The NHS is hiring assistants, not nurses - why might this be?

Quite who is complaining about this is one thing, what they’re complaining about another:

NHS hospitals are "plugging the care gap" with healthcare assistants amid a growing shortage of nurses, a new report suggests.

The study found the number of healthcare assistants is rising at four times that of nurses, amid a shortage of around 35,000 nurses.

For every nurse taken on between December 2015 and December 2017, four of the cheaper workers were hired.

In some areas, hospitals lost almost exactly as many nurses as they hired healthcare assistants, raising fears that the cheaper workers were being used as substitutes, endangering patient safety.

The study found almost one in three care roles in NHS trusts is now filled by a healthcare assistant.

We don’t know whether this is a good idea or a bad one, we’ll not claim expertise in clinical assessments. We do think it’s an entirely unsurprising outcome though.

The direction of movement in recent decades has been to make nursing a profession. Graduate entry only - or at least a degree is required as part of the training. It was quite blatantly pointed out that this was the aim, too. Make nursing that profession, a higher valued occupation, in order that nurses will be higher valued.

Well, people employ or buy less of higher valued things. Thus the creation of that graduate profession is going to lead to substitution with non-graduate staff. What else did anyone think would happen?

It’s also true that we still require the same amount of pillows plumped, bedpans emptied, bodies turned. The things that nurses might not be doing now that they’re prescribing and generally being more professional. So, again, substitution away from those with the higher qualifications to those with the minimum required to do that work that still needs doing.

We can imagine complaints about this view. That we’re not taking something seriously. But the logic is impeccable. For think about what the argument about the other end of nursing is. That nurses should be picking up goodly parts of doctoring. On the grounds that we don’t need people with 7 years of university, perhaps another decade of training, to do all that such have historically done. We can instead substitute to more specifically - and thus for a shorter period - trained nurse practitioners. Thereby using more narrowly but just as well trained staff to do what must be done.

Which does indeed make the logic impeccable. If nursing should move upmarket by biting off some of doctoring then that same new profession will find the lower levels of itself being chewed off by the nurse assistants.

What did anyone think was going to happen when nursing moves to an all graduate profession?

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Mariana Mazzucato does have problems understanding her economics, doesn't she?