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Baroness Gardner of Parkes: My Lords, is it not a fact that many health care assistants are doing exactly the same job as nurses have done in the past? Since everyone has moved up to higher levels of training and junior hospital doctors' hours have been reduced, state-registered nurses have replaced them and "diplomates" or graduate nurses are being replaced by health care assistants. Is it not time that we looked at renaming health care assistants and giving them the status that they deserve? Many people wish to enter nursing but cannot get the A-levels required to take up the Project 2000 training.
Lord Hunt of Kings Heath: My Lords, as I said earlier, Ministers are considering the question of the regulation of health care assistants. However, I do not think that there is evidence to support the point that they are filling the gap left by registered nurses. The ratio of qualified nurses employed in the health service compared with unqualified support staff is the same now as it was 10 years ago.
Baroness Masham of Ilton: My Lords, does the Minister agree that it was a retrograde step to do away with the state-enrolled nurse? He or she had to be qualified for two years and was a practical nurse.
Lord Hunt of Kings Heath: No, my Lords, I do not agree with the noble Baroness. The changes that we made to nursing training through Project 2000 have been very advantageous. Nurses are taking on more and more responsibilities. They must have the right training for that. However, I accept that enrolled nurses still have an important role. We have around 100,000 on the register.
Viscount Bridgeman: My Lords, does the Minister accept the need for the early implementation of a central register for carers which embraces all carers? That will make checking for criminal records much more straightforward and so give further protection to a vulnerable section of the population, the aged, so many of whom live alone.
Lord Hunt of Kings Heath: My Lords, I welcome the noble Viscount to the Dispatch Box for his first appearance. I think I would prefer to write to him on that question. As regards health care assistants, as I have said, Ministers are currently considering the legislative question.
Lord Hunt of Kings Heath: My Lords, no specified training has been laid down centrally for health care assistants. However, I can tell my noble friend that the Department of Health is encouraging NHS employers to train health care assistants and encouraging them to use NVQs as a training programme.
Lord Meston: My Lords, does the Minister agree that the risks are perhaps greatest in those homes, particularly private homes, where only one qualified nurse is required to be on duty at any time and which otherwise depend on auxiliary staff? Does he further agree that, at the very least, the proprietors of such establishments should be encouraged to require and to take up employment references?
Lord Hunt of Kings Heath: Yes, my Lords, we wish to encourage the proprietors and managers of nursing homes to do just that. Those proprietors have a duty of care to ensure that all employees are suitably qualified and competent.
Lord Rea: My Lords, can my noble friend say what practical steps the Government are taking to encourage back into the National Health Service those many nurses of all grades--nurses and nursing assistants--who have left to look after their families or to take up another occupation?
Lord Hunt of Kings Heath: My Lords, the Government inherited a very difficult situation in relation to nurse shortages, poor morale, the effect of the internal market and the ravages of macho management. The Government are dealing with the problem. We are injecting resources and we are abolishing the internal market. We are developing a new HR strategy, we are encouraging more students, we are encouraging returnees and we are developing better
Baroness Blatch: My Lords, the noble Baroness is astonishingly sanguine about what is nothing less than guerilla warfare and a war of attrition on these schools. It is not true to say that there will not be a revisiting of the petitions in the ballot. The petitioning system is revisited after four years, not five years--it is the ballot after five years--and will continue to be so. Does the noble Baroness agree that the resources, the time and the energy which are already having to be expended because of the activities of some of the noble Baroness's colleagues, such as the noble Lord, Lord Hattersley, is disruptive to the parents, to the staff and to the children?
Baroness Blackstone: My Lords, I am sure that my noble friend Lord Hattersley will speak for himself. I do not know whether he is in his place this afternoon. I do not agree with the noble Baroness. She seems to have forgotten that this was a manifesto commitment. The Labour Party made it clear in its election manifesto that there would be a system of asking parents whether they wished the admission arrangements in grammar schools to change. Clearly, the electorate think rather differently from the noble Baroness opposite.
Lord Pilkington of Oxenford: My Lords, may I ask the noble Baroness, in her academic mode as a person who ran institutions, whether she would have been happy if those institutions were subject to structural change every five years, subject to the electorate, particularly in view of the fact that grammar schools provide between 20 to 30 per cent. of the pupils from the state sector who go on to the more prestigious
Baroness Blackstone: My Lords, I am happy to switch to my academic mode, although I am not here to answer questions as an academic but as a Member of the Government. However, I can say from my experience as an academic, that the institution that I ran constantly suffered from the ravages--I can put it no differently--of the previous government's higher education expenditure cuts. The proposed changes are a matter for parents. They will decide whether they think it is right to petition and then to go for a petition again later, if a ballot is lost, after five years.
Baroness Lockwood: My Lords, can my noble friend tell me when balloting of schools first started and the difference between balloting for grammar schools and balloting for other state schools, which I believe happened quite frequently under the previous administration?
Baroness Blackstone: My Lords, I entirely agree with my noble friend. Noble Lords on the other side of the House have a tendency to accept ballots where they think that holding a ballot is desirable, but where they are obsessed with a particular issue--for example, a very small number of, say, 130 schools--they take a totally different position.
Lord Tope: My Lords, can the Minister confirm that the ballot information code, which comprises Schedule 4 of the regulations, applies not only to LEAs and governing bodies but to all groups and individuals wishing to influence the result of a ballot? The information code states, among other things, that written materials,