance --to write prescriptions for a limited number of products so that patients who are ill at home are able to receive them without having to go to their general practitioner's surgery to get his signature. The Bill does not cover advanced drugs or complicated matters that require diagnosis ; it would permit nurses to write prescriptons for such items as bandages, wound treatments, bedpads for those who are incontinent at home and for pain killers--the type of regular medical products for cases in which a community nurse will know exactly what is required and will be as well informed about the patient's needs as would any GP. For that reason, the Bill has been welcomed not merely by the Royal College of Nursing, but by the British Medical Association. Indeed, it has the support of almost everyone in the national health service because it is realised that the Bill will strip back one layer of the onion skin of bureaucracy. It will allow patients and nurses to work out in straightforward cases what medicaments and medical products are required and to get them to the patient as quickly as possible.

Getting this far has already been a long process. The Bill is not an idea that I pulled out of a hat. There have been no fewer than three reports in Britain on the subject--the Cumberledge report, a Select Committee report and the Department of Health's own report, the Crown report. All three reports advocated nurses writing prescriptions for a limited number of products. That practice is already in place in other countries, most notably in Canada and the United States. The Department of Health agrees that the practice should be allowed in this country within the next few years. My only disagreement with the Government is how soon we can put these sensible reforms in place. This afternoon, we have an opportunity to jump the gun and to let the Bill go ahead as quickly as possible. The medical profession is ready for it, and 29,000 community nurses are ready-- they have trained for the project and they know the list of medical products against which they could write a prescription. It is time for us to press ahead.

I understand that my hon. Friend the Minister for Health will have sensible reasons for saying that we should progress more slowly and perhaps have another cost

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benefit analysis. There is considerable pressure from the nurses and from doctors and general practitioners for the proposal to go ahead. It will cost nothing. It will greatly diminish suffering by allowing nurses to provide the right medicine with the minimum amount of delay. It will be a step forward. I know that my hon. Friend the Minister is sympathetic towards it. I hope that the proposal will be accepted as quickly as possible.

2.15 pm

The Minister for Health (Mrs. Virginia Bottomley) : I congratulate my hon. Friend the Member for Kensington (Mr. Fishburn) on his skill and determination in pressing his case for nurse prescribing. He has done very well to introduce his ten-minute Bill and to secure today's debate. I hope to convince him strongly of our sympathy for his cause and to offer him clear hope for the future.

The Government are fully committed to the idea of nurse prescribing. In one of my first speaking engagements as Minister for Health I said that, barring insurmountable obstacles, nurse prescribing would become a reality in the 1990s. Supporting the general idea of nurse prescribing does not mean that we can leap over some of the details that must be worked out. I hope to explain that we are making extremely good headway on overcoming the issues and concerns that have been identified.

As my hon. Friend the Member for Kensington knows, the Cumberledge report on community nursing recommended that

"the DHSS should agree a limited list of simple agents which may be prescribed by nurses as part of the nursing care programme and issue guidelines to enable nurses to control drug dosage in well defined circumstances."

We accepted the recommendation in principle and established the advisory group on nurse prescribing, chaired by Dr. June Crown, to advise

"how arrangements for the supply of drugs, dressings, appliances and chemical reagents to patients as part of their nursing care in the community might be improved by enabling such items to be prescribed by a nurse, taking into account where necessary current practice and likely developments in other areas of nursing practice."

We are grateful to the advisory group on nurse prescribing for its excellent work. It made many recommendations, the central one being that nurses in the community with a district nurse or health visitor qualification should be allowed to prescribe items necessary for the care of conditions for which they take professional responsibility. In addition, nurses with a district nurse or health visitor qualification and certain specialist nurses in the community should be able to supply patients with items within a group protocol and to adjust the time and dosage of medicines.

The report was published and issued for comment in December 1989. In total, 330 responses were received from the four United Kingdom countries. They included replies from health authorities, family health service authorities, medical, pharmacist and nursing organisations, from individual nurses, trade unions and pharmaceutical companies. In general, commentators were in favour of implementing the recommendations in the report.

