Nurses to take over doctors' role

NHS nurses are to take on more duties currently only carried out by doctors under controversial plans being put forward by Alan Milburn, the Secretary of State for Health.

NHS nurses are to take on more duties currently only carried out by doctors under controversial plans being put forward by Alan Milburn, the Secretary of State for Health.

In his first keynote speech as Secretary of State, Mr Milburn will say next week that he wants to remove some of the demarcation lines between doctors, nurses and other health workers. He will tell the first joint-conference between the NHS executive and the committee of vice-chancellors and principals that he wants hospitals to follow the lead taken in the emergency out-patient services at Leicester Royal Infirmary where treatment is administered by "generic" health workers.

Mr Milburn is also enthusiastic about allowing nurses to take responsibility for administering powerful drugs, including chemotherapy to cancer sufferers.

As part of the strategy, and to tackle the nursing shortage, Mr Milburn is also reforming the pay structure to remove ceilings to promotion and higher pay for nurses.

Mr Milburn will say in his speech that modernising the NHS means getting to grips with the way care is delivered. He will announce the establishment of a new training centre to provide more clinical responsibility for the 250,000 nurses working in the National Health Service.

Doctors and other health professionals will be nervous about seeing aspects of their jobs done by nurses, but Mr Milburn has told colleagues he is keen to see the removal of demarcation lines. Nurses' leaders are also likely to wary. The Royal College of Nursing has been campaigning for nurses to be given a wider role in health care, but would be concerned about the merging of roles. A spokesman described the proposal as "exciting", but added: "We want to look at the detail of it and would be wary of going down the generic health worker route, but we are positive about this."

Nurses were given more power to prescribe drugs along protocols set out by doctors following a report, the Crown report, on prescribing.

The RCN has also been pressing for the nursing prescribing powers to be extended. Mr Milburn will not be able to announce that step on Monday but he is keen to give nurses more responsibility in wards and in surgeries, to help end the shortage of NHS nurses in this country.

Mr Milburn is determined to press ahead with the modernisation of the NHS. He will promote more flexible working by family doctors, nurses and hospital consultant.

The Secretary of State wants to see more out-of-hours use of cancer scanning equipment in hospitals and is also seeking to expand the scope of private finance initiatives in packages for entire health authority areas, to encompass primary care surgeries as well as hospitals.

Expanding the role of nurses is a key element in Mr Milburn's strategy of shifting away from health waiting lists - which dogged the tenure of his predecessor as Secretary of State, Frank Dobson - to faster health care for priority cases.

The commitment to ensure that suspected breast cancer sufferers see a consultant within two weeks of referral by their GP is to be extended next year to all cancer sufferers.

Mr Milburn is planning to announce local health guarantees to patients to ensure that they know where they can get health care during the millennium bank holiday period. However, he will resist demands by junior doctors for extra pay for working over the holidays in England and Wales.

Mr Milburn is bidding for a big increase in the health service budget in the three-year spending review which is now under way, and his case will be strengthened if he can show so-called "performance-related improvements".