PARLIAMENTARY DEBATE
Draft Health Education England (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023 - 20 March 2023 (Commons/General Committees)

I beg to move,

That the Committee has considered the draft Health Education England (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023.

It is a pleasure to serve under your chairmanship, Sir Edward. I am grateful to be in the Committee today to debate these important regulations, which are intended to transfer all the functions of Health Education England to NHS England and to abolish Health Education England. They use powers under section 103 of the Health and Care Act 2022 that allow regulations to transfer functions between relevant bodies listed in the Act and to abolish a body if that transfer of functions has made it redundant.

The merger is in line with a recommendation from the Public Accounts Committee back in 2020 to review the effectiveness of having a separate body overseeing the planning and supply of the NHS’s future workforce, which the Department of Health and Social Care accepted.

Regardless of the transition and of who is in charge of education to train the doctors and nurses of the future, we need a lot more of them. Will the Minister assure us that the workforce plan that the Government are going to publish will deliver the doctors and nurses we need to meet rising healthcare need?

My right hon. Friend is absolutely right. We need medics across the NHS in various functions: consultants, doctors, surgeons, allied health professionals, nurses, nursing associates, apprentices and so much more. That is exactly why we commissioned NHS England to undertake a long-term workforce plan. She will know that the Chancellor set out in the autumn statement, and reiterated in the recent Budget, that we will publish that plan very shortly—certainly this spring. It will also be independently verified. It will set out our plan and the workforce requirements for the next five, 10 and 15 years. It needs a bit of patience, but it is a hugely important piece of work because, as she rightly says, the NHS needs that workforce to plan for the future.

Carrying on from what my right hon. Friend the Member for Chipping Barnet said about the doctors and nurses of the future, one of the very successful things that this Government did five years ago was introduce 10 new medical schools. The one in Chelmsford at Anglia Ruskin University is hugely successful and the first new doctors will graduate in just a few weeks. It has some of the lowest drop-out rates anywhere in the country, and the new doctors want to stay locally. Will the Minister press the case for expanding very successful medical schools such as the one in Chelmsford?

I thank my right hon. Friend for her question. She is absolutely right. I was due to visit her medical school but, unfortunately, because of illness I could not. I still very much hope to do so. She is right that we need to train more medics domestically, although we have international recruitment. We increased the number of doctors we train by 1,500—a 25% increase to 7,500 per year. I urge her to wait just a little longer for the long-term workforce plan, which will set out our requirements for the future and how we go about ensuring that we fill the places and get medics in training. I am conscious that doctors are one of those groups.

Both of my right hon. Friends talked about planning, which is very much at the heart of the regulations. Their intention is to more closely align workforce planning, which is currently the statutory function of Health Education England, with the service and financial planning responsibilities of NHS England. That will enable service, workforce and finance planning to be properly integrated in one place. Nationally and regionally, it will build on the work that has been done to develop the NHS people plan. It will also help to drive reforms in education and training further and faster so that employers can recruit the health professionals needed to provide the right care to patients in the future.

Merging Health Education England with NHS England will simplify the national system, leading the NHS to end the separate lines of accountability that exist for the two bodies. Currently, Health Education England is responsible for workforce planning, education and training, but NHS England is responsible for culture, retention, international recruitment, workforce and leadership. Uniting those functions will help us ensure a joined-up and long-term view of what our NHS workforce needs for the future.

I pay tribute to Health Education England’s leadership and staff throughout the organisation’s 10-year existence. It has played a hugely effective role in the delivery of growth in the number of health professionals trained in England. It has promoted the creation of new roles, such as nursing associates, and spearheaded reforms to professional training workforce growth; record numbers now work within our NHS. It was hugely flexible and effective during the pandemic, including by supporting the deployment of students to the frontline at critical moments.

I am delighted that as of 1 April this year, Dr Navina Evans will become the chief workforce, training and education officer in the new NHS England. Sir David Behan, the chair of Health Education England, was appointed as a non-exec director of NHS England on 1 July. Those appointments are both important, because they will ensure that there continues to be excellent national leadership of NHS education and training.

I know there will be concern in some quarters that the changes pose a risk of budgets being used for other purposes. However, we have put in place a number of measures, including ministerial oversight, to ensure that that will not be the case. I am happy to elaborate on that later if required. Very briefly, we will include objectives on the workforce within NHS England as part of the NHS England mandate. We will continue to monitor and track expenditure on education and training with, as I said, a ministerial chaired board to provide that important ministerial oversight and governance of the workforce in NHS England.

Health Education England and NHS England already work closely together to ensure that the NHS has the workforce that it needs for the future. As I said in response to the question from my right hon. Friend the Member for Chipping Barnet earlier, we have commissioned NHS England to develop that long-term workforce plan for the next five, 10 and 15 years’ time. In effect, that plan will look at the mix, the number of staff required, and the actions and reforms that will be necessary across our NHS to reduce supply gaps and—importantly—improve retention.

I am sorry to have missed the beginning of the Minister’s remarks, but I want to make a case for dentistry in all this. Given that the aim of the draft regulations is to align the workforce more with local need, and that they are designed to improve care standards and workforce availability, will he look at the dental deserts such as Lincolnshire, where we cannot straight-forwardly access NHS dental care? There are more dentists in London than one could shake a stick at—there are even more than there are barbers—yet in Lincolnshire it is very hard to obtain a dentist. Would he look at that in terms of the strategic change that he has described?

