Labour’s push to replace fully-qualified doctors with half-trained ‘associates’ now being matched by push for half-qualified nurses with no limit on type of work they can do
As Skwawkbox has exposed at length, Health Secretary Wes Streeting and his boss Keir Starmer have fully committed to the ‘integrated care’ programme for the NHS, copied from US ‘Accountable Care Organisations’ (ACO), that means closed hospitals and rationed treatment – and incentivises so-called ‘Integrated Care Boards’, of which the Tories set up forty-two to cover the whole of England, not to treat patients, because they receive a share of any budgeted money they don’t spend back as profits.
This system of perverse incentives has led to a huge drive to close hospitals and to drive down staff costs, to ensure that private providers can make the biggest possible profits and has already seen the government authorise – with Starmer’s Labour then in supposed ‘opposition’, collaborating fully with the Tories to push through the required legislation – the expanded use of so-called ‘physician associates’ (PAs) and ‘anaesthetist associates’, who have less than half the training of qualified doctors and are being used by many trusts to replace actual doctors. Several patients have already died as a result of misdiagnosis by PAs.
As Claudia Webbe pointed out in an article for the Morning Star yesterday, the General Medical Council (GMC) is collaborating with the government on this ‘associate’ push and has told doctors who expressed concerns about the misuse of associates by trusts that they were:
being “insufficiently flexible” and said that any framework must allow “for an increase in scope over time” and that the RCA was “go[ing] beyond [its] remit” by “seeking to place requirements on employers.”
But the government and its NHS England managers, not satisfied with foisting non-doctor doctors onto patients, is doing the same thing with nurses, using ‘nursing associates’ who have only half the training of registered nurses:
And as healthcare professor Allison Leary has pointed out, trusts and ‘countless’ GP practices are advertising for lower-paid ‘nursing associates’ in the expectation that they will do all the tasks usually performed by a fully-qualified registered nurse – and even more – even in high-pressure departments like Accident and Emergency:
The misuse of associate roles to replace qualified nurses is not new – it goes back to at least 2017 as the Tories pressured the NHS to cut costs regardless of danger to patients:
But as Prof Leary pointed out, it is accelerating and broadening in scope under the Starmer-Streeting axis – all to cut costs and ‘reform’ the NHS for the sake of what the Streeting-commissioned Darzi report calls ‘superior return on investment’.
The government knows expanding the use of associates means more patients put in more danger – because Streeting’s own department has told him so:
And Streeting is doing this in a way that ensures that the poor suffer the worst:
As Claudia Webbe said on Tuesday, Starmer and Streeting and what masquerades as the Labour party under them are betraying the NHS and the millions of UK people who depend on it – and putting lives in danger.
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I noticed the word ‘care’ is prevalent whenever the NHS is mentioned.
This plan can see that word scrubbed altogether, and replaced with ‘avarice’.
‘Care’ now becomes a very distant second, having been lapped many times.
Any doctor, nurse, PA or what-have-you buying into this method (where supposedly unspent monies are distributed, but in reality treatment is denied to maximize that particular pot) DOES NOT give a flying f**k about ‘providing care’.
And as for ‘Vocation’….pfffft.
Once people get wise to this format and its workings, the entire medical profession -and all within it – will lose the respect of ordinary people far & wide; sympathy for medical staff could very well (if not WILL) turn into distrust and dislike far greater than that of MPs (who are never shy to shriek about the so-called abuse they receive, but never cop it anywhere close to the scale of nhs staff ).
Worst case scenario is that an army of Louis Mangiones could result.
…And rightly or wrongly (rightly, imo) there’s a lot of sympathy for Mangione amongst Joe Public.
It sounds like a rehashed version of the State Registered Nurse (SRN) and State Enrolled Nurse (SEN) set-up of old.
Except there weren’t any profit-motivated integrated care boards then.
Did you not read the article?
Moreover, my experiences as a patient were that the junior nurse (SEN) under training was supervised by the actual registered nurse (SRN).
