Asked by
To ask His Majesty’s Government what plans they have to increase
the number of staff working in the NHS.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care () (Con)
A record number of staff are working in the NHS, including more
than 6,000 more doctors and more than 16,400 more nurses than
last year. We have backed the NHS long-term workforce plan with
more than £2.4 billion over five years. This will put us on
course to double the number of medical school training places,
almost double the number of adult nursing training places and
increase the number of GP training places by 50% by 2031. It will
also ensure that the NHS workforce is put on a sustainable
footing for the future.
(Lab)
I thank the Minister for his Answer, but he knows that there is a
dire shortage of staff right across the NHS, with 47,000 nursing
vacancies. The recruitment of nurses to training places is down
13% this year. Some 170,000 workers in the NHS left their jobs
last year, mainly under stress. Today, we have the news that a
survey found that 32% of students who are currently in medical
school have said that they intend to emigrate on completing their
studies. I repeat what I asked in my Question: what plans do the
Government have to increase the number of staff working in the
NHS?
(Con)
The whole House will, I think, recognise that we have extensive
plans that are, as I said, backed by £2.4 billion. That is what
the long-term workforce plan was all about. There were many
requests for us to put it in place and that is what we have
delivered. All of this comes in the context of 63,000 more
members of staff over the past year—actually, around 280,000 more
members of staff since 2010. Those are substantial increases. Do
we need to do more? Yes. Is that what the long-term workforce
plan is all about? Yes.
(Con)
My Lords, those within the NHS must be allowed to work safely.
Has my noble friend seen the reports today? A third of female
surgeons have been sexually assaulted by other doctors within
their workplaces, sometimes while they are actually operating on
people. It is as unbelievable as it is appalling. What plans does
my noble friend have for getting to the bottom of this, finding
out the truth of these allegations and holding responsible those
who are responsible for the safety of working practices within
the NHS? In its recent dealings with him, did the British Medical
Association mention this terrible issue—or have its interests
been concentrated solely on money?
(Con)
I thank my noble friend. Like all of us, I am sure, I was
appalled to hear about that study. The most fundamental purpose
of any employer is the safety and well-being of their staff,
obviously, and I am afraid that the hospitals that allowed that
to happen and allowed that culture to take place clearly failed.
Clearly, we need to get to the bottom of that. As I often say, it
starts with the leadership in each hospital and the culture that
is built up within each college. Those are the people who need to
be looking at themselves in the mirror and asking whether they
have the right culture to make sure that everyone feels safe in
the workplace.
(LD)
My Lords, we know that the Minister is a big fan of data
dashboards for tracking such things as the flow of patients
through hospitals. Does he agree that such a dashboard would be
an excellent way for us to track the Government’s progress
against all the various targets that they have put into their
workforce plan? Will he commit to producing one?
(Con)
I believe that the whole point of the workforce plan is that
every couple of years there is a review of our progress against
it and how it needs to be adapted, since it is a moving feast.
So, absolutely, it is vital and something we are working on.
Overall, the things that we said that we would do we are on
course for. We said that we would increase the number of nurses
by 50,000 over the course of this Parliament. It is currently
47,000. We said that we would increase doctors’ appointments by
50 million. That is currently on track. So a lot of good work has
already happened. A lot of targets have been hit. Yes, there is
more to be done and we are happy to track it.
(CB)
My Lords, it is currently predicted that there will be a shortage
of about 4,000 fully trained anaesthetists by 2025. The
Government’s plan to expand anaesthesia associate training will
also need anaesthetists to supervise the trainees in the
workplace. However, currently there is a bottleneck at a certain
level of the training of anaesthetists. That bottleneck can be
resolved by increasing the number of training slots. Why do we
not do that?
(Con)
In every area, anaesthetists being a very good example, we need
to be looking at where the bottlenecks are and moving to free up
those situations. I think we would all agree that with
practitioners such as anaesthetists and in other areas, it is a
very sensible approach to make sure that the most highly skilled
are focused on the most highly skilled jobs and that they can
have people underneath them who can be trained to work within
that. So hearing that there is a certain amount of opposition
from certain colleges and the BMA to those sorts of roles is
quite disappointing. I hope they would accept that this is a key
way of addressing the issue.
of Hudnall (Lab)
My Lords, can I take the Minister back to the original Question
from my noble friend Lord Clark? He put before the House some
quite startling statistics about the number of medical
staff—particularly but not exclusively doctors —who are leaving
following or shortly after the completion of their training,
either for other countries or for private practice? What view
does he take of that drain away from the National Health Service
and the effective loss of the investment that the country makes
in the very expensive training of clinicians?
(Con)
My first point on that is to ask what the real facts are. Five
years on from qualification, around 95% of doctors are still
registered with the General Medical Council and still practising
in the UK. So the fact is that retention is very high. That
notwithstanding, we want to do everything that we can to retain
people, and professional development is what the long-term
workforce plan is all about. Also, we all know that pensions were
a big reason for a lot of the brain drain and doctors leaving the
profession, and that was something we were quite radical in
supporting and changing. We are going through this bit by bit,
asking what key things we need to do to retain our staff and
resolve this.
(Con)
My Lords, I have seen press reports that suggest, from future
projections, that one in 11 people in the workforce will end up
being employed by the NHS. Does the Minister really believe that
this is sustainable? What plans does he have to avoid what would
be a completely impossible situation for the economy?
(Con)
Yes, I am aware of this. Health spending equates to roughly 11%
of the GDP of our country. Not surprisingly, the number of people
in the workforce reflect that. It is absolutely mind-blowing; the
amount of investment going into this space is bigger than the
economy of Greece. Without a doubt, we have to make productivity
improvements and look to technology, AI and all the things we can
do to improve output and make sure that that total is not just
ever-increasing.
(Lab)
My Lords, the Government’s workforce plan is silent on having
enough properly maintained treatment facilities, buildings and
equipment, all of which have become increasingly inadequate.
Could the Minister confirm what assessment has been made of the
physical capacity requirements to deliver the NHS workforce plan?
How will he ensure that staff have what they need to do their
job?
(Con)
The noble Baroness is absolutely correct: a workforce plan needs
to be backed up with the physical real estate to deliver it. As
noble Lords are aware, I am responsible for the new hospitals
programme, which is part of that. In primary care, much of the
long-term workforce plan is all about getting upstream of the
problem in terms of prevention, and clearly we need to make sure
that the physical real estate is there to support that. So the
next steps will be to make sure that the capital meets the
long-term workforce plan.
(LD)
My Lords, the NHS needs more recruits, but can the Minister tell
the House where there are pressing shortages that adversely
affect patient care and when he anticipates that the problem will
be sorted?
(Con)
As I say, the long-term workforce plan puts this on the right
footing, going forward. There are big increases in the number of
staff, so it is not like we have not been working hard on this
area already. By any definition, 63,000 more staff over the last
year is a prime example of that. So we are addressing this, but I
am not going to pretend to the House that this can be done once,
lightly and quickly; it is part of a long-term programme, which
the long-term workforce plan is all about.
