Opinion: Nurse your patients, sirs, not your egos

Peter Cardy, chief executive of Macmillan Cancer Relief

In spite of the scandals of Alder Hey, Bristol and Shipman, doctors are still among the most trusted people in British society.

The British Medical Association is one of the bodies that represents their opinions, and it commands attention whenever it does so. It is listened to not only by the public, but also by politicians and policy-makers when it speaks on ethical issues ranging from contraception to euthanasia. It often sounds like any charity that has only the interests of the public at heart - but it also carries the extra weight of its highly valued profession.

It's interesting to remember that the BMA isn't a charity but a trades union with a successful publishing house (including the renowned British Medical Journal) and an annual income of about £70m. From time to time, it reveals its true colours as a trade body whose first priority is the wellbeing of its members.

In a previous column (Third Sector, 28 September), I described a senior BMA spokesperson lecturing about choice in end-of-life decisions as if all the choices belonged to the doctors.

It's interesting to remember that it can also behave like a mediaeval guild, trying to protect the monopoly of its craft - just as it did a couple of weeks ago, when the extension of prescribing to nurses and other health professionals was announced.

Instead of welcoming the additional help for its hard-pressed members with open arms, the BMA stuck its head firmly somewhere, denouncing the decision as a threat to patient safety while denying the competence of nurses - or anyone other than doctors - to diagnose and prescribe. This scheme was set up with great care over the past decade and could be a huge improvement for patients.

How bigoted, I thought, as I listened to the BMA spokesman on Radio 4 while wrestling with my neglected black tie. I've seen many situations where it's clear that the nurse does the diagnosing and prescribing and the doctor merely signs the prescription. If the patients had to wait for a consultation with the doctor, they could wait weeks or months. The doctor often has less expertise and confidence in diagnosis than the nurse.

I was wrestling, incidentally, because I was on my way to a grand dinner where I was seated with the president and chairman of the BMA, so I was able to tell them exactly what I thought. I might not be invited back.

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