The role of the Health Care Assistant emerged primarily to support the professional nurse and to undertake perceived ‘non-nursing’ duties under the direction and supervision of qualified nurses. Health Care Assistants are employed in a variety of clinical settings and carry out a range of tasks and procedures. While they represent a substantial proportion of the health care workforce, the growth of their role has taken place without regulation, clear boundaries, or systematic education and training. This has raised serious concerns, especially with regard to the issues of patient safety and quality of care. For health professionals, regulations, role clarity and validated education and training are key elements of ensuring the safety of the public. This paper explores these issues with regard to the Health Care Assistant role and finds them wanting.