NHS care 'left to student nurses'

Lives are being put at risk because student nurses are being left on their own with patients, a study has claimed. A poll by the Royal College of Nursing of 1,500 student nurses found nearly half had been left unattended with patients without warning. Guidelines say student nurses should always be monitored except those in their final year and even that has to be prearranged. The government said patient safety was of "paramount importance".

The survey showed 44% of student nurses had been left unattended without warning and without a doctor or qualified nurse present. Eight in 10 of those said it had happened on at least three occasions. Of the 553 first-year students questioned, 42% said they had been left on their own. And 15% said they had witnessed adverse events while left unattended. But 84% said they did not report that they were left unsupervised.

Gill Robertson, the RCN's student nurses adviser, said there were reports of students just eight weeks into their training being left alone. She said this could happen on surgical wards and other areas of a hospital where patients were extremely ill. "That is like the average person being left with a patient. It should not be happening and is a risk to patient care."

She added nurses were being stretched because of the cuts being made - the RCN estimates over 22,000 health staff posts have been lost in the last 18 months. And another survey of nurses working in 173 hospital wards revealed a third of nurses thought patient care was being compromised on each shift because of reduced staffing.

RCN general secretary Peter Carter agreed the financial problems in the NHS were to blame for the problem. "Those registered nurses left have to do ever more with even fewer resources." Mr Carter also said he was concerned by the reports of student nurses not being able to get jobs once they had qualified. "I am hearing worrying stories from nurses who qualified last September who are still unable to get jobs because trusts are freezing entry levels posts to save money."

Health Minister Lord Hunt said: "Patient safety is of paramount importance to the government and NHS staff alike. "We would expect any nurse, whether in training or in practice, to report any incident they feel has an adverse effect on patient safety." Liberal Democrat health spokesman Norman Lamb said: "This is extremely worrying - patients' lives could be at risk. "The damaging deficits in the health service not only result in job losses but have a serious impact on the remaining workforce."

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NHS bungles pay deal -- more pay for less work

A pay deal that gave hospital consultants [senior doctors] a salary increase of 25 per cent left them working shorter hours and treating fewer patients, the National Audit Office has found. It says that the consultants deserved more money, but it was regrettable that the public and the NHS had not seen benefits in greater productivity and better services.

The contract, agreed in 2003, cost œ715 million in the first three years - œ150 million more than the Department of Health estimated. In that time the average consultant's pay rose to œ110,000 a year while the average number of hours worked fell from 51.6 a week to 50.2. Although there was an 11.3 per cent increase in the number of consultants working in the NHS in the two years after the agreement, the amount of consultant-led activity increased by only 4 per cent. "The bottom line is that the Department of Health has increased consultants' salaries without demonstrating any extra productivity in return," said Edward Leigh, MP, chairman of the Commons Public Accounts Committee, to which the audit office reports. "This is one more example of weak financial management by the Department of Health. It drove through the new pay deal with scant regard for proper evidence and solid financial forecasting."

Sir John Bourn, the Comptroller and Auditor-General and head of the National Audit Office, said: "Consultants deserve to be paid properly for the work that they do. However, the new contract was introduced to benefit not only consultants but patients and the health service in general. "Although a new contract was needed, it is regrettable that the costs are higher than expected and that we are not yet seeing any clear evidence of improvements in productivity or services for patients."

In negotiating the contract, the department used out-of-date information on the hours that consultants actually worked. In spite of evidence that the average was between 50 and 52 hours a week, the department worked on the assumption that it was 47 hours. It then agreed a contract with the British Medical Association that was based on an average of 43 hours a week. In fact, consultants continued to work much longer hours than these, and under the new contract were paid for them. As a result, the contract cost œ150 million more than the department expected.

Lord Hunt, the Health Minister, said: "The new arrangements reward and incentivise consultants who make the biggest contribution to service delivery and improving health services. This has helped us to recruit and retain highly skilled consultants, historically a challenge for the NHS. We now have low vacancy rates - fewer than 2 per cent - and more than 10,000 more consultants working in the NHS than when the Government came to power."

Andrew Lansley, the Shadow Health Secretary, said: "This confirms that the Government simply didn't understand what consultants were doing before they made assumptions about the new contract."

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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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