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Nurses should be banned from top NMC job, says super regulator

  • 45 Comments

Practising nurses and midwives should be banned in future from the top job at the Nursing and Midwifery Council, according to the body responsible for overseeing the troubled regulator.

The council’s senior executive holds the joint post of chief executive and registrar, and is responsible for both running the organisation and managing admission to the NMC register. 

The NMC’s last permanent chief executive and registrar, Dickon Weir-Hughes, was a registered nurse, though his interim replacement Jackie Smith is not.

But the Council for Healthcare Regulatory Excellence has called for the law to be changed to “prohibit” the appointment of a registrant as registrar, in order to avoid conflicts of interest.

It argues that the registrar has “considerable power” and their “integrity and independence from the profession should be beyond question”.

The CHRE has also recommended that lay members should form the majority over registrants on the NMC’s ruling council.

The CHRE’s comments come in response to proposals from the law commissions of England and Wales, Scotland, and Northern Ireland to restructure the way the NMC and other regulators operate. Its views are likely to be highly influential on the commission’s final recommendations to ministers.

However, the proposed move away from professionally led regulation is likely to be unpopular with nurses. A Nursing Times survey earlier this year found 71% of respondents though it was vital a nurse or former nurse was either chief executive or chair of the NMC.

Unison and the Royal College of Nursing have indicated that they would like to see at least one of the top positions held by someone with a nursing background.

But CHRE chief executive Harry Cayton said: “Regulation is solely and only about protection of the public. It is not about the promotion or enhancement of the status of any profession; that’s the domain of the professional associations and royal colleges not the regulator.”

The CHRE also backed the commissions’ proposals to introduce “financial penalties” for misconduct or failure to comply with fitness to practise proceedings, which were revealed in March.

  • 45 Comments

Readers' comments (45)

  • michael stone

    andy | 11-Jun-2012 12:55 pm

    'Maybe its time for all regulators to be funded by the state as it is there for the protection of the public and we are all members of the public.
    The NMC should not be called a professional body anymore, it should just be a regulatory body'

    The fact that the NMC is primarily to protect the public from incompetent or malicious nurses, is the basis of the argument for not having a nurse 'at its top'. The fact that assessments must properly take into account the practicalities of nursing, is the argument in favour of having a nurse 'at the top'.

    Actually, I think a dual 'top' with a nurse and a layman, in a joint job title, probably fits best. It is the right balance, which needs to be achieved.

    And, is the NMC 'a professional body' for nursing ? Isn't it just the regulator ?

    To my mind, it is the union aspect of the RCN where that problem lays – the RCN is, it seems to me, both 'the learned body for nursing' and also a union: doctors have the BMA as a union, and all manner of Royal Colleges as 'learned bodies'. But there is the 'Royal' in the RCN, but not in the BMA – so surely to be equivalent, you would split the RCN into RCN and also a separate BNA ?

    Candy Cooley | 11-Jun-2012 4:21 pm
    morag cunningham | 11-Jun-2012 10:40 pm

    Re what I write above, I am not entirely sure if you do agree with me.

    My point, from my original post, is that if nursing is a profession, and nurses are 'self-regulating' in the same way that doctors are, it is insulting and offensive to nurses to treat nursing differently from medicine. Obviously when assessing 'bad practice' you need nursing expertise to set the 'acceptable standard', but you should not have 'professional defensiveness' within the NMC protecting bad nurses (or bad doctors re the GMC): it is the role of whoever is acting as 'defence council' to provide that defence.

    And drifting, I think Police self-regulation is an area in need of correction much more than the self-regulation of the clinical professions !

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  • Is the concern that there may be corruption e.g., with police investigating police and nurses investigating nurses and removal of any objectivity.

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  • Are they suggesting that a nurse doesn't have the integrity to hold this position. I'd have thought you need a nurse to understand what nursing involves and have the knowledge and maturity to consider there may well be mitigating factors surrounding each case - maybe that's what they are scared of.

    Surely if they are considering financial penalties then there is no reason for their proposed huge increase in fees. I like to think that 'failure to comply' also means fining those who make false, exaggerated or spiteful referrals and also those managers who haven't bothered to deal with issues at local level.

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  • bob cat

    I agree with Mike, I would also argue the same for politicians!
    The real question, or one of them, is why does CHRE argue this point, what do they have to gain?? My instinct is that 'doing the right thing' is getting in the way of 'getting things done'.
    However, conflating competition speak phrases like 'conflict of interest' with professional accountability issues demonstrates either the lack of understanding that we are articulating, OR a better understanding with a deliberate and strategic application. Both scary!

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  • Does anyone know if Gp's hold the top job at the GMC ? Be a useful refernce point

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  • bob cat


    Professor Sir Peter Rubin, current chair of GMC ,doctor of medicine and still practising medicine.

    http://www.gmc-uk.org/about/council/9905.asp

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  • Good idea, a better suggestion and certainly more appropriate would be to have the House of Commons and our 'Honourable Members' overseen by animal trainers.

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  • Righto, lets remove all "specialism" and put Joe Soap in charge of the NMC ,he/she can't do a worse job than the Nurses at the top are doing right now. But then lets not call ourselves nurses either, because the real meaning of the title has so many diverse meanings in the mind of the public and meaning which I for one would never take on as the meaning of my profession.

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  • "Nurses should be banned from top NMC job, says super regulator"

    is this a typo? surely it should read "Nurses should NOT be banned..."?

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  • Anonymous | 14-Jun-2012 11:15 am

    sorry I should have read the article before making my comment, which I did way back on 11 June but have forgotten what it was all about.

    then I said to myself, what is the point! Now I am fed up, and I give and thank goodness I can retire.

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