The woes of the NHS are not just caused by a meddlesome Labour Government. I would draw your attention to this on NHS Blog Doctor. Why are the RCN so surprised that there are not enough nurses to do essential ward work? Could it be that nurses are too busy trying to be doctors on the cheap for the benefit of NHS managers’ balance sheets? There is an entertaining irony in the next RCN Chief being a doctor (of what I don’t know). Why is aspiring to be a ‘traditional’ nurse apparently viewed as under-achievement? If a nurse wants to be a doctor why doesn’t (s)he go to medical school? Contemporaries of mine successfully did just that.

The RCN has pushed the nurse practitioner role incessantly over recently years. Beverley Malone, not a woman I have been particularly impressed with at Conference Fringe meetings, has championed the role of nurses in delivering care traditionally reserved for doctors. I have no doubt that in the primary care setting nurses have taken on valuable roles within practices, delivering good quality chronic disease management. My argument is primarily with the secondary care sector. Patients on wards deserve properly qualified nurses to be nursing them when they are at their most vulnerable. If that means putting nurses on wards and not in specialist treatment roles then so be it. How about allowing doctors to be doctors and nurses to be nurses? Is that so radical?

I was interested to note a letter in the Telegraph today. Earlier this week, I discussed the unfairness of the present settlement for England in relation to the NICE decision on Velcade, a drug to treat myeloma.

Today’s letter to the Telegraph indicates the strength of feeling felt within certain sections of English society. Personally, I am not convinced that an English Parliament is presently desirable. To want something just because someone else has it strikes me as not enough of a reason. Do we really need further levels of public administration in this country? I could be persuaded to support an English Parliament if we were to do away with another level of local government, say the County Councils. I suspect that is not likely to happen any time soon.

A column in the opinion section of today’s Telegraph has caught my eye.

The alternative to secular multi-culturalism is not an enforced integration, such as we see in France. What is required is a proper and mutually respectful co-operation between religious faith and public authorities.

Enforced integration? At what point were the children concerned given a choice of faith. Religions themselves appear, to varying degrees, to rely upon a degree of enforcement from an early age. I believe that religious belief is stronger if based upon practice not enforcement (or indoctrination). I believe it would be better for all religions (and society as a whole) to have followers who have made an informed choice to follow a particular faith. I do not feel it is the role of the state to fund religious enrolment programmes.

Where I do agree with the Archbishop is his assertion that there is a ‘spiritual vacuum’ within society. Where I don’t agree with him is in believing that separating children on the basis of an acquired faith improves that position. As I have stated previously, I want all people of all faiths to be at peace with each other in this country. All faiths have a responsibility to preach tolerance. The government of this country has a responsibility to protect and nurture British society. An integral part of that responsibility is to actively encourage integration. I fail to see how single faith schools fit into that endeavour.

Visits to residential and nursing homes are sobering experiences. It has always been impossible for me to leave those establishments without considering my own future retirement. Would I like to be in a situation like that? One resident once described it to me as ‘a waiting room for heaven or hell’.

It says a lot about our society that these establishments have flourished in number in recent decades. Not so long ago, elderly parents were cared for in the home. Interestingly, if you go to the Mediterranean that tends to still be the case. Homes for the elderly appear to have developed more in Western societies where the financial cost of living has spiralled. Families struggle to make both ends meet with even both working-age people in full-time employment. How can they expect to also nurse and care for their elderly relatives?

In 2001, for the first time, there were more Britons aged over 60 than under 16. Furthermore, the post-war ‘baby boomers’ are fast approaching retirement. Hence, in 30 years time, more than one in four people will be over the age of 65. What are we to do? How are we to take our social responsibilities?

David Cameron, by making his comments today, is seeking to address this issue. The cynics will argue that he is just pandering to the ‘grey vote’. I like to think that he has realised that creating ghettoes for the elderly is simply not the right way to have gone. By seeking to encourage larger homes for families, he also seeks to provide loving and stimulating environments in which to grow old with dignity. He should be congratulated for raising this issue today.

The reported decision by NICE to deny the English and Welsh access to Velcade, a drug clinically proven to extend the lives of those with myeloma, is yet another example of how the devolution set in play by the Labour government has lead to blatant unfairness in the provision of healthcare in Britain. Whether NICE feels Velcade is worthy of being provided on the NHS or not is not my point here. If we believe in a nationalised healthcare service, ‘free’ at the point of delivery to all Britons irrespective of their means, how can we tolerate any regional discrepancies in provision? All Britons should have equal access to medical therapy deemed appropriate by NICE.

The state of the Union is concerning me. If only this cancer drug case was the first example of one rule for the Scots, one rule for the rest of us. What about long-term residential care? What about Parliamentary votes on foundation hospitals and tuition fees?

What I think is particularly galling for the English is the fact that more money is spent per head on healthcare and education in Scotland. This has been the case for many years. At the same time the Scottish are ‘over-represented’ at Westminster, possess a Parliament (West Lothian question?) and contribute less per head to the Exchequer.

I am a Unionist at heart. I want to see that Union continue. It will not if these issues are not dealt with. With such blatant unfairness on the front pages the resurgence of English nationalism on the political stage is not far off. I wonder what the response will be to the Conservatives doing very well in England and yet failing to stop a Scot becoming Prime Minister…..