first anniversary of the Francis report into the Mid Staffs hospital scandal with the introduction of a tough regulatory regime to improve patient safety in the NHS. Unfortunately, Mr Hunt’s attention has been elsewhere – privatising the health service at an accelerating rate. Since April last year, 70 per cent of NHS contracts have gone to the private sector. Tackling public concern following Mid Staffs has been placed firmly on the back burner. Healthwatch England is toothless. It needs to be replaced by a much tougher centralised inspectorate that will improve patient safety and boost public confidence. We need to return to a system similar to that of community health councils. Abolished by the government in 2003, they had the clout to expose failings in the provision of patient care. In the wake of the Francis report, Unite called for all NHS institutions to have an independent patient safety officer, so that staff and patients can raise concerns without reprisal. We also called for the establishment of a national intelligence unit to co-ordinate information about trusts. Today, we repeat these demands for a cultural renewal in the health service. We can start by looking at public scrutiny. Rachael Maskell, head of health, Unite, London

MORE SCHOOL NURSES ARE NEEDED TO END FEMALE GENITAL MUTILATION More than 24,000 girls in the UK under the age of 15 are at risk of genital mutilation. Campaigners have been calling for better data on how many women and girls there are in the UK who have been subject to genital mutilation. The government has now instructed hospitals to record whether a patient has undergone female genital mutilation (FGM), if there is a family history of it and if an FGM-related procedure such as deinfibulation has been carried out.

By September this year, all acute hospitals will be required to report this information to the Department of Health. This will help provide a clear picture about FGM in the UK. Schools should be playing a significant part in raising awareness of FGM. An education programme adopted by every school in the country could provide a breakthrough in cultural attitudes. But where are the school nurses to help effect this change in attitudes? There are 20,000 primary and secondary schools in England, but only 1,200 school nurses. We need many more school nurses. Charlotte Adams, Birmingham

PICTURE OF NURSE WITH RED NAILS SENDS WRONG MESSAGE ON HYGIENE I was puzzled by the photograph used to illustrate Dinah Gould’s article on hand hygiene (Student life January 29). It shows a nurse with bright red painted fingernails holding a patient’s hand. I have just finished a week of teaching first-year nursing students on the importance of cutting their nails and not wearing nail polish in clinical practice. Such images are confusing and do not help to promote the message of appropriate hand hygiene. Mark Wheatley, senior lecturer, school of health and social care, Teesside University

DAVID NEWNHAM IS MY WEEKLY ANTIDOTE TO DOOM AND GLOOM I couldn’t be without my copy of Nursing Standard for a number of reasons, but the main one is that I would miss reading columnist David Newnham’s weekly articles too much. His column is the first thing I read when the magazine plops through the letter box. He is witty and insightful, and his writing is always a joy to read. With so much doom and gloom surrounding nursing today, I am hanging on to my weekly uplifting read. Thanks very much. Roslyn Poslad, by email

TWEETS OF THE WEEK I hate having to pay for the privilege to work in the first place – never mind a 20% increase in fees. I’d like a 20% wage rise #NScomment @seanfdocherty

It is a slap in the face to all nurses. I struggle to pay the £100 and now they want to increase it @kirsty_ramkirs

It will put people off nursing. I’ve just qualified and it is hard work without making it harder for people to afford it too @crazihaze

NMC claims 50%+ increase in workload. I can’t see how this is matched with performance @garywalkeruk

Didn’t ‘protect the public’ before, so why believe now? Perhaps managers would like to volunteer the 20% @JoinedU1

Dislike it when nurses ask ‘Are you sure you want to be a nurse? I wouldn’t do it again.’ Of course I do. I want to be more every day @_amelia_19

Can’t we send letters to ex nurses asking if they want to return, get a feeling for the level of need? #WeNurses @moodomsmum

So tired #student #nurse #placement @NicoleMarie_xx

Follow Nursing Standard @NScomment and join the #NScomment chat on Thursdays at 12.30pm

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More school nurses are needed to end female genital mutilation.

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