International Women’s Day

Baroness Rafferty Excerpts

Thursday 6th March 2025 Lords Chamber

[Baroness Rafferty (Lab) (Maiden Speech)]

My Lords, I draw attention to my interests in academic nursing as professor of nursing policy at King’s College London.

My heartfelt thanks go to my noble friend Lady Smith, the Leader of the House, for her incredible support up to and during my introduction and her generosity throughout. The noble Baroness, Lady Watkins of Tavistock, who is also my friend and a fellow nurse and academic, has been exemplary as my second supporter and introduction agency to the House throughout. My noble friend Lady Thornton—Glenys—has been so kind in shepherding me around the House and easing me into its ways.

I come to this House as a nurse and academic. Reading the brilliant biography by the late Baroness Patricia Hollis of Jennie Lee, one of my heroines, I could never have imagined speaking to you today. Like Jennie Lee, I was brought up in Fife, Kirkcaldy in fact, birthplace of Adam Smith and constituency to my other hero, Gordon Brown. Both Jennie Lee’s father and mine worked in the coalfields of Fife. It was a tough life. I remember my dad cycling to Seafield pit in all weathers, coming home for a rest and a bite to eat before going out again to his second job in a local pub. My mother trained as a nurse in the 1930s and during World War II in the Civil Nursing Reserve. She inspired me to enter nursing through her stories of nursing prisoners of war in Bridge of Earn military hospital in Perthshire. I loved delving into her textbooks, devouring the gruesome details of disease. I also became fascinated by the practices of the past, firing my imagination both for nursing and its history.

Nursing is a science as well as an art, and I have been fortunate to work in a variety of roles as a clinician, academic and policy researcher, but I did not get off to a good start. Like my noble friend Lady Levitt, I spent rather too much time outside the headmaster’s office, skipping classes and preferring the pool hall—in which I became very proficient—to homework.

Today’s debate is highly relevant to nursing. Not only was international nursing forged in the crucible of the international women’s movement at the end of the 19th century but the rationale for doing so was, in part, to combat the prejudice surrounding women’s education by setting nursing on a scientific footing.

While nursing in England has become a graduate subject since 2013, its fate remains precarious, a situation made much worse by the increasing financial frailty of the university sector. The Office for Students estimates that over 70% of our universities will be in deficit this year. UCAS data shows that nurse recruitment in the UK has fallen by 4% since its pandemic peak. In Wales, nurse recruitment has fallen by 14%, yet a recent announcement by Cardiff University stated its intention to close the school of nursing. Particularly concerning is the steady downward trend of mature applicants to nursing. These numbers just do not compute in a scenario of chronic shortage of nursing staff. A landmark study that we published from King’s College London in the Lancet in 2014 demonstrated that bachelor’s-prepared nurses have better outcomes for patients in terms of mortality rates. A further study demonstrated that senior nurses contributed more than twice the benefit to patients, compared with their more junior colleagues.

Investing in nurse education and staffing across the career span yields clinical and economic benefits, reduces hospital length of stay and facilitates return to work. I am grateful for the excellent 2016 report —of which the noble Baroness, Baroness Watkins was also an author—from the all-party parliamentary group in global health, chaired by the noble Lord, Lord Crisp, which identified the triple impact of growing nursing globally. These include strengthening health systems, universal health coverage, gender equality and women’s participation in the workforce, and skilled employment opportunities.

However, the engine room of the academic workforce is not in good shape. Council of Deans of Health estimates that more than 50% of the workforce is, like me, over 50—can you believe it?—with many universities struggling to recruit. In contrast, applications to engineering are booming. Could it help to boost the standing of the profession by designating nursing as a STEM discipline? I am sure that my noble friend the Minister will agree that we cannot deliver the refreshed long-term workforce plan or the 10-year NHS plan to come unless we support nursing education to secure the students, nurse scientists and clinicians of the future. I thank my noble friend the Minister for raising this debate, and I hope that these points might assist with the planning the Government are undertaking.