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Brexit: Nursing Staff

Volume 783: debated on Tuesday 27 June 2017


Asked by

To ask Her Majesty’s Government what assessment they have made of the impact on the NHS of figures released by the Nursing and Midwifery Council showing a 96 per cent reduction in the number of nurses registering to work in the United Kingdom in the year since the referendum on leaving the European Union.

My Lords, the Government are aware of a reduction in the number of European Economic Area trained nurses applying to register with the Nursing and Midwifery Council. The department’s assessment suggests that this is largely a consequence of the NMC introducing language testing, rather than the vote to leave the European Union. The number of European nurses working in the NHS increased by more than 400 between June 2016 and March 2017.

My Lords, what the Minister did not say is that there has been a 96% fall in the number of nurses coming from EEA countries in the space of nine months. This comes on top of a shortage of thousands of nurses in the NHS. The RCN has today issued a statement which absolutely disproves the Minister’s argument that it is to do with English language testing. It is quite clear that it is to do with the Government’s obsession with migration control at the expense of our public services and the imposition of a pay cap on nurses and other NHS staff. He and his fellow Ministers have found £1 billion to bung the DUP; when are they going to find the money that is needed to get rid of the cap on nurses’ pay and pay them what they deserve?

I am afraid the noble Lord is mistaking cause for correlation in this instance, and let me explain why we think that is the case. The General Pharmaceutical Council introduced language testing in November 2016; it had experienced no significant drop-off in applications from EEA member countries after Brexit but before that point and a big downturn in applications after that point. So it is language testing; it also happened with the GMC as well when it introduced language testing. I know this is something that the noble Lord supports—he said as much in a debate on this very issue in 2015—because it is an issue of safety. That is why language testing has been introduced. I would like to say, however, that of course we value the work of EU staff who come here, and, indeed, all nursing staff. As the Prime Minister set out yesterday, we want them to stay and have offered a generous package to allow them to do so, and there are more EU nurses here than there ever have been.

My Lords, the Department of Health’s own modelling predicts that there will be a shortage of 40,000 nurses by 2026. My own local hospital has 60 nurse vacancies, and I am sure other noble Lords have similar examples. What do the Government propose to do to avoid the NHS becoming unsafe because of these nursing shortages, given that some nurses are already being asked to stay on at the end of 12-hour shifts in order to fill gaps in the roster?

I thank the noble Baroness for giving us the opportunity to talk about the fact that we have increased the number of nurses and health visitors by nearly 5,000 since 2010. She is quite right to say that we need more of them; we have a growing and ageing population and higher expectations of what the NHS should be delivering. It is for that reason that we have a number of things in action: we have 52,000 nurses in training; we have a return to practice programme, which has already prepared 2,000 nurses to come back into the profession; and we are introducing nursing apprenticeships and nursing associates. We are not complacent about this issue—we know it is important—but there are a number of programmes in train to fill the gap that she has identified.

My Lords, perhaps the Minister could consider that one of the reasons that people are not coming from the European Union is that they feel unwelcome; housing is almost impossible to get, particularly in some of the metropolitan areas; the reduction in the value of the pound against European currencies means that salaries have stagnated even more for some of these people; and, actually, morale is so poor in parts of the health service and social services that people would rather remain and work in their own countries.

I reiterate the point that the Prime Minister made yesterday about the welcome, and indeed the offer of settled status, not just to nurses but to any other EU citizens and workers in the country. It is absolutely not the case that they are unwelcome—quite the opposite. They are as valued as much as any other person working in the health service. The noble Baroness mentioned housing, and she is right, of course, that housing is a huge issue for everybody. Indeed, one thing that I want to look at in the next few years is how we can take surplus land that sits within the NHS and make sure that some of it is used to provide the kind of key-worker housing that nurses, doctors and, indeed, other members of the public sector can use, so that they are able to come into the service and support our hospitals.

My Lords, it is a fallacy to continue repeatedly to suggest that EU nurses and doctors are not welcome in this country. Quite frankly, I am fed up with it. I worked in the NHS for over 25 years, and this is damaging staff morale because people are almost being targeted to feel that way. EU nurses and doctors do tremendous good work, and they are respected, welcomed and valued, as are other nurses and doctors from across the world. We have a great opportunity to celebrate this. Does the Minister agree?

I completely agree with my noble friend, who speaks from experience. It is important not to peddle a myth of unwelcomeness, when it is clearly the case that nobody has said that they are unwelcome. No one in government has said that they are unwelcome; nor has the BMA, the RCN, or anyone else for that matter. They are valued as highly as any other member of the medical profession.

My Lords, does the Minister accept that any fall-off in the number of nurses and doctors from the EC poses a real risk to the health service? Does he accept that, while the number of nurses in training may be increasing now, the Government were wrong in the coalition period after 2010 to cut the number of nurses in training in the UK?

The critical point is to have enough nurses and, indeed, enough medical staff. Of course, where they come from is going to be dictated by various circumstances. As I have discussed already, language controls have been introduced in order to focus on patient safety. We do need to increase the number of nurses in the health sector. That has happened since 2010. There has been an increase. There are more in training. But clearly there need to be more as we have a growing and ageing population.

I do not have that information at my fingertips. Of course, at any time there will be unfilled vacancies as nurses move around. As I said, we know that recruiting more nurses into the health service is an important priority for the years ahead, which is why we are undertaking the programmes that I mentioned.