Tories hoped to pass new legislation on new non-doctor roles ‘with a whisper’ and fail to keep it quiet – but it passes anyway after Starmer decides not to oppose
A Tory attempt to keep dangerous new ‘secondary legislation’ on NHS care quiet by passing it with little or no debate failed today, but the legislation passed anyway – because Keir Starmer decided that Labour would not oppose it.
Doctors’ Association co-chair Matt Kneale published a thread before the meeting explaining the dangers of new ‘Physician Associate’ (PA) and ‘Anaesthetist Associate’ (AA) roles that are not medically trained – but are allowed to do much of a doctor’s work. The roles are a core part of the Tories’ so-called ‘NHS Workforce Plan’ – a way to rapidly create lots of positions that patients will think are doctors – but which do not have medical qualifications.
At least two deaths have already been linked by coroners to incorrect diagnoses by PAs – 30-year-old Salford woman Emily Chesterton, whose embolism was diagnosed as a calf strain, and 25-year-old Ben Peters, who was sent home from A&E after his serious heart condition was dismissed as a panic attack.
Below are a few excerpts from Kneale’s lengthy thread about the government con and its dangers – click through on any of the tweets to read the whole thread:
Many other medical professionals chimed in on social media to condemn the planned change and point out that it is highly dangerous. Others pointed out that the government is preventing highly qualified doctors from becoming GPs, and health companies are making serving GPs redundant, while pushing PAs:
The government’s expansion – and renaming – of these roles is part of what experts call ‘scope creep’: physician’s assistants and anaesthetist’s assistants, as they were originally called, are valuable roles in carefully limited settings, but NHS England, the government body appointed to run (and run down) the NHS has been using them way beyond their original scope, for example even to perform some types of brain surgery and expecting them to ‘learn on the job’.
Scope creep is not limited to these roles. A hospital boasted recently of one of its ‘nurse practitioners’ being the first to take a lead in a heart operation. But the government hopes to con the public about the fact that PAs and AAs are not medically trained – first by renaming them and now by having them regulated by the General Medical Council (GMC), which oversees qualified doctors. The GMC appears to want the change to increase its influence, but the British Medical Association (BMA) – and, according to a BMA survey, 90% of doctors – want the roles to revert to their original names and be regulated by the Health and Care Professions Council (HCPC), like other non-doctor roles.
The workforce plan is a key part of the government’s push to so-called ‘integrated care systems‘ (ICS) – a direct import of the US ‘accountable care organisations’ (ACOs), which were originally called the same by the UK government but renamed to ICS after bad publicity about US ACOs. ICS involve rewarding health bodies in the English NHS for not spending their budgets, creating a perverse incentive for them to withhold and ration care because they will make more money.
The purpose of all this is to simplify and reduce NHS care so that it is more profitable for private providers, but it is being ‘sold’ to the public by claiming it’s about sustainability and providing ‘more’ care outside hospitals.
As Kneale pointed out the day before the meeting to pass the ‘statutory instrument’ (so-called ‘secondary legislation’ without a debate or scrutiny in the House of Commons), the Tories hoped to get the legislation through with ‘a whisper’, with almost no notice. This tactic failed – people present at the meeting told Skwawkbox it was unprecedented in the number of people who turned up, both doctors and campaigners against the change and representatives of the GMC to promote it, as well as MPs.
But the government was able to pass the legislation – because Keir Starmer had told Labour not to oppose it, as he has done so often with even the most damaging Tory measures, including so-called ‘Integrated Care’ – unsurprisingly when Starmer, Streeting and co have accepted huge sums from private health companies and investors. This is a yet another betrayal of Labour members and unions, who have voted repeatedly at Labour conferences for the party to fight downskilling and integrated care:
Skwawkbox understands that only one MP – independent Claudia Webbe, who has written in the Morning Star of the issues with Integrated Care and everything being done under its banner – spoke up to oppose it.
If you need to receive treatment, make sure to check that any ‘doctors’ who will be providing the treatment are in fact doctors.
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