Health and Social Care Workforce

Catherine West Excerpts

Thursday 13th July 2023 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

rose—

[Catherine West (Hornsey and Wood Green) (Lab)]

rose—

[Steve Brine]

Such a choice. I give way to the hon. Member for Hornsey and Wood Green (Catherine West).

[Catherine West]

I thank the hon. Gentleman for securing this debate at such an important moment, when waiting lists are at record levels, if the press are to be believed. Does he agree that we need urgent improvements in the way the workforce from abroad are employed? Some really exploitative practices are going on out there in certain care homes. Does he agree that that needs to be tackled urgently?

[Steve Brine]

Anybody employed in health and care should be treated properly and with respect, and they should be welcomed to this country with thanks for the work they are doing. If the hon. Lady has specific examples of something—I am guessing she may have from her intervention—I ask her to please speak in the debate and put them on the record.

--- Later in debate ---

[Steve Brine]

Yes. One witness at our session yesterday said that the tap is well and truly on but the plug is still half out, which is a very good way of putting it. The recovery plan for primary care published a few months ago is really strong. It is really positive: it talks about wider primary care roles and it has been created in conjunction with the Royal College of General Practitioners. We need to see a fast-paced roll-out of that plan. We need the extra money for community pharmacies to move through the contract fast, so that it moves the dial even faster, because that is critical to the retention of general practice staff, and it is also critical to this winter being better than last. So, yes—point taken.

Another important point to note about the workforce plan is that it is iterative, so it will be refreshed every two years. I guess there are two ways of looking at that and I would appreciate the Minister’s comments. I understand it is at the Treasury’s insistence that it is looked at every two years, which is fine. We can look at it two ways: either the Treasury wants to make sure the plan is ambitious enough and, if necessary, that it is more ambitious so it can put more funding behind its next iteration, or—to look at it the half-empty way—the Treasury may wish to trim back. It is very important that the Department, Ministers and the House make sure that it is the former. The iterative side of the plan is important, and while we are still in the early stages, it is also important that the plan starts to deliver quickly in a practical way for people on the ground. That is why I said what I did about working with the primary care plan.

One of the possible risks to delivery—there are a few, because the plan contains big assumptions and models of numbers—is that the plan is based on a pretty ambitious labour productivity assumption of 1.5% to 2%. During the statement when the plan was put forward, somebody in the Opposition—it may have been the Opposition Front Bencher, the hon. Member for Bristol South (Karin Smyth)—said that the NHS has struggled to achieve that kind of productivity gear change in the past, so achieving it now will be a challenge. That does not mean that it is not the right thing to do, but I would like to understand from the Government what will happen to the projections in the plan—not necessarily today, but as we go forward—if the productivity assessment is not achieved.

[Catherine West]

What assessment have the hon. Member and the Committee made of the iterative process and the Treasury’s assumptions, building in the ageing workforce and the acute nature of mental health needs among the younger population?

[Steve Brine]

We have not done that yet, but I merely put down a marker today that I hope there will be a review process, so that we can be even more ambitious. If we were to write a risk register for the plan, I would suggest that one part of that register could be the productivity challenge, which the NHS has long struggled with.

Let me turn to social care. In many ways, the picture there is more challenging. The Committee’s report notes Care England’s finding that in December 2021,

“95% of care providers were struggling to recruit staff, and 75% were struggling to retain their existing staff.”

The report concluded:

“Care workers often find themselves in under-paid roles which do not reflect the value to society of the service they provide. Without the creation of meaningful professional development structures, and better contracts with improved pay and training, social care will remain a career of limited attraction”—

not poor attraction, because many people want to do it—

“even when it is desperately needed.”

I know that the Minister is passionate about this issue and that she will give a passionate response today. We noted, however, that health and social care services are obviously interdependent, and if efforts in the plan to tackle the challenges in the NHS are to be successful, capacity needs to increase across both health and care. The Minister knows that, but I feel that I have to say it. That point is crucial, and with the welcome focus on the NHS workforce, it is vital that the issues affecting the care workforce are not forgotten. The NHS workforce plan cannot succeed if the challenges facing the social care workforce are not tackled.

I visited the HC-One care home in my constituency last month during Care Home Open Week, and I met a very interesting lady from the Prince’s Trust, who is working with the care home group on the pipeline of social care staff. I recommend that the Government get in touch with the Prince’s Trust, which is doing good work in trying to inspire young people to go into a career in care. I accept that the social care workforce is a different kind of workforce and that not all the levers are under the Government’s control, as I said, but the Government know that there is much to do on this issue.

To conclude, the 75th anniversary is a huge milestone for the NHS. Millions of people still have huge affection for the organisation, but to misplace that and take it for granted would be to do the opposite of serving the NHS faithfully. The anniversary cannot be an exercise in nostalgia. It must be an opportunity to look forward and to make sure that we have an NHS that works for our constituents now and in the decades to come; that is a prevention service as much as it is a sickness service; and that is among the best organisations in the country, in the public or private sector, for the way it looks after its staff. I am very optimistic about the workforce plan. It is a big step in the right direction. The fact that it is out there is a big moment, but there is plenty still to be done, and the Minister knows that my Committee will be right there scrutinising that work as it is taken forward. The plan is just the start.