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NHS Staffing: Long-term Plan

Volume 795: debated on Monday 4 February 2019


Asked by

To ask Her Majesty’s Government how they will ensure that there are sufficient nurses, doctors and community specialist care staff to deliver the National Health Service long-term plan, published on 7 January 2019.

My Lords, the Secretary of State for Health and Social Care has commissioned the chair of NHS Improvement, working closely with the chair of Health Education England, to lead a number of programmes to engage with key NHS interests to develop a detailed workforce implementation plan. These programmes will consider proposals to grow the workforce, including consideration of additional staff and the skills required to build a supportive working culture and ensure first-rate leadership for NHS staff.

I thank the Minister for her Answer. Both the NAO and the Commons Public Accounts Committee have stressed that the NHS long-term plan is at risk and cannot be delivered if current staff shortages of over 100,000 are not addressed, and if we do not recruit more staff in key specialities to meet future need and demand. Last Thursday’s major debate on the plan showed that this view is shared across the House.

Today is World Cancer Day. The ambition in the plan, for example, to diagnose 75% of cancers at stage one or two by 2028 is welcome, but there are chronic staff shortages in the cancer workforce across both primary and acute care, with more than one in 10 diagnostic posts currently unfilled. It is the same scenario for other key priority ambitions in the plan, but the long-term workforce implementation plan, as the noble Baroness said, has yet to be drawn up, developed and costed, and is not included in the extra funding promised for the NHS. Do the Government have any idea how they are going to take the NHS plan forward?

We absolutely do. The NHS employs record numbers of staff now compared to any other time in its 70-year history, with significant growth in newly qualified staff over the period from 2012. There are almost 13,400 more nurses on our wards since 2010. However, the noble Baroness is right—the current vacancy levels are not sustainable. Therefore the Government have put several actions in place to increase nursing workforce supply, covering improving staff retention, return to practice, overseas recruitment, expanding nursing associates, improving sickness absence and a review of language controls.

Bearing in mind that one of the key problems facing doctors is those leaving the NHS as soon as they qualify—a significant number, both male and female, choose to go abroad—should the Government not have a look at the Singapore system, where they have to sign up for five years once they qualify and after that it is entirely free, regarding their medical practice?

I thank my noble friend for that question. I am certainly aware of the Singapore model. I reassure him that we are expanding undergraduate medical education by funding an additional 1,500 medical school places in England. We have also recently announced the removal of doctors and nurses from the ambit of the cap on tier 2 visas, which means that all overseas doctors needed in the UK should be able to come and work here. We have more doctors than ever before, but there is no doubt that the pressures are huge. That is why we want to train more doctors. However, I understand the point that my noble friend makes, which is perhaps something we need to consider.

Do the Government recognise the GMC’s statement that the medical profession is on the brink of breaking point, that up to a third of doctors report being burnt out and that around 10% at times have depression? There is evidence that errors are twice as likely to be made by people who feel burnt out. Do the Government recognise that this is urgent and whatever plans they have to train more people will take several years to come through the system?

I agree with the noble Baroness: we need to take care of our workforce and ensure that supportive mechanisms are in place so that there is greater flexible working. We are already looking at medical training and different modules. We want a first-class workforce and we will do everything in our power to support doctors so that they stay and remain healthy while they work in the NHS.

Is the Minister aware that we have recently opened a new medical school in the University of Lincoln? We hope that this will assist the recruitment and retention of more doctors. However, what are the Government doing to mitigate the increased cost of specialist community nursing provision in remote and sparsely populated rural areas?

I am delighted that a new medical school is being opened in Lincoln, which is very welcome. On community nursing, we are trying to attract more nurses and medical practitioners to areas where there is greatest need, which are community nursing, psychiatry, mental health and learning disabilities. Last year, the Secretary of State announced golden hellos. We are also looking at further, more flexible training to enable a greater number of people to enter the profession.

My Lords, with concern being voiced about current vacancy levels among mental health professionals, let alone the additional 21,000 mental health practitioners the Government have said will be needed to treat a million more people by 2021, will the Government agree to fund a collaborative mental health careers campaign aimed at secondary school, college and university students, particularly psychology graduates, to help plug this gaping hole?

My Lords, we are looking at allied professionals and more creative ways of bringing a wide range of people into the profession. I cannot comment precisely on the question that the noble Baroness has asked. However, as she is aware, HEE has published the mental health workforce plan, which has the stretching ambition of delivering 21,000 new posts and employing 19,000 additional staff. As well as increasing recruitment and retention in mental health training, the NHS is creating new roles such as physician associates, nursing associates and allied health professional associates as well as looking at advanced clinical practitioners. On the specific question asked by the noble Baroness, I shall write to her.