I hope none of you were too encouraged by the vocal opposition of the nursing profession to Andrew Lansley’s NHS ‘reforms’. I see from yesterday’s Times (sorry – can’t link to it since Mr Murdoch started charging for electronic access) that the hitherto hidden agenda of our nursing colleagues was made explicit at the no-confidence debate at the RCN’s annual conference.
Actually, let me amend that last sentence. I have lots of nursing colleagues for whom I have the greatest respect. The comments I’m about to describe came from that strident subset of the sisterhood who strut their stuff on the national stage provided by the conference.
The two key comments were the following. First, a lady from Birmingham, one Bethann Siviter, told delegates that since GPs had mismanaged the flu jabs, “how are they going to manage the NHS?”. Then in the face-to-face session with Lansley, an un-named nurse spoke of his (Lansley’s) “Victorian view that the doctor is everything”.
The first of those comments is presumably a re-hash of complaints in the media earlier in the winter that some GPs had not ordered enough vaccine, and takes no account of the effect of moving DoH goalposts such as the late inclusion of healthy pregnant women in the vaccination group. Whatever the truth of that particular matter (and even the Daily Mail blamed the government rather than the GPs) the glee with which the argument was resurrected hints at the underlying reasons for the interest shown by nurses in the reforms, and their opposition to them.
But it’s that second comment that confirms the true nature of the nurses’ dissatisfaction with the government proposals. It’s not the threat to the integrity of the NHS that drives their concern – it’s their obsession with an outdated perception of their position in the medical hierarchy. They clearly haven’t grasped the real problem with Lansley’s plans – the fact that the insistence on plurality of provision will result in the fragmentation of the NHS – for them, it’s all about their unrequited desire to take up the mantle of the white coat and stethoscope. They need to read Jacky Davis’s clear description of the issues in these pages.
I was tempted to write to The Times, but it won’t help the opposition to Lansley if we are seen to be fighting amongst ourselves. However, it is depressing to witness the failure to grasp important issues exhibited by fellow professionals in their national forum, and their determination to use the genuine fears over the effects of reform programme to advance their own agenda. And of course, the government’s belated recognition of the fact that GPs are not the only health professionals who need to be involved in commissioning is likely to result in the promotion of these same politically active nurses to the consortia, not the more sensible ones we work with in our hospitals.
I can’t help thinking, like the unreconstructed, arrogant, paternalistic monster of a consultant that I undoubtedly am, that it would be a lot better for the NHS, and certainly for patients, if nurses would just get on with the job of nursing. Then perhaps we’d hear fewer complaints about elderly patients sitting in pools of urine all day, and going unfed because they can’t reach their dinner.