Temporary Indemnity for Designated Care Home Settings: Contingent Liability

Helen Whately Excerpts

Thursday 25th March 2021 Written Statements

[The Minister for Care (Helen Whately)]

Further to the written statement made on 18 January 2021 by the Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), I am tabling this statement for the benefit of hon. and right hon. Members to bring to their attention the undertaking of a contingent liability. This relates to an extension of the designated settings indemnity support (DSIS), which offers targeted and time-limited state-backed indemnity arrangements to care homes registered, or intending to register, as “designated settings”, and which are unable to obtain sufficient insurance cover.

On 18 January 2021, the Minister for Covid Vaccine Deployment announced in a written ministerial statement, and accompanying departmental minute, provision of these temporary indemnity arrangements under the DSIS. The DSIS includes cover for clinical negligence, employer’s and public liability where a care provider seeking to become a designated setting is unable to secure sufficient commercial insurance, or where an existing provider has been operating without sufficient cover. Employer’s and public liability is covered under the new coronavirus temporary indemnity scheme; clinical negligence is covered by the clinical negligence scheme for trusts. The DSIS is supervised by DHSC and administered by NHS Resolution, and, to date, has proved to be an effective package of support to designated settings.

DSIS initially provided cover for designated settings until the end of March 2021. Following a review of DSIS, it will now be extended until 30 June 2021, in order to maintain the current level of support for these vital settings. This extension will benefit current DSIS participants, as well as any additional settings who may wish to apply for the support and who meet the criteria for inclusion. A review of DSIS will take place in early June.

I regret that in this circumstance, due to the need to ensure that there are no gaps in DSIS cover after the current 31 March end-date, the normal 14 sitting days for consideration has not been possible. A departmental minute will be laid in the House of Commons providing more detail on this contingent liability.

[HCWS894]

NHS Pay

Helen Whately Excerpts

Wednesday 24th March 2021 Westminster Hall

[The Minister for Care (Helen Whately)]

It is a pleasure to serve under your chairmanship, Mr Hosie. I thank the hon. Member for Liverpool, Wavertree (Paula Barker) for securing the debate on this important issue and giving me the opportunity to talk about our NHS staff. I come from a family of doctors and nurses, and before I became an MP I spent years working in hospitals and other NHS organisations, particularly to make the NHS a better place to work, because NHS staff are our health system’s greatest asset. In normal times, they go the extra mile, but in the pandemic they have done so time and again.

I welcome many of the points made by hon. Members this morning. Many have talked about the huge sacrifices that staff have made during the pandemic—not only them, but their families. Some, for instance, moved out of their family home to ensure they did not bring coronavirus home with them.

Colleagues have talked about not only nurses but other members of the healthcare workforce, including healthcare assistants, who are often overlooked in these conversations but are a vital part of our health service.

Some Members have talked about vacancies in the NHS workforce, of which I am well aware, and I will provide some reassurance on that in my remarks. Hon. Members have talked about PPE, but I do not see it as a choice between paying the NHS workforce and providing PPE—we must do both. PPE is not a choice; it is essential to protect those working in the NHS, and to me, it is non-negotiable. The shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), spoke about the need to invest in our workforce. I wholeheartedly agree with that, and the Government are doing so.

As I said, NHS staff are the NHS’s greatest asset. In fact, the NHS is, in essence, its people. The Government are determined to ensure that the NHS can retain and recruit the staff it needs. Over the last few years, the have worked with trade unions to deliver multi-year pay and contract-reform deals for more than a million of our NHS staff. Over the last three years, nurses specifically have seen their starting salaries increase by more than 12%. We have increased the lowest starting salary in the NHS by more than 60%.

We all know that our NHS staff work around the clock to provide care. That is why, on top of the basic salary, NHS staff earn premium rates of pay for working at night and over the weekend, and for agreed overtime. That increases individual pay by around £4,000 on average. On top of that, the NHS reward rightly includes benefits that go beyond the statutory minimum on holidays, sick pay and pensions.

We have also invested in our junior doctors, recognising the huge contribution that they make to the NHS. The deal that we have agreed with the British Medical Association improves junior doctors’ working lives, protecting rest requirements and reducing the number of consecutive shifts worked. By the end of that deal, junior doctor pay scales will have increased by at least 8.2%, and around one in eight junior doctors will receive more as they reach a new higher pay point to reflect their level of responsibility. For our nurses and non-medical staff, this is the final year of the multi-year “Agenda for Change” deal. We have asked the independent pay review bodies to make recommendations on the pay of our NHS staff for 2021-22.

