Health and Social Care Workforce

Eleanor Laing Excerpts

Thursday 13th July 2023 Commons Chamber

[The Minister for Social Care (Helen Whately)]

My grandfather was a doctor, my mother was a doctor, my father was a surgeon and my aunt a nurse, so when I think of the NHS, I do not picture a hospital or an ambulance; I picture the people—the doctors, nurses, pathologists, radiologists, physios, healthcare assistants, porters and all the other people who make the NHS what it is. The NHS is its workforce, and the same is true for social care. Life is made possible for hundreds of thousands of people thanks to the hard work, skills and compassion of social workers, nurses, care workers, care home managers and all the other people who work in social care. That is why I welcome this chance to talk about our health and social care workforce.

I thank my hon. Friend the Member for Winchester (Steve Brine), the Chair of the Health and Social Care Committee, for his comments and for all his and his Committee’s work on their report. In the Government’s response to that report, we were right behind the key recommendation to publish workforce projections, and last week we put that into practice when we published the NHS long-term workforce plan. It is an ambitious plan to train many thousands more doctors, nurses and other health professionals; retain more of their talent and experience; and reform how they train and work to secure the future of the NHS, backed by an investment of £2.4 billion. I will not try to set out everything in that plan this afternoon, but I will share some of the highlights and respond to the points made by my hon. Friend the Member for Winchester and other hon. Members.

In brief, the plan forecasts the increase needed in the NHS workforce between now and 2037, and sets out how we will expand the numbers of doctors, nurses and other health professionals that we train. We will double the number of medical school places, boost the number of GP training places by 50%, increase the number of adult nurse training places by over 90%, and expand the number of dentists we train by 40%. We will widen the talent we bring into the NHS by increasing the number of staff trained as apprentices from 7%, as it is now, to 22% by 2032. That will give more people the opportunity to earn as they learn, widening access to healthcare careers to more people from different backgrounds.

However, as hon. Members have highlighted, the NHS is already full of talented people whose skills we want to retain. Of course, some people will always want to move on to new things or indeed retire, but the NHS can and must do better at retention. That is why we made retention an integral pillar of the long-term workforce plan. The NHS is the UK’s largest employer, and it should set a real example in how it cares for its staff. As the plan says, the NHS will do more to support people throughout their careers, increase opportunities to work flexibly, and look after its workforce’s own health and wellbeing.

My right hon. Friend the Member for Wokingham (John Redwood) spoke about the importance of individual trusts as employers, and the importance of their leaders and managers to staff retention. I very much agree with him about that—I have spoken about it previously in this House, probably as a Back Bencher. How well people are led and managed is probably the biggest determinant of their experience at work, and is therefore a big factor in retention. I would flag to my right hon. Friend that the Messenger review, which I expect he is familiar with, is excellent in this area, and the long-term workforce plan references that review’s recommendations. Taking them forward will be an important part of the plan.

I should also mention pay. Pay is not the only factor affecting recruitment and retention—in my many years of talking to NHS staff, I have heard far more often that having enough colleagues on their team is arguably the most important thing—but it does matter. NHS staff should be fairly rewarded for the work they do. That is why we listened and reached agreement on pay for staff on “Agenda for Change” contracts. Under that deal, over 1 million NHS staff, including nurses, paramedics, midwives and porters, have received a 5% pay rise and extra one-off payments. In addition, as we announced today, the Government have accepted the recommendations of the doctors’ and dentists’ remuneration body for this year in full.

We should not forget that the NHS pension scheme is one of the best that can be found, and we have made it more flexible to make the most of the experience of staff who are particularly close to retirement. Since April, former NHS staff claiming NHS pension scheme benefits can return to work and rejoin the scheme, and from October we will introduce a partial retirement option that gives more flexibilities to staff, meaning that patients will benefit from their skills for longer. We have already acted on the tax treatment of pensions, which we know is a factor in the decision of some doctors and other NHS staff to retire early or reduce their hours. My hon. Friend the Member for Winchester referred to that as the BMA’s No. 1 ask.

The final part of the plan I will mention is reform, because as care changes, so must how we work and, indeed, how we train staff. That is why the plan includes reforms to training, such as increasing the number of apprentices, which I mentioned; increasing the focus on generalist skills alongside specialisms; increasing the share of training in settings outside of hospitals, such as GP surgeries; adopting more blended learning and the use of simulation; and making sure that we get the right duration of training programmes. When it comes to how people work in the NHS, the places that people receive care are changing, with more care outside of hospital and closer to home. As such, the plan envisions a faster rate of increase in the number of staff working outside of hospitals, with the mental health workforce growing fastest, followed by community and primary care. In fact, over the period of the plan, the NHS community workforce is planned to double.

The way people work will also change, with staff working more in integrated teams coming together from different parts of the NHS and, indeed, together with social care. Joining up care is better for patients and their families. It is more effective, but also more efficient.

On productivity, all of this will be supported by new technology. We will use advances in technology in how we train and in how people work. We will use technology such as AI to support clinicians, increase efficiency and improve patient care, so giving staff the gift of time—time to spend with patients.

Equally important in our future health and care system is our social care workforce. As my hon. Friend the Member for Winchester said, this is indeed something I am passionate about. I have heard many calls, including today, for a social care workforce plan. The good news is that we are well under way with substantial social care workforce reforms. They were first set out in the White Paper, “People at the Heart of Care”, and then described in more detail in our next steps plan published in April. We are investing £250 million in reforming care as a career, with a new care qualification, specialist training courses for experienced care workers and a new career structure for care workers to support career progression.

Those reforms build on the work we are already doing to build the social care workforce, with record funding available for local authorities to spend on social care—up to £7.5 billion announced in the autumn Budget—which, through the fees local authorities pay, supports care providers to pay their staff better in turn. The reforms also build on our introduction of Care Quality Commission assurance of local authorities’ care duties and our introduction of the care worker visa, so that care providers can draw on international recruitment.

On that point, I will pick up on the intervention made by the hon. Member for St Albans (Daisy Cooper) on the question of exploitation of international recruits. I think that is very serious, and I am very concerned about it. I say that against the backdrop that, as we know from the data from Skills for Care, the number of care workforce vacancies is falling—that very good news was published yesterday—coupled with what I hear from the many care providers I speak to, which is that international recruitment is really helping fill vacancies and meet the care needs of our society.

In general, I know that care providers are working very hard to support the international workforce they are recruiting, but I am very disappointed that we have heard stories of exploitation at a minority of care providers. I do not want anyone working in health or social care to be exploited. That is why we have provided guidance to people who are receiving a care worker visa on their employment rights and how to seek help. We are also funding local support to be provided to international recruits into social care, and we are working across Government—including my Department, working particularly with the Home Office—on tackling exploitation.

All in all, I would say that what we are doing to support the social care workforce is working. The number of care vacancies is falling, retention is improving and care is on the path to getting the recognition it deserves.

In closing, I thank the Chair of the Health and Social Care Committee for welcoming the NHS long-term workforce plan. I was very glad to hear him say that many boxes had been ticked by the plan. I hope my response has provided him and other hon. Members with further assurance. The NHS long-term workforce plan is historic in its ambition to recruit, retain and reform the NHS workforce. Our social care workforce reforms are also ambitious to make care work a profession that gets the recognition it deserves. The workforce are the heart of our national health service and social care. All that skill, compassion and dedication is essential to the lives of people up and down the country, and that is why we are looking and planning ahead to secure the future of our health and social care system.

[Madam Deputy Speaker (Dame Eleanor Laing)]

To conclude the debate, I call Steve Brine.