NHS Workforce

Chris Stephens Excerpts

Tuesday 6th December 2022 Commons Chamber

[Steve Barclay]

No, of course not. The hon. Gentleman knows that is not the case. It is a bit like when he goes around the media to charge the Government with refusing to talk to the unions. Simply misrepresenting our position is not a fair reflection of Government policy.

The motion talks about workforce, and this Government have committed to increasing the number of international recruits in the NHS. The Leader of the Opposition seems to think we should not be encouraging that. That is the wider point to make. Of course, that sits alongside domestic recruitment, which is why, as I said a moment ago—again, the hon. Member for Ilford North has chosen to ignore this—we have had a 25% increase in medical undergraduate places, with five new medical colleges set up by the former Prime Minister, my right hon. Friend the Member for Maidenhead (Mrs May). That underscores this Government’s commitment to increasing the number of doctors in training.

[Chris Stephens (Glasgow South West) (SNP)]

The hon. Member for Bath (Wera Hobhouse) raised an important point about problems with the visa process, so will the Secretary of State outline what work he is doing with the Home Office to resolve some of these issues?

[Steve Barclay]

I discussed this issue with the Home Secretary this week: how we work together across Departments, not just on the visa system, but on other equities. For example, the amount of time spent by police on mental health is an issue of concern to not just the Home Office, but wider government. So there is scope across Departments to work more closely together and we are doing that, both on the issue of international recruitment, which is a key equity within the Department of Health and Social Care, and on mental health pressures on the police, which is an issue within the Home Office. That is how we are working more collaboratively across government, but we are clear that we are boosting the numbers in the short term while, in parallel, increasing the domestic supply of recruits, for example, with the boost in medical undergraduate places. We are also looking at what more we can do in areas such as apprenticeships: how we hire more nursing apprentices and boost supply through that as well.

Finally, the motion does not reflect the pay uplift that was awarded, where the Government accepted in full the recommendation of the independent NHS Pay Review Body. More than 1 million staff have seen an increase of at least £1,400 in their pay. Of course, that comes on top of the 3% rise last year, at a time when pay was frozen across the wider public sector.

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[Chris Stephens (Glasgow South West) (SNP)]

It was noticeable that the Secretary of State talked very little about the workforce in the speech we have just heard, although he spoke about many other things. I want to confine my remarks to the workforce, staff wellbeing and their pay.

Let us recognise, first, the impact on the NHS and staff of not just decisions made in this place on the economy, but of Brexit—that cannot be ignored. For example, the director of the CBI has called on the UK to use immigration to solve worker shortages. The Secretary of State did touch on that, but we really need assurances about the work being done between the Department of Health and Social Care and the Home Office to resolve the many visa issues that the Royal College of GPs had outlined, as other Members have said. According to that research, 17% of international graduates are considering leaving the UK altogether as a result of the challenges they are facing within those visa processes.

Research by the Nuffield Trust has revealed that Brexit has worsened the UK’s acute shortages of doctors in key areas of care and led to more than 4,000 European doctors choosing not to work in the NHS in the UK. Martha McCarey, the lead author of that Nuffield Trust analysis, has said:

“The NHS has struggled to recruit vital specialists…and Brexit looks to be worsening longstanding workforce shortages in some professional groups.”

That has been backed up by a number of organisations that have those very concerns, because the challenges in health and social care are felt in many sectors. What we certainly do not need is some of the right-wing rhetoric on immigration that we hear in this place, because in many areas of the UK we need more rather than less migration.

Clearly, staff pay is a real concern. In Scotland, we have seen discussions between the Scottish Government and the trade unions; a pay offer is on the table to staff and the trade unions have recommended that the staff accept that latest offer. In England, as an excellent Unison briefing is outlining, we are seeing a number of NHS workers considering leaving the service because they do not believe they should be subjected to a pay rise of 70p an hour. That is a very real concern to them and I believe it is simply not enough—it is not enough when food inflation is at 16%, and we have the high energy costs and housing costs that many people across the country are being subjected to.