As the Government have set out, the coronavirus pandemic has placed a huge strain on public finances, and the economic outlook remains uncertain. The Government’s written evidence to the independent pay review bodies set out that, in settling the Department of Health and Social Care and NHS budgets, the Government anticipated a headline pay award of 1% for NHS staff. That compares with the pay freeze for the wider public sector and, as we all know, with the context of many people facing unemployment and pay cuts in many parts of our economy.

[David Linden]

The Minister is setting out the bleak fiscal picture for the Government and the tough financial choices that have to be made. Will she explain, then, why they have seen fit to invest in more nuclear warheads but not in pay for NHS staff?

[Helen Whately]

The hon. Gentleman will recognise that although the Government have to make some difficult decisions, various things are non-negotiable. One of those things is ensuring that the NHS is there for all our constituents who need it, and another thing is ensuring that we have the defence that we need to protect people from threats from overseas.

Let me return to the matter in hand and set out a bit more about the process that we are going through on NHS pay. As I mentioned, the evidence that we recently submitted to the NHS pay review covered a wide range of data that was relevant to the decisions that that pay review body will make. The pay review bodies themselves are independent advisory bodies made up of industry experts. Their recommendations are based on a comprehensive assessment of evidence from a range of stakeholders, including trade unions. The wide range of factors that they will consider includes the cost of living, recruitment and retention in the NHS, affordability and value for money for the taxpayer, and comparisons with wider public and private sector earnings.

As the pay review bodies are independent, I cannot, and would not wish to, pre-empt their recommendations. We have asked the NHS pay review body, and the review body for doctors and dentists, to report later in the spring, and we will carefully consider their recommendations when we receive them.

[Justin Madders]

The Minister is setting out the pay review process, but it is also the case that she voted for a 2.1% pay increase only last year. Why has that changed?

[Helen Whately]

I am very glad that the hon. Gentleman has brought this point up. There have been no changes to the 2.1%. I specifically looked into that, and we are absolutely consistent—the 2.1% in the long-term plan will be invested in the workforce as planned. That 2.1% includes the funding not only for the pay agreements that we will reach through this process, but for existing pay deals and further workforce development, so we will be standing by that 2.1%.

As would be expected, I have had many conversations with NHS staff, from porters to healthcare assistants, nurses, allied healthcare professionals, junior doctors and consultants, both during the pandemic and for many years before. I have asked many times what would help; what do staff most want? Pay is rarely mentioned in those conversations—[Interruption.] The hon. Member for Warrington North (Charlotte Nichols) may laugh, but I am describing the many conversations I have had over many years with NHS staff, including during the pandemic. What is most often mentioned to me is that staff want more colleagues. They want more staff working alongside them so that they can have more time to give patients the care that they want to provide.

[Justin Madders]

Will the Minister give way?

[Helen Whately]

I will make some progress, as time is limited. Staff have told me many times that they want to feel genuinely supported and valued in their work. Someone said that one of the upsides of the pandemic is that when a colleague asks them how they are, they feel that the question is actually a meaningful one at the moment. If they say, “No, I’m not okay”, it has led to a conversation in which they have talked about what would help. I would like to see that continued in easier times.

Staff told me many times that they would like more autonomy in their jobs, and to be able to really make a difference and make improvements in the area they work in. Most recently, staff told me how much they want to be able to take time off, to have some time to spend with their families and time to recover and recuperate from the stresses and strains of the pandemic. I am determined that we shall deliver all those things for our NHS workforce.

Throughout the pandemic, I have worked with NHS England to make sure that all possible support is in place for staff. That includes practical support, like hot food and drinks and the free parking that has been much talked about; and psychological support: mental health support, “wobble rooms”—which I have spoken to staff about and they value them—dedicated support lines and helplines, and access to specialist support through new mental health and wellbeing hubs. As set out in the people plan, we are working with the whole NHS to build a more supportive, compassionate and inclusive culture. A culture in which those who care are cared for in turn.

On the first of the asks that I mentioned, that NHS staff want more colleagues, we are making real progress. In the NHS there are now over 6,500 more doctors, almost 10,600 more nurses and over 18,700 more health support workers compared with a year ago, and we are well on our way to delivering 50,000 more nurses for the NHS by the end of this Parliament.

We estimate that there are 70,000 nurses and midwives in training at the moment, and that includes 29,740 students who began nursing and midwifery courses this academic year. That is an increase of 26% from last year. Forty-eight thousand students have applied to start nursing and midwifery courses later in the year. That is an increase of over a third compared with the number of applicants at the same time last year, so I can assure hon. Members that the supply of people training and coming forward to train to work in the NHS is strong.

Vacancies in the NHS—indeed, there are vacancies, but they are decreasing—have fallen by over 11,000 since last year. There are 2,500 fewer nursing and midwifery vacancies and 1,800 fewer doctor vacancies.

