Health secretary Andrew Lansley has sought to emphasise the role nurses should play in commissioning, after being “rebuked” in a no confidence vote by the Royal College of Nursing.
The health secretary made the remarks as he attended a 90 minute “listening seminar” with nurses at the RCN Congress in Liverpool today.
The listening event followed the passing of motion of no confidence in Mr Lansley’s management of NHS reform by congress this morning. It was passed by more than 98 per cent of delegates.
Responding to the vote of no confidence, Mr Lansley said: “From my point of view I take it as a rebuke.”
After hearing concerns from 62 nurses in the seminar, Mr Lansley apologised that he had not made it clear that “nurse leadership” was at the centre of the NHS reforms.
He said: “It was about nurses having a central role, not only in the delivery of care for patients but also in the decision making about that care. We need to get that right, we haven’t got that right, we need to make sure we do.”
He added: “From my point of view, it’s about clinical leadership and nurse leadership. We need to move from a top down management structure to a front line led clinical leadership and nurse leadership culture. If I’ve not got that across I apologise.”
The government has so far not made it mandatory for the new GP-led commissioning consortia to have boards, or set out who should sit on them.
However, following campaigning from a number of groups, including the RCN, it has been suggested that making it a statutory requirement to have boards with nurse representation is a possible concession in the Health Bill, which has currently been “paused” while Mr Lansley listens to concerns about it.
He said: “We are intending to make changes, the intentions of which are to improve the bill… This is a co-production.”
RCN chief executive and general secretary Peter Carter said: “We’re genuinely hoping that this listening exercise means something, the real tangible proof of that will be if there are the changes – most of the changes if not all of them – that we want.”
RCN regional director for the South East Patricia Marquis said nurses from a range of specialities had raised concerns over privatisation, the future of nursing education and the question of whether GPs were fit to be handed commissioning budgets.
She said nurses needed to play a real role in commissioning. “We don’t want a token nurse, what we want is nurse involvement on commissioning boards,” she said.
Ciaran Hurley, RCN representative for perioperative nurses, told Nursing Times: “The biggest concern was the absence of nursing and representation on the consortia, and all the structures they’re proposing.
“I’m not reassured by what I’ve heard today – there remains a power imbalance between doctors and nurses, and I’ve not heard anything that would change that.”