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House of Lords Hansard
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12 December 2017
Volume 787

Question

Asked by

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To ask Her Majesty’s Government what assessment they have made of the number of doctors from European Economic Area states working in the United Kingdom who may be planning to leave the NHS after the United Kingdom’s withdrawal from the European Union.

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My Lords, the Government value the contribution of all European Union staff working across the NHS and social care systems immensely. We have set out a clear pathway to permanent residency for these EU citizens. According to the latest NHS digital data, there are now more non-UK EU doctors working in the NHS than ever before, with almost 500 more since 30 June 2016.

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My Lords, according to the BMA, almost half of EEA doctors are considering leaving the UK and one in five has already made plans to do so. Given that it takes 13 years to train a consultant, what is the Minister doing to fill these gaps in the short term? Is he aware that there are numerous doctors from around the world already resident in the UK but whose qualifications fall short of what is required by the NHS? They would dearly love to be able to upgrade their qualifications and help us to fill the gap that is going to be left by the Tory Brexit, but there is no organisation that will advise and support them to improve their qualifications. What will the Minister do about that?

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I recognise that, as the noble Baroness pointed out, there has been uncertainty. That is why I am sure that the entire House will welcome the agreement reached last Friday to provide that certainty, and I encourage all noble Lords to look at and circulate the letter written by the Prime Minister to EU citizens explaining how much we value them, how much we want them to stay and how we have now agreed with the EU a process for doing that. The noble Baroness will be interested to know, as I am sure will other noble Lords, that there were 470 more EU doctors working in the NHS in June 2017 compared to June the year before—so, happily, we have not seen the exodus that so many people have warned about. We need to grow more of our own in the future, of course, and there are 1,500 training places for doctors coming on stream in September 2019, but I shall certainly look at the issue that she raises about providing opportunities for doctors—not least refugees; that issue has been raised with me—to upgrade their qualifications so that they can serve in the NHS.

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My Lords, can the Minister guarantee, if the Government sort out the immigration status of EU medical staff in a timely fashion, that this will be with the retention of existing workers’ legal rights such as the working time regulations and related employment directives in UK law for the current and future workforce?

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I think I may have detected a qualified welcome from the noble Baroness for the achievements of last year in providing that reassurance. Clearly, we want to make sure that there is the best possible working environment for our medical staff, wherever they come from, and that involves, as the Prime Minister has set out, having world-leading employment rights.

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My Lords, is the Minister as concerned as I am that this Question refers to the EEA as well as the EU? I am mystified about why any Norwegian or Icelandic doctor should be concerned about Brexit. In addition to that, is my noble friend not absolutely correct? I went to Bedford Hospital a week ago on a Sunday with an EU doctor. That doctor made it quite clear to me that the reassurance that had been given by Her Majesty’s Government was sufficient for her—and, I believe, her husband—to continue to work in the NHS.

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I thank my noble friend for pointing that out. It is extremely reassuring to know that the message is getting through. We as a department and as a Government have a job to do in making sure that everybody hears that message of reassurance, because we want those EU workers to stay and contribute to our NHS.

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My Lords, what work has been done by the Department of Health to identify what impact leaving the European Union is going to have on the health service, and what is it doing about it?

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The noble and learned Lord will know that a variety of reports have been published. I am sure that he has taken the opportunity to sign in and read them, which is very welcome, and I encourage all noble Lords to do that. One of the greatest things that we have to do is look at workforce issues. I come back to the point about being able to provide reassurance to people who are thinking of leaving but have not yet done so. I stress that we have more EU and EEA people working in the NHS, which is a very welcome thing and I hope they take comfort from that.

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My Lords, over the weekend a number of Ministers, including the Secretary of State for DExEU, said that these agreements are fine but that nothing is settled until everything is settled. That seems to be not quite the reassurance that everyone would want. Is it possible for the Government to go further and say that they will offer a guarantee to all EU citizens working in the National Health Service that, whatever else happens, they will continue to be welcome? I am conscious that the figures on nurses and midwives are not as good as those for doctors at present and that we are in severe danger of having a short-term gap in the number of nurses and midwives, which would be very serious.

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I point the noble Lord to the Prime Minister’s letter, in which she talks about the fact that the rights will be written into law as we leave the EU. He is right to point out the position of nurses and midwives; that is the only category where fewer EU staff are working in the National Health Service year on year. However, as we have talked about many times in the House, new language tests may have had a critical role in that and that is something we are reviewing it to make sure that we can continue to welcome nurses from abroad.

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Given the current vacancy factor, and the fact that we have some refugees who are doctors and some who are nurses with an enormous amount of clinical experience but whose English language skills need to be improved, what are the Government doing to provide targeted English language training and apprenticeship attachments so that these refugees can enter the workforce and become economic contributors?

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This is an excellent idea that the noble Baroness has shared it with me before. We are looking at it and we have a workforce strategy coming out, so I will do my best to ensure that it includes something on this.