NHS and social care staff do a fantastic job, and they continue to go the extra mile time and again, especially during the pandemic. We must recognise their skill and dedication and make sure the rewards of work in the NHS support the recruitment and retention of the workforce our health service needs. That is why we have the independent pay review bodies. They will properly assess all the evidence, and the Government will consider their recommendations and respond in due course.

Those of us who have spoken today may disagree about many things, but we all care deeply about our NHS and our NHS staff. I thank all the hon. Members who spoke today for showing their support.

Specialty and Associate Doctors’ Contract Agreement

Helen Whately Excerpts

Wednesday 24th March 2021 Written Statements

[The Minister for Care (Helen Whately)]

I am pleased to confirm that specialty and associate specialist doctors have backed a multi-year pay and contract reform agreement.

This is a diverse group of doctors who play a vital role in delivering high-quality care within healthcare teams and we recognise the particular issues they have faced. This agreement focuses on fixing long-standing concerns around equality of pay and terms and conditions for this group of staff. The agreement will improve their experiences of work and provide more opportunities to progress in their careers, in return for contractual changes which will deliver improvements to NHS services.

The deal will give around 10,000 doctors the option to transfer to new contracts. The contract changes prioritise doctors’ physical and mental wellbeing through introducing new limits on work in unsocial hours and additional annual leave to improve equity with other staff groups. The new pay scales will have fewer progression points, enabling faster progression to the top of the pay scale, heeding the recommendations from the gender pay gap in medicine review. The introduction of a new senior grade will expand opportunities for career progression for specialty doctors.

Over recent years we have sought major contractual reforms right across the NHS workforce. Public sector pay must deliver value for money for the taxpayer and this agreement commits investment in return for reforms which will help improve recruitment and retention, enhance morale and boost capacity and productivity.

This agreement delivers on the commitment in the NHS People Plan to make these roles more attractive and fulfilling and will help us retain more talent to ensure our NHS is there for everyone in the years to come.

[HCWS877]

Social Care Reform

Helen Whately Excerpts

Thursday 18th March 2021 Westminster Hall

[The Minister for Care (Helen Whately)]

It is a pleasure to speak under your chairmanship, Dr Huq. I thank the hon. Member for Worsley and Eccles South (Barbara Keeley) and her co-sponsor, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), the Chair of the Health and Social Care Committee, for securing this debate on the important and interconnected subjects of social care reform and the social care workforce.

The 1.5 million people who make up the paid social care workforce, and the 5.4 million unpaid carers, do the most wonderful thing—caring for people, whose lives depend on what they do. It is a service not just to those individuals, but to the whole country, and never has that been more true than during this cruel pandemic. Yes, our social care system needs reform. It has needed it for decades, and my party committed to that in our election manifesto. The pandemic gives us a moment in time; if not now, when? The pandemic has delayed our work, but I reiterate the Government’s commitment to bringing forward plans for social care reform this year.

This has been a really good debate, with many well-informed contributions from across the parties. I will mention just a few of them. The hon. Member for Worsley and Eccles South talked about the long-term nature of the problems with social care; the fact that the system is as important for those of working age as it is for older people; and the importance of unpaid carers.

The Chair of the Health and Social Care Committee, my right hon. Friend the Member for South West Surrey, talked about the catastrophic costs faced by one in 10 people, who end up spending over £100,000—using their life savings—on their care, and about the problem of high turnover in the care workforce. I thank him for his recognition of my personal commitment and the work I am doing, largely behind the scenes, on social care reform.

My hon. Friend the Member for Northampton South (Andrew Lewer) drew on his experience in local government, going back around 20 years, if my maths is right. He spoke about the need for closely integrated health and social care. My hon. Friend the Member for Peterborough (Paul Bristow) draw on his personal knowledge, as I have heard him do with great value before. I very much look forward to reading the report on supported housing that he mentioned, and I will look it up. This debate would have been missing something if my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) had not mentioned the German system as one for us to consider as we work on proposals for reform.

I will set out some of the support we have given to social care and the social care workforce over the last year, because it really is quite different from anything that has been done by Government for social care before. I also want to pick up on several points that hon. Members made during the debate.

At the start of the pandemic, we identified carers, both paid and unpaid, as essential workers or key workers. That was in recognition of how crucial they are, but also so that they could access support, such as places at school for their children when schools were closed, or priority slots at supermarkets. We made it clear, in guidance and communications to care providers and local authorities, that care staff should receive full wages if required to self-isolate because of covid. That has been one of the uses allowed for the infection control fund, which to date has amounted to £1.4 billion in ring-fenced funding for social care.

