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Health: Cancer Nurses

Volume 790: debated on Wednesday 2 May 2018


Asked by

To ask Her Majesty’s Government what assessment they have made of the impact of the shortage of more than 400 specialist cancer nurses reported by Macmillan Cancer Support.

My Lords, we welcome Macmillan Cancer Support’s report, which acknowledges the fact that the number of specialist cancer nurses has increased by nearly 1,000 full-time equivalent posts, or by 30%, since 2014. There is more to do, however, and Health Education England is working closely with Macmillan and the cancer alliances, so that we can achieve our aim that every cancer patient has access to a specialist cancer nurse by 2021.

I thank the Minister for that Answer. The census also pointed to the facts that there are vacancy rates as high as 15% for chemotherapy nurses in some areas, that the proportion of specialist cancer nurses who are over 50 years old continues to climb, and that almost one in 10 specialist cancer nurses comes from the European Union. We know that there has been a cliff edge for recruitment from the European Union. I want to ask two questions. First, will the Minister assure the House that this census will be used by the Department of Health and Social Care, Health Education England and the cancer alliances to inform their strategic workforce planning? Secondly, will he explain what steps the department has taken to assess the level of funding required to deliver the recommendations contained in the Cancer Workforce Plan, including the long-term strategy?

The noble Baroness is quite right that the Macmillan report highlights some challenges around vacancy rates and the age profile of cancer nurse specialists. It was explicitly set out in the cancer workforce strategy that it would have a phase 2 of planning once the census had been published. This census has been published, so there is an absolute commitment by Health Education England to work with Macmillan and the cancer alliances to bottom out how many more staff are required to meet the standard that we have set out—for every patient to see a cancer nurse specialist by 2021—and how many extra people we would need to recruit for that, and therefore to deliver the funding that would enable that to happen.

My Lords, I declare my interest as a member of the General Medical Council. What assessment have the Government made of the effect on cancer services of the repeated refusal of visas to overseas doctors qualified to work here, and who have been recruited by the NHS to work here, but not being allowed to enter the country because of Home Office policies? Given the severe shortages of doctors across the board in the NHS, not just in A&E, is it not time that the cap on tier 2 visas for doctors was lifted?

The noble Baroness will know that the NHS benefits from many of those visas issued under tier 2, which obviously has great benefits for our workforce. It is in the long-term interests of this country that we recruit more of our staff, wherever possible, from the domestic workforce. On that basis, Health Education England has committed to increase the number of cancer consultants by more than 20% between 2016 and 2021, as well as increasing the number of radiographers and others.

My Lords, does my noble friend really think it necessary that specialist cancer nurses are educated to degree level? If he does think that, given that because of their levels of remuneration most of the student loan will not be paid back, would it not be a good idea to consider writing off those student loans for those nurses who stay for a period within the health service?

What comes to life in the cancer workforce strategy and the Macmillan report is the complexity of the workload that these nurses carry out, so a very high level of qualification is required. One thing we do not have at the moment is a national competency framework, which is being designed. Funding for nurses is obviously a topic that we come to often in this House and it is worth noting that the income point at which repayment of the loan starts has been increased by this Government, to make sure that lower-paid nurses and other staff are alleviated from that burden.

My Lords, how many nurses from overseas have applied to work in the National Health Service and have been refused permission on the grounds of the arbitrary target set by the Prime Minister, as exemplified by the 100 Indian doctors who wish to work here and have fallen foul of this arbitrary rule?

I do not believe that nurses would have fallen into that category as nursing is named as a shortage profession in the immigration system, but I would have to check those figures and I will write to the noble Baroness.

My Lords, the failure to screen nearly half a million women for breast cancer is a scandal. When it is coupled with the report of Macmillan Cancer Support, it has really been a bad few days for cancer. Immediate action is required on both counts. Is it the Government’s view that this shortage of cancer nurses is due to local budget constraints or to workforce planners’ failure to act on the demographic trend of the ageing workforce?

My Lords, regarding the Statement made by my right honourable friend the Secretary of State earlier today about the errors in the breast cancer screening programme, I take this opportunity to apologise wholeheartedly and unreservedly on behalf of the Government, Public Health England and the NHS for the suffering and distress that has been caused to women by this flaw in the screening service. We will have an opportunity to discuss this at greater length tomorrow, when I will repeat the Statement.

The shortage that has been described is based on an analysis of vacancy rates. The number of cancer nurse specialists has actually increased by 1,000—that is 30%—in the last three years alone. That is a huge increase. Of course we know that we need to do more, but it is worth recognising the great steps forward that we have made in cancer treatment in this country.

My Lords, can I take the Minister back to the question from the noble Baroness, Lady Hayman? In his answer, he made the rather odd observation that it was in the long-term interest of the service that we should recruit our workforce domestically, and no doubt that is at least an arguable position. However, we are not talking about the long term here: we are talking about the immediate term. In the interest of joined-up government, could he go back to his colleagues at the Home Office and ask them to look again at whether they have made the right decisions in this case?

I reassure the noble Baroness that we have lots of discussions with the Home Office about the recruitment of international doctors and nurses. I reiterate the point, however, that it is our intention to increase the number of training places for doctors and nurses from this country.