'The opportunity to regulate HCAs must not be missed'

After the exposure of the neglect and uncaring situation at Mid Staffordshire Foundation Trust and the appalling cruelty at the care home Winterbourne View, I feel we cannot sit back and do nothing. On asking several people if they watched the Panorama programme on Winterbourne View they confessed to me that after a few minutes they had to turn the television off as it was too distressing.

We have an opportunity with the Health and Social Care Bill now in the House of Lords in trying to change the government’s view that voluntary registration for healthcare assistants will do. I do not think this will be adequate.

I have received a letter from The Registration Council for Clinical Physiologists who had said the government’s preference on the issue of regulation is for “assured voluntary registration” and as such, although clinical physiologists were recommended for statutory regulation by the Health Professions Council in 2004, ministers are currently unwilling to consider the possibility of statutory regulation for their registrants. They have significant concerns about the government’s position in favour of “assured voluntary registration”, which they believe is unsustainable in the long run and currently stands to penalise both dedicated health professionals and patients.

“If we continue to play second best by not having full registration of people giving direct patient care it could mean a serious threat to patient safety”

In Europe such procedures are undertaken by statutory registered professionals. If we continue to play second best by not having full registration of people giving direct patient care it could mean a serious threat to patient safety. I hope ministers will listen and realise what works and what does not work and put patient safety first.

We should learn from each other. There is no incentive for clinical physiologists to register and that the voluntary register’s informal arrangements do not provide adequate attention for patients nor does it have powers of enforcement. This will be a similar situation if the HCA register is only voluntary.

It has been found almost four in ten nursing staff at some hospitals are untrained HCAs. It is patchy across the country and in some hospitals there is a big difference of the quality of care between wards.

I have witnessed some very good and some abysmal care. On one occasion some years ago when my husband had to be admitted to a hospital in Peterborough as an emergency when he became ill on route to Yorkshire. I found him in a ward where the one trained nurse was run off her feet doing the drug round and every now and again she had to stop and answer the telephone - she had no help. As I am a paraplegic and use a wheelchair I had a helper with me and a patient who was desperate to use the lavatory asked my helper if she would take him which she did. Another patient asked if she would give him a shave - these were patients in need of basic care. To my amazement on the way out of the ward there were two HCAs chatting at the nurse’s station when patients needed them. That picture has stayed in my mind to this day.

Last year I had the unfortunate accident breaking both my legs and while waiting for an operation I spent a short period of time at the Spinal Unit at Stoke Mandeville Hospital. On a Monday morning an HCA rang in to say he could not come in to work and one of the hard working nurses told me “he does it every Monday morning”. It was so frustrating for the whole team being let down by an unreliable HCA who never seemed to be disciplined.

I have had many letters from concerned people, many of them retired nurses, who feel HCAs need training in basic nursing, hygiene and bedside manners. This would give them confidence and pride in their work.

It is of great concern to many people that nurses who have been struck-off their register can then work with vulnerable patients as HCAs with no registration and are free to carry on with their unsatisfactory behaviour putting patients at risk.

Baroness Masham

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