NHS Workforce Expansion

Helen Whately Excerpts

Tuesday 28th February 2023 Commons Chamber

[The Minister for Social Care (Helen Whately)]

I am grateful for this chance to come to the House and talk about the NHS workforce. I am happy to begin with something that I expect is a point of agreement with those on the Opposition Benches: praising our fantastic NHS workforce and all they have done through the pandemic and are doing now as we recover from covid. Hon. Members will not be surprised to learn that my colleagues the Secretary of State for Health and Social Care and the Minister for Health and Secondary Care, who has responsibility for workforce, are today focused on discussions with the Royal College of Nursing, so it is my particular honour to speak on behalf of the Government today and to take a moment to re-set the tone, and indeed raise the bar, in this debate.

I am very happy to talk about our NHS workforce at a time when we have record numbers of doctors and nurses working in our health service. I am equally happy to talk about our social care workforce, the very people the hon. Member for Ilford North (Wes Streeting) seems to forget time and time again. I note that they are forgotten in his motion again today. In contrast, the Government are working with our whole health and social care workforce, not only training record numbers of doctors and nurses, and recruiting a whole host of healthcare professionals into the NHS, but bringing historic reforms for the social care workforce—all that despite the global pandemic, which created the most challenging backdrop any Government have faced for decades.

[Karin Smyth (Bristol South) (Lab)]

Will the Minister give way?

--- Later in debate ---

[Helen Whately]

I will make a bit of progress, so that there is the opportunity for Back Benchers to speak.

We have heard and will no doubt continue to hear about how we have been in power for 13 years so far, so it is only right to look at some of the figures since 2010. Since 2010, we have 35,000 more hospital doctors and 46,000 more nurses and health visitors, not to mention a nearly 50% increase in medical consultants and a near 60% increase in paramedics. That is what we have done.

[Aaron Bell (Newcastle-under-Lyme) (Con)]

I am very grateful to the Minister for giving way. In addition to the excellent point she made about the absence of social care in the motion, does she agree that the figures the Opposition have chosen to use in the motion do not give the whole picture at all? They do not include vacancies filled by bank staff, very often from the same hospital.

[Helen Whately]

My hon. Friend makes a very good point about the selective use of figures by Opposition Members.

[Karin Smyth]

I want to pick up the point about social care, on which, as the Minister knows, I am very keen to see progress. Her Government shelved their social care plans. The former Prime Minister said he had fixed social care, leading the entire country through that dance. He promised people that it was fixed and that people in their older age or with disabilities could be secure, so it is rather shameful for her to raise that point without then saying—maybe she will go on to do so—when we will actually see any progress on social care. Why have her Government shelved their plans?

[Helen Whately]

On the contrary, we have already made progress on some things in our social care White Paper published just over a year ago. We will soon publish next steps, particularly focused on workforce reforms. I have been talking to several stakeholders involved in exactly that area over the last few weeks. If the hon. Lady is patient she will see some of that coming forward.

I was talking about some of the things that we have done to vastly increase the number of healthcare professionals in the NHS. As part of our ambitions for the future, more than 26,000 students were accepted on to nursing and midwifery courses in England last year—a 28% increase on 2019. We are on track to meet our manifesto commitment of 50,000 more nurses by 2024. Much as we continue to strive to go further and faster, those are the figures as they stand. We might wish to make a comparison with Labour-controlled Wales, though it is sometimes hard to do so because it does not collect crucial data such as vacancy rates. One has to wonder why. That is the same Labour-run Wales where patients are twice as likely to be waiting for treatment as in England. Some 50,000 people are currently waiting over two years, while here in England we eliminated two-year waits last year.

I will move on from the situation in Wales, as I am sure Opposition Members will be glad to do so. The Leader of the Opposition has said that he thinks we are hiring too many people from overseas in health and care. The same gentleman spent several years campaigning for a second referendum on freedom of movement. Whatever his views this week, it is the work of a responsible Government to look at every available option to give this country the health and care workforce that it needs. Alongside training more doctors and nurses, recruiting from overseas and giving people from other countries a chance to work in the NHS is the right thing to do.

[Chi Onwurah]

I am pleased to hear the Minister say that it is the Government’s duty to look at every available option. During the pandemic, I take it that she clapped on her doorstep for the NHS workforce who did so much to get us through it, so why will she not look at the option of abolishing the non-dom tax loophole, to fund more nurses and doctors and a better NHS in future?

[Helen Whately]

A responsible Government take a responsible approach to funding our public services, including the NHS. Later I will come to exactly the point about the Opposition’s proposals to use that funding pot again and again for the health service.

Coming to social care and international recruitment, we have put care workers on the shortage occupation list. As a result, social care employers have already been able to offer care worker visas to more than 34,000 people. I welcome international nurses joining our nursing and midwifery register, and I make no apology for continuing to encourage bright and talented international doctors to come and work in the NHS. In fact, that is the very idea of the points-based immigration system that we have so successfully implemented.

As well as recruiting the best and the brightest, it is vital that we retain them. Ultimately, our goal is to make sure that the NHS is one of the very best places to work in the world; both my parents were NHS doctors and, believe me, I have had plenty of conversations about why sometimes it is not. What is most frustrating is when the system prevents them from giving people the very best care.

It is not simply all about pay, as Opposition Members might have us believe. The hon. Member for Ilford North talked about nursing pay, but he will understand that we are currently in talks and now is not the moment to play politics with this issue. We are pleased that the Royal College of Nursing has paused strike action. We have no doubt that both sides are committed to finding a fair and reasonable settlement—one that recognises the vital role that nurses and nursing play in the health service, the wider economic pressure facing the United Kingdom and the Prime Minister’s priority to halve inflation.

