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RCN rejects split calls in row with Hunt

The Royal College of Nursing Congress has almost unanimously rejected calls for the organisation to split into two in a direct rebuttal to criticisms from the health secretary that there is a conflict of interest in the current set up.

The row between the RCN and health secretary Jeremy Hunt began this morning when general secretary and chief executive Peter Carter launched a scathing attack on the government’s plans to require trainee nurses to complete a year working as a healthcare assistant before starting their full training.

Mr Carter claimed the policy had been formed “on the back of a napkin” in response to the Francis report into Mid Staffordshire Foundation Trust and had “more holes than a Swiss cheese”.

Asked about the criticisms in an interview with Sky News at lunchtime, Mr Hunt said the RCN had its own “very serious questions” to answer in relation to its involvement with Mid Staffs.

Mr Hunt added: “Let me say this, I think the Royal College of Nursing have got to be very, very careful. They missed what happened at Mid Staffs. The Francis report levelled some very serious criticisms about it. It said that they basically allowed their trade union responsibilities to trump their responsibilities as a royal college to raise professional standards and that they have a conflict of interest.”

Robert Francis QC recommended the RCN give consideration to splitting its functions into a professional body and a trade union

In response to Mr Hunt’s comments the RCN council tabled an emergency resolution this afternoon. In total 99.34% of the 455 voting members present at the session agreed that the RCN was “more effective because of its dual role as a Royal College and a trade union”.

Council chair Kathleen McCourt told congress the RCN’s professional work enhanced the trade union work and “vice versa”. She gave the example of staffing levels as an area which is informed by both members on the front line and professional practice.

East Midlands council member David Harding-Price said: “Our strength is being able to address both the professional side and the trade union side… The doctors are split [into trade union and professional colleges] and Mid Staffs still happened; Unison and other unions don’t have a professional arm and Mid Staffs still happened.”

Readers' comments (17)

  • Mr Hunt why don't you also require trainee doctors to complete a year working in accountancy as that is where you want to take the NHS into the private sector, where doctors run the health business.
    You insist trainee nurses become care assistants first as that will teach them to care. It seems that you are implying that generally nurses are not caring or the probability of having a caring nurse is greater if that nurse becomes a carer first. As a doctor you suprised me on that assumption.
    Please show us the evidence.
    I work wih a nurse who was a carer first and she is a very difficult person to work with, yet I am not so stupid to believe that all nurses who are carers first are difficult people. If this person was employed any where else people would have the same problems with her.

    As for spliting the RCN in two parts it does not matter either way, what matters is to do the job without fear or favor.






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  • Hi
    I am led to believe that only nurses were employed at Mid Staffs, what about the docs, AHPs, radiotherapists, domestics, etc,etc,
    We are an easy target. If you are not a caring person 20 years as a HCA wont make a difference!
    Deal with the number of nurses on shifts and stop trying to scapegoat the nurses

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  • Asking trainee nurses to work as healthcare assistants for a year is just delaying the process and unlikely to attract candidates. Why oh, why not just get the training and education worked out properly? Why, oh why not recruit nursing students from people who are caring in the first place? I believe that the ability to be caring is innate and you cannot and should not have to be taught it. I still think that healthcare assistants are just being used as task orientated poorly paid staff and used as an excuse to save money than paying and recruiting trained staff. Wards are run on far more trained nurses than ever before and the care is worse... what is that all about? Well, the poor training and poor recruitment. In fact, I feel that we are getting much better caring students through now who also use their brain cells. At long last I feel there even be hope for nursing and care of ill people, (not to mention improving the health of the nation), in the future.

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  • it seems that it is once again pushing the real issues to the side instead of investigating and addressing them, and applying yet another sticking plaster. the issues won't go away with this method but just create more and more problems which may become increasingly more apparent after time has passed making them even more difficult and costly to deal with.

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  • Odd. I was encouraged to do a year as an HCA before moving into training and that was thirty years ago. Hardly a new idea is it?