To the point made by the hon. Member for Luton North (Sarah Owen), who spoke about care workers being told to work despite having symptoms, that absolutely should not have happened. I have heard of a small number of cases and have investigated, and work has been done to stop that happening. It has been made very clear to care providers that nobody should come into work with symptoms. The Government’s funding was provided specifically so that care workers would not have to worry about lost earnings in the event that they were either covid-positive themselves, or required to isolate as a contact. In addition to that, in January we provided a further £120 million to boost the social care workforce and help providers that faced staff shortages, particularly as a result of staff sickness and self-isolation.

During the pandemic we have also provided free PPE, which runs through to June. We have provided millions of tests to identify covid cases in social care, protecting staff and those who receive care. I was disappointed to hear the shadow Minister, the hon. Member for Leicester West (Liz Kendall), suggesting that there was some form of requisitioning of PPE from social care by the NHS. When I heard stories about that, they were investigated, and the investigations simply did not bear that suggestion out.

On vaccinations, as we started the herculean task of rolling out vaccinations across the country, we put care home residents and staff in the highest priority group. Thanks to the dedication and hard work of so many people, by the end of January we were able to offer vaccinations to all residents in over 10,000 care homes for older people. More than 90% of residents and over 70% of staff have now been vaccinated.

The hon. Member for Central Ayrshire (Dr Whitford) talked about how the pandemic had affected social care workers, including how some social care workers have been bereaved by the sad loss of those they cared for. She is absolutely right about that being a hard part of the experience of the care workforce. I have talked to many care workers over the last year and knowing that they have been facing that during the pandemic has been a real concern to me. I have spoken to employers about this, and many care providers have put in resources—access to counselling and mental health support, for instance—to support their staff to cope with what they have been going through. In government, we have worked alongside the NHS and brilliant organisations such as the Samaritans, Hospice UK, and Shout to provide a package of emotional, psychological and practical resources for the workforce, which includes support helplines and guidance and specific support for registered managers in care homes.

I want social care to have a stronger voice in our health and care system and more visible leadership. That is why, in December last year, we appointed Deborah Sturdy as the first chief nurse for social care. Deborah is providing that leadership. She is already a galvanising force, particularly in supporting infection prevention and control, which must continue, even with the high levels of vaccination that we have.

Hon. Members spoke about vacancies in the care sector and the problem of staff turnover. I am well aware of the challenges for social care employers and how some do struggle to recruit and retain the staff they need in both care homes and the domiciliary care sector. We are and have been supporting the sector with a national recruitment campaign across broadcast, digital and social media, highlighting the vital role that the social care workforce has played during the pandemic, along with the longer-term opportunities of working in care. We are working with the Department for Work and Pensions, and I am working with ministerial colleagues in that Department to promote adult social care careers to jobseekers. I am hearing directly from care providers that they are seeing people taking up those jobs in care and discovering the rewards of care work. However, I am clear that that alone is not the solution to the challenges of having the workforce we need in social care and that, as part of our reforms, we must also focus on what is needed to develop and support the social care workforce.

I turn to social care reform. The Government are absolutely committed to the reform of the adult social care system. As I have said, we will bring forward proposals this year. Despite the challenges of the pandemic, we have been gearing up for the reform so that, as we build back better, we have a system that is fairer and fitter for the future. I assure hon. Members that the work has already begun. In fact, our White Paper, published last month, sets out plans for a health and care Bill that will both further integrate health and social care services and improve the oversight of how social care is commissioned and delivered for people. The Bill will also allow us to get better data on what is going on at a local level so that we can follow the evidence about what works.

The enhanced assurance framework set out in the White Paper will introduce an independent voice through the CQC, with clear and consistent oversight of adult social care, supporting local authorities to improve the outcomes and experience of people and their families in accessing high-quality care and support. That is only the beginning. For the long term, we want a sustainable adult social care system that meets people’s needs and aspirations and gives them the care and support that they need to live life to the full. We want to empower recipients of care and support people to live independently in their own homes and communities for as long as possible. We also want to improve the information provided to the public about the social care system, enabling people to plan for their care and make more informed choices. A stable and well-qualified workforce is central to our ambitions for social care.

[Kevin Hollinrake]

The Minister is doing a fantastic job on this issue, which is one of the biggest issues that faces us. If this is not going to be a blank cheque for the taxpayer or for the recipient of the care, does the Minister agree, as I think the shadow Minister, the hon. Member for Leicester West (Liz Kendall) did, that there has to be a pooled solution, perhaps like the German-style system of social care premiums?

