Letters

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I am keen to get back into nursing, but fear for the future of the profession When I left the profession more than five years ago to have children, I chose to let my registration lapse. An intensive three-month return  to nursing course, which I have just  completed, has cost me the best part   of £1,500.  I read with a heavy heart about  the stagnation of nurses’ salaries and  the complete lack of respect from  the government in suggesting to the  pay review body that we not even be  awarded a paltry 1 per cent rise   (Editorial and News October 9).  I am desperate to get back into the  profession. Yet, despite having paid out  such a sum for my return to practice  course, I will struggle to find work once   I regain my registration.  My local hospital is again freezing  recruitment in an attempt to save money,  despite the fact that it is responsible for  covering 40 per cent of Scotland.  The profession and the NHS need  dedicated nurses. We need and deserve a  decent pay rise. Can the same be said for  government ministers and MPs? Victoria Roebuck, by email

SATURDAyS DID NoT woRk foR DeNTISTS, So how wIll GPs fARe? At a time when GP surgeries are being encouraged to open for longer hours and over the weekends, I find it ironic that my NHS dental surgery is no longer open on Saturdays. As a busy manager, I found my Saturday dental appointments particularly convenient. I was in less of a rush and the experience of visiting the dentist at the weekend was much less stressful than on other days. When I asked my dentist about closing on Saturdays, he said one word: ‘DNAs’ – did not attend. Despite text message reminders on the day before their appointments, up to half 34  october 23 :: vol 28 no 8 :: 2013 

the people booked in for a Saturday appointment failed to turn up. The receptionist also said the dental nurses, hygienists and receptionists were not paid any extra for working at the weekends. It proved to be unpopular with their families and interfered with their social lives. As more GP surgeries are coerced into opening on Saturdays, will they experience something similar? Adrian Broad, by email

leT commISSIoNING fIND ITS feeT befoRe we hAve moRe chANGeS There has been much coverage of Michael Dixon’s vision for the NHS. As chair of the NHS Alliance and president of NHS Clinical Commissioners, he speaks with some authority. He makes a case for clinical commissioning groups (CCGs) to control the budgets for primary and secondary care, and has gone so far as to describe the splitting of primary and secondary care budgets as ‘lunacy’.

I agree that we need to develop primary health and social care, and to address the use of secondary care expertise, facilities and technology. But let’s take things one step at a time. We first need to allow some time for CCGs to get established and see what works in the existing new arrangements and what does not. The new set-up is complicated, with unclear demarcations and relationships between organisations such as CCGs, Monitor, the Competition Commission, NHS England, the NHS Commissioning Board, Healthwatch and the Department of Health. There may well be a case for integrating the budget for primary care – which goes to NHS England – with that for commissioning community and hospital services – which goes to CCGs. But please, not just yet. Organisations are a bit like people. They first need to crawl and walk, before trying for a mad sprint. Anthony Wells, Bristol

NURSING STANDARD

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Let commissioning find its feet before we have more changes.

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