NHS Long-term Workforce Plan
Debate between Grahame Morris and Steve Barclay(1 year, 4 months ago)
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Steve Barclay
My hon. Friend raises a perfectly valid point. As we expand the primary care workforce, there is a capital consequence. The 50% expansion he talks about builds on the expansion from 2,100 in training in 2014 to 4,000 now, so there has already been an expansion, but we are taking that further by 50%—and on the higher figure. His point about section 106 applications is absolutely valid, and that is part of the primary care recovery plan. I understand that he is discussing the importance of getting that funding in place with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough.
Grahame Morris (Easington) (Lab)
Given the number of pressures and crises that our NHS faces, it would be a mistake for the Secretary of State to be seen as complacent in how he delivered his workforce plan. Our job as MPs is to speak the truth to power, so I want to raise with him the lack of cancer treatment capacity, particularly in radiotherapy. International comparators suggest that between 55% and 60% of cancer patients should be able to access radiotherapy either directly or in tandem with other treatments. Currently, only 27% do. What is the Secretary of State doing to increase the size of the highly specialised and relatively small radiotherapy workforce? The target is for 85% of patients to start their first treatment within 62 days of an urgent GP referral. What is the current figure?
Steve Barclay
To take the hon. Gentleman’s first point, the plan does not get into individual specialties. That was a Health Committee recommendation, which I have discussed with the Committee’s Chair, my hon. Friend the Member for Winchester (Steve Brine). There is a clear reason for that. Within the framework of numbers, the impact of AI and service design will evolve over the 15 years, so it is right that we commit to the number and then the NHS take that work forward with individual specialities and have discussions with the royal colleges.
The hon. Gentleman made a perfectly valid point about boosting capacity. We have already rolled out 108 of the 160 community diagnostic centres that we have committed to deliver. We are also looking to innovate, and I will give two practical examples. Our deal with Moderna, which is looking at individual bespoke vaccines for hard to treat cancers such as pancreatic cancer, will allow us to get ahead on that. We are already seeing a significant reduction in cervical cancer as a result of prevention measures. Likewise, by going into deprived communities with a high preponderance of smoking, the lung cancer screening programme is detecting lung cancer, which often presents late, much earlier, which in turn is having a significant impact on survival rates.
NHS: Long-term Strategy
Debate between Grahame Morris and Steve Barclay(1 year, 10 months ago)
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Steve Barclay
Again, I can understand why the hon. Gentleman does not want to talk about the performance of the Welsh Government, but I was talking about the Scottish, French and German Governments, and about the fact that the pandemic has had a severe impact across the UK and across Europe.
Steve Barclay
I know that the hon. Gentleman has been keen to get in, so I will give way, but then I must make some progress.
Grahame Morris
I am grateful to the Health Secretary for that. On the point about relative performance, I want to touch on cancer treatment capacity. Our performance as a nation is lamentable on the seven most common forms of cancer. If the buzzword is innovation, surely we have a tremendous opportunity to roll out advanced radiotherapy. About one fifth of the machines we have in our hospitals are more than the recommended limit of 10 years old. Surely that is a perfect example of a cost-effective means by which we could apply artificial intelligence and diagnostics in parallel, and we could treat many more patients and improve outcomes. Is he open to that idea?
Oral Answers to Questions
Debate between Grahame Morris and Steve Barclay(4 years, 4 months ago)
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Steve Barclay
It is a key part of this Government’s commitment to improve transport links such as that. I know that my hon. Friend has submitted a proposal, which the Department for Transport is considering. Having been able to hear the trains on that line from my kitchen growing up, it is one that I take a particular interest in, and I know that it is a very strong scheme.
Grahame Morris (Easington) (Lab)
The Chief Secretary to the Treasury (Steve Barclay)
House building is an important catalyst for the wider economy and we have put in place an unprecedented package of support in this sector. Last week, the Prime Minister announced measures to stimulate house building, including a £450 million boost to the short-term house building fund.
Grahame Morris
I thank the Minister for his answer. Horden, Easington and Blackhall in my constituency need investment in housing regeneration. The recovery plan is ready. However, we need investment to help us transform our communities with new, modern, clean and green housing. Will the Chancellor invest in housing regeneration in east Durham, because these schemes can deliver jobs, training, opportunities, green energy and sustainable domestic supply chains, and boost the local economy?
Steve Barclay
This is an area where I agree with the hon. Gentleman. That is why, in addition to the fund I mentioned a moment ago, the Prime Minister also confirmed £12.2 billion of funding for affordable homes, and there is the £400 million brownfield land fund to get schemes working immediately with Mayors for exactly the reason he sets out.
