(8 years ago)
Lords ChamberMy Lords, can the Minister comment on the ratio between nurses retiring from the service and those coming in? I too welcome the potential development of the nursing associate—although we need to get it right—and graduate-entry nursing, but we still need a system to rapidly increase the number of registered nurses over the next five years. I do not believe that the figures illustrate that we will be replacing like with like in terms of numbers.
My Lords, the best estimate of Health Education England is that, making reasonable assumptions about the attrition rate of students and the retention of existing nurses, by 2020 we will have 40,000 more registered nurses working in the NHS than we do today.
(8 years, 5 months ago)
Lords ChamberMy Lords, this is a difficult issue. You can lead a horse to water but you cannot make it drink. To some extent you have to rely on local people working together, and it is behaviour and culture that determine long-term sustainable improvement. If we try to force the pace beyond that at which local people are prepared to go, in the long run we may not make as much progress. In the first instance we hope that the STP process, involving all local people and giving them a framework for working together, will deliver the results we need. If it does not, we will have to revisit it.
My Lords, could the Minister ask why the NHS has not considered funding nursing home places for people who are ready to be discharged for two or three weeks, so that they can have 24-hour care funded by the NHS while they prepare to move back home? People who live alone, in particular, are just waiting for financial assessments while reducing other people’s access to acute hospital beds, including young people who are routinely having standard operations cancelled.
My Lords, looking back over 20 years, the reduction in the number of what you might call step-down facilities—community hospitals and the like—has been a huge mistake. We lack step-down facilities. In America they are called skilled nursing units. The fact is that an acute hospital is not a good place to be for anyone once they are medically fit to be discharged; all the evidence suggests that it is more expensive but, more importantly, less good for the patient. I agree entirely with the noble Baroness that we need to explore avenues of discharging people earlier to nursing homes, community hospitals or, better still, back home with the right community support.
(8 years, 8 months ago)
Lords ChamberMy Lords, the demand on the health service is rising for many reasons, of which the growing population is clearly one. However, without the extraordinary contribution made to the NHS by people who have emigrated here from other countries, we would not have an NHS at all.
My Lords, will the Minister comment on how we might prevent people going into hospital through much better structuring of community teams led by nurses? Last week, I was told at the Secretary of State’s conference on patient safety that the mean age of patients on a medical ward at Oxford was 83. When I was a ward sister, it was around 50.
My Lords, clearly it must make more sense to provide better treatment for elderly people in their homes, away from hospitals, particularly for those with often multiple long-term conditions. One of the tragedies of government policy since 2000—this goes across both parties—is that, although the rhetoric has been about moving care out of hospitals into the community, it has been extremely difficult to do it.
(8 years, 10 months ago)
Lords ChamberMy Lords, what consideration have the Government given to enabling people who want to study nursing as a second degree to have loans in the way that they will allow for those studying some STEM subjects? We have traditionally had mature entrants who are already graduates.
My Lords, we are still consulting on the details of this scheme, but I assure the noble Baroness that the loan scheme will be available for mature students doing their second degree as it is for those doing their first degree.