Draft Anaesthesia Associates and Physician Associates Order 2024

Claudia Webbe Excerpts

Wednesday 17th January 2024 General Committees

[Claudia Webbe (Leicester East) (Ind)]

It is a pleasure to serve under your chairship, Dame Caroline. I am concerned, however, that this matter is not being debated in the main Chamber.

The renaming of NHS medical assistant roles to physician associate and anaesthesia associate is confusing the public by blurring the clear distinction between doctors and other professionals who do not have medical physician qualifications and training. In response to a British Medical Association survey last month, 30% of patients said that they had no idea that they were not seeing a doctor, and 90% of doctors believe that the shift has been dangerous for patients.

According to at least two coroners, including the Chief Coroner, and the British Medical Association, the use of associates instead of fully qualified physicians has contributed to the avoidable deaths of patients who were misdiagnosed. Emily Chesterton from Salford, who was 30 years old, and 25-year-old Ben Peters both died after being sent home by physician associates who diagnosed emergency health issues as a calf strain and a panic attack, respectively—in Mr Peters’s case, despite a history of heart problems. Ms Chesterton’s family said that she was never aware that she had not been seen by a doctor.

The use of associates has been the subject of dangerous scope creep. One physician associate told a podcast that he was performing basic brain surgery and “learning on the job”. Another hospital—in Leicester, as it happens —congratulated a nurse practitioner on being the first to perform a heart operation unsupervised. According to NHS campaigners, such non-medical roles are being used and expanded to cut staff costs and to fill vacant places as part of overall cost-cutting in the so-called integrated care service programme, which is the US accountable care system under a different name. A deliberate system of incentives ensures that the NHS and its regional providers will keep cutting the corners of what used to be a comprehensive, state-funded service, turning it into something that business can profitably provide.

The plan to regulate these non-medical roles through the General Medical Council adds to the dangerous confusion. It has been opposed by both the Royal College of General Practitioners and the British Medical Association. For the safety of patients and the proper functioning of the NHS, I urge the Committee to oppose the draft order. Instead, the titles of these roles should revert immediately to the previous titles, physician assistant and anaesthesia assistant. The NHS workforce plan must put doctors into doctor roles and unambiguously distinguish between medically qualified roles and other roles. As the British Medical Association has recommended, the Government must regulate those assistant roles through the Health and Care Professions Council, so that patients and their families are fully aware of who is treating them and how qualified they are.