The SEN’s duties did not include [checks the job advertisement quoted in this article above from Lincolnshire with the Peterborough post code]
Quote:
“….all the tasks normally undertaken by an experienced RGN”
Which would include supervision. Presumably of themselves.
Let’s consider a simple example: I’ve been having regular blood tests over the past twelve months. Back in November the trainee nurse struggled to find a vein and had to call an actual nurse with experience to carry out the procedure. In the absence of that experience and with no back up – as proposed here – both trainee and patient would struggle.
And that’s just a simple blood test.
Billy boy is, as usual, somewhat cavalier in his attitude and approach to those of us who actually have to experience the health system on a regular basis.
Dave – SENs were not trainee nurses they were qualified and regulated State Enrolled Nurses who had completed and passed a 2 year training course (the training course for SRNs was 3 years at the time).
Given that SENs were phased out in the 90s the value of your anecdote is at best questionable.
What’s ‘questionable’ about it, soft lad?
Nowhere dies dave mention SEN/SRN’s in the example (or anecdote, if you insist) he gives.
He does, however, mention a trainee nurse.
For the second time in as many posts, its evident you have failed to read and comprehend what’s actually been/being said, and are just posting your usual irrelevant SHITE
Toffee – I suggest that you reread Dave’s comment.
Oh. And there’s also this:
I’ve been having regular blood tests over the past twelve months. .
That’s twelve months or one year since.
It IS NOT the 1990s, you complete fucking kimball tag.
Toffee – Oh dear, are you really that stupid. 😞
And nowhere, “Einstein”, in the job description of an SEN or in practice was the requirement to cover “….all the tasks normally undertaken by an experienced RGN”
Which includes a supervisory role. This was the case when I was hospitalised (for six days) with a burst stomach ulcer – requiring six (6) pints of blood, many years ago and many years earlier in much younger days for nearly seven weeks with serious bowel issues.
Toffee is correct, Billy, you only read the bits you want to read and either discard anything which does not suit your bullshit narratives or subjectively re-define it beyond recognition to suit your convenience.
Once again, you are making things up – i.e. lying through your teeth.
In comparison, a corkscrew is a straight line.
So we got non doctor doctors and non nurse nurses. What’s next? Non lawyer lawyers. Non pilot pilots. Non police police. Non HGV driver drivers. The list is endless.
Well, we already have non-representative representatives in Government and Local Authorities.
So this is what’s meant by ‘Community health’ is it? – now any old Tom, Dick or Harriet can be your NHS ‘doctor’ or ‘nurse’.
What’s next? Recruiting from prisons? – that’s an intrinsic part of the US economy too, if we are intent on playing copy-cats. I’m sure there are quite a few locked up that are handy with the pharmaceuticals.
DIY healthcare is looking like the safer option these days – but if it goes wrong, at least you’d be in control of your own ‘death by a thousand cuts’.
I can just imagine the new black comedy TV series … “OOOHH! ER-R?” we’ll call it … documenting all the deaths and disasters that will inevitably spin out of Streeting’s NHS sinkhole project.
There’s a saying in tech that if you don’t pay for it, you are the product … Streeting is evidently extrapolating this as the business model for the health of this nation. ‘Free’ healthcare will be paid for by the patients, whether by creaming the money off the service to reward CEOs and shareholders or selling your personal data to very dubious corporates to exploit for nefarious reasons.
“There’s a saying in tech that if you don’t pay for it, you are the product”
Or, to put it another way, if you are in a card game and can’t spot the mark, it’s you.
‘the new black comedy TV series … “OOOHH! ER-R?'”
Get Harry Hill in to present a Medical Bloopers show in the old TV Burp format. Being a former med student (or was it doctor?) himself, he’d bring an extra satirical bite to proceedings!
It’s the plan. As devised by United Health Insurance, PWC and McKinsey. And implemented by Tories and Labour. Screw staff. Deny care. Subsidise privateers. Hand health data to Palantir.
Roll out American accountable care.