NHS: Staff Numbers

Lord Clark of Windermere Excerpts

Tuesday 12th September 2023 Lords Chamber

Asked by

[Lord Clark of Windermere]

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 (Lord Markham) (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.

[Lord Clark of Windermere (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?

[Lord Markham (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.

NHS: Doctors’ Strikes

Lord Clark of Windermere Excerpts

Wednesday 5th July 2023 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend for his kind words. We are willing to look at all solutions. We have to balance the salary wishes of doctors with making sure that we keep the money in front-line services. Everyone is aware that pay rises of 35% would eat heavily into what we can do and afford on the front line. We need to get that balance right.

[Lord Clark of Windermere (Lab)]

My Lords, one of the greatest concerns of individuals working in the NHS is lack of confidence about the future. The real problem is retention. I understand that there is a massive shortfall of staff. Will the Minister tell us how big that shortfall is and what the Government are doing to make it up?

[Lord Markham (Con)]

The noble Lord is absolutely correct; that is why I was delighted, as I think all sides of the House were, by the launch of the NHS Long Term Workforce Plan. As Amanda Pritchard, the CEO of the NHS, said, it was a “truly historic” moment for the NHS; it absolutely recognises that staff are the backbone of it all and that we need to do everything to recruit and retain them. Retention is all about professional development and all those things that make up staff morale.

NHS: Nurses

Lord Clark of Windermere Excerpts

Tuesday 1st November 2022 Lords Chamber

Asked by

[Lord Clark of Windermere]

To ask His Majesty’s Government what discussions they have had with the Nuffield Trust further to their research finding, published on 30 September, that more than 40,000 nurses have left the NHS in England in the past year.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

We welcome the Nuffield Trust publication and the spirit in which its analysis was conducted. Leaver numbers should be seen in the context of overall growth in the workplace. We are more than half way to delivering on our commitment to have 50,000 more NHS nurses by 2024, with nurse numbers more than 29,000 higher in August 2022 than in September 2019 and more than 9,100 higher than in August 2021.

[Lord Clark of Windermere (Lab)]

I thank the Minister for his Answer, but I think his figures are a little out of date now. A record number of nurses left the profession last year, and we are now 46,000 nurses short. These figures show that the Government’s plans for nurse recruitment are inadequate. Retention of staff is the key. In view of the fact that nurses have seen their pay fall by 20% in recent years, will HMG not rectify this and give nurses the pay they deserve?

[Lord Markham (Con)]

With respect, the numbers I quoted are up to date. They take into account the overall increase. We saw 36,000 leavers and 45,000 starters in the last year, so that is an overall growth of 9,000, which shows that the work we are doing to encourage people into the profession is working.

Vaccinations

Lord Clark of Windermere Excerpts

Wednesday 15th June 2022 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for that question. I am afraid I will have to write to her with the details.

[Lord Clark of Windermere (Lab)]

My Lords, the country deserves credit for the high level of people coming forward to get vaccinated. As we move forward to the spring booster kicking in on 30 June, will the Government ensure that we maintain the high level of vaccinations? Will every individual who has received a vaccination then receive a letter informing them of their spring booster, either from their GP or the NHS?

[Lord Kamall (Con)]

The noble Lord makes a very important observation about the programme and it is very important that we learn from that. One of the difficult issues was that, quite often, when you publicise the fact that there is a vaccine, a certain number of people come forward but, after that, there is hesitancy in different communities. Sometimes we have to show a bit of humility in Westminster or Whitehall; we are not always the best people to connect with some of those communities—so we have worked with various local community and civil society organisations. There is also innovation: certain places have a jab cab, a bus goes around Merseyside encouraging people to get vaccinated and there is often encouragement to get vaccinated at music festivals, local community festivals, mosques, gurdwaras, temples et cetera.

North East Ambulance Service

Lord Clark of Windermere Excerpts

Monday 23rd May 2022 Lords Chamber

[Lord Kamall (Con)]

Absolutely. It is really important that we have a duty of candour and that people can be open. We saw this during the passage of the Health and Care Act, with HSSIB. Although there might be an initial reaction to find the culprit, or whatever the issue is, it is really important that we learn from mistakes made. It is a difficult balance, but we have to make sure that we have an open environment and culture so that people feel safe to come forward and explain what happened, and to make sure that these services learn from what went wrong. We have been absolutely clear that there is a cultural issue that has to be addressed, but also that NDAs have no place in the NHS.

[Lord Clark of Windermere (Lab)]

My Lords, we really must learn the lessons, having witnessed this cover-up in one of the most deprived parts of the UK. I say to the Minister that he should not look at the case, for example, of the ambulance drivers in isolation. Will the Government announce now that they are prepared to have a proper workforce plan for the NHS?

[Lord Kamall (Con)]

I take the noble Lord’s point that you cannot look at things in isolation; we have to take a systemic view. Are these issues confined to the ambulance service or is it the wider NHS or the wider trust? These are all issues that have to be looked at. On the workforce plan, I assure the noble Lord that I have tried, but clearly there are issues. Health Education England has been mandated to come forward with workforce strategies, and there are workforce strategies at trust level as well.

