It’s not unusual for a trade union representing its members to resist change, and today the Royal College of Nursing is sticking well and truly to form. Not only has Peter Carter, its chief executive, called the government’s plan to put nurses through a year of work as healthcare assistants ‘stupid’, he has also penned an op-ed for the Guardian in which he appears resistant to the suggestion that the profession needs to consider wholesale reform following the Francis Report. Carter writes:
‘For the million or so people working in the NHS, a number of things come with the job: a boom-and-bust budget, growing demand and a high level of public expectation. What staff don’t always expect, although many have now become attuned to it, is repeated criticism from the government responsible for the health service.’
Carter goes on to call Jeremy Hunt’s remarks about the ‘normalisation of cruelty’ ‘unintentionally misdirected’, adding that ‘the sad reality is his remarks disappointed many in the health world, myself included. Yes, poor care happens and the Royal College of Nursing will never be a refuge for it; however, it is not systemic and if the rhetoric is overblown, people will take comments like these less seriously’.
It must of course be disappointing to hear a hard-working and altruistic profession which you have served for many years being painted in the light that Jeremy Hunt chose to do following the shocking Francis Report. But the RCN must beware appearing resistant to any suggestion that the training and continued development of nurses needs examining to ensure patients’ best interests are the priority. Does the profession believe, for instance, that good nurses should be rewarded for their hard work with a promotion that gives them a clipboard and more time away from the bedside? Can the RCN explain what the boundaries between healthcare assistants’ work and nursing should be? Carter says in his pieces that HCAs must be regulated and trained, as recommended by Francis. He also wants legally enforceable staffing levels on wards. These are all sensible ideas, but there is no suggestion in his response that nursing itself has any questions to answer.
Unsurprisingly, Ann Clwyd, the Labour MP leading a review of the way the health service handles complaints, took a dim view of this argument that no systemic failures exist in nursing. On the Today programme this morning, she told Carter:
‘Two thousand emails can’t be making up a story. Two thousand people have bothered to write to me and are still writing to me and they all mention the same things over and over again. Things like having panic buttons out of reach, not being able to reach their food and water. I had one story about a woman who had two broken wrists, they were up in the air and the food and the water were dumped at her side. That story is repeated over and over again.’
Those who defend the NHS from all criticism often use emotional case studies to shut down valid debate about the service it provides. But Clwyd’s case studies are just as compelling as the success stories. They – and the recommendations of the Francis report – cannot be ignored, and the RCN must beware appearing to dismiss any case for reform out of hand.