[Helen Whately]

My hon. Friend makes an important point. I will not be drawn into further detail about the system at this point. The questions about funding lie with the Treasury rather than with the Department of Health and Social Care. We want to tackle the problem of the catastrophic costs of care that a minority of people face, as mentioned by my right hon. Friend the Chair of the Select Committee. I emphasise that we have made the commitment that no one who needs care should be forced to sell their home to pay for it. How we do that is indeed part of the reform work.

As we emerge from the pandemic, we will continue talking to stakeholders, pivoting the many conversations that we have been having about covid to more conversations about reform. Our reforms will be informed by a wide range of voices, not only colleagues and experts in the sector but also care providers, the workforce and those with lived experience of the care sector.

I thank all right hon. and hon. Members who have contributed to this important debate. I know that everyone who has spoken is deeply committed to their support of the social care workforce and reforming social care. The Government are on the case to make that happen. I take this final opportunity to thank all of those on the frontline providing care—people who go the extra mile to care for our loved ones, day in and day out. Carers have been truly remarkable throughout this pandemic. It is for them and the people they care for that we must move forward with the much bigger plans for the reform of social care.

World Social Work Day

Helen Whately Excerpts

Thursday 18th March 2021 Westminster Hall

[The Minister for Care (Helen Whately)]

It is a great pleasure to serve under your chairmanship, Mr Twigg. It is also a great pleasure to reflect on World Social Work Day, which was on Tuesday, and to celebrate the vital role of social workers within our communities and our health and care services across the country. I would also like to thank my hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds) for securing this debate on such an important topic. He brings a wealth of experience in this area, particularly from his time in local government, and he spoke eloquently about the importance of social work and the difference that social workers can make.

We have around 96,000 social workers practising across the country. For adults, 19,000 of them do so within local authorities and the NHS, and there are around 32,000 social workers working with children and families. I pay tribute to the Under-Secretary of State for Education, my hon. Friend the Member for Chelmsford (Vicky Ford), for the brilliant work that she does supporting children’s social work. Many thousands of social workers are also supporting people at the heart of our communities, in charity and voluntary organisations and in the independent sector, and many others are engaged in vitally important research. Wherever they work, social workers are helping people receive the care they need to live more independent, more fulfilled and happier lives.

The theme for this year’s World Social Work Day was inspired by the Zulu word “ubuntu”, which translates as, “I am because we are.” This speaks to our individuality, but also to the strength we draw from others. Social work, wherever it is practised in the world, is about forging and strengthening connections between individuals, families and our wider communities. Ubuntu is therefore a particularly apt concept.

As we look back over the past year, we reflect on how the pandemic—isolating and disruptive in so many ways—has also, almost counterintuitively, spurred us to break down barriers. Barriers have melted away between professions, organisations and services, as closer connections have been forged out of necessity and from the desire to do the right thing.

Coronavirus has upended all our lives, but closer collaboration has been a vital part of the response. Parts of our recently announced health and social care White Paper have been inspired by, and will build on, that collaboration.

Social workers occupy a unique position in our health and care system. Often, they are the linking professionals between clinical and care services, helping to create and maintain a wider network of support, with the individual’s needs, aspirations and right to choose at the centre. For that reason, it is my sincere belief that social work’s core values have helped us to rise to the unique challenges posed by covid-19. Social workers have responded rapidly to huge pressures and changing needs. They have remained on the frontline to support those shielding and those at higher risk of infection, including people needing safe discharge from hospital.

Meanwhile, our chief social workers for adults have played a vital leadership role in guiding local government and national Government’s response to the pandemic. They have reminded Government of the importance of human relationships, maintaining connections and asking the questions that need to be asked. Under Fran Leddra and Mark Harvey’s joint stewardship, social work’s values and grass-roots perspectives have been writ large in the work of the covid-19 social care taskforce, the winter plan and, now, our post-pandemic recovery planning. The ethical framework that the two social workers produced at the outset of the public health crisis has provided a strong foundation for those endeavours and many others, both centrally and across the regions.

I pay tribute to the principal social workers network. That alliance of highly experienced senior social workers has worked closely with Mark and Fran to maintain a strong link between central Government and the local delivery of social work. That is a valued relationship that we want to build on and continue to learn from. We know how vital social work is in the provision of mental health services; the essential role of approved mental health professionals, or AMHPs, enshrined in the Mental Health Act 1983, is almost wholly undertaken by social workers.

As part of World Mental Health Day last year, I met an inspiring group of AMHPs from across the country who are working in settings across NHS and local authority services. The meeting was one of the most memorable I have had as Care Minister. The group of people I spoke to brought to life the game-changing role that they play in people’s lives.

