Nurses: Training

Debate between Lord Prior of Brampton and Lord Clark of Windermere

Tuesday 22nd November 2016 Lords Chamber

[Lord Clark of Windermere]

To ask Her Majesty’s Government how many individuals completed training to become qualified nurses in England in 2015.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, the latest data available from the Higher Education Statistical Agency show that approximately 23,000 nursing students qualified from higher education courses regulated by the Nursing & Midwifery Council in England in the 2014-15 academic year.

[Lord Clark of Windermere (Lab)]

I thank the Minister for his considerate Answer and his personal commitment to the health service. I much appreciate it, but does he appreciate that the figures he has provided today mask the true picture of nursing in this country? Will he accept that the coalition Government in 2010 made a massive mistake when they made those savage cuts in nurse training? Even with the increases of late, there are still only 0.6% more nurses now than there were in May 2010, which is in spite of a 31% increase in hospital admissions. Does the Minister accept that the staff of the NHS are keeping the ship afloat? Can the Government offer some concessions to the generosity, commitment and dedication of those staff?

[Lord Prior of Brampton]

My Lords, there were 3,500 more nurses working in the NHS in 2015 than there were in 2010. In retrospect, we did not anticipate in 2010 the Mid Staffordshire crisis and the Francis report, which led to a very substantial increase in nursing levels after about 2013. The noble Lord is right; we were short of nursing throughout that period. We are addressing that now with a 15% increase in nursing places and we expect that by 2020 there will be 40,000 more nurses than there were in 2015.

Medical Students

Debate between Lord Prior of Brampton and Lord Clark of Windermere

Wednesday 26th October 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, overseas doctors account for about 25% of the total number of doctors employed by the NHS, which is a very high number. I do not have the breakdown for the Commonwealth countries but it is an interesting question; I will research it and write to my noble friend. She is absolutely right that there are shortages in particular specialties. General practice and psychiatry are probably the two areas where there is the biggest shortage. HEE is determined to increase the intake in those areas. Certainly, the number of doctors going into GP specialty training this year is just over 3,000. That is an increase on last year but is still not enough.

[Lord Clark of Windermere (Lab)]

My Lords, we welcome the increase, but is it sufficient to meet the problem? I understand that about 100,000 overseas doctors, including European doctors, work in the NHS. Given an extra 1,500 places a year, it will take many years to reach the target. Why do we not make a gesture to those overseas doctors working in the health service and offer them permanent residence here?

[Lord Prior of Brampton]

I think it will be helpful if I quote from the Health Secretary’s speech at the Conservative Party conference, talking about overseas doctors. He said:

“They do a fantastic job and the NHS would fall over without them. When it comes to … EU nationals, we’ve been clear we want them to … stay post-Brexit”.

Let us be absolutely clear: we want overseas doctors from the EU or elsewhere to stay here post-Brexit.

NHS: Bursaries

Debate between Lord Prior of Brampton and Lord Clark of Windermere

Wednesday 25th May 2016 Lords Chamber

[Lord Prior of Brampton]

I think that it is a good deal for the Government—as the noble Baroness puts it like that—on a number of fronts. It is good for patients because there will be more nurses. It is good for the Government because there will be less need to recruit overseas nurses and agency nurses. Of course, the noble Baroness is right that for mature students coming in, the time to repay the student loan debt will be shorter than for younger people, but the Government will still make a return on that.

[Lord Clark of Windermere (Lab)]

Is the Minister aware that nursing students spend about 50% of their time on clinical placements? Given that there is no provision in the consultation document for extra financial facilities to be made available to hospitals providing those placements, how will they cope with the overstretch that is already in the hospital mentoring system?

[Lord Prior of Brampton]

That is a good question. Nurses spend 2,300 hours of their three-year course in clinical placements in hospitals. They are supernumerary. They are clearly supervised and mentored in that setting, but they also provide a fair amount of care in those hospitals as well. I am pretty confident that hospitals will work out an arrangement with universities to ensure that they create enough clinical placements for those nurses.

NHS: 111 Service

Debate between Lord Prior of Brampton and Lord Clark of Windermere

Monday 21st March 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, 100% is clearly the only acceptable level but, realistically, it would be extremely difficult to get to that. Referring back to the charge of complacency, we recognise that significant improvements need to be made to the 111 service, but it can be a vital part of the way that we deliver urgent care in Britain.

[Lord Clark of Windermere (Lab)]

My Lords, we all accept the Minister’s commitment to the NHS. He has just stated that improvements to the service need to be made. When are they going to be made?

[Lord Prior of Brampton]

My Lords, it may sound trite, but we need to make continuous improvement in all aspects of the NHS. We can never be satisfied with where we have got to. Interestingly, the licensing arrangement which underpins the NHS Pathways—the algorithm developed by the Royal College of GPs—has within it an audit to ensure that continuous improvement is being made.

