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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)

  • posted before I was finished.

    Stupid - I mean the website, not me! (well, to be really honest, I give it the benefit of the doubt in this case).

    correction to last para.

    then I said to myself, what is the point! Now I am fed up, and I give up and thank goodness I can retire. I still have a passion for nursing and can watch from the sidelines but can severe myself from the clutches of the NMC before they hike their fees, incur further managerial problems and inefficiencies and before I have any trouble from them which could mar the end of a successful career.

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  • Anonymous

    Nobody is arguing, I think, that you must not have nursing expertise within the NMC.

    The point is that if the NMC is to rule on good or bad behaviour, it has to be seen to be neutral: if there were only nurses considering the behaviour of other nurses, accusations of potentially 'protecting our own' could arise. If you only have laymen, they don't understand the job of nursing.

    You need both - and I think, from memory, that when the GMC sets up a panel to decide if a doctor is fit or not, the panel has a majority of lay members on it (But I am not 100% sure that I can trust my memory on that).

    Politicians are not keen on being regulated by anybody. I have always wanted a Pinocchio nose device, to be fitted to all politicians as standard: when they tell a porky pie, their nose grows so the rest of us can see for sure what is going on. It would change the way they behave, and it would let us all see if the reasons they give for policies, are their true motivations !

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  • bob cat

    Interestingly both NMC and GMC hearings work on a similar basis, I had a look after the comment above. Both have lay members as part of the panel, as well as professional nurses or doctors. So why would CHRE be calling to ban nurses being in the top job at the NMC and not the GMC? Where's the money?

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  • bob cat

    FAO NT: Where does it say that the CHRE is stating that a registrant should be prohibited from holding the position of registrar because I can't see any reference to that in the interim report. Would you provide your reference for us please?
    Thanks

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  • Toby Ornottoby

    Does the military have non-military people to run its disciplinary processes? Should NMC disciplinary hearings (a court martial) be organised by a lay person?


    Me thinks not. To quote the Americans, because they actually have a written Constitution.... The panel of a court martial...

    https://en.wikipedia.org/wiki/Courts-martial_in_the_United_States#Constitutional_foundation_for_courts-martial

    "A court-martial has always been an ad hoc tribunal created and appointed by the order of a commanding officer, as the convening authority, the tribunal is established the express purpose of considering a set of charges that the commander has referred to the court.

    The convening Authority considers the statutory prescription offered by the United States Congress, those "BEST QUALIFIED," in selecting the "panel" or jury for the court-martial. In turn, the members of the court-martial, who are generally under the command of the convening authority, take an oath to "faithfully and impartially try, according to the evidence, their conscience, and the laws applicable to trial by court-martial, the case of the accused." By their oath, the panel members expressly agree to leave behind any influence from the commander who appointed them. The current practice in the United States Armed Forces is to appoint a number of officers to a standing panel of members. In cases where the accused is an enlisted member, the accused may request that enlisted service members be appointed to the panel.

    The appointed or retained defense attorney may challenge both the military judge and members of the panel for cause. However, the military judge determines the relevance and validity of any challenge. The prosecution and defense initially possess one peremptory challenge to members of the court-martial. The accused may also challenge a member of the panel for cause "at any other time during trial when it becomes apparent that a ground for challenge exists." The UCMJ prohibits a convening authority from unlawfully influencing the court. A defense attorney may bring a motion to challenge the validity of the court-martial where it appears that a convening authority has unlawfully influenced court-martial members."

    Very long-winded I admit but it does point out that professionals should judge professionals because only they can actually understand the intricacies of a particular case.

    While I acknowledge that the vast majority of senior nurses I know couldn't organise a "grand urination celebration in a distillery" I would at least be able to talk peer-to-peer with them instead of teaching them the basic of nursing and/or spelling.

    Much fun is currently being enjoyed by watching the Leveson Inquiry. Who is the panel made up of? Yup MPs judging MPs... Of course it's the lunatics supervising the lunatics... BUT AT LEAST IT IS DONE IN FULL VIEW OF THE PUBLIC!

    Imagine the mirth with these headlines....

    George Collins (former manager of BetterBuys) Head of the Metropolitan Police said today that from now on every Wednesday will now be a statutory police holiday.

    C of E Archbishop George Stropolis (former CEO of the Bank of Greece) today abolished singing in churches due to the risk of airborne infections.

    His Holiness Pope Dave Betts (former housewife) decreed that, according to equal opprtunities legislation, men can now become Nuns.

    Queen Elizabeth II has abdicated and appointed Tinkerbell as her direct successor.

    Actually... I'd be happy the last one!

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  • Tiger Girl

    Toby Ornottoby | 15-Jun-2012 8:11 am


    If the court martial is internal - just soldiers involved, disobeying orders, etc - then clearly it is a purely military affair (human rights of individual soldiers apart).

    But nurses and doctors are involved with patients, and patients are usually not nurses and doctors: a bit like would you use a court martial, if a rogue soldier had started to machine-gun people in Trafalgar Square ?

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  • Toby Ornottoby

    Tigga - Court Martials are used for all breaches of professionalism in the armed forces - including interactions with the public they serve. Most professional organisations have "Departments Of Internal Affairs" and most of them are staffed by members selected from within their own ranks.

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  • bob cat

    We're not the armed forces though. Different model. There could be a case for including lay members in court martials as well.

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  • bob cat

    Any progress on that reference NT?

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  • Toby Ornottoby

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