However, the report had identified various issues requiring additional work before final decisions could be taken and a schedme implemented. There are four main issues and my hon. Friend the Member for Kensington, who has worked closely with me and with the nursing organisations, is aware of many of them. First, there

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needed to be an authoritative cost-benefit analysis. Secondly, the consequences for education and training needed to be identified and schemes established. Thirdly, the precise type of drugs that nurses can prescribe needed to be settled and, finally, detailed administrative arrangements needed to be worked out.

Those are obviously important aspects that are vital to establishing a viable and successful scheme and they need detailed attention. We are taking them all forward at the same time, but the work cannot be completed overnight to allow immediate legislation. Perhaps the most important area requiring further work is the assessment of the cost and benefits of the report's recommendations. We all realise that nurse prescribing will bring benefits to patients and staff, but, as the report recognised, a more thorough study of those benefits and a full assessment of costs are needed before the final decisions about implementation may be made. Therefore, we have commissioned the management consultants Touche Ross to carry out a full cost-benefit analysis.

The consultants are collecting data from a representative sample of health authorities and family health service authorities, through interviews and questionnaires, to discover how nurse prescribing would affect community nurses, GPs, hospitals, pharmacists and patients. In their assessment, they have been asked to include the resource effects of potential changes in the volume and type of drugs, bandages and dressings prescribed, and in the number of pharmacists dispensing fees ; any additional training required ; necessary administrative arrangements ; and any changes in the time worked by nurses and GPs.

The consultants' report is due at the end of August. We would hope to take decisions about implementation soon after. I hope that my hon. Friend the Member for Kensington will agree that that is a swift timetable for action. However, there are details and complexities which need to be considered and tackled properly for fear that otherwise they will emerge at a later date and will cause difficulty when a Bill goes through this place.

As I have said, much work is also being carried out on the other issues identified in the advisory group's report. The United Kingdom Central Council for Nursing, Midwifery and Health Visiting is working on the education and training implications. We have asked it to let us have its initial views about the training programme by the end of June. Once the training requirements have been established, it will, of course, be necessary to devise training materials and to train the trainers before appropriately qualified nurses could start their top-up training.

My hon. Friend the Member for Kensington will also be aware of our great commitment to nurses' education. Recently, I was able to announce a further 14 Project 2000 courses and £71 million is being spent on Project 2000 this year. We are well aware that training and the development of professionalism in our nurses are fundamental to the health service's ability to provide high-quality patient care. Two issues will have to be tackled : initially, the training of the 28,000 community nurses, district nurses and health visitors who, it is thought, are the most appropriate groups to undertake nurse prescribing ; and, secondly, the way in which that training can be incorporated in the mainstream

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of training for nurses who plan to join those groups. No training can take place until we have finalised the details of the formulary. This month, officials will be meeting members of the joint formulary committee of the British National Formulary to ask them to set up a nurse practitioners formulary sub-committee, along the lines of the dental practitioners sub-committee, to advise us about the appropriate contents of the nurse formulary. My hon. Friend the Member for Kensington identified, in general terms, the items that it was expected that nurses should be able to prescribe. However, he will be the first to recognise that, when it comes to deciding exactly where the demarcation line should go, there are a number of complex issues to be resolved. We expect that the sub-committee will need about a year to complete its work. If, as is likely, the nurse practitioners formulary contains prescription-only medicines, we will need it to liaise with the Medicines Commission about appropriate procedures.

My hon. Friend the Member for Kensington will understand that it is important to have discussions with pharmacists, general practitioners, nurses and with a great range of experts to ensure that they all properly understand how the arrangements should be carried out. There is also the question of the link with general practitioners and, for example, the way in which the prescribing scheme works. We have made good headway in recent years on thoughtful prescribing. There is a strong initiative to ensure that patients receive the drugs that they need and I have no doubt that there is a place for nurse prescribing within that framework. However, we need to be sure that we have the details right as we move forward to legislation. We are also carrying out work to establish the administrative arrangements for the introduction of nurse prescribing. Officials have already had detailed discussions with the Prescription Pricing Authority about pricing mechanisms and arrangements for providing information about nurse prescribers' prescribing. In due course other practical details will have to be sorted out, such as the design of the prescription pad.

