Regulating HCAs would not cost 'too much', says Robert Francis
Regulating healthcare assistants would be simple and would not “cost too much money”, Robert Francis QC has told Nursing Times.
In an interview following the publication of his landmark report from the Mid Staffordshire Foundation Trust public inquiry yesterday, Mr Francis said he believed regulating the HCA workforce was necessary to protect the public.
His comments are in contrast to those of prime minister David Cameron who said regulating HCAs could be “complicated” during his Commons statement responding to the inquiry report.
The report had identified the Nursing and Midwifery Council as the orgnisation that should handle any future regulation of HCAs. Mr Francis told Nursing Times he recognised there were concerns about the way the NMC had been delivering on nurse regulation.
He said: “All organisations have to ensure they are working properly and efficiently and that shouldn’t necessarily cost more money.”
But he said his recommendation on HCA regulation had been designed “not to be resource hungry”.
“Looking into it, it didn’t appear to me that it would cost a huge amount of money if you got a registration fee paid by each HCA, which would be less than it costs to regulate nurses - because in theory, at least, it’s a simpler job.
“We do need a system that protects the public by ensuring people are prohibited from continuing in that role when it’s not safe that they do so,” he added.
Mr Francis also explained why he wanted to see student nurses tested for their values before beginning their training arguing he was not suggesting nursing was not a technical job.
He said: “It seems to me to be a fundamental requirement of nursing that you have the personal qualities and commitment to make you a compassionate and caring person.
“I believe people doing this work need to demonstrate their aptitude for it otherwise they shouldn’t be coming in to do the work. Delivering compassionate work may sound easy but many people would not like to do the work that these people do.”
One key recommendation in the report was the creation of a legally-binding duty of candour on all NHS nurses and healthcare organisations.
Mr Francis said this would protect nurses who spoke out against poor care or risks to patients. He said: “There is support of a statutory nature for people you would loosely call whistleblowers.
“I have called for a statutory duty of candour that trusts tell the truth to regulators and that there should be criminal sanctions if there’s willful obstruction of anyone performing their duties and informing their trusts about concerns to patients,” he said.
“That is about as rigorous protection of whistleblowers as you can imagine and that’s what I intended.”
Commenting on his wider hopes for the NHS, Mr Francis said the system had to change and learn the lessons from the events at Mid Staffordshire.
“The leopard has to change its spots if the public are to retain trust in the system,” he said.
“The NHS mustn’t sit back and expect to be told what to do; it must take responsibility for implementing the recommendations. We need leaders to accept the lessons of the report and take the matter forward.”