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NHS: Nurses

Volume 801: debated on Tuesday 7 January 2020


Asked by

To ask Her Majesty’s Government when they expect to meet the Conservative party manifesto commitment to deliver 50,000 more nurses in the National Health Service.

My Lords, we expect to increase nurse numbers by 50,000 by 2025. Eligible preregistration students on courses at English universities from September 2020 will receive additional support of at least £5,000 a year, which they will not need to repay. Additional payments of up to £3,000 will be available for some students in regions or specialisms struggling to recruit and to help students to cover childcare costs. We encourage everyone considering this incredible career to apply before the deadline on 15 January.

My Lords, I am grateful to the Minister, but the manifesto pledge and what she said today seem to me to have a whiff of fantasy, due to double counting, uncertain finances and a less than precise timetable. Of the 50,000 extra nurses, it turns out that only 30,500 will actually be additional nurses, of whom 12,500 will have to be recruited from other countries. Of the 18,500 that the Government are so magically going to persuade to stay on against the current trends, 12,400 were already pledged in the NHS plan published earlier in the year. It all seems to be on a bit of a wing and a prayer as to whether the Government will get anywhere near a net increase of 50,000. How can the Minister be confident that they are going to succeed when the student nurse attrition rate is at 25% and 14,000 qualified applicants were turned away from nurse courses last year?

My Lords, first, I thank the NHS staff who have worked so hard over the Christmas and new year period. I point the noble Lord to the recent record; the NHS now has over 20,300 more nurses on our wards than in 2010 and over 52,000 more nurses in training. We have increased our training places by 25% since September 2018 and made available 3,000 more midwifery places to ensure that we can achieve this outcome. We have put in place several actions on recruitment and retention, because we need to retain our extremely experienced and excellent nurses and to recruit more nurses to support them. That is why we have announced this new package, which will not only increase nurse payment by 12% but provide support for those in training, attracting more nurses in to support those already in place.

My Lords, from the point of view of both retention and recruitment of nurses, would my noble friend not think it a good idea to allow student nurses who stay in the profession for a period of time to have their fees written off, given that because of their levels of pay they will not pay back the student loans required for the profession? That would save the taxpayer a good deal of money and encourage people to come into the profession.

I always take very careful note of proposals from my noble friend. At the moment, that is not under consideration, but it will certainly be looked into. As the entry salaries rise, it is more likely that student loans will be repaid, but what is important at this stage is that we attract the most nurses into the profession. At the moment students are able to access student loan funding for maintenance as well as the non-repayable funding from the DHSC, which means that we will meet our target of 50,000 more nurses by 2025, which is what we need to be able to deliver a sustainable NHS.

My Lords, could the Minister provide an estimate of the number of people the Government expect to recruit from countries where the nurse-to-population ratio is already inadequate? If this is morally right and what we need to do, how can we ensure that some of our overseas aid budgets through DfID are used to increase nurse training in countries that we will recruit nurses from?

The noble Baroness is very expert in this area. I cannot give her specific numbers on specific recruitment from individual countries; I do not know which specific countries she is asking about. I can tell her that the recruitment of nurses from overseas non-EU territories has increased by 156% in recent years; as the daughter of a South African nurse, I can also tell her that this is a long-term pattern and has been good for the NHS. However, we must also make sure that we invest in many of those nations as we do through the overseas budget, which is part of the department’s healthcare priority. I would be happy to write to her with details.

My Lords, many noble Lords will know that 2020 is the Year of the Midwife. I am delighted that the Minister was able to make an announcement on the number of midwives but I want to know by when they would be in post. I also want to know, as I am sure the House does, who is responsible for the delivery of those 50,000 new nurses.

The primary responsibility for their delivery will fall to the Secretary of State and NHS England but, obviously, it falls under the NHS people plan put together by Dido Harding —my noble friend Lady Harding of Winscombe—so it will be delivered through that programme.

My Lords, can we turn to the terrible situation facing nurses in Northern Ireland? Currently, there are 2,800 nursing vacancies, nurse pay has fallen by 15% in real terms in recent years, and nurses in Northern Ireland are the lowest paid in the United Kingdom. On 18 December, members of the RCN—the Royal College of Nursing—went on strike. That is absolutely unique. They plan to take further strike action on 8 and 10 January. Does the noble Baroness agree that this crisis cannot wait for the restoration of devolved institutions and that, given that he has the locus and power to do so, the Secretary of State should sort this out?

The noble Baroness raises an important issue. It is under active and serious consideration but, at this point, we are unable to give specific details about it. I will come back to the House on this when I am able to do so.

My Lords, I congratulate the Government on the new funding scheme for those wanting to come into nursing. Can the Minister say a little more about when this funding will be available?

The bursary will be available for new and continuing nursing, midwifery and allied health students for courses from September 2020. As I said, students will be able to access both student loan funding and this additional, non-repayable funding from the Department of Health and Social Care while studying. This means that students will have more cash in their pockets than they ever have before, which should attract them. It also means that we will be able to target funding to areas and specialisms that struggle to recruit, which we believe will definitely improve the sustainability of the nursing workforce and reduce its variability up and down the country.

My Lords, I declare an interest as chair of the National Mental Capacity Forum. Do the Government recognise that we need to do more than just put more money into nursing for learning difficulties, given that there are now 1,000 fewer such nurses than there were four years ago and given that the mortality and morbidity rate in the population of people with learning difficulties is alarming, in that their life expectancy can be around 10 years shorter than that of the rest of the population? This area needs to be targeted. Given the stresses involved in this type of nursing, it takes more than money to retain people.

As ever, the noble Baroness raises a serious issue. We have introduced a targeted initiative for students who commence loan-funded postgraduate preregistration nursing courses particularly for those going on to work in learning disability, mental health and district nursing—to give them a golden hello, as it were. We have also introduced more clinical placements, where students can gain specific professional knowledge and be attracted into those very specialised and important areas of expertise.