PARLIAMENTARY DEBATE
NHS Workforce - 19 June 2018 (Commons/Commons Chamber)

NHS England, NHS Improvement and Health Education England are working with trusts on a range of recruitment, retention and return-to-practice programmes to ensure that the required workforce are in place to deliver safe and effective services.

The nursing vacancy rate in England is more than double that in Scotland, with one in 10 positions unfilled. The Royal College of Nursing has welcomed the Scottish Government’s Health And Care (Staffing) (Scotland) Bill, which will enshrine safe staffing levels in law. Will the Minister now follow the Scottish Government’s example and bring such a provision into law for NHS England?

I fear that the hon. Gentleman wrote his question before yesterday’s announcement. I thought that he might have started by welcoming the additional £2 billion of investment that Scotland’s NHS will be receiving. We are making historic investment in recruitment, which is why we are opening five new medical schools in England, training 1,500 new medical doctors, taking initiatives such as on apprenticeships and opening new pathways into clinical roles.

While I welcome yesterday’s announcement and the workforce strategy that is coming out in the autumn, will the Minister comment on the Home Office’s new proposals to allow greater flexibility for professional clinicians coming to work in the UK, and on what impact that might have on filling vacancies?

My hon. Friend is right to draw attention both to the Home Office’s welcome announcement on tier 2 visas and to the work on the workforce strategy, in which he played a key role. It will ensure that we have the right workforce for the NHS for the next 10 years.

But the Royal College of Nursing and the Nursing and Midwifery Council are both now so worried about Brexit’s impact on the staffing crisis that they have called for a people’s vote on a deal. Given their on-the-ground experience and the demolition of the myth of a Brexit dividend for the NHS, is it not becoming ever more clear that the dogmatic hard Brexit being pursued by the Government is already doing untold damage to our NHS?

The right hon. Gentleman, as a former Minister of State, will not want to choose selectively from the data on European economic area recruitment into the NHS. He will know full well that there are 3,200 more NHS staff from the EU since the referendum, which shows that people are still coming. If he has an issue with the Brexit dividend, perhaps, as my right hon. Friend the Secretary of State pointed out yesterday, he will raise that with his party leader, who sees that there is a Brexit dividend.

Kettering General is a wonderful hospital with amazing staff, but one of its big financial problems is caused by its over-reliance on agency staff. What can be done to reduce the reliance of so many hospitals, including Kettering, on agency staff to populate their wards?

My hon. Friend rightly points to the key issue of how we bring down the £2.5 billion of agency spend. That goes to the heart of the Prime Minister’s announcement yesterday. Up-front investment in our workforce will allow us to reduce that agency cost.

Order. The question should relate to the workforce, which is the matter we are dealing with now, but never mind. I am sure that the hon. Gentleman is interested in hearing about the workforce situation.

The two do go together because the mental health workforce is a key component of the NHS workforce. I am sure that the hon. Gentleman will welcome the extra £1 billion by 2020 that the Prime Minister announced yesterday, as well as the Government’s prioritisation of mental health, which for too long has been seen as a Cinderella service within the NHS.

In 2015, the Secretary of State suggested that junior doctor rotas contributed to avoidable hospital deaths, but research shows that the most important factor is the number of patients under the care of each registered nurse. A 7% increase in mortality for every patient means that 36,000 nursing vacancies in England pose a real threat to patient safety. So with no announcement, and a 33% drop in applications since the removal of the nursing bursary, will the Government follow the Scottish Government’s policy and reintroduce the bursary?

The hon. Lady will be well aware that there are 14,000 more nurses in the NHS than five years ago, but she is right to point to the wider issue of long-term workforce planning. That is why she will be aware that Audit Scotland criticised NHS Scotland for its lack of long-term workforce planning.

The hon. Lady’s second question will be a lot shorter, I am sure.

As the Minister heard, the Scottish Government have just passed a law on staffing. With an ageing population, social care is critical to the function of the NHS, but the charity Independent Age says that we will be short of 700,000 care workers by 2037. With no extra funding for social care announced yesterday, how will the Secretary of State make caring a real profession? Would not it be good to start with a decent wage?

The hon. Lady’s supplementary question really reinforces the answer that I gave a moment ago: the essence of why we need a long-term plan is so that we anticipate these issues. We are addressing that through the Green Paper on social care, and that is part of the investment that the Prime Minister announced yesterday.

Yesterday the Prime Minister said that

“current workloads are not sustainable”—

is that any wonder after eight years of Tory cuts and austerity? The Minister knows that the number of health visitors in the workforce is falling, and that health visitors are vital to improving child health and wellbeing outcomes. No new public health money was announced yesterday; new money will come in 2020. Can the Minister guarantee that health visitor numbers will not continue to fall and that the public health budget will be ring-fenced?

I am grateful that the shadow Secretary of State has drawn attention to public health because the Government have been making significant progress in that area. We have the lowest ever number of teenagers smoking and the lowest ever teenage pregnancy rate. Binge drinking is down and we are addressing child obesity with the sugar tax, which is among a number of measures that the Government have been bringing forward. We are making progress on public health and the hon. Gentleman is right to draw that to the attention of the House.

This Government are breaking the Tory manifesto promise and raising taxes, yet they cannot even answer basic questions about health visitor numbers. The NHS workforce deliver the constitutional performance targets, including the 18-week referral-to-treatment target, and targets for accident and emergency and cancer treatment. Will the Minister reassure patients and the taxpayers whose taxes are going up that he will rule out dropping those essential targets?

Once again—as we heard yesterday—there is no welcome for the announcement of additional funding for the NHS. Opposition Front Benchers are playing politics and talking down our NHS. The Prime Minister has set out a long-term vision to improve standards and raise mental health, which Labour Back Benchers highlighted. The hon. Gentleman should come to the House and welcome that investment in our NHS.