[Wes Streeting]

Will the Minister give way?

[Helen Whately]

I will not, as the hon. Gentleman had a long time at the Dispatch Box.

Our talks are focused on pay, terms and conditions and enhancing productivity. We are hopeful that we will find a pragmatic way forward. We also know that pensions and the interaction between pension, pay and taxes matter. In general practice, we are consulting on changes to the pension scheme so that clinicians who want to stay in the NHS will not have to worry that they might lose out financially. Going beyond pay, from my conversations with staff I know the importance of their day-to-day experience at work, and of having the resources and the support that they need. We will continue to press ahead with supporting the mental health and wellbeing of NHS staff.

As we work to support our workforce, we must move beyond discussion just about numbers and pay. In the NHS we have one of the largest workforces in the world, with many hundreds of organisations within it. It is an entire ecosystem. We have an incredible opportunity to do things differently at real scale, with bold new ways of working. Take our surgical hubs, which are getting hundreds of thousands more patients quicker access to procedures. Community diagnostics centres are bringing diagnostic care nearer to home without the need even to visit acute hospital sites.

We are empowering our community pharmacists to do more. We have already introduced a range of new clinical services in community pharmacy, including blood pressure checks and minor illness referrals from GPs and NHS 111. This year we will introduce more services, including a pharmacy contraception service. Just as these innovations are good for patients, they are good for the workforce too, freeing up more time for colleagues to do what they do best.

On training, the Opposition motion calls for an expansion of medical school places. I will not pre-empt the upcoming NHS workforce plan, but I can say that it will set a clear direction for our workforce, making sure that we have the right people with the right skills in the right places over the next 15 years. It was this Government—through the Chancellor when he was Health Secretary—that expanded medical school places from around 6,000 each year to more than 7,500—a 25% increase in just three years. In fact, that was such a substantial expansion that it saw the creation of five new medical schools in England, one of which in east Kent I visited earlier this month. There, they are not only training more future doctors but innovating in how they do so, preparing medical students to work in the NHS of the future.

Equally, it is not for me to tell the House what will be in the spring Budget. In the current fiscal environment there are far fewer public spending elements that can be traded off against health and care spending compared with previous decades. Yet even when faced with tough choices in the autumn, including very real pressure on public finances, this Government made a deliberate choice to prioritise health and social care, including investment of an additional £14 billion over the next two years.

When it comes to the spring budget, I can guarantee to the House that our sums will add up, unlike those of the hon. Member for Ilford North, who seems to be banking on what he believes will be an inexhaustible pot of non-dom taxation, including for his uncosted and unfunded reorganisation of primary care. He did not mention that much earlier—a policy so roundly mocked by the sector that we woke up to it on the “Today” programme and found it had been put to bed by “Newsnight”.

Since the business investment relief scheme, introduced in 2012, non-doms have invested more than £6 billion in the UK. They play their part in supporting the vital public services that we all depend on. Even a former Labour shadow Chancellor has said that scrapping non-doms would probably end up costing Britain money—to be fair, that seems to be the Labour party’s main objective, with £90 billion of unfunded spending commitments to date, and counting.

[Grahame Morris]

It is not correct that Labour’s spending plans are unfunded, and I hope that the Minister will put the record right. On the cancer plan, there is information out there that the incidence of cancer is increasing. To get value for money, would it not be sensible for the Government to invest in precision radiotherapy, as a treatment that improves patient outcomes in a cost-effective manner? That would get the best value for money for the taxpayer.

[Helen Whately]

I know that the hon. Gentleman feels very strongly about the issue; we have talked about radiotherapy. He will know that we have invested more than £160 million in improving radiotherapy equipment. This year, we are investing an extra £50 million in the cancer and diagnosis workforce. We are continuing to work hard with the NHS on reducing the backlogs that we have seen since the pandemic, when people did not come forward for cancer treatment as they would have in normal times.

[Aaron Bell]

The Minister mentioned non-dom status under the previous Labour Government, and what they said about it. Is she aware that Alistair Darling said that

“such a charge could discourage men and women—doctors and nurses, business men and women—from coming to this country…and we do not want to turn them away”?—[Official Report, 9 October 2007; Vol. 464, c. 171.]

Gordon Brown considered a five-year cap and abandoned it. Ed Balls said that it would end up “costing Britain money”. The supposed heir to Blair is sitting at the Opposition Dispatch Box, opposite the Minister. Is it not surprising that he has not learned more lessons from new Labour?

[Helen Whately]

My hon. Friend makes an excellent point. We hear about this source of funding again and again—we hear that non-doms will provide all this money—but plenty of the shadow Health Secretary’s predecessors in Labour have said that they do not think the policy he suggests would generate any more income whatsoever.

It will imminently be time to give Back Benchers an opportunity to speak, so let me end by saying that it has been an honour to open this debate on behalf of the Government and to respond to the array of misrepresentations from Labour Front Benchers. The NHS exists to care for patients, and they should always be our first priority, but the NHS’s greatest asset is its workforce.

From a lifetime of talking to staff, I know that what they want is to care for patients in a way they feel proud of. They can do that only if they themselves are cared for, feel valued, are looked after and have enough colleagues to support them. The Government are working flat out on every one of those areas. We are hiring more staff, harnessing new technology, joining up health and social care, and building bridges between parts of the system like never before. I know how tough it has been and, on too many days, how tough it still is on the frontline. I am determined that we will continue to do what is right by health and social care staff, for them and for the people they look after.