Draft Nursing and Midwifery (Amendment) Order 2018
Debate between Grahame Morris and Steve Barclay(6 years, 5 months ago)
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Stephen Barclay
The hon. Gentleman absolutely sees my enthusiasm for this order, and that is why I hope that colleagues on both sides of the Committee will support it. Alongside the apprenticeship levy, it offers an alternative to a student loan and what we might see as a more conventional degree. That is not to say that we will not continue with that route, because obviously it will remain a main pathway into nursing, but it is good to give flexibility to employers and to school leavers and others who see the opportunity to go into nursing. We are conscious that, currently, many people who want to do nursing are rejected when they apply, so having different pathways is a key part of the system.
Stephen Barclay
I did say that I would make some progress, but I am conscious that I have not taken an intervention from the hon. Gentleman, so I will take one more and then, with the leave of the Committee, I will make some progress.
Grahame Morris
It is interesting that the Minister is setting out arguments for a kind of continuing professional development. We are talking about an additional grade of people who could go on to become registered nurses, but I wonder how that might be possible, given that Health Education England’s budget for workforce development, which is largely used for continuing professional development for nurses, has been cut by more than 60% in the last two years, from £205 million down to £83.45 million in the current year. How does that square with that ambition?
Stephen Barclay
The hon. Gentleman raises an important point, because continuing professional development is key. When two thirds of what we spend on the NHS goes on staff, how we effectively train them is key. That is in part why my right hon. Friend the Prime Minister made the commitment she did on Monday on the funding settlement—again, that is slightly beyond the scope of today’s deliberations. It is also why the Government have committed to, for example, 1,500 new doctors being trained, opening five new medical schools and other initiatives, including, as I said a moment ago, the apprenticeship levy, as other vehicles.
One piece of feedback that I get from nurses when I go out to visit hospitals is the importance of CPD, which I am looking at very closely, because of the need for a wider skills mix. To take GPs, for example, it is important to look at whether all the activity that they are currently doing is necessary or whether some of those tasks could better be performed by others, if there were a wider skills mix. However, that is slightly beyond the scope of today’s deliberations, so I will make some progress.
The draft order amends the offence provisions in the Nursing and Midwifery Order 2001. The amendments provide that a person commits an offence in connection with the nursing associate part of the register, nursing associate qualifications or the use of the nursing associate title when not entitled to. The offences were drafted to reflect the fact that nursing associates will be regulated in England only.
The draft order makes provision to allow admission to the register to those who complete or commence their training by 26 July 2019 through the pilot courses run by Health Education England or through an apprenticeship route. It excludes nursing associates from being given temporary prescribing rights in a time of national emergency, such as a pandemic flu outbreak. It also removes the screener provisions from the 2001 order, as they are now redundant.
The draft order makes consequential amendments to the Nursing and Midwifery Council’s rules and to other legislation, and closes sub-part 2 of the nurses part of the register by amending the Nurses and Midwives (Parts of and Entries in the Register) Order of Council 2004, which determines the parts of the NMC’s register and the titles that may be used by those included in that register. The Department carried out a full public consultation across the United Kingdom on the proposed amendments and received 373 responses. There was broad agreement on the proposed legislation to regulate nursing associates in England.
Health Education England has established two pilot groups of 1,000 nursing associate trainees, who are due to complete their training in early 2019, and the Health Secretary has announced plans for up to 5,000 additional nursing associates to commence training via the apprenticeship route in 2018, and up to 7,500 a year thereafter. The draft order will insert a new provision in the Nursing and Midwifery Order 2001 to allow applicants who have started or completed a nursing associate qualification through either the HEE pilot or the apprenticeship route by 26 July 2019 to have their qualifications recognised.
In summary, these are important changes to the governing legislation of the Nursing and Midwifery Council that will see the nursing associate role regulated. Nursing associates will support nurses so that they can focus on the more clinical aspects of patient care, and will support the increase in nurse numbers by providing a clear pathway into the nursing profession, which the hon. Member for Huddersfield alluded to.
Grahame Morris
I am grateful to the Minister for giving way; he is being generous. What is his estimate of the current number of vacancies for registered nurses in the system?
Stephen Barclay
The Health Committee’s estimate of 11% is at odds with the actual working vacancy rate of 1%—obviously, if one factors in places filled by agency and bank staff, one gets a different number. However, that is an interesting point, because the whole draft order is about how we get additional staff into the workforce to support nurses—it is about how we provide more resource to work alongside nurses. If the hon. Gentleman’s point is that we need more nurses in our workforce, that will be achieved both by increasing the clinical profession, which the Government have done—we can run through how many more people there are in the profession compared with 2010—and by creating new pathways into nursing. That is what the draft order does, and that is why I commend it to the Committee.
