I welcomed your very useful exploration of the issues around regulating healthcare assistants ('A force to reckon with', pages 24-27, 9 April).

When JM Consulting considered this issue in relation to the review of the Professions Supplementary to Medicine Act 1960, it stated: 'In accordance with our definition of which professions should be registered, we do not recommend the registration of helpers/assistant grades (with the Health Professions Council)'. This has been accepted as government policy. In general terms, a state-registered practitioner is expected to work unsupervised and to be responsible for their actions.

Assistants are, by definition, supervised and so do not meet the criteria.

Further, most work in regulation is not in the field of conduct, but approval and validation of education. This requires a structured, uniform system of education leading to registration. Such systems do not exist regarding any or most assistant grades.

However, it would be anomalous for HCAs to be registered in the social sector under a General Social Care Council but to remain unregulated in the (acute) health sector. Should this situation arise, the Council for Professions Supplementary to Medicine would welcome constructive proposals and would be pleased to offer relevant assistance, as we did to the Nuffield Foundation for its work on dental auxiliaries.

MD Hall, Registrar, CPSM, London SE11.