Nurses jeer minister over health changes: Royal College of Nursing conference unimpressed by claims that it takes longer for benefits of policy to reach hospitals

NURSES jeered a health minister yesterday when he attempted to defend the Government's changes to the National Health Service.

Dr Brian Mawhinney, Minister of State for Health, was heckled by delegates at the Royal College of Nursing annual conference as he acknowledged the widespread scepticism among NHS staff over the Government's changes. He suggested that their concerns were due to the fact that 'it takes longer for the benefits which the new system is bringing to be noticeable in the hospital ward'.

But the minister added later that nurses could no longer be guaranteed jobs for life. 'As money follows patients and contracts, so the old concept of a (staff) establishment, a fixed number of nurses employed in a hospital, has got to be under review.'

Dr Mawhinney's speech to the 1,200 delegates in Harrogate, Yorkshire, was interrupted by a demonstration by about 30 student nurses against job cuts and plans to employ more health care assistants on the wards in place of qualified nurses. They raised banners saying 'Quality needs qualified' and 'Jobs not dole'.

In his speech, the minister said he was aware of the pressures, the 'increasingly frantic pace' at which nurses appeared to work. 'We have got to find the appropriate balance between getting the work done and providing the time and space which allows nurses to minister instinctively to those needs of their patients that cannot be measured by science.'

But Dr Mawhinney's conciliatory remarks were met with mutterings of cynical disbelief around the conference hall. When he recalled his experience as a young man being treated for a suspected kidney stone at Belfast City hospital and his gratitude to the nurse who held his hand during a particularly painful episode, one delegate shouted to roars of approval: 'She wouldn't have time to do that now]'

The conference welcomed the minister's announcement of grants worth pounds 1m to advance the best clinical practices in nursing, in particular a new bursary to honour the West Indian- born nurse Mary Seacoal, a previously unsung heroine of the Crimean War.

Professor June Clark, president of the Royal College of Nursing, attacked the 'contract culture' pervading the NHS, including training. In place of a national strategy for training nurses, reflecting projected population changes, there was now a vacuum that had led to the closure of some teaching institutions. 'There seems to be no central guidance about what training should be purchased and how. This whole contracting process has turned out to be hugely expensive and inefficient,' she said.

Professor Clark warned nurses to be on their guard against moves in the health service to 'dilute, de-skill and de-professionalise' nursing. 'If unchecked it could destroy the greatest resource which the NHS has - the commitment of its nurses.'

Plans to allow nurses to prescribe some drugs and medical treatments have been shelved indefinitely as part of the Government squeeze on public spending.

A Tory backbench Bill paving the way to nurse prescribing was passed by Parliament more than a year ago. But implementation of the measure was postponed last autumn because of fears that it would add to the spiralling NHS drugs bill.

Dr Mawhinney was unable to say when, or whether, nurses would be given prescribing rights. According to an analysis by the Royal College about pounds 7m would be needed to introduce nurse prescribing, but it would save more than pounds 500,000 a year in unnecessary travelling costs incurred by district nurses and health visitors.