Accident and Emergency Services: Staffing

Debate between Lord Prior of Brampton and Lord Clark of Windermere

Tuesday 23rd February 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, the noble Baroness calls for a national debate but sometimes I feel that, in this House, we talk of almost nothing else. However, I understand the serious point that she makes. The fact is that the Government are committed to investing £10 billion of new money into the NHS. It is a very significant investment and is no more and no less than her own party promised at the last general election.

[Lord Clark of Windermere (Lab)]

My Lords, the Minister has said that we have to train more of our own doctors, and on previous occasions he said that we have to train more of our own nurses. In training the nurses, we are taking a risk in abolishing the bursary system so that when those new nurses are qualified in 15 months’ or 18 months’ time they will have debts of about £40,000. What progress are the Government making in trying to reward those nurses who spend a considerable time in the health service—perhaps 10 or 15 years—so that those debts can possibly be written off?

[Lord Prior of Brampton]

The noble Lord will know that we are consulting on the proposals to remove bursaries and replace them with student loans. All the indications are that this will enable us to increase the number of nurses because the current system means that many young men and women who wish to become nurses are not able to do so. I think that three out of four people who apply are not able to get on the right courses. We hope that the new system will increase the number of nurses available to the NHS.

National Health Service: Nurses

Debate between Lord Prior of Brampton and Lord Clark of Windermere

Tuesday 26th January 2016 Lords Chamber

[Lord Clark of Windermere]

To ask Her Majesty’s Government what plans they have to ensure that there are a sufficient number of nurses in the National Health Service.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, Health Education England is responsible for workforce planning in the NHS. In 2016-17, the HEE commissioning and investment plan forecasts an additional supply by 2020 of 40,000 nurses as a result of undergraduate and postgraduate commissions placed with universities between 2012 and 2016. Moving new nursing students on to the student loans system from August 2017 allows universities to offer up to 10,000 extra nursing, midwifery and allied health degree places by 2020-21.

[Lord Clark of Windermere (Lab)]

I thank the Minister for his answer, and we all wish the Government well in trying to make up the shortfall of nurses which is bedevilling our National Health Service at the moment. I am dubious about the abolition of the bursary scheme and think that the Government’s proposals are highly risky, but I wish the Government well. I ask the Minister for an assurance that if they proceed with the abolition of the bursary scheme, they will recognise that the cost to nurses at the end of their training will probably be approaching £50,000. Will the Government give a commitment that they will fund a payback or reward scheme so that those nurses who have spent a number of years in the National Health Service will have some of those debts written off?

[Lord Prior of Brampton]

My Lords, I thank the noble Lord for wishing the scheme well. It is intended to increase the supply of young men and women going into the nursing profession, with which I think everyone in this House would agree. It is true at one level to say that people receiving loans rather than bursaries will have a debt of about £50,000 at the end, but the repayment of that is, as the noble Lord knows, graduated, and only 9% of the excess over £21,000 a year will be payable, not the full amount, as he suggests.

Health: Skin Cancer

Debate between Lord Prior of Brampton and Lord Clark of Windermere

Wednesday 22nd July 2015 Lords Chamber

[Lord Clark of Windermere]

To ask Her Majesty’s Government what has been the increase in diagnosed skin cancer over the past 10 years.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, over the past 10 years in England, there has been a 61% increase in new cases of melanoma, the most serious form of skin cancer, and an increase of 41% in non-melanoma skin cancers. In 2012 there were 11,281 new cases of melanoma and 79,743 new cases of non-melanoma skin cancer.

--- Later in debate ---

[Lord Clark of Windermere (Lab)]

My Lords, I thank the Minister for that Answer, which shows an alarming increase in skin cancer. I understand that NICE is in the process of issuing new guidelines in this respect, due out this month. Will the Minister advise the House whether these guidelines are mandatory because they are so central to the Government’s campaign in fighting skin cancer, or are they merely “guidelines” and need not be followed? Secondly, is the Minister aware that there is concern among consultant dermatologists in hospitals that the clinical commissioning process may not be sufficiently robust to deal with this increased spate of skin cancers?

[Lord Prior of Brampton]

The NICE guidelines are due to come out at the end of July or in August. I believe that they are guidelines, not mandatory, although they should be read in the context of the report by Harpul Kumar, Achieving World-Class Cancer Outcomes. Cancer is a very high priority for this Government, and this may come out in further questions. In commissioning these services, we have to be very careful that we do not disaggregate dermatology services in hospitals; the provision of routine and complex emergency dermatology services and, of course, the training of dermatologists should be commissioned as a whole.