infection and complications occurrence is not due to qualification of a person whatever physician, nurse or pharmacist. All of us are working as a health team for  achieving optimum health status for the patient. Everyone whatever his/her qualification should follow principles of aseptic techniques and rules of own institution strictly and honestly within allowed health licence of his/her qualification.   

Lifted from your post NHS in UK allowed nurses to clinically examine, diagnose and prescribe drugs in 2006. Since they started working as doctors the 37000 people died with sepsis (complications of infections), admissions increased by 48% and children less than 5 years admitted in hospital for 24 hours doubled. Are you saying that role extension of nurses in UK is the cause of morbidity due to sepsis? If this is true then it needs examination of competencies of nurses, scope of practice, and regulating laws.

Should we allow chemists to dispense drugs. To answer this question it needs review of regulating laws and scope of practice if drug dispensing can be regarded as domain of chemist.

Nurses are not doctors they are still nurses. They are trained before they are allowed to practice as primary health care nurses. Did the research look at the total value chain of the treatment processes. Is there any research that was done as baseline prior the introduction of curative primary health care services by the government. South Africa is using the same system and it is working. Nurses have dispensing licence so they also dispense the medication they prescribe.   I found UK NHS being the place that check nurse's competency skills before allowing you to practice.  

This is where I differ. I was employed to train, assess nurses competency and skill but what can a doctors do when he finds out the nurses do not have the knowledge, clinical skill to diagnose any illness? Doctors like me pass PLAB Examination conducted by General Medical Council to prove we are competent to work as doctors "Under Supervesion" for five years, pass exams again to prove we are competent to work independently as a specialist or primary care physician.

A nurse who is thought by nurses and sat as an observer in my consultation room for 12 days, gets certified by university as "Competent"!!! you must be joking. I would not even allow my pet ant to be treated by these so called "Nurse Practitioners". The have not only brought us shame for not defending our profession but also helped bacteria develop resistance by prescribing wrong or low dose antibiotics.

I raised concern about this in 2004 and in 2006 after collecting evidence to prove this is substandard care and so must be stopped but do the people in power listen? NO. Publication only talk about "Patient Satisfaction". You must know we doctors are not here to satisfy, our job is to make the right diagnosis early and prevent complication. At times what we diagnose may not be that makes people happy, we may refuse certain treatment that patient demand because it may not be in their interest. We promise to "Do No Harm".

My books and apps are created to protect you. If I will not accept clinical diagnosis or treatment from a nurse (who has not studied and qualified from medical school), why should I allow you to be examined, diagnosed and treated by a nurse practitioner or prescriber?

Since I raised concern, the number of scandals in hospitals, death rate, admission, cost of emergency care, compensation claims have all increased but the quality of care has declined. Its disgrace too hear 44,000 people die every year because of septicaemia, do you think this what we call "Best Healthcare Service in the world"?

Please read articles in my book and you will get to know why I am against the system. Its not the fault of nurses but the people in power who have made the nurses work like doctors.

http://news.bbc.co.uk/2/hi/health/4955428.stm

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1285084/