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Why would one NHS Trust employ someone who had been dismissed by another? Even more bizarre why would a Trust dismiss someone as a nurse and reemploy them as a health care worker? Surely they have shown themselves to be untrustworthy and unsuitable for the caring profession and as such should not be employed in any post that has direct contact with patients.

A recent article in the Health Service Journal (HSJ) highlighted the issue of struck off nurses being employed in hospitals as health care workers. Nursing and Midwifery Council chief executive Dickon Weir-Hughes is quoted as saying “ I don’t think any member of the public would expect a  struck-off nurse or midwife to be looking after them as a healthcare support worker.”….” “We’ve struck people off as nurses who have then come back and worked as healthcare support workers. There’s nothing to prevent them from doing that.”

Well there may be nothing the Nursing and Midwifery council can do about it but that doesn’t mean an employer can’t do something about it. Surely any employer who received a reference for someone who had been dismissed from their post as a nurse and struck off the professional register would not be offering them a job bathing, toileting or feeding patients? It is of course up to employers to enquire about any gaps in a reference and to clarify why someone left a previous post and if an employee lies on their application form to hide the fact that they have been sacked as a result of disciplinary action well that is gross misconduct and a sack able offence.

Dickon Weir-Hughes acknowledges that some nurses may have been stuck off for “technical reasons” the implication being that just because you are no longer permitted to perform nursing tasks that does not necessarily mean you can’t perform other tasks for patients. Well I disagree.

 Presumably the thinking is that health care support workers work under the professional supervision of a qualified nurse or is that health care assistants are only responsible for the basic care tasks of washing, toileting and occasionally feeding!  Well my personal experience of hospitals both as a patient and relative of a patient is that it is not the professional medical care that determines the quality of your experience in hospital but whether someone comes when you buzz for help to go to the toilet or get a bottle, whether your made to feel a nuisance when you can’t get a drink because the water jug is out of reach, whether any one notices that you haven’t eat your meal because you can’t cut up your food and how long you are left in soiled sheets.

As a senior manager in a local authority I chaired many disciplinary hearings and I know just what misery can be inflicted on to a vulnerable person if the wrong type of person is responsible for their day to day care. If someone is struck off from being a nurse how could a mangers ever take the risk of trusting them in another caring role?

Blair McPherson is a former director of community services in a large local authority. He is author of a number of books on management the latest being Equipping managers for an uncertain future published by www.russellhouse.co.uk

Is the public sector running out of ideas or just running out of room to manoeuvre? I ask this question following a publication by a very high profile local authority chief executive. In this article he acknowledges that public sector managers have been very good at “squeezing efficiencies out of budgets by smart management and clever accounting”, he refers to changes in procurement, reforms of back office services and out sourcing of services. He could also have referred to pay cuts and redundancies but I suspect that in chief exec speak these human resource casualties are assumed as part of the changes and reforms.

 This was the reality of the recent past, year on year efficiencies. Sometimes these efficiencies were delivered within the context of a small growth in budget to take account of population changes which would cause an increase in demand like the growth in the numbers of older people. In effect this was giving with one hand but taking away with the other.

 Today as mangers start to work on next year’s budget the reality is very different the ”new normal” is to spend less each year. This is not expected to be a one off scenario but the normal state of affairs for the next four or five years. The management task shifts from making efficiency savings to” lowering costs and managing demand”. This is chief exec speak for lowing wages as this is the single biggest cost element and rationing or disqualifying people from a service. We have already seen evidence of this in how local authorities manage their adult social care budget with the tightening of eligibility criteria to exclude all but the most severely disabled whilst freezing or even reducing the fee level they pay to resident home owners and home care providers.

 Whereas efficiency saving required some creativity and some different ways of doing things, cutting wages and “managing “ demand is more about ruthlessly determined management, stopping some services because we can no longer afford them, and being fairly arbitrary in who gets a service.

Public sector managers will always have ideas about how services can be improved and efficiencies made but this is no longer the name of the game. The new normal is about reducing spending and reducing demand. For many managers in the public sector this means there is no room to manoeuvre, no way to protect the service and no way to protect their clients. Which of course many will view as no way to run a public service. 

Blair McPherson author of Equipping managers for an uncertain future and People management in a harsh financial climate both published by www.russellhouse.co.uk