PARLIAMENTARY DEBATE
Healthcare Staffing Levels - 23 July 2019 (Commons/Commons Chamber)

Across the UK, the number of registered nurses and doctors has increased over the past nine years. In England, there were over 112,000 doctors in NHS trusts in March 2019, 17,000 more than in March 2010, and over 8,000 more nurses than in 2010. There is more to do, and the NHS people plan will ensure a sustainable workforce for the long-term future of the NHS.

As the Secretary of State may be aware, earlier this month—conveniently in the Holyrood recess—we learnt that medical students who come from the rest of the United Kingdom and want to apply for an undergraduate course at Scottish universities will find their chances greatly diminished. Most Scots are appalled by this policy. In fact, the British Medical Association, the Royal College of General Practitioners and medical schools are all expressing concern. Does the Secretary of State agree that the Scottish Government need to be attracting the brightest and the best—no matter where they come from across the United Kingdom—to address the GP crisis?

Yes, I do. I was surprised by the recent news that I read about medical schools in Scotland being told to discriminate against medical students from elsewhere in the UK. I understand that the Scottish National party itself accepts that this is discriminatory. I doubt that the policy will last and I look forward to an SNP U-turn.

Mitie recently signed a £150 million contract at St George’s Hospital, but staff are already facing job cuts. My union, the GMB, balloted its members; 99.6% of them voted to take industrial action. Will the Secretary of State commit to visiting staff on the frontline and show them solidarity during this very difficult time?

I am always very happy to visit hospitals around the country, including St George’s. Of course, the individual management of staff is a matter for the hospital itself. I look forward to discussing with the hon. Lady what more we can do.

The Secretary of State has quite rightly outlined the global progress that has been made on the medical and nursing workforces, but he will be aware that the picture is very different in mental health services, with the loss of 4,000 mental health nurses over the last decade. Indeed, the fill-rate for doctors entering higher training in child and adolescent mental health services this August is only 63% and only half the higher trainee posts in general adult mental health have been filled. What is the Secretary of State going to do to turn the very good rhetoric on mental health into a reality on the ground for patients?

The increase in funding for mental health services, which is the largest increase as part of the overall £33.9 billion increase, goes to mental health services. Of course, the vast majority of that will go towards employing more people. As my hon. Friend says, we need to encourage more people into training in mental health services and psychiatry, as well as mental health nursing, which is also under pressure. The expansion of these services ultimately means that we need to have more people doing the work: supporting people to improve their mental health and supporting people with mental ill health. My hon. Friend is absolutely right to raise this issue, which is right at the top of the priorities for the NHS people plan.

Sexually transmitted diseases such as syphilis and gonorrhoea are on the rise. Will the Secretary of State target more resources at staffing and investment to ensure that we tackle this rise?

We have recently announced that the way in which we are going to proceed with regard to sexual health services is co-commissioning between local authorities and the local NHS. This is the best way to ensure that we get the services on the ground. I would just slightly caution the hon. Gentleman; although he mentioned that some sexually transmitted diseases have been on the rise, others have been falling quite sharply. We have to ensure that we get the details of what we try to implement right, but I support the direction of travel that he proposes.

What can we do to make the workload terms and conditions more attractive for salaried GPs and GP partners compared with locums? GPs in my constituency tell me that a great number want to be locums, but that not so many want to be salaried or GP partners because of the workload. What can we do about that?

My hon. Friend is dead right. This is an important part of the work that Baroness Dido Harding is leading in the NHS people plan to ensure that we can make careers in the NHS—whether as doctors, other clinicians or more broadly—the most attractive that they possibly can be. This week we announced a pay rise for doctors and earlier this month we announced a long-term agreement with junior doctors, which I am delighted they accepted in a referendum with over 80% support. But there is more work to do.

The rules around annual and lifetime allowances are having an impact on the NHS workforce in Scotland, and the options contained in the recent consultation on doctors’ pensions do not provide the level of flexibility necessary to resolve this situation. We know that the solution lies with the Treasury, so what pressure can the current Secretary of State put on the Chancellor to ensure that urgent reform takes place to stop this terrible impact on our NHS workforce?

I have been working hard with the Chancellor of the Exchequer to ensure that we can resolve this important issue. The hon. Gentleman will have seen the consultation document that we put out yesterday to resolve the problem. The consultation is open and asks open questions about the best way to fix it. I am absolutely determined that we will fix it to remove some of the unintended consequences of changes in pension tax law. It is a pity, though, that the SNP spokesman did not stand up to accept that the proposal mentioned by my hon. Friend the Member for Angus (Kirstene Hair), which would discriminate against people from outside of Scotland, is wrong and should be withdrawn.

The Secretary of State is in denial. There is a crisis in GP retention. In fact, there are now 1,200 fewer fully qualified permanent GPs than there were in 2010. Because of this, patients are waiting longer than ever to get a GP appointment. He has promised, as he did again today, to address this, but it is a fact that the situation is getting worse, with a pension system that is effectively charging GPs to work extra hours. Does he really believe that this is the best way to retain GPs in the NHS? Does he have a detailed plan, and can he explain how he is going to sort out this mess?

I think it is worth starting with a few facts. One fact is that I published a detailed plan yesterday, on which we are consulting, to tackle the pension issue. The other two facts that are worth noting, and that the House will want to know about, are the following. First, there is a record number of GPs in training—3,473. Secondly, the overall number of GPs is rising, with, as of March 2019, 300 more doctors working in general practice than a year earlier. I want to see that number continue to rise.