Government urged to act now or destroy faith in the NHS with a repeat of last winter's hospital beds crisis

The leader of Britain's nurses said yesterday that the Government had just six months to save the health service.

If extra staff and resources were not put in place before winter to avert a repeat of this year's crisis, the public would lose faith in the service, said Christine Hancock, the general secretary of the Royal College of Nursing.

Addressing the opening session of the college's congress in Bournemouth, Ms Hancock recalled the Labour leader's warning to the nation on the eve of the 1997 election. "Tony Blair told the electorate it had 24 hours to save the NHS," she said. "Today, I think the Government has a little longer. But not much - maybe six months." She said the people who delivered and received health services had to "feel the difference very soon".

Referring to the Government's drive to cut waiting lists and improve cancer and heart care, she said: "Targets and headline figures are all well and good, but if we see a repeat of this winter's sorry tale of an NHS on its knees, people will lose faith in the NHS ... as nurses we cannot stand back and let last year's winter trolley-waits occur again."

Ms Hancock said later at a press conference that ending the practice of keeping patients waiting on trolleys in accident and emergency departments should be a top priority.

She cited a survey by the Association of Community Health Councils, which earlier this year found that almost one in five casualty patients waited for four hours or more before receiving attention.

The other immediate priorities for the health service should be the abolition of mixed-sex wards, which caused distress to many patients, and a drive to improve the cleanliness of hospitals."They are not difficult, they are almost easy - and the fact they don't happen is a disgrace," she said.

Boosting staff numbers on the wards was equally important though harder to achieve. But there were immediate measures that could be taken to prevent nurses leaving, attract qualified nurses back into the health service and encourage part-timers to increase their hours.

About 12,000 nurses leave each year, according to figures from the college. "If you just stop people leaving it would make an enormous difference," she said.

Ms Hancock confronted critics who demanded the return of "matron" as an answer, lampooning the battleaxe of popular legend who woke patients at 6am and limited visiting to two hours a day. But she said that patients wanted to know who was in charge on the wards. They wanted nurses with the authority of "matron" but without her inflexibility.

"I am not saying, 'Bring back matron. I am saying, 'Invest in nurse leadership' - because what patients want is an experienced nurse with the authority to make things better." She said a new breed of "super ward-sisters" was receiving training under the college's leadership programme, which began last year. A total of 432 nurses from 38 NHS trusts were being trained to give them more influence over care on the ward.

Ms Hancock made a sober assessment of the state of the health service. She said nurses were becoming increasingly important because of innovative developments such as NHS Direct, walk-in clinics and intermediate-care centres for convalescent patients. In a jibe at doctors and managers, she said: "The power base within the health service is beginning to shift." She also announced a campaign to persuade managers to work alongside nurses to solve local problems such as long trolley-waits.

Earlier Chris Watson, the president of the college, urged the Government to end inequities in the funding of long-term care for the elderly. She called for the introduction of free nursing care in nursing homes (where it is currently means-tested) as well as in hospitals. To applause, she said: "We want an end to what is a form of rationing targeted at some of the most vulnerable people in society."

* Nurses rejected a proposal yesterday that would boost the supply of organs for transplant by introducing an "opt out" system of donation.

Three out of four delegates to the congress ruled that the danger of damage to patients' trust in their carers outweighed the potential increase in the supply of organs. Opt-out schemes, under which patients are presumed to consent to their organs being used after their death unless they have registered an objection, are in place in a dozen European countries.

In Britain under the current law, people "opt in" as donors by registering their consent or carrying a donor card.