NHS: Abuse of Nurses

Lord Clark of Windermere Excerpts

Tuesday 5th April 2022 Lords Chamber

Asked by

[Lord Clark of Windermere]

To ask Her Majesty’s Government what steps they are taking to reduce the abuse of nurses in the NHS.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

Abuse directed towards nurses is unacceptable, and we are determined to tackle this. NHS England has established a violence reduction programme to address deliberate violence and aggression towards NHS staff and to ensure that offenders are punished quickly and effectively. This includes implementing the NHS violence prevention and reduction standard, which requires employers to implement plans to tackle violence in the workplace. In addition, the Government are legislating to double the sentences of those who are violent towards NHS staff.

[Lord Clark of Windermere (Lab)]

I thank the noble Lord for his Answer. He is clearly aware of the problem, which is indeed growing. Nurses and other NHS staff are abused daily and many are being reduced to tears. As the retention of nurses is at a critical stage, with abuse being a key contributing factor, what specific plans have the Government to tackle this problem as a matter of urgency in trying to build up the key respect in which the general public used to hold NHS workers?

[Lord Kamall (Con)]

The noble Lord is absolutely right that we have identified the issue, and the NHS is working on a number of plans. All of us abhor any abuse of nurses or indeed any other NHS staff. The NHS has looked into this and has seen that many cases of violence against NHS staff are committed by individuals who are in a mental health crisis, or suffering from dementia or other neurological conditions, rather than the classic perception of attacks on staff by the public. The NHS has not only the violence prevention and reduction programme but a number of other initiatives to try to tackle this unwarranted issue.

NHS: Nurse Recruitment

Lord Clark of Windermere Excerpts

Thursday 27th January 2022 Lords Chamber

Asked by

[Lord Clark of Windermere]

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

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

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.

[Lord Clark of Windermere (Lab)]

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?

[Lord Kamall (Con)]

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.

Respiratory Viruses

Lord Clark of Windermere Excerpts

Tuesday 11th January 2022 Lords Chamber

[Lord Kamall (Con)]

There was an unseasonal surge in RSV activity during the summer of 2021, which peaked in late July at about 15.7% swab positivity and a hospital admission rate of 2.5%. But, following the summer surge, RSV activity declined and positivity currently sits below seasonally expected levels. As a consequence, the RSV hospitalisation rate has declined since the summer surge.

[Lord Clark of Windermere (Lab)]

My Lords, thankfully, influenza is low again this winter, largely on account of the most effective way to counter flu: hand washing, covering one’s mouth and vaccination. The House will recognise that those are the identical solutions for fighting Covid. So I urge the Minister and his colleagues to keep hammering those three simple messages in their anti-Covid approach, because at the same time that will reduce many deaths by keeping flu down.

[Lord Kamall (Con)]

The noble Lord makes a very important point that we should acknowledge. The fact is that the preventive messages against Covid are equally valid against influenza. Indeed, the reduction in social contact since the pandemic has led to a reduction in seasonal flu, as we would expect, compared with previous years. I take the noble Lord’s point and will make sure that I repeat it when I can.

NHS: Elective and Cancer Care Backlog

Lord Clark of Windermere Excerpts

Tuesday 7th December 2021 Lords Chamber

[Lord Clark of Windermere (Lab)]

One of the reasons for the backlog is poor patient flow. The key exit block is from hospitals into care homes, and the problem is the lack of staff being attracted into those homes. Will the Government look at some unexpected ways of dealing with this issue—possibly even offering a bonus to members of staff of care homes and the NHS who spend several months working for their service?

[Lord Kamall (Con)]

The noble Lord raises an important point about making sure that patients are released earlier from hospital into care homes, and into their own homes as well. I have answered questions previously on what is being done to make sure that it is as joined-up as possible. Some 75% of patients on the waiting list do not actually require surgical treatment but are waiting for diagnostics. The Government have invested in rolling out 100 new diagnostic centres. Some 80% of patients who require surgical treatment do not actually require an overnight stay in hospital, while 20% of people waiting for surgery are waiting for musculoskeletal or eye-related surgery. In many ways we know what the issue is—it is targeting.

NHS: Primary Care Surgeries

Lord Clark of Windermere Excerpts

Wednesday 24th November 2021 Lords Chamber

[Lord Kamall (Con)]

I am sure that noble Lords agree that it is appropriate that GPs register as many patients as they are able to see, and that their patients, whatever their needs, can access our great system of healthcare in this country. I would indeed be concerned if there were barriers to accessing GP services.

[Lord Clark of Windermere (Lab)]

My Lords, the cost of locum doctors to the NHS is £6 billion a year, much of it in primary care surgeries. Does the Minister feel that this is good value? What are the Government doing to try to get back to having regular doctors?

[Lord Kamall (Con)]

The Government recognise that it is important that people can see GPs and, as much as possible, invest in making sure that there are more full-time equivalent GPs. We have done that and we will continue to do so.