‘Almost no evidence’ NHS pseudo-doctors can be used safely – new report

Govt knows ‘physician associate’ programme is dangerous, yet is determined to expand it as part of NHS cost-cutting to maximise profit

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.

The latest of these completely avoidable deaths was that of Pamela Marking, who died after being sent home after a PA diagnosed her with a nosebleed when she was suffering severe abdominal issues – leading a coroner to warn that PAs are being used far outside their scope of competence:

But a new study has found that there is almost no evidence that any ‘safe’ scope for the use of PAs exists at all. The study, by Oxford University, concluded that far from enough studies have been done to assess whether any such safe scope is possible – and that there is no evidence that using them adds any value to NHS patient care:

No evidence was found that physician associates add value in primary care or that anaesthetic associates add value in anaesthetics; some evidence suggested that they do not.

This comes as no surprise to Wes Streeting or any of his executioners in NHS management – the government’s own studies concluded that using PAs poses ‘high risk’ to patients:

Govt’s own analysis says its non-doctor ‘associate’ plan poses HIGH risk for patients

More than nine out of ten NHS doctors say that in their experience, the use of PAs in a patient setting is dangerous to patients. Such PA ‘pseudo-doctors’ – most patients don’t realise they’re not being treated by a doctor – are being more and more widely used by NHS trusts to cut costs and the government plans to drastically expand their use, while the General Medical Council, which is abetting their use by agreeing to regulate it instead of only fully-qualified doctors, has refused to commit to national standards and practices in their use because such requirements would be ‘insufficiently flexible’ for NHS trusts. In some cases, associates have been used even for brain and heart surgery.

Indeed, it seems the only reason for trusts using PAs is to cut costs by using them instead of doctors, rather than to assist doctors. The same is increasingly true of nursing, with trusts now openly advertising for partially-qualified ‘nursing associates’ to do ‘all the duties of a [fully-qualified] registered nurse and more’.

The more evidence comes out, the clearer it is that there is no place for this use and inevitably ABuse of partially qualified people in place of properly qualified and regulated doctors and nurses. But Streeting and Keir Starmer, who have taken large donations from private health interests eager for profit, remain committed to it – just as they were and are determined to cut the Winter Fuel Allowance despite their own analysis telling them it will kill thousands of pensioners every year, and to cut support for disabled and long-term sick people, despite the United Nations condemning such policies as a gross breach of their human rights and despite knowing that it leads to deaths and severe distress for the victims.

Social murderers should be in the dock, not in office.

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