Oral Answers to Questions
Debate between Baroness Laing of Elderslie and Helen Whately(11 months ago)
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Helen Whately
The hon. Member refers to yesterday’s announcement on migration. First, I am very grateful to all the international workers who come here to help in our health and social care system and to care for our loved ones. Clearly, we must get the balance right between migration and making sure that our health and care system has the workforce that it needs. That is what we are doing, both with the migration changes announced yesterday and with our reforms to the social care workforce to ensure that working in social care is appealing to home-grown talent.
Abena Oppong-Asare (Erith and Thamesmead) (Lab)
Thanks to their own internal chaos, the Conservatives have utterly failed in their promise at the last general election to fix the crisis in social care once and for all. We now have over 150,000 care vacancies and 390,000 care staff leaving their jobs each year, meaning that 60% of patients in England who are fit for discharge are being kept in hospital each day. Will the Minister therefore back Labour’s plan to deliver a fair pay agreement, with better terms, conditions, training and pay, to ensure that we have the staff required to care for all those who need it?
Helen Whately
Labour really have not got a leg to stand on when it comes to social care reform. They did not do anything the last time they were in government, and they still do not have a plan for social care. In government, we are reforming social care careers—[Interruption.] If the hon. Lady will take a look at what we are doing, we are introducing a new career structure for people working in social care, introducing new qualifications and investing in training for social care. We are doing what needs to be done to ensure that social care as a career works for UK workers. [Interruption.]
Madam Deputy Speaker (Dame Eleanor Laing)
Order. You won’t get your turn if you shout from there.
Helen Whately
My hon. Friend makes a very important point about the additional challenges in rural areas. I want to ensure that this winter people get care when they need it and get it faster. We are already seeing progress on that. For instance, we are investing in making sure there are more ambulance hours on the road, and we are seeing ambulances get to people quicker—in fact, this October, they got to people 20 minutes faster than last October. Ambulance handover delays are reducing and we are already seeing progress in A&E, where people are being seen faster, too.
Madam Deputy Speaker (Dame Eleanor Laing)
Order. Can Members please cut their questions in half? Otherwise, I will have to stop this questions session and people will not get a chance at all.
The Minister for Social Care (Helen Whately)
I would be delighted to meet my hon. Friend’s constituent. What the employer does is really important for retention and recruitment of adult social care staff, along with our ambitious workforce reforms for the care workforce.
Health and Social Care Workforce
Debate between Baroness Laing of Elderslie and Helen Whately(1 year, 3 months ago)
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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.
NHS Update
Debate between Baroness Laing of Elderslie and Helen Whately(3 years, 3 months ago)
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Madam Deputy Speaker (Dame Eleanor Laing)
Just before the Minister responds, I will say that Mr Speaker will be annoyed, to say the least, that the hon. Member for Tooting (Dr Allin-Khan) did not receive the statement from the Minister in time. The Minister did apologise at the beginning of her remarks, so I have noted that apology and we do not have to go any further on that, but I have also noted what the hon. Lady has said.
Helen Whately
Thank you, Madam Deputy Speaker. I reiterate my apology to the hon. Lady for the late sight of the statement and thank her for her invitation to join her, but I will say that I am shocked by some of the language that she uses. I would just say—[Interruption.]
Madam Deputy Speaker
Order. The hon. Member for Tooting must not shout at the Minister across the Dispatch Box. She was heard, and the Minister must be heard.
Helen Whately
What we say in this Chamber is clearly important and it has ripples beyond the Chamber, so I for one consider the tone of what we say to be extremely important. The hon. Lady spoke about pay for NHS staff. As she knows, the Government asked for recommendations from the NHS pay review bodies. The Government are rightly seriously considering those recommendations, and we will be responding as soon as we possibly can. She also knows that last year the Chancellor committed to NHS staff receiving a pay rise at a time when there is a wider freeze on public sector pay, recognising the extraordinary lengths that NHS staff have gone to during the pandemic.
The hon. Lady talked about the pressures on NHS staff, which she and I know go back a long way, but yes, of course they have been so much greater during the pandemic. We know that NHS staff have gone above and beyond, time and again, during the pandemic to care for patients. Recognising that, and knowing that that has been happening throughout the pandemic, I have worked with NHS England, and particularly the people team there, to put in place all possible support for staff during these difficult times. That includes practical support with some of the day-to-day challenges of working shifts and the extra disruption to people’s lives and home lives during the pandemic, as well as mental health support, including setting up 40 new mental health hubs for staff, which I have heard from staff on the frontline are really making a difference. In fact, some of these things are making the NHS a better place to work for the future, and we should try to continue some of the improvements to mental health support for staff, recognising the importance of this to people who are doing extremely challenging jobs.
I also say to the hon. Lady that we now have record numbers of staff in our NHS. We have over 300,000 nurses, as I said earlier—around 9,000 more nurses than a year ago—and record numbers of doctors, so we have more staff in our NHS. We are also seeing a huge interest in NHS careers. For instance, we have seen a 21% rise in applications to UCAS for nursing degrees this year, which comes on top of a rise last year as well. I welcome the fact that so many people now want to join our NHS to support it, and I am determined that we as a Government will continue to support our NHS workforce in the weeks and months ahead.