I thank my right hon. Friend for his question. He is right to raise dentistry, because, as he rightly points out, there are dental deserts across the country. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), is looking closely at dentistry, including workforce and supply and the use of a skill mix. Of course, it does not have to be a dentist, as others who have similar qualifications can do a lot of work that a dentist does, including on children. My hon. Friend will publish a dental plan in the coming months, and I hope that addresses my right hon. Friend’s point.

In conclusion, the merger will continue to build on Health Education England’s great work, putting education and training at the heart of service planning for the long term. The draft regulations will simplify the architecture of our NHS at national and regional level and ensure it has the workforce that it needs now and in the future. I commend the regulations to the Committee.

It is a pleasure to serve under your chairmanship, Sir Edward, and to represent the shadow Health and Social Care team. As has already been noted, the draft statutory instrument facilitates the merger of the body responsible for the education and training of the health workforce —Health Education England—with NHS England. We agree that it is a sensible move. With a wry smile, I conclude that it is yet another of the bureaucratic reforms introduced by Lord Lansley that are now being unpicked by this Government, although it is a sensible choice.

The Government have rightly stated that the purpose of the integration is to improve long-term workforce planning and strategy for healthcare staff recruitment within the NHS. Labour is committed to long-term workforce planning for the NHS and for social care, which would necessitate independent workforce projections. The fact that the NHS has not had a workforce plan since 2003 is staggering. We want the Government to get on and deliver a plan. Our plan or their plan—a plan—would be great. For that reason, we will not oppose these measures.

I wish, however, to raise a couple of points on which I would appreciate some clarity from the Minister. When we debated the merger of NHS Digital and NHS England in January, I made the point to the Minister that we must ensure that talent and expertise are retained. I do so again today. Given that we are looking at an estimated 40% cut in workforce numbers, we need to ensure that NHS England still has the staffing resources it needs to function adequately in this sphere. Will the Minister provide an update on how that work is progressing? What assurances can he give to Members that staff are being treated fairly throughout the process? Can he also set out what specific service improvements he anticipates as a consequence of the merger, and what metrics will his Department use to judge NHS England’s performance within its new remit?

It was recently reported that a £100 million redundancy budget has been set for the mergers, alongside a £13 million contract to PA Consulting to oversee the merger. I do not quote those sums to put the Minister on the spot, but instead to reinforce that public money is being spent, so we need to ensure that we see positive results at the end of the process. That is something we want to see, which is why I ask about it in the spirit of co-operation.

Finally, given that the merger will, according to the Government, put healthcare staff recruitment and retention at the forefront of the national NHS agenda, can the Minister outline when the NHS workforce plan will be published? He gave an indication to his right hon. Friend the Member for Chipping Barnet that it would be soon. I am a little more impatient than that, given that we have not had one since 2003. Also, what will NHS England’s role be within that workforce plan when we get it?

The Opposition will not oppose these very sensible regulations.

I thank the hon. Gentleman for his support and that of the Opposition Front-Bench team. I will go through his questions in reverse order. First, the NHS long-term workforce plan is coming shortly. I know that is a broad term when it comes to the Government. It is a bit like spring—it can stretch all the way to June and July—but it will be published shortly and it is being finalised. I cannot be more precise than that. It will certainly be soon. We commissioned it, and NHS England drafted and produced it, and will be integral in delivering against it.

He mentioned talent and expertise being retained across both Health Education England and NHS England as the two organisations are merged. He is absolutely that all Health Education England staff will automatically transfer to NHS England. The merged organisation will reduce in size by between 30% and 40% by April 2024. However, it is important to stress that both NHS England and Health Education England have already had recruitment controls in place since July 2022. They also launched an initial voluntary redundancy scheme in January 2023. Of course, we keep a watchful eye on that because we want to ensure that we are maintaining the very best talent and expertise in the area, especially given the importance of workforce to the short, medium and long-term future of the NHS.

The hon. Gentleman asked about performance and how we will monitor performance. That is done in a number of ways. First, on performance and what good looks like, the merger is designed to help us ensure that service, workforce and financial planning are integrated into one place, at both a national and a local level. That is what we are trying to achieve through the regulations. We are also trying to ensure that we drive change in education and training much further and faster than we can at the moment through HEE.

That will be monitored in two ways. First, through robust governance, as we will set objectives and place them on the NHS England mandate. We will also have a ministerial chaired board. I suspect that I—or the occupant of my role, at least—will chair that, but that is not confirmed. Also, we will ensure that we have clear governance plans in place to track and monitor performance going forward. That is particularly important in addressing some of the concerns that people have about the NHS England training budget, given the importance of the workforce to the NHS. I think something like 65% of all the funding allocated to the NHS rightly goes on the workforce—the beating heart of the NHS.

I hope that answers all the questions from the Committee. I thank the hon. Member for Denton and Reddish, the representative for His Majesty’s Opposition, and all hon. and right hon. Members for their interventions and contributions. I commend the regulations to the Committee.

Question put and agreed to.