“Competence, like truth, beauty and contact lenses, is in the eye of the beholder.”

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NURSES

“under any of the scenarios examined in the report, the number of nurses planned is almost sufficient to match demand.”

So, we will have enough nurses, but with a proviso.

“However, this depends on the assumptions made about average length of hospital stay in the National Beds Inquiry being met. If they are not, there is likely to be a shortfall of nurses over the next twenty years.”

THERAPISTS AND SCIENTISTS

“The number of therapists and scientists is projected to exceed demand slightly, although this may mask shortfalls in certain professions.”

We will have enough therapists and scientists.

DOCTORS

“However, whichever of the Wanless scenarios is adopted, there is likely to be a significant shortfall in the number of doctors, estimated at around 25,000 in twenty years’ time.”

There are not going to be enough doctors!

This is also the view of the CMO. Liam Donaldson on several occasions has stated we need more doctors. He does not seem to buy into the argument we are overproducing doctors.

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“All these projections are made on the basis of current skill mix.

The report estimates that, if 20% of the work of junior doctors and GPs passed to Nurse Practitioners, the potential shortfall in the number of doctors would be eliminated. 20% is, on the basis of research in general practice, at least, a fairly conservative estimate, and should be easily achievable.

However, the report points out that Nurse Practitioner consultations are, on the research evidence to date, longer and there is, therefore, a productivity loss that could increase the demand for nurses by a further 10%.

This could be filled if 12.5% of nurse workload could shift to Health Care Assistants (HCAs). But on the basis of a transformation rate of 1.5, this would require additional recruitment of almost 70,000 HCAs in addition to a projected increase in demand anyway of 74,000. The report concludes that, although there is scope to increase the number of HCAs, it may be difficult to recruit so many additional HCAs on top of the existing workforce of 350,000.

All these projections are, of course, dependent on the ability to recruit and retain the large numbers of extra staff involved. Wanless points to the importance of pay modernisation in sustaining improved recruitment and retention. However, local recruitment and retention initiatives, and the possibility of career progression, are at least as important as revised pay arrangements and the possibility of career progression, are at least as important as revised pay arrangements. If it is true, as is often anecdotally stated, that local nonhealth employers of unskilled and semi-skilled labour are the main competitors in the labour market for support staff, then offering a genuine chance of career progression must be a key component of any recruitment strategy.

So HMG plans to woo unskilled and semiskilled labour by giving them competetive terms and conditions in addition to what is considered an attractive competency based career structure.

The unskilled labour will acquire competencies that will turn them into little fragments of nurses.

The nurses will acquire competencies that will turn them into little fragments of doctors.

The doctors will acquire competencies to plug the gaps, to train the fragments, and take the blame.

And all the little fragments will be joined together with the super-glue of teamwork.

Those who think this plan will work, feel we are producing an excess of doctors.

Those who think this plan is ill-conceived, complex, overambitious, expensive, and destined to fail, feel we are underproducing doctors.

The Witch Doctor comes into the latter group.

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LINK TO UK MISSING KIDS WEBSITE

LINK TO MISSING PERSONS WEBSITE

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