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NHS: Nurse Recruitment

Volume 818: debated on Thursday 27 January 2022


Asked by

To ask Her Majesty’s Government what plans they have to increase the number of nurses working in the NHS.

The Government are committed to increasing nurse numbers in the National Health Service in England. We are on target to deliver this commitment by the end of the Parliament. We are increasing domestic recruitment, expanding nursing apprenticeships, increasing ethical international recruitment and taking action to improve retention across the NHS. Nurses employed by NHS trusts and clinical commissioning groups have increased by over 10,900 since October 2020, to almost 310,100 as of October 2021.

My Lords, I very much welcome that increase in the number of nurses in the NHS but it is not enough, as the Minister knows. If we are to meet the needs of the NHS, we shall have to look at our dedicated and committed workforce to see if we can increase the level of retention among them. I know that the Minister talks to nurses and I am sure he hears the same as I do: almost every one will say that every day they are on the wards, they face abuse from patients. Can the Minister look at the best practice, which some hospital authorities may be pursuing, to see whether that can be applied more widely across the NHS?

I thank the noble Lord for giving us the opportunity to thank the nurses, and indeed all medical staff, for the incredible work that they do for us, day in, day out. On retaining staff, since 2017 NHS England and NHS Improvement have supported trusts with an intensive retention and support programme. There is also emotional, psychological and practical support for NHS and care staff. It is really important that we not only recruit new staff but retain the great staff that we have.

My Lords, would the Government consider repaying student nurses’ and other healthcare workers’ course fees to retain new, young graduates in the NHS who work, for example, for two or three years?

As the noble Baroness will be aware, there is a bursary available to encourage people into nursing but we are looking at completely different training pathways. It is not the old-fashioned way of being trained as you leave school and that being your one chance. We now have a number of different ways in, including degrees and apprenticeships. I could read all the different pathways out but I am happy to write to the noble Baroness with these details.

My Lords, it is the turn of the Liberal Democrats and the noble Lord, Lord Jones of Cheltenham, wishes to speak virtually. This is a convenient point to call him.

My Lords, the Government signed up to the 2010 World Health Organization code of practice committing to a self-sustaining supply of doctors and nurses in the UK. Yet Patrick Cockburn and Professor Rachel Jenkins point out that the UK still trains proportionally fewer medical staff than other OECD countries. When does the Minister expect us to reach the WHO target, rather than recruiting medical staff trained by countries in much worse situations than ourselves?

We do not think we should just have a protectionist view on staff. It is important that we recruit British staff from the UK, but we should not have a policy of British jobs for British workers. There are very good staff across the world. Indeed, in some countries they train more staff than they have places for in their health system so that they become a foreign revenue earner. Many people who have looked at the statistics say that remittances quite often are more effective than foreign aid.

Could the Minister say how many agency nurses are being employed by the NHS? Is he not concerned that so many are being employed when they are so much more expensive?

My noble friend makes a valuable point about the cost of agency nurses, which is why we have the goal of recruiting 50,000 nurses. We are looking at completely different pathways to ensure that we can encourage people into nursing. I do not have the statistics with me, but I will write to my noble friend.

The Minister referred to ethical recruitment of health service professionals from overseas. Can he explain to us precisely what he means by ethical recruitment from overseas?

I thank the noble Lord for giving me the opportunity to explain that. It is really important that we do not suck out the best talent from countries, especially those with a shortage of medical staff. We are very clear that we talk to countries that train more staff than they need for their domestic service so that they can come here as foreign revenue earners. We have also published updated guidelines.

Is it not a real problem that the Treasury has not yet set the budget for Health Education England, given that there are fewer than three months before the new financial year and it has the responsibility for the number of new nurses that are going to be trained in this country?

I am afraid I disagree with the noble Lord, because we are on track to reach our 50,000 target, particularly because we are not just using one route in. We are using a number of different routes; people can retrain from other courses, and we have apprenticeships. We are looking at completely different, innovative pathways into nursing.

My Lords, the Government’s own impact assessment suggests that mandatory vaccination against Covid could lead to the loss of some 73,000 NHS staff in England. When designing their policies, did the Government take into account how many nurses might be among this number? Will the Minister take the opportunity of the Health and Care Bill to bring forward a long-term workforce plan to address the shortages of nurses and other staff?

I congratulate the noble Baroness on bringing up an issue for the Health and Care Bill. In terms of VCOD—vaccination as a condition of deployment—most NHS staff are vaccinated, and those who are reluctant to be vaccinated are being offered one-to-one conversations with management to see whether they can be persuaded to take the vaccine or be redeployed elsewhere.

My Lords, over the last two years I have been encouraged by the way in which the NHS has creatively met the mental health needs of nurses and other healthcare workers, encouraging their well-being and recognising what contributes to that. Can the Minister reassure us that the funding that has gone in over the last two years will continue to be put into the NHS, ensuring that we look after the well-being of our staff?

That is an incredibly important point, which relates to an earlier point put by the noble Lord about retention. It is important that we look after our staff. We know that the last two years have been incredibly stressful, even more than usual, and that is why we have a number of different ways to help the health and well-being of the staff.

My Lords, is it not the case that the NHS should never have got into a situation where we are so dependent on international staff from developing countries? Can he confirm whether it is true that the NHS trusts are being paid by NHS England up to £7,000 for each vacant post to try to fill those posts from overseas countries, including India and the Philippines?

I cannot comment on the exact numbers, but I will find the answer and write to the noble Baroness. I might add that I am the son of people who came from outside the UK or European Union, and I get slightly concerned with the tone when people say, “Let’s not have foreign nurses in our NHS.” It is important. Immigration plays a brilliant role in this country and always has. If you look at the post-war public services of this country, it was people from the Commonwealth who came and saved our public services.

Can I say to the Minister that more nurses means more uniforms and more garments? The NHS boasts about being the largest employer in Europe, so what action does the National Health Service take to ensure that the cotton in any of the garments used for NHS nurses’ uniforms is not grown in Xinjiang in China? The technology is available to do that; paperwork is not required, and people tell lies. The use of technology would guarantee that we could play our part in making sure that slave labour is not part of the production of our nurses’ uniforms.

I hope the noble Lord will forgive me if I tell him that I have not examined nurses’ garments in detail. In terms of provenance, it is important at the moment—and we are doing this on lots of equipment that comes to the UK—to ensure that it is not from regions where there is slave labour, or where the Muslim Uighurs are being persecuted by the Chinese Government. We need to do more; indeed, I have had conversations in the department to find out how we can trace the sources of the products and equipment that we buy to make sure that they are ethically sourced.

My Lords, the Minister has now said on several occasions that the Government will meet the target of 50,000 nurses. Can he tell us, if the Government do meet that target, what will the remaining deficit be?

I am afraid I do not have the answer to that question, but I can certainly look into it. I am not sure what the deficit will be but, as I said, we are on course to recruit 50,000, not just from the UK and from different pathways—not only degrees and apprenticeships—but also from all over the world and not just Europe.