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NHS Workforce: Retention and Recruitment

Volume 726: debated on Tuesday 24 January 2023

The long-term workforce plan that is being developed by NHS England will help to ensure that we have the right staff numbers with the right skills to deliver high-quality services in the future.

Is the Secretary of State fully aware that under this Government every part of the NHS is in crisis? Are the Government satisfied with the fact that, as medical students in their second year told me recently, the shortage of staff on hospital wards and the pressures on those wards are affecting their training? The students also told me that they had little aspiration to work as junior doctors in the UK after qualifying, because of the acute strain on the NHS and because they felt undervalued. Does the Secretary of State know about this, and what is he going to do about it?

We see a considerable number of applications for medical undergraduate places, far in excess of the number of places available. We have boosted the number of places—[Interruption.] The hon. Member for Ilford North (Wes Streeting) chunters from the Opposition Front Bench, but when I was last in the Department and the Chancellor had my role, we increased the number of medical undergraduate places by 25%. Indeed, we have more doctors and nurses than we had last year, and 3.5% more full-time equivalent staff: we have over 42,000 more people working in the NHS than we had last year.

The British Heart Foundation has reported that by the end of August 2022 a record 346,000 people were waiting for heart care. Despite the best efforts of NHS staff, workforce shortages are affecting primary and secondary care services. Can the Secretary of State explain how the Government’s comprehensive NHS workforce plan will address specific gaps in the workforce, especially those in cardiology services?

The hon. Gentleman has raised an important issue. I think that, in particular, we should look at our approach to major conditions, and I will say more about our thinking in that regard at the start of topical questions. I also think that we need to look at the issue of heart conditions in the context of the wider debate about excess deaths; we know that there is a particular issue in the 50 to 64-year-old cohort. As well as providing those extra doctors and clinicians—and from next autumn we will also have the additional medical doctor degree apprenticeship route—we need to look at methods of upstream testing, particularly in respect of heart conditions.

In reference to my right hon. Friend’s earlier answers, we are keen to see the success of the new Lincoln medical school leading to more locally trained NHS professionals working across Lincolnshire. What more can the Government do to remove barriers to entry to ensure that anyone who can do so is able to train to become a doctor, nurse, dentist or dental nurse in our NHS, specifically in Lincoln and Lincolnshire?

My hon. Friend raises an important point on two levels. The first relates to how we boost recruitment in areas such as Lincolnshire, and the new medical school in Lincoln will play a key part in that. The second relates to how we increase the retainability of staff in those parts of the country, and having more on-the-job training and apprenticeships is a key way of doing that. That is why things like the new medical doctor degree apprenticeship will be particularly relevant to cohorts of the population in areas such as Lincoln.

One of the biggest issues my local hospitals raise with me in outer London is the impact of Sadiq Khan’s ultra-low emission zone expansion, with nurses and other staff facing charges of £12.50 per shift or £25 if they are working nights. Given that 50% of London’s emergency service workers live outside the capital, does the Minister agree that the Mayor and the Labour party should stop ignoring Londoners and drop their ULEZ tax rate?

My hon. Friend raises an important point about the additional costs that the London Mayor is imposing not just on NHS staff but on all staff working in the capital, in contrast to the approach the Chancellor has taken to energy support to help staff across the workforce, including in the NHS, with the cost of living.

Most of the GP practices in South West Devon report to me that their biggest challenge is recruiting new doctors. Does my right hon. Friend have an estimate of the number of young doctors finishing their training this year who are likely to want to become GPs, and can he reassure us that that is a greater number than the number who are likely to retire in the next 12 months?

My hon. Friend raises two important themes. The first relates to how many are in training, and I think it is around 4,000. We have boosted the number of GP training places and we have looked at medical schools as a specific issue. Also, he will have seen some of the changes being made around pensions in order to better retain staff, mindful of those clinicians who are leaving the profession, and further discussions are taking place with Treasury colleagues in that regard.

In Shropshire there are 14% fewer GPs and 29% fewer GP partners than in 2019, yet in the period from April to November 2022, they provided 6% more appointments. It is this additional workload that is causing burnout in GP practices and a flight from the profession. What is the Secretary of State doing to improve the retention of GPs as well as recruitment?

It is important to look at the number of doctors in general practice, and those numbers are up. There are 2,298 more than there were in September 2019, so we are increasing the number of doctors. What is also important is getting the right care at the right time within primary care, which is about the wider workforce—the paramedics, the mental health support and others working in primary care—and there are an extra 21,000 there. This is enabling GPs to see more patients a day and allowing more patients to get the right primary care, perhaps not from a doctor but from others who can offer specialised support.

One of the best ways to improve recruitment and retention is to make sure that staff have an excellent working environment, which is why I campaigned for a new urgent and emergency care department at Walsall Manor Hospital. I was successful, and it is opening in March. Will one of the ministerial team join me to celebrate this success?

I welcome my hon. Friend’s drawing attention to the investment that has been made, which is in no small part due to his campaigning and championing his constituents, as he does so assiduously. I think the Minister of State, Department of Health and Social Care, my hon. Friend the Member for Colchester (Will Quince) has plans to join him to mark the opening of that important facility, which shows our investment in the estate within the NHS.

One way to improve retention and recruitment of NHS staff at Northwick Park Hospital, which serves my constituency and which I believe the Secretary of State visited last Thursday, would be to invest in doubling its intensive care beds. Did the Secretary of State discuss that issue with the chief executive of Northwick Park when he visited last week? Will he tell us when he might be able to announce funding for the new 60-bed unit that Northwick Park needs?

The hon. Gentleman is right to highlight the importance of bed capacity at Northwick Park, but my discussions with the chief executive were more in the context of how step-down capacity will relieve pressure on A&E. The hon. Gentleman will know that Northwick Park has one of the busiest, if not the busiest, A&Es in London on many days, and the chief executive spoke to me about the value of adding extra bed capacity from a step-down perspective, much more so than from an intensive-care perspective. If there are specific issues for intensive care, I am happy to follow them up with the hon. Gentleman.

In mental health we rely on staff, not shiny machinery, so why is the Secretary of State rehashing old announcements and scrapping plans? It is because the Government have run out of ideas. Labour has a plan. We will recruit 8,500 more mental health professionals, ensuring a million more patients get treated every year. We will double the number of medical school places. We will train 10,000 extra nurses and midwives every year, and we will focus on retaining the fantastic staff we already have. Where is the Government’s plan? We have had our plan for two years, but they are binning theirs.

It is slightly odd for the hon. Lady to talk about a plan when she does not agree with the plan of the shadow Health Secretary, the hon. Member for Ilford North (Wes Streeting). He plans to use the private sector, which he describes as “effective and popular,” whereas the hon. Lady said:

“In my own brief in mental health we have use of the private sector, which ultimately often lets patients down.”

First, the hon. Lady does not agree with the shadow Secretary of State. [Interruption.] The hon. Lady chunters, but she asked about a plan when she does not agree with her own Secretary of State.

Secondly, the hon. Lady talked about shiny new equipment. I am delighted that she allows me to draw the House’s attention to yesterday’s announcement of a fleet of 100 new mental health ambulances, which will relieve pressure on A&E. I am delighted that she gave me an open door to highlight that investment, which is part of our £2.3 billion investment in mental health.