By the way ... Stop putting blame on care assistants

AT MEDICAL school, we were constantly reminded to be sceptical, taught never to accept what we were told at face value.

With this in mind, I felt suspicious when reading a recent European study which found that cutting numbers of highly qualified nurses on the wards in hospitals and replacing them with untrained assistants increases the chance of death by 21 per cent.

It prompted the researchers to say that a government plan to deploy 2,000 nursing associates (who will have had less training than registered nurses) is a ‘risky experiment’.

It sounds like an obvious conclusion. However, it seems to me there are far too many confounding factors to point the finger for increased risk of death at the nursing assistants.

There have been cutbacks and reductions in other hospital services, too, including imaging, laboratories and pharmacies, all of which may contribute to the deterioration of standards that can lead to greater death rates in hospitals (although we don’t know for certain that they have actually increased).

This is not the first time there have been changes to the nursing workforce. In the Nineties, the training of student nurses was moved away from the wards and into universities. At the same time, state enrolled nurses (SENs) were abolished — they had only two years of training in contrast to the state registered nurses who were trained for three years to diploma level.

In my experience, some of those SENs were the best — bedside nursing largely being a matter of good instinct, discipline and common sense.

The SENs were replaced by healthcare assistants, who have no registration and no formal training. Nonetheless, many are very good — pairs of hands where pairs of hands and proper caring are needed.

These days, the university trained nurses are more likely to be at computers dealing with all the hoops and jumps required by regulation.

The savings needed in the NHS — cutbacks amounting to billions — drive a tendency to reduce the numbers of trained nurses and instead bring in healthcare assistants.

But to say that the result of this staffing change is a heightened death risk, when the change is due to cutbacks placing enormous pressures on healthcare across the board, is reaching the wrong conclusion about cause and effect.

And it is unfair on those healthcare assistants who at least are there on the wards to wash, feed and offer basic care to patients — demanding and very personal work that the graduatelevel nurse is now too overwhelmed to achieve.