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Wednesday, 27 September, 2000, 16:31 GMT 17:31 UK
Labour's health pledges: can they be delivered?
ward scene
Health workers will be taking on new roles
The major NHS expansion flagged up at this week's Labour party conference relies on finding the staff to do the work.

Plans to cut waiting times and expand screening services could stand or fall on finding school leavers, technicians and unqualified staff to do many routine tasks in the health service.

There are various people that could do a significant amount of the work such as technicians and school leavers

Sir George Alberti, Royal College of Physicians
And the public may have to accept having simple procedures carried out not by a doctor or nurse, but by a new breed of healthcare worker.

The immediate future will see further expansion of the role of nurses and development of healthcare workers who will be delegated many technical jobs such as carrying out blood tests and ECGs.

Increasingly, technicians and operating department assistants, as well as school and college leavers, will be brought into provide more care for patients.

Professor Sir George Alberti, president of the Royal College of Physicians agrees that the government's pledges on health are deliverable if urgent moves are made to delegate work to people other than doctors and nurses.

"You don't need to train as a nurse to be an effective health care practitioner. There are various people that could do a significant amount of the work such as technicians and school leavers," he says.

Professor Alberti suggested that men, and people from ethnic minority groups, not traditionally attracted to nursing, may be more willing to carry out the more technical tasks, including administering drugs and taking blood.

"Getting this all up and running in four years is going to be challenging but it is entirely feasible if we start to get the training and the recruitment in place now.

"Much of this work will be non-doctor work. If we get more nurse practitioners in place and the health care practitioner role up and running we can leave the consultants free to consult," he added.

Schemes already in place include training theatre nurses in Manchester to work as surgeons' assistants, and appointing support workers in Lincoln and Louth to tasks such as taking blood, meaning junior doctors are disturbed less when on call.

tourniquet and arm
Trained non-doctors already take blood
Katherine Murphy, deputy director of the Patients' Association, said that NHS moves to employ increasing numbers of unqualified staff should not cause alarm for patients, providing proper safeguards are put in place.

"As long as the support and the supervision and the training is in place this should be a good idea in principle. But getting the right people is the key and you only do that by paying them the right salary."

Her views were echoed by Patient Concern director, Joyce Robins, who said there were major reservations about people being taught to perform a number of specific tasks.

"The thing is these tasks - like taking blood - can go wrong and who will pick up the pieces then?" she asked.

"Who is going to supervise these people and who is going to teach them? Maybe the solution is to improve working conditions in the NHS so we might be able to attract back some of those nurses we have trained at great public expense."

Cancer screening pilots

Expansion of the breast cancer screening programme will include piloting of new ways of working at three breast cancer screening units.

This will involve splitting the workload between nurses, doctors and radiographers to free up radiologists time.

Extending the role of nurses has been championed by the Royal College of Nursing and is supported by the Department of Health as a means to help reduce waiting times.

Health secretary Alan Milburn has reinforced that nurses will get additional powers under the government's health strategy but also promised more money for nurses' pay as well as funding for creches in NHS hospitals.

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See also:

27 Sep 00 | Labour
Milburn pledges anti-cancer drive
26 Sep 00 | Labour
Blair pledges to make amends
05 Apr 00 | Health
Nurses' powers to be increased
13 Apr 00 | Health
Patients 'prefer nurses'
16 Aug 00 | Health
Consultants 'reject NHS Plan'
07 Jan 00 | Health
Pledge to extend breast screening
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