My Lords, we are committed to ensuring that nursing remains an attractive career so that the NHS builds on the record number of nurses currently on wards, but we need to do more. We have put in place several actions to address this, such as improving staff retention, return to practice, overseas recruitment and sickness absence, expanding nursing associates and reviewing language controls.
I thank the Minister for her Answer. Does she accept that the 41,000 nursing vacancies in the NHS conceal even worse problems? The number of district nurses has been cut by 50% and the number of both mental health nurses and school nurses has been cut by over a quarter. Does the Minister accept that the long-term plan for the NHS will work only if proper attention is paid to staffing issues? Can she confirm there is currently no money for any future staff training and reform in the budget, which depends on the Department of Health and Social Care’s education and training budget? How confident is she that that money will be forthcoming and when will we hear how much it will be?
My Lords, I agree with much of what the noble Lord said. There is a shortage of nurses in the NHS: 41,000 vacancies, as he rightly identified. To put that into context, our policies have enabled the NHS to put more than 13,400 more nurses on our wards since 2010. We are not complacent. We have increased nurse training places by 25% from September 2018. To reassure the noble Lord, there are more than 52,000 nurses in training. Although there are more applications than places, we know that we need to do much more work with universities. On the NHS 10-year plan, the noble Lord rightly identified that the training budget has not been set yet. We will do that by the spring. My noble friend Lady Harding is taking a quick look at the forward plan, the type of vacancies and how we can recruit more nurses into the NHS.
My Lords, it was encouraging to see in yesterday’s plan a commitment to an extra 5,000 funded clinical placements for trainee nurses from the next academic year, 2019-20. Can the Government indicate when the funding for those places will be guaranteed? Are we certain that training places are available to absorb this welcome jump in demand?
There were 22,200 acceptances to study nursing and midwifery in 2018, compared with 22,575 in 2017, which we estimate will increase the final number of students on nursing and midwifery courses by a further 650. The numbers are coming through, but we recognise that we need radical campaigns to ensure that we attract more people into nursing, particularly in the community.
My Lords, bearing in mind the loss to the NHS of more than 23,000 nurses from the EU as a direct result of the referendum, what special measures do the Government have in mind to ensure absolutely free movement from the EU of people wishing to come and work in the NHS as nurses, doctors or other professionals to ensure that the NHS long-term plan can be implemented?
The noble Baroness is absolutely right to say that we need the staff to deliver the long-term plan and that without them we cannot do that; it is very important. We recognise absolutely that Brexit is a pressure on the system, but we should also recognise that 4,800 more professionals from the EU are now working in the NHS than there were at the date of the referendum. We are of course lifting the cap on Tier 2 visas so that more nurses and skilled clinical staff will be working within the NHS. We value EU and international staff because they genuinely make a difference to our NHS.
I recognise the point made by my noble friend and she is right to say that we need a diversity of people coming in to the profession. We have plans to train up to 5,000 nursing associates through the apprenticeship route through 2018 along with up to 7,500 in 2019. That offers a foundation course from which student nurses can move into other areas, involving either further apprenticeship or nurse degree courses.
Following the question the Minister answered about the European Union, while I am happy that she has confirmed that nurses from the EU are still welcome, what about the proposed threshold of £30,000, which I gather is in the immigration purposes, when the average starting pay for a nurse is £23,000? Perhaps the noble Baroness could enlighten the House on what is happening in the discussions between her department and the Home Office?
I would like to reassure the noble Baroness that we work very closely with the Home Office. As a transitional measure, our temporary workers route will allow employers to bring in migrant labour at all skill levels for short periods, subject to strict conditions. Many jobs in the NHS, along with senior care roles, are still at skill levels above RQF 3, which is the equivalent of A-levels. Migrants will be able to come to the UK through our new skilled worker routes. We will also be asking the Migration Advisory Committee to keep salary levels under review. However, at the moment, as far as I am aware, there are no plans to curtail those.