has rejected mandatory registration for HCAs. They are not really answerable. I do not think this is right. Sorry if I sound exasperated with it all.

The NHS is the visible tip of the very large iceberg that is older people’s care. The most vulnerable people in society deserve better from us.

Gill Johnson, by email

Malcolm Harrison, Derby

WE NEED SAFE STAFFING IN CARE HOMES AS WELL AS HOSPITALS It is not only hospitals that need safe staffing levels (News, Analysis and Letters December 4). Nursing homes need them too. Staffing must be linked to levels of dependency and provide for dignity in care. Dignified care takes time. We are able to provide basic care for residents, but not a personal service. The care of older people is woefully underfunded. And why do we pay more to NHS staff than to those working in nursing homes? Many care home residents have decided that they do not want hospital treatment, preferring ongoing care in the home. This necessitates skilled nursing interventions – and time. Pay rates in care homes should be commensurate with those in hospitals. We say we want the care of older people to be person-centred rather than institutional, but if we continue to fund care at the minimal level, we will again find ourselves with problems similar to those at Mid Staffs.

PLEASE TAKE THE TIME TO LOBBY YOUR MP ABOUT THE CARE BILL A new clause on hospital reconfiguration added to the Care bill has a second reading on Monday December 16 in the House of Commons. Please lobby your MP to vote against this measure. With this clause, health secretary Jeremy Hunt is planning to take powers to make centralised decisions about the future of hospitals in England. Following his defeat in the high court and the court of appeal in the judicial review brought by the people of Lewisham, he is now taking steps to give himself the powers the court ruled he did not have under the Health and Social Care Act 2012. If this extra clause in the Care bill goes through, the health secretary will have the power to direct a trust special administrator to include other hospitals in the plans to make changes in the case of a failing hospital – and local people will have no rights to stop this. If there is a case for reconfiguration, it needs to be argued through locally, and the decisions taken locally. Mr Hunt should present his case through a proper bill devoted to this issue, rather than as an add-on to a bill that is primarily about something else.

Sue Funnell, by email

THE MOST VULNERABLE PEOPLE IN SOCIETY DESERVE BETTER FROM US Am I the only one getting fed up with all this talk of safe staffing levels in NHS hospitals (News, Analysis and Letters December 4)? It is not that I disagree with it. But why is the focus on hospitals? Why is no one speaking about unsafe staffing levels, inappropriate staff skill mixes and poor training in care homes? When things go wrong in care homes, many of the problems transfer to the NHS. Many care homes are shutting down and hospitals are closing wards for older patients with complex conditions such as dementia. Costs and services are being reduced to win contracts.

Gay Lee, by email

HELP ME PLAN A REUNION OF THE MAY 1984 GUY’S HOSPITAL SET I am planning a 30-year reunion for the May 1984 Guy’s Hospital set. Please email me at [email protected] or call 01306 743363. Judy Foster (née Hayden), by email

REUNIONS Are you planning a reunion or trying to trace former colleagues? Email [email protected] with the details and we will post them at  www.nursing-standard.co.uk

TWEETS OF THE WEEK #NScomment The idea of a named nurse for every patient was popular some time ago, but fell out of fashion. Was it impractical? @RogerEvansE1

@RogerEvansE1 The named nurse system needs nurse-patient contact. Tricky on three 12-hour shifts per week. It’ll become a token gesture @nursehels

@nursehels @RogerEvansE1 Indeed – and @nursingpolicy are going to be looking at the issues around 12-hour shifts @alisonleary1

@RogerEvansE1 Was ‘named nurse’ ever evaluated? Not as I recall. But that is not sufficient reason not to try this approach. O’wise condoning deficiencies @PublicInvolve

Named nurse is not viable. What happens if you are pulled to another ward for cover? @BeeNiBee

Reports of nurses working overtime unpaid shows how dedicated they are to their profession. Doesn’t match with apparent ‘uncaring’ culture @StudentNHSnurse

Fondly remembering #Mandela telling Labour conference in 2000 that he was ‘just an unemployed pensioner with a criminal record’ @TomHarrisMP

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

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Please take the time to lobby your MP about the care bill.

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