Helen Whately
The hon. Lady is absolutely right that retention is vital to us for maintaining the staff that we have in the NHS. For instance, to achieve our 50,000 more nurses for the NHS, there will be a combination of new domestic recruitment, staff training to become nurses, international recruitment, but also retaining the nurses that we have, which is a really important part of it. That is why we worked so hard during the pandemic to support NHS staff to stay with the NHS. What we have seen—I am truly grateful to many staff for this—is people sticking with the NHS during this time. Some staff have even delayed their retirement in order to help the NHS through the pandemic. Looking ahead, we must be ready to continue supporting staff, including, for instance, staff who are nearing the end of their careers, making sure that, if they want to work a bit differently—more flexibly for instance—that should be available. That is one thing among a whole host of things that we are doing in order to support the retention of staff.
Madam Deputy Speaker (Dame Eleanor Laing)
I must just say to the House that the hon. Member for Hackney South and Shoreditch (Meg Hillier) is not the only Member this week and in recent weeks who has addressed the Minister as “Minister”. I am sorry to pull up the hon. Lady. I am doing it to her because I know that she can take it and will not be upset by my criticising her. I am rather more gentle with the new Members, so I thank the hon. Lady for helping me in this by allowing me to use her as an example. When a Member asks a question, you do not say, “Minister, are you going to do this?” You say, “Madam Deputy Speaker, or Mr Speaker, does the Minister understand that she must do this?” We must not lose sight of that because it changes the way in which dialogue occurs in this place. Just because it is hot, the end of term and we have covid problems does not mean that we let our standards fall.
Helen Whately
It is very good to hear that Wirral Council is supporting social care workers in its area. Local authorities are a crucial part of our work in social care reform and they have so many of the direct relationships with the care providers who are providing that social care. We are absolutely committed to bold, ambitious reforms for social care. As the hon. Lady knows very well, we will be bringing those forward during this year.
Madam Deputy Speaker (Dame Eleanor Laing)
I ought to conclude the statement here, because we are running way behind time. However, I appreciate that Members have important questions to ask and that the Minister will want to answer them. But I ask for much greater speed and brevity, because otherwise it is not fair to people who are waiting for us to come on to the next item of business. I call Dr Ben Spencer.
Madam Deputy Speaker (Dame Eleanor Laing)
Finally, we go by video link to Peter Bone.
Axial Spondyloarthritis
Debate between Baroness Laing of Elderslie and Helen Whately(4 years, 1 month ago)
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Helen Whately
The hon. Member makes a really important point, again drawing from her own personal and family experience, about the importance of awareness of what is the best treatment for this condition. If she would like me to do so, I am happy to take away her specific point and look into how we can address the need for improvement in the treatment, as well as her general point about needing a better pathway. I am also happy to meet my hon. Friend the Member for Gedling, as he requested, to talk further about how we can make more progress on the right treatment for this condition, and awareness of it.
Coming back to the overall points about what we can do to improve the treatment, the NHS long-term plan set out our plans to improve healthcare for people with long-term conditions, including axial SpA. That includes making sure that everybody should have direct access to a musculoskeletal first-contact practitioner, expanding the number of physiotherapists working in primary care networks, and improving diagnosis by enabling people to access these services without first needing a GP referral—in fact, going directly to speak to somebody with particular expertise in the area of musculoskeletal conditions. The hon. Member for York Central (Rachael Maskell) intervened to make a point about the demands on physiotherapists. I have asked to be kept updated on progress on delivering the expansion of the number of physiotherapists in primary care networks and, more broadly, on the implementation of the NHS long-term plan. We do indeed need to make sure that we have sufficient physiotherapists to be able to deliver on that. I anticipate that that should have a positive impact on the problem of delayed diagnosis for a range of conditions, and particularly for this specific condition.
While better education and awareness of AS should improve the situation, there is clearly more that we can and must do to understand the condition. The National Institute for Health Research is funding a wide range of studies on musculoskeletal conditions, including AS specifically. That research covers both earlier diagnosis and treatment options for the condition, so that we continue to build our understanding of good practice and improve both the treatment and the outcomes for those who have the condition.
In conclusion, I want to pick up on my hon. Friend’s point about the importance of awareness and the call for an awareness campaign by the APPG, and I should of course commend the National Axial Spondyloarthritis Society for its work in this area. My hon. Friend mentioned that there is clearly a huge amount of public health messaging going out at the moment, but I hope the time will come when we can gain more airtime for this particular condition. However, the fact that we are having this conversation in the Chamber is in itself a step towards raising awareness of the condition, and so, too, is all the work that is going on; that is important as well, because along with having the policy and the pathway, we must make sure it is put into practice.
I congratulate my hon. Friend again on bringing this subject to the attention of the House and on the work he is doing and the effect that this will have. I truly want to support him and to do our best for all who suffer from this condition and may suffer from it in future, to ensure that we achieve much earlier diagnosis and treatment and better outcomes for those with the condition.
Madam Deputy Speaker (Dame Eleanor Laing)
I commend the hon. Member for Gedling (Tom Randall) on his courage in bringing such a personal and difficult matter before the House. Many people will not appreciate that that is a difficult thing to do, and I am sure that he will have made a difference to many by what he has done today. [Hon. Members: “Hear, hear.”] I am pleased that those in the Chamber are in agreement.
Question put and agreed to.