The AMHP role marries well with social work skills, experience and capacity for independent oversight. AMHPs have the authority to make informed judgments on hospital detention, thinking wider than clinical need, and making sure the decisions taken are the correct ones for the individual. It should be no surprise, therefore, that we have committed ourselves to expanding the number of social workers specialising in mental health, through our Think Ahead graduate training programme. But we are not stopping there. We will invest in more training and development as part of post-pandemic recovery planning and preparation for the reformed Mental Health Act.

We are also committed to the delivery of responsive, high-quality adult safeguarding. As we celebrate World Social Health Day, it is important to remember that social workers in both adults’ and children’s services are the lead professionals in delivering safeguarding. In the coming months, our chief social worker will publish a briefing on the importance of transitional safeguarding. It is vital that young people are positively supported as they move from children’s services into the adult world.

Our amazing social care workforce have been through so much and they need our support. Prioritising their mental and physical health has never been more critical. To that end, we have supported social workers through the pandemic, including providing social workers with PPE and prioritising our frontline social care workforce for vaccination. On that point, last year, the chief social worker worked with the Tavistock and Portman NHS Foundation Trust to publish guidance for the support and wellbeing of adult social workers and social care professionals during the pandemic. In the years ahead, we will continue to support the mental health and wellbeing of our hard-working and dedicated social care professionals.

It is vital that we support people with learning disabilities and autistic people to live as independently as possible. Again, social workers are the key professional group in contact with those individuals, helping to develop care and support plans, enabling people to aspire and live as independently as possible. Last month, our chief social workers for adults and for children published a joint report entitled “A spectrum of opportunity”, which looks at the role of social work in support of autistic young people. The report draws on the experiences of young people and their families across a range of local authorities and highlights the exceptional work social workers have been undertaking and what more can be done to strengthen practice. Across Government, an all-age autism strategy informed by that learning will be published this year.

I spoke earlier of the complex world we find ourselves in. Coronavirus has had a cruel and disproportionate impact on black, Asian and minority ethnic communities. Protecting the health and wellbeing of our health and care workforce is a crucial step towards tackling health inequalities. We know that 21% of the adult social care workforce are from ethnic minority backgrounds, but there are huge regional variations, with London’s vibrant and diverse communities registering 66% of staff from ethnic minority backgrounds. There are also variations by professional role.

As of April, 18 local authorities will be implementing a workforce race equality standard across their adult and children’s social work departments, building on the learning of the NHS RES, which is in its fifth year. The RES is one step in my ambition to improve our information on the social care workforce, allowing us to identify and address barriers that prevent the full spectrum of voices from being heard. That will provide positive insights into staff progression and representation in senior management to support us fostering equal and fair opportunities for all. I look forward to the lessons that social workers will bring to us during the first phase of implementation.

In closing, I put on record my sincerest thanks to social workers across the country not just for their work throughout the covid-19 pandemic, but for all they bring to our health and care services. No other profession touches, teaches and transforms so many parts of our health and care system and liberates so many individuals, families and communities to live the lives they want and deserve to lead.

NHS Staff Pay

Helen Whately Excerpts

Monday 8th March 2021 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the Department of Health and Social Care’s recommendations on NHS staff pay.

[The Minister for Care (Helen Whately)]

This pandemic has asked so much of our health and care system. The whole country recognises how our NHS workforce have performed with distinction and gone the extra mile throughout this crisis, which has also had a huge impact on our economy. It has been and still is a tough time for businesses and all those who work in them.

As hon. Members will be aware, most of the public sector is having a pay freeze. However, even against that backdrop, we will continue to provide pay rises for NHS workers, as the Chancellor set out at the spending review. This follows a multi-year pay deal, which over a million NHS staff have benefited from and which includes a pay rise of over 12% for newly qualified nurses. We are also ramping up our investment in our NHS, with a £6.2 billion increase for 2021-22, as part of our £34 billion commitment by 2024-25, and £3 billion for supporting recovery and reducing waiting lists. As part of that, we are increasing the number of staff in the NHS, with over 6,500 more doctors, almost 10,600 more nurses, and over 18,700 more health support workers in the NHS now than a year ago. We are also on track to have 50,000 more nurses in the NHS by the end of the Parliament.

Last week, we submitted our evidence to the NHS pay review bodies, which are independent advisory bodies made up of industry experts. Their recommendations are based on an assessment of evidence from a range of stakeholders, including trade unions. They will report their recommendations in late spring, and we will carefully consider their recommendations when we receive them.

I can assure the House that we are committed to the NHS and to the amazing people who work in it. Just as they have been so vital throughout this pandemic, they will continue to be the very essence of our health service, together with all those who work in social care, as we come through this pandemic and build a health and care system for the future.