My hon. Friend will be aware that in our determination to provide a high- quality health service to patients, we need to make sure that all our professional groups work to the maximum of their ability. Indeed, 95 per cent. of health care takes place in the community. Now that we have implemented the main part of the NHS side of the National Health Service and Community Care Act 1990, we are swiftly moving towards implementation of the community care aspects. The link between the health service and social service departments in implementing care in the community is essential. The role played by community nurses, health visitors and district nurses and the full contribution that they can make is a matter to which we have given careful consideration.

Recently we produced a report under the chairmanship of Sheila Roy, a regional nursing officer, on nursing in the community. It described the various models of provision of community nursing, whether attached to GP practices, working essentially on a patch system or under the different models which are becoming commonplace in various parts of the country. All are agreed that the role, status and standing of nurses, in whom the public and the Government have great confidence, must be addressed comprehensively and thoroughly. We have reorganised nurse management in the Department. Nurses are the largest group in the NHS.

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They provide the hands-on, direct patient care. They understand the patient and especially the patient within the community.

I hope that I have made clear to my hon. Friend the Member for Kensington today that we see a clear role for nurses and an opportunity for them to develop and evolve their skills. I cannot give detailed support to my hon. Friend's Bill, but I assure him unequivocally that I have carefully noted his points. I value the contribution that he made by introducing the Bill. We shall work with determination and all possible urgency to give effect to the aims for which he has so effectively worked and the measure for which he argued in the House today.

2.26 pm

Mr. James Arbuthnot (Wanstead and Woodford) : I join my hon. Friend the Minister in warmly congratulating my hon. Friend the Member for Kensington (Mr. Fishburn) on the measure that he has introduced today. As a former deputy mayor of the royal borough of Kensington and Chelsea, I have kept in close touch with my hon. Friend's borough, and still live in it. I am well aware of the amount of work that he puts in on behalf of his constituents. I am also aware that he is tireless in bringing to the House interesting, imaginative and fresh proposals which could help not only his constituents but the entire country.

It is a truism to say that, whenever our constituents go into hospital they agree that a body of people has been absolutely fantastic in the level of care, sympathy and expertise given to the patients. Those people are the nurses.

I recently spent a weekend at Whipps Cross hospital, which serves my constituency. I arrived at 9 am on Saturday and left at 5 pm on Monday, having spent the time in between closely shadowing a junior hospital doctor and discovering the amount of time that junior doctors have to put in. I also discovered that the amount of work which nurses put in is beyond compare. I hold in high esteem the body of nurses who serve Whipps Cross hospital, as I know my constituents do.

It was encouraging and heartening that my hon. Friend the Minister gave such a positive reaction to the principles behind the Bill. The timetable that she set out in her speech was swift and encouraging. It is true that we need to get the Bill absolutely right to avoid the risk of spoiling the good measures which it introduces by bringing them in too hastily. The Bill is of considerable excellence. I have one reservation. If nurses are allowed to prescribe drugs, even minor drugs, which would in no way endanger or cause an adverse reaction in the patient unless the patient was taking some other form of drug and that combination--

It being half-past Two o'clock, the debate stood adjourned.

Mr. Deputy Speaker (Mr. Harold Walker) : Debate to be resumed what day? No day named.

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Private Members' Bills

TRAINING AND ENTERPRISE COUNCILS BILL

Order for Second Reading read

Mr. Deputy Speaker (Mr. Harold Walker) : I understand that the Bill is not printed. Second Reading what day?

Second Reading deferred till Friday 10 May.

PUBLIC SAFETY INFORMATION BILL

Order read for resuming adjourned debate on Second Reading [8 February].

Mr. Deputy Speaker : Not moved.

LOCAL GOVERNMENT FINANCE ACT 1988 (AMENDMENT) BILL Order for Second Reading read.

Mr. Deputy Speaker : Not moved.

WATER REQUIREMENTS (PLANNING) BILL

Order read for resuming adjourned debate on Second Reading [19 April].

Mr. Deputy Speaker : Not moved.

GARDEN SUPPLIES (SUNDAY TRADING) BILL

Order for Second Reading read.

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