[Jamie Stone]

The hon. Gentleman is making an interesting contribution, and I am thinking about what he has just said about Scotland. The fact remains, as I illustrated in a question earlier today, that the consultant-led maternity service based in Caithness, which has a close connection to his family, was downgraded to its current deplorable state because it could not hire the people. He has just mentioned housing, and I believe that in order to fill the gaps in the most rural areas of the UK we are going to have to offer a more comprehensive package to encourage them, involving housing, something on the mileage rate people are paid and even transport. If we just go down the ordinary route of recruited people from overseas, they will tend to go to the more central parts of the UK, where there is housing and where transport is much easier. We cannot have the rural, faraway corners of the UK left out.

[Chris Stephens]

The hon. Gentleman knows of my affection for his constituency—many members of my family live there. He raises an important point about rural communities, and in relation not just to the NHS but to the other challenges he outlines. He makes a pertinent point about what all the health services need to consider when applying their services to the areas that he has the privilege of representing, and I thank him for that.

The Secretary of State talked about the autumn statement, but it will not deal with the increasing cost of food and energy, and all the other pressures facing staff. There must be a serious discussion about the NHS workforce, about retention, about giving staff career opportunities and also about wellbeing. I thank NHS staff for what they have done not just during the pandemic, but when I and family members have had health challenges. The work they do and the miracles they perform on a daily basis should be recognised in this place.

[Dr Evans]

It is worth stressing that point. For all the Daily Mail headlines about the NHS, we must not lose sight of all the good work that goes on unrecognised for the countless thousands of people who go to hospitals, GP surgeries or mental health services and get excellent care. If two patients are on similar pathways but one receives excellent care and the other receives poor care, should not the emphasis be on moving more towards excellent care and less—if not an outright stop—towards poor care?

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[Chris Stephens]

The hon. Gentleman is right; everybody should have excellent care.

As we debate the NHS workforce, we need to recognise what the challenges of the workforce are: whether they are paid adequately and whether there is a real retention strategy. We need to ensure that we have as many staff as we can and that we pay them properly. I did not hear much from the Secretary of State about the state of play of the pay negotiations and what the Government are doing to try to resolve disputes. I see him sighing; he is more than welcome to intervene. [Interruption.] Oh, he was yawning. I am sorry. [Interruption.] Oh, he was not yawning either. He was making a facial expression. I do apologise. We really need a serious debate about pay for public sector workers, and NHS workers in particular.

[Richard Foord (Tiverton and Honiton) (LD)]

When we think about pay for NHS staff, we also need to consider pay for those who work in NHS dentistry. The Government claim to have reformed the NHS dentistry contract earlier this year, but they brought no new money to bear. Does the hon. Gentleman accept that the Government should be measuring not only the number of dentists who are employed to carry out NHS dentistry, but the number of hours that are committed to NHS dentistry? We need to see whether there is a correlation between that and the poor pay that they are receiving for NHS dentistry.

[Chris Stephens]

The hon. Gentleman makes an excellent point; it is all about pay. What he says about hours is pertinent as well. We know that NHS staff go the extra mile. We know that they work long hours, and we should recognise that. His point about the dentistry service is also important.

As I outlined earlier, the Scottish Government are listening to feedback from the trade unions on pay, and there is a new offer on the table. That means that, in Scotland, porters who are at the top of band 2 will be making £2,502 more a year, nurses or midwives at the top of band 5 will be making £2,431 more, and a paramedic at the top of band 6 will be making £2,698 more. Currently, that is the best deal across the UK, and it is significantly more than the uplift on offer in England—the average value in England is around 4.5%, whereas in Scotland it will be 7.5%.

The Secretary of State also had his usual kick at Wales, but it should be noted that the Welsh Health Minister and the Scottish Health Secretary have written to the UK Government, calling for additional funding this year to support pay deals for NHS staff. I wonder whether, in his response, the Minister will give us an update on the answer to that letter.

I will conclude, because I know that this is a heavily subscribed debate. It is important that we deal with the mental wellbeing of our NHS staff. The Scottish Government have published a wellbeing strategy. We need to show more compassionate and collaborative leadership across the health, social care and social work sectors on these islands. I shall leave it there, Mr Deputy Speaker. The SNP will be supporting the motion submitted by the Labour party today.