Health and Care Bill

Baroness Merron Excerpts

Consideration of Commons amendments
Tuesday 26th April 2022 Lords Chamber

Moved by

[Baroness Merron]

At end insert “, and do propose Amendment 29D in lieu—

29D: Page 42, leave out lines 14 to 19 and insert—
“(1) The Secretary of State must, at least once in every three years, lay a report before Parliament describing the system in place for assessing and meeting the workforce needs of the health, social care and public health services in England.
(2) NHS England and Health Education England must assist in the preparation of a report under this section.
(3) The organisations listed in subsection (2) must consult health and care employers, providers, trade unions, Royal Colleges, universities and any other persons deemed necessary for the preparation of this report, taking full account of workforce intelligence, evidence of trends in healthcare and demand for it, and workforce plans provided by local organisations and partners.””

[Baroness Merron (Lab)]

My Lords, I beg to move Motion A1 as an amendment to Motion A to insert the words as printed on the Marshalled List. My noble friend Lady Wheeler will speak to Motions D and D1 and I will focus my remarks on the issue of the health and social care workforce. However, before I do, I welcome the compromises reached on the reconfiguration of local services and on NHS procurement while avoiding modern slavery. I believe the constructive discussions that we have had have truly improved this Bill and I am grateful to noble Lords across the House and to the Minister for his efforts and commitment.

The importance of the workforce has been debated extensively, both in the other place and in your Lordships’ House. Once again, I am arguing for the importance of implementing a proper forward-looking plan. That I am doing this even after yesterday’s proceedings in the other place conveys just how strongly we feel on this issue. Over 100 organisations of healthcare professionals, think tanks, practitioners and patients have supported our efforts. They continue to press us to make the point that, without mandated forecasts of staff numbers, meaningful workforce planning—something that every other efficient organisation undertakes—cannot take place. They continue to despair at the Government’s now repeated refusal to demonstrate proper commitment to safely staffing our hospitals and other healthcare settings.

We all know that there is desperate understaffing. The staff know it; they feel the pressure and they see the adverse outcomes. The patients know it, often falling into a cycle of long waits, in pain and discomfort, because of staff shortages. Resolving this is quite straightforward. We need a national staffing picture, otherwise how will we know whether we are training enough staff to meet the needs of the country? Yet the Government continue to refuse to commit to producing such an assessment. They say that the necessary work has already been done, or is going to be done, but we, and stakeholders, vehemently disagree, and it is hard to follow the Government’s logic.

If the Secretary of State will not show leadership then NHS England must step up and produce its own requirements and projections, or the Local Government Association could commission such work across the country by local authority. Some way, somehow, every integrated care system and local authority will have to quantify their future workforce requirements and projections and plan for how these will be met.

The Government’s current drafting leaves open some serious questions. We do not know whether the plan will cover health and social care workforces. What is the intended timeframe of the commissioned NHS England plan, and will it be recommissioned once this period expires? Can the Minister confirm that robust data on staff numbers in our healthcare workforces will be published and, if so, when? I would be grateful for any clarification that the Minister can provide.

I deeply regret that the Government have felt unable to meet with parliamentarians—the Opposition, other political parties or indeed any of our experienced Cross Bench Members—even to discuss this issue. This is an irregular and unwarranted response. I hold out hope that, even at this late stage, the Government may see good sense in planning for the workforce that we need, instead of leaving it to chance. I beg to move.

--- Later in debate ---

I also remind noble Lords that at the beginning of the consultation we had an open meeting with the Minister for Care, Gillian Keegan, to answer all questions, including on the cap and the metering. Please let us grasp this opportunity or we could be waiting for another proposal. This proposal could wait, gathering dust on shelves for many years to come, like previous proposals. Let us grasp the opportunity and have the courage to address social care. I ask that noble Lords support our amendments.

[Baroness Merron (Lab)]

My Lords, in opening this debate, the Minister said that Motion A by and large did the job that Motion A1 seeks to do. I beg to differ, and so do more than 100 key organisations that work day in, day out on health and social care. Unless we plan and prepare to have the right workforce in place, it will continue to be the case that we do not have the right workforce, so what is happening now will simply continue. We will not be sure of safe staffing levels, nor have the people in place to give the levels of service that mean patients do not have to continue to suffer long and painful waits.

I remain deeply disappointed that on workforce, a central pillar of how we run our health and social care services, the Government have refused to even discuss this matter. I ask the House to agree to Motion A1.