My Lords, the latest data available from the Higher Education Statistical Agency show that approximately 23,000 nursing students qualified from higher education courses regulated by the Nursing & Midwifery Council in England in the 2014-15 academic year.
I thank the Minister for his considerate Answer and his personal commitment to the health service. I much appreciate it, but does he appreciate that the figures he has provided today mask the true picture of nursing in this country? Will he accept that the coalition Government in 2010 made a massive mistake when they made those savage cuts in nurse training? Even with the increases of late, there are still only 0.6% more nurses now than there were in May 2010, which is in spite of a 31% increase in hospital admissions. Does the Minister accept that the staff of the NHS are keeping the ship afloat? Can the Government offer some concessions to the generosity, commitment and dedication of those staff?
My Lords, there were 3,500 more nurses working in the NHS in 2015 than there were in 2010. In retrospect, we did not anticipate in 2010 the Mid Staffordshire crisis and the Francis report, which led to a very substantial increase in nursing levels after about 2013. The noble Lord is right; we were short of nursing throughout that period. We are addressing that now with a 15% increase in nursing places and we expect that by 2020 there will be 40,000 more nurses than there were in 2015.
My Lords, is the Minister aware of the fact that the Blair Government introduced only one standard for nursing? You had to have five A-levels and take a university degree. The abolition of the state-enrolled nurses, who would have made—and did make—a marvellous contribution, has been very retrograde. Now we are dependent on a large number of foreign nurses. In every hospital that I have visited, we rely on them completely. Why can we not have that intermediate level of training back?
My Lords, as my noble friend probably knows, we are introducing nursing associates into the NHS. There are a thousand in place today, and a further thousand will come in next year. That is the bridge between healthcare support workers and degree-trained nurses. We recognise that there should be another route into nursing—not just the university route, but a more traditional apprenticeship route.
My Lords, can the Minister comment on the ratio between nurses retiring from the service and those coming in? I too welcome the potential development of the nursing associate—although we need to get it right—and graduate-entry nursing, but we still need a system to rapidly increase the number of registered nurses over the next five years. I do not believe that the figures illustrate that we will be replacing like with like in terms of numbers.
My Lords, the best estimate of Health Education England is that, making reasonable assumptions about the attrition rate of students and the retention of existing nurses, by 2020 we will have 40,000 more registered nurses working in the NHS than we do today.
Will the Minister accept—at last—that simply providing more training places and increasing the number going through both the associate route and the graduate apprentice route is only part of the solution? At the moment we are losing a huge number of nurses, with roughly 10% of our graduate registered nurses going through attrition each year, as the Minister accepted. Two years ago, the Secretary of State gave a mandate to reduce attrition by 50%. Can the Minister tell the House how successful that has been, and can he put in the Library the figures showing how many fewer people are leaving the profession simply because we are not looking after, nurturing or caring for our existing workforce?
I think that there is some confusion here. The attrition rate that I was referring to was the one in nursing schools, which on average has been running at about 9.5%. Attrition among the regular workforce, which I think the noble Lord is referring to, is clearly a huge issue for us. Interestingly, we have set up a return-to-practice initiative, which has brought a thousand nurses back into the profession at a cost of £2,000 per person. That is extremely good value if we can persuade people to come back into the service. The noble Lord is absolutely right: people retiring early or leaving early is potentially very damaging for the service. However, I reiterate that the figure of an extra 40,000 nurses in the NHS by 2020 is arrived at after making reasonable assumptions about the level of attrition among the existing workforce.
My Lords, the Minister has told the House that there is strong evidence to suggest that moving from bursaries to nurse student loans will increase the availability of nurses. Can he explain exactly what this evidence is and when he considers that the Government will be in a position to publish an independent assessment of the impact on both current recruitment levels and addressing the serious shortage of qualified nursing? Does he accept that the Government’s move to bursaries is particularly risky in the light of the possible threat to EU qualified nurses?
It is not possible to carry out an independent assessment at the moment, as we will not know the rate of applications to nursing schools until January 2017. The courses have consistently, over many years, been oversubscribed by about 40,000 people so, even if there is a fall-off in the number of young men and women who want to become nurses, a significant number of people would like to go to nursing school but are not able to get in at the moment. I think we will have to wait until January before we can be sure whether the switch from bursaries to loans is having an impact.