[Jonathan Ashworth]

I am grateful to the Minister, but where is the Secretary of State? Why is the Secretary of State not here to defend a Budget that puts up tax for hard-working families and cuts pay for hard-working nurses? The Secretary of State has stood at that Dispatch Box repeatedly, waxing lyrical, describing NHS staff as heroes, saying they are the very best of us, and now he is cutting nurses’ pay.

Last summer, when asked by Andrew Marr if nurses deserved a real-terms pay rise, the Secretary of State replied:

“Well, of course I want to see people properly rewarded, absolutely.”

Yet now he is cutting nurses’ pay.

Last year, the Secretary of State brought to this House legislation to put into law the NHS long-term plan. He said from that Dispatch Box that his legislation represented

“certainty for the NHS about a minimum funding level over the next four years and certainty for the 1.4 million colleagues who work in our health service”.—[Official Report, 27 January 2020; Vol. 670, c. 571.]

That long-term plan was based on a 2.1% pay increase for all NHS staff. Every Tory MP voted for it, the Minister voted for it, and now every Tory MP is cutting nurses’ pay.

The Minister talked about the Budget. Where is the Chancellor? Where are his glossy tweets? Where is his video? Why did he not mention in the Budget that he was cutting nurses’ pay? Why did he sneak it out the day before in the small print?

This is happening at a time when our NHS staff are more pressured than ever before. In the midst of the biggest health crisis for a century, when there are 100,000 shortages, what does the Minister think cutting the pay of NHS staff will do the vacancy rates? Perhaps she can tell us.

The Minister talked about the pay review body, but she did not guarantee that the Government will implement any real-terms pay rise that the pay review body recommends. Why is that? It is because Ministers have already made up their minds to cut, in real terms, NHS pay in a pandemic. Our NHS staff deserve so much better. If this Government do not deliver a pay rise, it shows once again that you simply can’t trust the Tories with the NHS.

[Helen Whately]

I thank the shadow Secretary of State for his welcome. As it is International Women’s Day, it is a shame that he does not have a female colleague by his side at the Dispatch Box.

[Mr Speaker]

Order. I think we just need to get back into reality. I do not think we need the personal slights. The shadow Secretary of State is entitled to ask for an urgent question and I have granted it, so you are questioning me, not the shadow Secretary of State.

[Helen Whately]

My apologies, Mr Speaker.

I do not think that we should play politics with these very serious questions as we come through a pandemic that has hit us and the world so hard, when people have lost their lives, people have lost their jobs, and we as a Government have had to spend so much to support the economy, individuals and, indeed, the NHS. I have been speaking to staff on the frontline of health and social care throughout this pandemic, and I and the Government are grateful to them and thank them from the bottom of our hearts for what they have done and are still doing. While so much of the public sector is having a pay freeze, NHS staff will get a pay rise.

In these difficult times, the Government have submitted their evidence to the pay review bodies and, as I said in my opening statement, they will report back to us. They will look at a wide range of evidence, including, for instance, evidence from trade unions, inflation, and the wider situation with the economy and pay levels, and we will of course look at their recommendations carefully.

The right hon. Gentleman talked about the vote that we had on the NHS Funding Act and, yes, we absolutely did vote for it. We are fulfilling our commitment to record investment in the NHS—£34 billion more. He also referred to the long-term plan and, although not something we voted on, the 2.1% increase within it will be invested in the NHS workforce this year. That will include not only these pay rises, but pay progression and further investment in the NHS workforce.

We will continue to invest in more doctors and more nurses for the NHS, and I wish that the right hon. Gentleman would welcome that. We will continue to support the recovery of our economy and restore our public finances, so that we can fund our NHS not just through the pandemic, but into the future.

[Jeremy Hunt (South West Surrey) (Con) [V]]

The long-term plan budgeted for a 2.1% increase in salaries, which has now gone down to 1%, but an even bigger gap in last week’s Budget was identified by the Office for Budget Responsibility as a lack of funding from next year for annual covid vaccinations, for Test and Trace, for long covid and for millions of catch-up operations delayed by the pandemic. What discussions has the Health Secretary had with the Chancellor about that gap in funding, and where will that money come from?

[Helen Whately]

I thank my right hon. Friend for his question. He mentions the 2.1% increase within the long-term plan. That figure covers not only this pay rise for the NHS workforce, but the pay deals that have been agreed for staff in other multi-year pay deals, pay progression, and other investment in the workforce. As for his question on funding for the broader extra covid costs, that is not in the main NHS budget. Just as we had £63 billion invested in those costs throughout this year, there is an extra £22 billion set aside for covid costs outside the NHS budget and also £3 billion specifically for recovery and bringing down waiting lists.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

The proposal for a mere 1% pay rise suggests this Government do not value the risks taken and sacrifices made by health and care staff throughout the pandemic, nor the challenge that they will face to clear the backlog. Like their initial refusal to extend free school meals, it also shows the Government are out of touch with the public.

