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Do we need a chief nursing officer in government?

Last week I spotted a headline about the possible loss of the chief nursing officer (CNO) role in England. The current holder, Dame Christine Beasley, is due to retire later this year and the proposed new structure for the Department of Health places the most senior nurse two rungs below where it is now.

Questions are being asked about whether there will be a replacement, in spite of assurances from the health minister last year that there would be. We do know that the position of the chief medical officer will not change under the proposals.

While nurses may have different views about how effective the current CNO has been, the loss of this post would be a real blow to nursing at a time when morale is at the lowest I have ever known. I wonder what the reaction from the medical profession would be if the proposals showed a similar change in the role of the chief medical officer?

I thought I would have a look to see which other countries had a CNO and what their role was. It was quite interesting. Australia appointed their first CNO in 2008 and the post was described as a recognition of how important nurses are. The Australian minister for health said, “Commonwealth Chief Nurse (CCN), Ms Bryant, will be a strong voice within government on all issues relating to Australia's 200,000-strong nursing workforce”.

In Canada, too, there is a chief nurse and there is an interesting Powerpoint presentation on the internet which describes her role. New Zealand has a chief nurse; the USA has a CNO for the Public Health Service; and Singapore has a CNO. Closer to home Scotland, Wales and Northern Ireland all maintain the role of CNO.

It made me wonder why I had not read more about this and speaking to other nurses I was not alone. Though I work in Scotland I do feel quite strongly that this is a real concern and it makes me wonder what respect the government has for nursing as a profession when it can propose changes as important as this without any consultation.

The Department of Health website provides a description of the CNO, whose role is to:
•    Provide expert advice on nursing, midwifery and health visiting to government and help to develop, implement and evaluate government health policy, leading on nursing, midwifery and health visiting policy and strategy in support of the government's objectives.
•    Provide professional leadership to the nursing, midwifery and health visiting professions in England, working closely with the professional statutory bodies, professional and staff associations, NHS managers and the voluntary and independent sectors.
•    Ensure an effective UK contribution to nursing and health policy in international fora, including the World Health Organisation, the Commonwealth and Europe.
•    Contribute to the Department's central task of managing the NHS.

Downgrading the position of CNO is a real kick in the teeth to nurses in England. We all know there is going to be even more pressure on our NHS both financially and in terms of workload. Nurses do need a strong voice in government representing nurses' interests and I feel there should be parity with the CMO role.

If you agree, start asking questions and challenge these proposals, or you could ask your own trade union organisation if they have responded. Nurses are, and increasingly will be, vital to meet the targets for health, and if decisions are not challenged our voices cannot be heard.