Public Services: Workforce (Public Services Committee Report)

Baroness Pitkeathley Excerpts

Friday 16th December 2022 Lords Chamber

[Baroness Pitkeathley (Lab)]

My Lords, it is a pleasure to follow the noble Lord, Lord Kamall, whose speech reminds us that his tenure as Minister for Civil Society was all too short. It has been a privilege to serve on the Public Services Committee, so wisely and ably chaired by my noble friend Lady Armstrong. I know, as she said, that many more Members would have liked to speak in this debate, had the timing been more propitious.

Our report on the workforce was very much on my mind this week when I had a hospital procedure. It was carried out with the efficiency, care and commitment that we rightly expect and get from the NHS, but I was struck by the air of disillusionment among the staff—the weariness and the acceptance that, as one member of staff said, “It’s never going to change, is it? We’re always going to be ignored.” Their department is constantly short of staff, with staff constantly covering for each other and running to catch up. Most of all, you can sense the despair of staff who feel they are falling short and not meeting patients’ needs in the way they would like. I emphasise that this was not the case, as the service was in fact efficient and caring, but I worried about the price being paid by those who deliver it. The conclusions of our report were emphasised again for me this week as a patient: services in crisis, serious staff shortages and very low morale.

We were frustrated in our inquiry by the lack of willingness to take this workforce crisis sufficiently seriously, as though it were a blip, caused perhaps by the pandemic or Brexit, which would somehow get better of itself with time. Yet of course the inescapable fact is that demand for services will rise faster than the working-age population, as will the number of people with complex and multiple needs. Staff numbers cannot presently keep up with demands and the problem is only going to get worse.

In spite of the crisis we are facing, however, our report is not all gloom and doom. The problems are solvable if we tackle them robustly, making a substantial difference and securing a more sustainable workforce for the future, but we are required to be imaginative and innovative.

Why do people work in public service? It is certainly not for the money, nor usually for the status or recognition. What you get in public service is the satisfaction, even the reward, of knowing that you are somehow contributing to the betterment of society, whether as an individual, a group or an institution. Take away that satisfaction and you might ask yourself: why do it? You can earn more stacking shelves in the supermarket.

We have relied for too long on the good will of employees—to stay on at the end of a shift, for example, or cover for a sick colleague. We must harness that good will by empowering the workforce and ensuring that services meet the needs of the consumers, not the ideas of the planners. We have powerful examples from users of services of the need for training to highlight the importance of so-called co-production—that is, designing services with the help of those who will use them—and how it can save money as well as more effectively meet the needs of users.

It is clear that such co-production also brings job satisfaction and starts to tackle low morale. In turn, this leads to greater retention of staff and is a more attractive offer when we look at how public service staff are recruited. As my noble friend has reminded us, however, and as many of our witnesses told us, recruitment takes too long, is too inflexible and has a dated format.

Skills in the public sector are precious but not always as readily recognised as they should be. I have lost track of the number of former carers who have told me that they were unsuccessful in applying for public service jobs. All the skills they acquired as unpaid carers—which are a lot, and include not just practical but administrative skills—were dismissed as irrelevant because they did not conform to a rigid job description or person specification.

It is important to note that what we need to tackle our workforce crisis—I emphasise that it is a crisis—is a strategy embraced by all government departments which takes account of the different needs of all parts of our workforce and emphasises flexibility. As an example, we wish to give all employees status, training opportunities and recognition, but what you give a doctor who needs seven years’ training and a guarantee of employment at the end is quite different from what you give a care worker.

The carer workforce has a 40% turnover every year. What good is registration to them? You have to compete with the competition, which, in this case, is Sainsbury’s and Lidl, and give job satisfaction, which is the only discriminating difference in choosing one occupation over another. “Training to retain” is a memorable phrase but training must encompass development opportunities and the ability to move between one service and another. I first heard the idea of a workforce that could move freely between health and social care some 40 years ago. How much progress has been made? Very little, because it requires a cultural shift in leadership, which has always been the hardest nut to crack.

Our report emphasises—as much of the work of this committee has always done—the importance of preventive services. As my noble friend has reminded us, these can effectively reduce the need for service input and thus the strain on the workforce. I hope the Minister can give the House an assurance that the Government are committed to supporting preventive work.

Avoiding the workforce crisis is no longer an option. It was gratifying and a tribute to my noble friend and the excellent staff who supported us that the Government agreed eventually—I repeat, eventually—with all our recommendations. Investment in apprenticeships and improving the recruitment, retention, progression and well-being of staff in adult social care is a start, but we should be under no illusion: there is a long way to go. I hope the Minister can give us an assurance that, as well as accepting all our recommendations, the Government are committed to implementing them.