“The times they are a-changing”

Published: 17 August 2011

Howard Catton, RCN Head of Policy and International, describes the growing support for mandatory regulation of health care support workers

It is five years since the RCN first called for the regulation of all health care support workers (HCSWs) and began actively lobbying to achieve that. At times it has felt that we may have been a lone voice but as Bob Dylan might observe, "the times they are a-changing".

The commission on the future of nursing and midwifery, set up by Gordon Brown, recommended regulation; Dickon Weir-Hughes, Chief Executive of the Nursing and Midwifery Council, has regularly highlighted the significant public protection issues caused by lack of regulation; and the Commons Health Select Committee said recently it was particularly concerned about a range of groups who undertake nursing care but are not regulated. Momentum behind HCSW regulation is gathering, as Bob might say, like a rolling stone.

Chaired by the influential and respected former Health Secretary, Stephen Dorrell MP, the Health Committee’s report said: "The committee endorses mandatory statutory regulation of health care assistants and support workers and we believe that this is the only approach which maximises public protection."

This is significant because other types or models of regulation such as licensing, voluntary or employer-led systems have recently been proposed by the Government. Read between the lines and these other options are effectively second best. Plus it raises the question of why patients or the public should not be entitled to a system that will maximise public protection.

Of course, moving ahead with regulation is a significant challenge but it is time now to move the debate on from the "if" to the "how and when". This will mean tackling some tough issues such as the scope of practice, delegation, accountability, standards and competencies.

Some might see this as indulgent professional navel-gazing, but get this right and the outcome will be higher standards and quality care for patients – and, I would argue, a more confident and collegiate nursing team.