Dear Mr. Clay
Thank you for your letter of 21 January setting out the current concerns of the Council of the Royal College of Nursing and your letter of 22 January requesting a meeting.
I note the Council's concern about expenditure on the NHS. In common with many other countries we face the challenge of financing increasing demands for health care. But this challenge must be met not just by the taxpayer providing extra resources—which we are planning to the tune of £1100 million extra next year alone—but also by making the best use of the resources available. I welcome the full involvement of all the professional bodies concerned in the widespread discussion of how best to achieve this and to secure the best deal for both patients and taxpayers.
I also note your comments on the implementation and funding of any recommendations of the Review Body for Nursing Staff, Health Visiting and Professions Allied to Medicine. But I believe it is right that as in the past the Government should await the Report and then take decisions on implementation and funding.
You mention the current Project 2000 proposals for the reform of nurse education and training. I can understand the profession's desire for removal of the uncertainty about the future direction of education and training. The proposals raise complex issues—which, as you acknowledge, range wider [end p1] than purely educational matters—and we have engaged in an extensive consultation exercise on them. We remain committed, however, to a response as soon as possible because we recognise the need to ensure that nurses, midwives and health visitors are properly prepared to fulfil their vital role in the delivery of health care.
I should like to stress that I welcome the College's reaffirmation of its policy on industrial action. We have always recognised that the professional ethics of nursing do not permit action which might put patients at risk. That is why we decided that the pay of nurses should be determined by an independent Review Body. This system has served nursing well in the recent p* the sensible course for the profession must surely be to await the outcome of the Review Body's deliberations.
Finally in your second letter you requested a meeting with me which would involve the General Secretaries of the other nursing unions. I believe that such discussions should take place with the Secretary of State for Social Services, and I understand John Moore has already agreed to see a deputation from the Royal College of Nursing on 1 February and from the TUC on the following day.
If the Royal College of Nursing still wish to see me following these meetings I will of course be available.
Yours sincerely
Margaret Thatcher