Nursing Auxiliaries and Health Care Assistants (Hansard, 10 December 1998)

§ Lord Hunt of Kings Heath
My Lords, concerns have been raised in the past about the need for regulation of support workers, which include, among 1028 others, nursing auxiliaries and health care assistants. Some concerns were raised during the consultation process for the review of the Nurses, Midwives and Health Visitors Act, completed earlier in the year. The Government are currently considering the report's recommendations.

§ Lord Clement-Jones
My Lords, I thank the Minister for that reply. Does it mean that the Government really do believe that there are standards of recruitment which are not currently being met in hospital trusts? When the Bill to modernise the NHS comes before the House, will they take the opportunity to introduce regulation of nursing assistants and health care assistants?

§ Lord Hunt of Kings Heath
My Lords, on the question of legislation, I am afraid that the noble Lord will have to await the outcome of Ministers' current consideration. On the wider issue, we recognise some of the concerns that have been expressed about the non-regulation of such health care assistants. I point out to the noble Lord that health care assistants carry out assigned tasks supervised by registered professionals and for the most part we owe a great debt of gratitude to the thousands of health care assistants working in the health service.

§ Baroness Gardner of Parkes
My Lords, is it not a fact that many health care assistants are doing exactly the same job as nurses have done in the past? Since everyone has moved up to higher levels of training and junior hospital doctors' hours have been reduced, state-registered nurses have replaced them and "diplomates" or graduate nurses are being replaced by health care assistants. Is it not time that we looked at renaming health care assistants and giving them the status that they deserve? Many people wish to enter nursing but cannot get the A-levels required to take up the Project 2000 training.

§ Lord Hunt of Kings Heath
My Lords, as I said earlier, Ministers are considering the question of the regulation of health care assistants. However, I do not think that there is evidence to support the point that they are filling the gap left by registered nurses. The ratio of qualified nurses employed in the health service compared with unqualified support staff is the same now as it was 10 years ago.

§ Baroness Masham of Ilton
My Lords, does the Minister agree that it was a retrograde step to do away with the state-enrolled nurse? He or she had to be qualified for two years and was a practical nurse.

§ Lord Hunt of Kings Heath
No, my Lords, I do not agree with the noble Baroness. The changes that we made to nursing training through Project 2000 have been very advantageous. Nurses are taking on more and more responsibilities. They must have the right training for that. However, I accept that enrolled nurses still have an important role. We have around 100,000 on the register. 1029 The Chief Nursing Officer at the Department of Health has encouraged, and continues to encourage, the health service to employ enrolled nurses.

§ Viscount Bridgeman
My Lords, does the Minister accept the need for the early implementation of a central register for carers which embraces all carers? That will make checking for criminal records much more straightforward and so give further protection to a vulnerable section of the population, the aged, so many of whom live alone.

§ Lord Hunt of Kings Heath
My Lords, I welcome the noble Viscount to the Dispatch Box for his first appearance. I think I would prefer to write to him on that question. As regards health care assistants, as I have said, Ministers are currently considering the legislative question.

§ Baroness Castle of Blackburn
Is the Minister aware that auxiliary nurses, who in many cases play a vital role in the running of a ward, receive no training whatever before they appear on the ward?

§ Lord Hunt of Kings Heath
My Lords, no specified training has been laid down centrally for health care assistants. However, I can tell my noble friend that the Department of Health is encouraging NHS employers to train health care assistants and encouraging them to use NVQs as a training programme.

§ Lord Meston
My Lords, does the Minister agree that the risks are perhaps greatest in those homes, particularly private homes, where only one qualified nurse is required to be on duty at any time and which otherwise depend on auxiliary staff? Does he further agree that, at the very least, the proprietors of such establishments should be encouraged to require and to take up employment references?

§ Lord Hunt of Kings Heath
Yes, my Lords, we wish to encourage the proprietors and managers of nursing homes to do just that. Those proprietors have a duty of care to ensure that all employees are suitably qualified and competent.

§ Lord Rea
My Lords, can my noble friend say what practical steps the Government are taking to encourage back into the National Health Service those many nurses of all grades—nurses and nursing assistants—who have left to look after their families or to take up another occupation?

§ Lord Hunt of Kings Heath
My Lords, the Government inherited a very difficult situation in relation to nurse shortages, poor morale, the effect of the internal market and the ravages of macho management. The Government are dealing with the problem. We are injecting resources and we are abolishing the internal market. We are developing a new HR strategy, we are encouraging more students, we are encouraging returnees and we are developing better 1030 working conditions. For nurses and for people coming into nursing, the future is very bright in the health service.