Plans to scrap the nursing policy unit in the Department of Health are worrying.
Nursing has a vital role to play in coming up with practical and sensible solutions to the issues the health service currently faces. And there is an across-the-board consensus that nurse leadership, at the highest level, is the key to driving forward the development of best practice and policy.
But with these plans, the government is cutting off access to impartial and balanced advice – advice that is based on experience and knowledge, which could help create the very best policy, at a time when health services are under pressure as never before, and the RCN has written to the Secretary of State to make this case.
Nurses can draw on knowledge from their close contact with patients. This is an invaluable resource, rooted in the patient experience, which is vital to the creation of sensible, well-thought-out policy. To miss out on this is to miss a vital trick.
The government is already failing to listen to stakeholders and getting policies like those on student nurse funding very wrong. Without senior nurse leadership at the centre of government, bound by the civil service code, offering balanced advice and formulating and interrogating proposals, the situation will only get worse.
And it goes beyond UK policy. Having nursing within government is key to our ability to influence across Europe and across the world. The International Council of Nurses has already expressed concern that we may be falling behind the rest of the world because of nursing’s weak representation within UK government. We need strong policymaking at European level and this can only be properly done by government nurses working with nurses from other governments.
Equally, the profession’s influence in key international networks, such as EU presidency meetings of the chief medical and chief nursing officers, or in working with the department’s international team to shape EU legislation, is being weakened. We also lack nursing representation on World Health Organization delegations.
Across the world, there is a real appetite for examples and demonstrations of best practice from the UK that other countries can learn from. Indeed, the RCN works with sister organisations doing just that. But we need a senior, UK-government nursing voice to do the same.
Our health services are under immense pressure. The work of nurses in government goes on behind the NHS and it is essential that there is leadership across all sectors of healthcare. We have seen time and time again that when things go wrong for nursing, things go wrong for patients – and that is something none of us want.
Unless we have nursing advice and leadership at the heart of government, given the prominence and respect that it deserves, then the profession will be in the permanent position of trying to shape and alter policy from the outside. Decisions are made by those that are in the room. Nursing needs to be in that room.
As RCN member Edward Freshwater said, on proposing the motion at Congress, “Good leaders listen to their critics as well as their fans. The influence of nursing will be diminished by the decision to axe this team. Rather than side-lining the voice of nursing, there is a clear need for qualified and dedicated expertise. Nurses should be treated with the respect they deserve but this decision made them supplementary, at best and “an annoyance to be tolerated.” He ended by saying: “We are not silent and we will be will not be silenced.”
I agree. Decisions are made by those that are in the room. Nursing needs to be in that room. NT
Janet Davies is chief executive and general secretary of the Royal College of Nursing