My Lords, in her absence I thank the noble Baroness, Lady Greengross, for introducing the debate earlier this afternoon on the regulation of healthcare support workers, which opened the discussion leading to the two amendments that are down here. The first is in my name and the second in that of the noble Lord, Lord Willis, who unfortunately is unable to be with us. We wish him a speedy recovery.
I want to make one or two points by way of introduction. First, I would be remiss not to say that the Royal College of Nursing has long called for the mandatory registration and regulation of healthcare support workers. The RCN believes that it is an important part of the registration and regulation process because it has done a tremendous amount of work in talking to both registered nurses and healthcare support workers. It feels that this should be the way forward in the interests of patient safety. However, disappointed as they have been that we could not have regulation, they have moved on and are sympathetic to the amendments that we have laid down.
Mention was made of the disappearance from this setting of enrolled nurses. I went back to look at the case that was made for that disappearance and the end of enrolled nurse training. It happened because the enrolled nurses were being abused and misused by being left in charge of wards and being required to undertake tasks for which they had not been trained or were not being supervised. I have to say that the various skills currently being used by healthcare support workers far exceeds the definition of basic skills. They are doing things that might suggest that they are being abused and misused. I am sure that the House will agree that we need to do something about the situation. The Francis report requested that we look at the registration of support workers.
The question of standards leads into the amendments that we have put down. When a healthcare support worker is under the direction of a registered nurse, that nurse is working to care standards that have been determined by the Nursing and Midwifery Council. It seems sensible that the skills for care should be linked to care standards so that the registered nurse who delegates to the support worker can understand to which standards that support worker has been trained as well as the level of understanding that that support worker should have. I think that I used this example before in a debate on the health Bill, but instead of them just being taught how to carry out a skill such as taking a blood pressure, they should also understand the side effects of a raised or lowered blood pressure and what that means in terms of reporting it to the person who has delegated the task.
That brings me to the amendments we have tabled. If I may, I will move straight to Amendment 23A, which is a more succinct qualification of our first amendment and brings in all the points. It is in the name of the noble Lord, Lord Willis of Knaresborough, and is supported by me and the noble Lord, Lord Patel. The first point of the proposed new clause is that:
“Any individual working directly with patients or clients must be certified to have completed training in basic standards”.
In other words, they must go through training which equips them to have a certificate of qualification.
Secondly:
“The standards, in subsection (1), will be published by Nursing and Midwifery Council and approved by HEE”.
There should be some agreement between the NMC, which is the regulatory body, and Health Education England on subscribing to that.
Thirdly, the amendment states:
“Employers must retain a register”.
Once the support worker has been through the agreed LETB training, which would be delegated to a college of further education, they would reach the basic standard and be on a register and hold a certificate. The additional point in Amendment 23A is that it would be,
“an offence for any employer to employ an individual to work directly with patients or clients who is not registered as holding a certificate of training in basic standards”.
That would get over the point that people could go from one place to another without a valid certificate. We are interested to know how the Minister will respond to the amendment’s proposals on basic training certification in place of registration and regulation. I beg to move.
6.45 pm