Sunday, November 13, 2005


They cannot provide enough doctors so you get a nurse instead!

Nurses and chemists are to be allowed to prescribe any medicine except controlled drugs such as diamorphine, the Government has announced. The British Medical Association called the changes “irresponsible and dangerous” and called for an urgent meeting with Patricia Hewitt, the Health Secretary. The plans allow for “extended formulary nurse prescribers and pharmacist independent prescribers” to be able to prescribe any licensed medicine for any medical condition from next spring.

James Johnson, chairman of the BMA, said: “We need to meet urgently with the Secretary of State to clarify the conditions under which other professions can prescribe. It is difficult to see how healthcare professionals who are not trained to diagnose disease can safely prescribe appropriate treatment. “The BMA will be seeking assurances from the Government that patient safety will not be compromised.”

The Department of Health said that the extension of prescribing powers would mean, for example, that specialist nurses running diabetes and heart-disease clinics would be able to prescribe independently.This could help patients to control high blood pressure, quit smoking and manage their diabetes, and would take pressure off GPs and allow them to focus on more complex cases.

But Dr Paul Miller, chairman of the BMA’s consultants’ committee, said: “This is an irresponsible and dangerous move. Patients will suffer. I would not have me or my family subject to anything other than the highest level of care and prescribing, which is that provided by a fully trained doctor.” Hamish Meldrum, chairman of the BMA’s GPs committee, added: “While we support the ability of suitably trained nurses and pharmacists to prescribe from a limited range of medicines for specific conditions, we believe only doctors have the necessary diagnostic and prescribing training that justifies access to the full range of medicines for all conditions. “This announcement raises patient safety issues and we are extremely concerned that the training provided is not remotely equivalent to the five or six years training every doctor has undertaken.”

Qualified nurses have had prescribing powers for a number of years which have been gradually increased to include more and more drugs. Nurses and pharmacists will be able to take on the extended prescribing powers once they have completed training courses. Once trained they will have to keep their skills up to date.

Ms Hewitt said: “By expanding traditional prescribing roles, patients can more easily access the medicines they need from an increased number of highly trained health professionals. Today’s announcement means that the young person wanting to control their asthma or the terminally-ill patient being cared for at home by a multi-disciplinary healthcare team will soon find it easier and more convenient to get the medicines they need. “This is another step towards a truly patient-led NHS, giving patients the power to choose where and by whom they are treated.”

Christine Beasley, the Chief Nursing Officer, added: “Nurses are the biggest single staff group in the NHS and they have demonstrated that they are safe, careful and professional prescribers. Pharmacists have wide knowledge of medicines and the effects they have on people. This knowledge is invaluable to their colleagues and to patients. “Today’s announcement demonstrates our confidence in nurses and pharmacists and our wish to use their skills and professionalism to the full.”

Beverly Malone, the general secretary of the Royal College of Nursing, said: “This is something we have been campaigning on for over 20 years and the Government must be applauded for taking this step. “This is good news for nurses and most importantly it is good news for patients. They will now get even better care and faster access to medicines and research shows that nurse prescribing is safe, cost-effective and popular with patients."



For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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