Stephen Barclay
I am grateful to the hon. Gentleman for his support for the role of nursing associates. He raised several important issues, which I will address.
Let me first respond to the point that the hon. Member for Huddersfield raised about the Royal College of Nursing. Under the heading “Our position”, the RCN has said in a briefing note:
“We support the introduction of the nursing associate…role and the plans to regulate it.”
It goes on to raise several points, some of which the hon. Gentleman gave good visibility to. I hope that gives the general tenor of the RCN’s support for the role, although that support is not unqualified and it has some questions—I do not want to mischaracterise its support. I hope that addresses that issue.
The hon. Member for Ellesmere Port and Neston raised the replacing of nurses, and he is absolutely right that it would be a concern if that were the intent behind the draft order. He will be aware that the CQC has oversight of staffing models, and that it will therefore be for trusts to discuss with the CQC how they will satisfy the necessary models.
Members referred to the harrowing report that Bishop Jones published today. I recently went up to Liverpool Community Health NHS Trust, on which the Kirkup report contained some shocking revelations, highlighted, as the hon. Gentleman knows, through the tenacious campaign of the hon. Member for West Lancashire (Rosie Cooper). We have also seen what happened at Morecambe, after the tireless work of James Titcombe following the death of his baby, Joshua, and at Mid Staffordshire. Too many such cases sadly come before the House, and I know there is consensus on both sides of the House that we must ensure that the right staffing and the right regulatory system are in place.
Grahame Morris
The Minister is absolutely right about ensuring that standards are maintained. I served for five years on the Health Committee, which oversees, and has an annual hearing with, the Nursing and Midwifery Council. A point of contention was always the level of fees that its members must pay, because it is linked to professional standards and professional development. Will the Minister clarify what level of fees will apply to nursing associates? Is that set out in the draft order?
Stephen Barclay
From memory, the fee is the same as for a nurse in the NMC, which is £120, although I am sure that my colleagues will correct me if my memory is misplaced on that. That is a flat rate applied by the NMC across the board.
The hon. Member for Huddersfield and the Opposition Front Bencher also raised the issue of overseas staff. This will be a new role, and the Prime Minister’s announcement on tier 2 visas applies to existing roles, such as doctors and nurses, whereas this role is not currently in place. However, the opening of the nursing associate part of the register will provide a new registration route for overseas nursing staff whose competence and qualifications fall short of those of a registered nurse, providing that they can demonstrate that they meet the same high standards expected of a nursing associate trained in England. Again, just as it is a ladder for his constituents, it is a pathway through which European staff could potentially enter the NHS. [Interruption.] My memory was correct: the NMC has consulted on applying a fee of £120.
The hon. Member for Ellesmere Port and Neston mentioned the guidance. The Department is working with arm’s length bodies, NHS Employers, healthcare environment inspectorates and the regulators—the NMC and the CQC—to develop guidance. That will obviously need to be in place before the first tranche of nursing associates come out of their training in January ’19. I also note his point on panels. It is a perfectly fair observation, and I take it on board.
Oral Answers to Questions
Debate between Grahame Morris and Steve Barclay(6 years, 6 months ago)
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Grahame Morris (Easington) (Lab)
The Minister for Health (Stephen Barclay)
Nursing remains a strong career choice, with more than 22,500 students placed during the 2017 UCAS application cycle. Demand for nursing places continues to outstrip the available training places.
Stephen Barclay
It is not a false economy to increase the supply of nurses, which is what the changes have done. Indeed, they form part of a wider package of measures, including “Agenda for Change”, pay rises and the return to practice scheme, which has seen 4,355 starters returning to the profession. More and more nurses are being trained, which is why we now have over 13,000 more nurses than in 2010.
Grahame Morris
I respectfully remind the Minister that this is about recruitment and retention. The RCN says that we can train a postgraduate nurse within 18 months, which is a significant untapped resource, so why are the Government planning to withdraw support from postgraduate nurses training, too?
Stephen Barclay
We have a debate involving postgraduate nursing tomorrow, but the intention is to increase the number of such nurses by removing the current cap, which means that many who want to apply for postgraduate courses cannot find the clinical places to do so. That is the nature of tomorrow’s debate, and I look forward to seeing the hon. Gentleman in the Chamber.