    Also I fail to see the difference between this option and what is currently occurring with HCAs and Apprentices securing a vocational qualification with many then subsequently going on to nurse training. It can't be a cost thing as it would mean that people would have to be salaried for an extra year, what it does mean is that nurses who subsequently qualify via this route will have accrued more insight into direct patient care and experience on day one of their course.

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  • @ Anon 1.24pm.

    You are wrong. It is exactly about the money. Universities will have to wait a year for people to start training and because of that an extra year before they can receive funding.

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  • A lot of the time trained nurses are taken away from the bedside to attend to the reams of unnecessary paperwork. This does leave a lot of the basic work that is vitally important in the hands of the HCAs. I have worked with some appalling HCAs and also some very good ones. It appears from the Francis report that it is at this level where there were a lot of failings. Of course under staffing played a part but also poor training of HCA's. Presumably it would be the latter who these trainee nurses would be working with so potentially exacerbating an already poor situation.

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  • Problem is student nurses are accepted onto training courses on the basis they will achieve the academic standard not on the basis that they have the attitude and personal skills to get on with and care for people many of whom are quite vulnerable.
    I feel that making student nurses supernumerary on wards has not helped matters and may somehow have given students an idea that they (not all) can choose not to be hands on.
    I agree with previous comment that there are many other professional involved in a patients care and they also have accountability for the overall standards of care within a hospital setting.

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  • michael stone

    Opening myself up to being bashed here, but:

    1) It would make sense for nursing to have a Royal college which is separate from 'union' activity;

    2) I think the 'you have to work as an HCA before we let you come on the course (or I think 'before we give you a grant' ?)' was not intended to claim that 'caring' people cannot be 'academic'. It was, I think, an attempt to deter people who are academic to the near exclusion of 'being caring centred'.

    3) As I've been writing on this site for months, do not allow the goverment to sidetrack the issues about resources, management, etc, by rabbiting on ONLY about the 'caring or non-caring 'attitude'' of nurses - it seems to have won that battle, and distracted everyone from what Francis actually said !

    COMMENT: I'm sure there are loads of great nurses, and great HCAs, out there !

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  • Making students work as HCAs might have been feasible when we had Schools of nursing. Now we have universities, how would a person go about becoming a nurse? Would they have apply to an individual hospital/ trust? Or spend 4 years on the books of a university? That initial year would be very difficult to arrange. Suppose your local hospital/ trust has no vacancies. How far would a student/HCA commute?

    Training can be a good thing, but it has to necessary. Students spend long periods of time on wards already. Maybe they could spend longer periods in clinical areas such as care of the older person. This would seem more practical to me. Having droves of would be student nurses arriving at a hospital might affect the job prospects of potential HCAs. After all if you know every year your trust will get x amount of trainees for a year. Why bother hiring anyone else?

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  • It's a good point that the concept of a year as a health care assistant is to deter non caring people however where is the evidence that the uncaring nurses at mid staffs were academics?

    Also what I wonder is why say nurses have to be able to do basic care and then say in order to gain experience of that they need to do the job of HCA. If it is a part of the role of a trained nurse won't they do it while nursing? Surely basic training can include a significant amount of basic care - enough to mean that academics would be put off with three years that includes this work. Is there anything wrong with learning the job from the basics up? I like to think the further you progress the more things you can do - not that for every new skill you take on you drop a more basic one. Unfortunately NHS managers soon perpetuate this myth that progress means stepping away from hands on care. I hope this will end the saying that 'it doesn't take a trained nurse to...'

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  • Anonymous | 22-Apr-2013 8:32 pm, not sure what makes you think Jeremy Hunt is a doctor. http://www.jeremyhunt.org/about-jeremy

    Either way this suggestion is barking mad. As others have said the structure of employment and universities no longer supports the apprentice model. I know HCAs unable to access university courses and caring people unable to get experience as HCAs despite both being adequately qualified academically.

    Personally I have not come across more than a handful of uncaring nurses in a 25 year NHS career. However on an almost daily basis, I have come across nurses who are exhausted from excessive workload. Almost all spend many years working full time in addition to spending almost as much time studying often largely in their own time and own expense.

