Caring for the profession
31 May 2005
MRSA, bad food, nursing shortages - sometimes it seems like every bit of press coverage on the NHS is negative. Even the recent general election campaign featured the Conservatives targeting "dirty hospitals" and lengthy waiting lists.
For most Britons, these issues only affect us once in a while. But 380,000 people confront such problems every day. They are the members of the Royal College of Nursing (RCN), which was granted its Royal Charter in 1928 and has been in existence for 89 years.
Looking after the concerns of the nurses and other healthcare professionals who belong to the RCN is director of legal services Richard Bernhard. A former insurance litigator who now handles an annual legal budget of £3.5m and a core team of 15 lawyers, Bernhard is at the forefront of the RCN's constant fight to safeguard the interests of its members.
The legal team operates from the RCN's headquarters in Central London. It is split into two halves - one half dealing with personal injury claims and the other with employment cases. Regional offices have some legal capability, but tend to employ 'locum lawyers' to help with the burden of work.
Bernhard also has responsibility for the organisation's corporate legal work, which is primarily focused on drafting agreements between the RCN and other bodies. This includes 'affinity agreements' for teaching programmes globally, as well as an agreement with insurance company the Liverpool Victoria, which provides insurance and financial services to members.
Naturally, the college's involvement in insurance meant that potentially it came under the umbrella of the Financial Services Authority (FSA) when it took over regulation of the insurance industry in January this year. Bernhard instructed Davies Arnold Cooper (DAC) to successfully "help us get an exemption from the FSA requirements". This is because the organisation makes no profit from its insurance arrangements, which are made in coordination with the Liverpool Victoria.
The employment and personal injury side of the RCN's legal work takes up more of Bernhard's time. The college receives 2,000 new cases each year, and recovers a total of £4m in damages. An average compensation award for an RCN member is between £7,000 and £10,000 - much higher than most - and according to Bernhard, they enjoy a better success rate than most trade unions manage.
Along with its panel of outside law firms - Douglas Mann & Co, Freeth Cartwright, Hugh James, Irwin Mitchell and Russell Jones & Walker - the RCN's caseload includes nurses who have problems at work through stress, violence or unsuitable working conditions. It also helps foreign nurses trying to get jobs in the UK with immigration queries, an aspect of the workload that has increased over recent years.
"The main focus is on problems caused by shortage of nurses," says Bernhard. "Stress levels are high because of lack of staff. There are still incidences of poor manual handling that we still have to deal with, though not as many as there used to be."
He cites an occasion where a nurse had to try to lift a patient who weighed more than 30 stone, alone, although the patient had been lifted out of her house by a hoist through an upstairs window.
Violence against hospital staff is another ongoing problem. Before the general election the RCN organised a 'question time' session for politicians from the three main parties to promote its campaign to criminalise assaults against nurses. "Our aim," says Bernhard, "is to encourage nurses to come forward and for us to take legal action so that it is stamped out."
He is also pushing for nurses to bring claims against employers if an accident at work causes them to be injured. "We're giving more publicity to the work of the legal department, as far fewer accidents are reported than occur," he says. "Nurses are not swift to come forward; they're reluctant to do anything that may harm patients. There's this great feeling that there is too much work to do and they must get on with it even if they're injured."
He admits that promoting the legal department will benefit the external panel too, because if more cases come in, more will have to be outsourced.
Regulation is the other area where Bernhard's team is increasingly busy. New legislation has to be scrutinised and challenged where necessary. The personal injury team is taking on the work, as the RCN examines acts such as the Protection of Vulnerable Children and Protection of Vulnerable Adults Acts. While Bernhard stresses that the college wants vulnerable children and adults to be protected, he says that nurses' names could be added to a government register listing those who should not work with vulnerable people without a proper investigation. "There's a risk that nurses could find themselves without a career, without any full inquiry and properly adjudged decision," he says.
In the long term, Bernhard says the RCN's challenges are principally the recruitment and retention of nurses in an increasingly tough environment. This includes examining NHS pension schemes, as the college resists attempts to raise the retirement age to 65.
Although MRSA is highlighted constantly in the media, and Bernhard admits the bacteria is a "grave concern", he stresses that it is not an issue that should be overemphasised. The main concern for both the RCN and its legal team remains the welfare of its hard-working members.
Director of legal services
The Royal College of Nursing
|Organisation||The Royal College of Nursing|
|Director of legal services||Richard Bernhard|
|Reporting to||General secretary Beverly Malone|
|Main law firms||Charles Russell, Davies Arnold Cooper (corporate); Douglas Mann & Co, Freeth Cartwright, Hugh James, Irwin Mitchell, Russell Jones & Walker (employment and personal injury)|