    This government needs to look carefully at the features of Magnet Hospitals in the USA, rather than looking at the USA to support its privatisation whims, no doubt with the intention of lining their own pockets.

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  • michael stone

    Anonymous | 23-Apr-2013 6:52 pm

    It's a good point that the concept of a year as a health care assistant is to deter non caring people however where is the evidence that the uncaring nurses at mid staffs were academics?


    I have not read all through Francis, but if there was evidence of that, I have not heard about it. What I have heard, is the Julie Bailey issue - that 'the level of caring' seemed to be higher in HCAs and newly-qualified nurses, the implication being that soemhow 'the system they are working in, is 'driving out' the placing of 'we are here to care' from nurses'.

    I know a lot of that is perception - I know you can't 'show care' if you are permanently rushed off your feet, and have got no time to sit with a patient and talk to the patient. But if a patient 'feels I'm being ignored' for heaven's sake tell the patient 'I know I'm 'ignoring you' - I simply do not ahve enough time to not 'ignore you'' (IF THAT IS TRUE) - if you explain that, perhaps patients will start to lobby for more staff ?

    But the goverment has very cunningly avoided widespread discussion about 'are there too few nurses to care' by pushing 'are we recruiting people who are not committed to caring, as nurses'.

    I am puzzled, by one aspect of this - which could indeed imply some 'on the hoof' statements from goverment. I had originally assumed that this 'HCA experience' was going to be somehow 'before we will accept you to train as a nurse', but it has apparently morphed into 'before we will give you a grant to cover your training as a nurse'. And if 'working as an HCA' is INSIDE actual nurse training, THEN it becomes rather barmy as an idea ! And as I've said before, a year seems too long for a simple 'filter'.

    It is rather muddled - perhaps 'all other things being equal, if you apply for a nursing course and have already got at least 3 months work experience as an HCA, then your application will be given preference over those who have not got such experience' is what they should have gone for ?

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  • DH Agent - as if ! | 24-Apr-2013 10:12 am

    do you propose to read right through Francis?

    Have you read the several hundred pages of the reforms?

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  • michael stone

    Anonymous | 24-Apr-2013 1:25 pm

    I've read some of Francis, but I've also heard him talking about his findings, and heard him putting his conclusions to MPs, etc - and from what I've come across, he and I are on the same sheet of paper.

    I would read his entire report, if I wasn't so busy arguing with people about my special interest.

    More to the point, though, it is clear that Francis was very analytical both in identifying the problems, and in explaining a 'nested set of solutions' - the goverment is trying to get away with cherry-picking and implementing only the proposals it likes: everyone should be keeping up the pressure, to try and make sure that the 'integrated response' Francis clearly described, comes so fruition !

    The goverment is already trying to dodge 'there are not enough nurses to properly care' by implying that 'too many nurses do not want to care' is the issue -and they seem to be getting away with it !

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  • DH Agent - as if ! | 25-Apr-2013 9:33 am

    from Anonymous | 24-Apr-2013 1:25 pm

    thanks for your interesting update. I was just curious as I haven't read right through either of these docs. either and wonder how many actually have apart from those in government and senior management. it is easy enough to pick up the main gist of its content from the media and the many comments. I also watched the Francis being responded to by Cam in parliament on their website when it was first released and found their reactions very optimistic at that time, however, sadly from past experience I supposed the cherry picking was fairly predictable and I am particularly interested in the last paragraph of your comment.

    I do not have access to the full printed reforms doc. as I am abroad other than requesting the DH to send a copy to me, probably at great expense, and I am not able to read something anywhere that length on my computer screen but have skimmed over the online version.

    Although I watch all the developments with interest I am not directly involved and think that most of us have more important or interesting things to do with our time than to plough through the whole of this very dry reading whose policies will only stand until the next series of enquiries and proposals!

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  • One of the quickest ways to find out more about the reforms is this website
    http://www.legislation.gov.uk/ukpga/2012/7/contents/enacted/data.htm
    And just scroll to the bit you're interested in.

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