With a workforce crisis before the pandemic, does the Minister really believe that such a mean award will help recruit and retain healthcare staff? Senior band 5 nurses in England already earn up to £1,000 less than their Scottish counterparts, while the removal of the nursing bursary and imposition of tuition fees has saddled recently qualified nurses with up to £50,000 of debt. I am sure the Minister knows that shops do not accept claps instead of cash. Will this Government not give health and social care staff a decent pay rise and consider a one-off thank you payment, as in Scotland?

[Helen Whately]

I am somewhat surprised by the language the hon. Lady used around 1%, because a 1% pay rise for this large number of staff will cost around three quarters of a billion pounds. She should remember that this all has to be paid for in the context of, sadly, around three quarters of a million people losing their jobs through the pandemic, while others are seeing pay cuts or reduced hours. We are in a time of huge economic uncertainty, but while much of the public sector is going to have a pay freeze, the NHS workforce is going to have a pay rise.

[Peter Gibson (Darlington) (Con) [V]]

I acknowledge the very difficult decisions that the Government have had to take as a result of the pandemic, with the majority of public sector salaries being frozen this year. Will my hon. Friend confirm that our amazing NHS staff being the exception to that in part acknowledges their hard work, and that we should now await the outcome from the pay review bodies?

[Helen Whately]

My hon. Friend is absolutely right. The NHS workforce is the exception to the pay freeze for the wider public sector, recognising the huge amount of work done and the lengths they have gone to in looking after us all during covid. He is absolutely right that we will wait for the response from the independent pay review bodies before we announce the pay settlement.

[Munira Wilson (Twickenham) (LD) [V]]

The Test and Trace programme, which the Scientific Advisory Group for Emergencies considers has had only a marginal impact on covid-19 transmission, will have had an almost 150% increase on its original £15 billion price tag following the small print buried in the Chancellor’s Budget last week. Is this Government’s claim that the 1% pay offer to NHS staff is all they can afford actually serious?

[Helen Whately]

The first thing I would say to the hon. Member is that the Test and Trace programme is doing a truly phenomenal job. The other thing I would say is that in the pandemic what we absolutely need is an effective test and trace programme, so I make no apologies for the fact that we are making sure it is funded.

[Bob Stewart (Beckenham) (Con)]

Although everyone in this Chamber would really like to give nurses a decent pay rise as much as possible, may I ask the Minister how that equates with equivalent grades in the police, the fire service and the armed forces, particularly given that, as she has already mentioned, they are on a pay freeze at the moment?

[Helen Whately]

As my right hon. Friend says, most of the public sector—and that includes the police—is regrettably under a pay freeze for the coming year because of the challenging times we find ourselves in and in recognition that across the economy there are people who have lost their jobs and that we are having to spend a huge amount of money to support people’s incomes. It is against that backdrop that we are giving NHS staff a pay rise, but indeed these are difficult times that we are living through.

[Jim Shannon (Strangford) (DUP) [V]]

I have received literally hundreds of emails from constituents and from the Royal College of Nursing. The Democratic Unionist party and I support the campaign for a fair wage increase for NHS staff, because they have been at the forefront of the war against covid-19. They put their lives on the line day by day in defence of this great nation of the United Kingdom of Great Britain and Northern Ireland. Since 2010, average weekly pay in the private sector has grown by 22%, compared with only 17% in the public sector, so I ask the Minister, very gently and kindly, whether she will in the name of justice and for moral reasons consider reviewing the decision and deliver for NHS staff.

[Helen Whately]

The Government have submitted our evidence to the pay review body of what we can afford for NHS pay, but the review bodies will look at a wide range of evidence on what is the right level to set and will make recommendations over the spring.

[Andrew Percy (Brigg and Goole) (Con)]

I am proud to play a small role on the NHS frontline, and this last, most recent wave has been particularly brutal on nurses, healthcare assistants and, especially this time round, ambulance crews. May I urge her, during this period while the review body is considering the matter, to open up discussions with the Treasury to look at what more we can do for our NHS staff, be that a one-off additional payment or other support, such as just giving people more rest and recuperation time? We should do everything we can and make every effort to go further than what has so far been recommended.

[Helen Whately]

I thank my hon. Friend; I know that he does tremendous work on the frontline. He makes a really important point: beyond pay, the question of what other support we are giving to the NHS workforce is really important. Through the pandemic, there has been lots of extra support for the workforce, whether that is with practicalities such as hot food and drink—things that make work and long hours more manageable—or mental health support, which is so crucial for those who have had really traumatic experiences. We are absolutely looking at what continued support we can put in place in the months ahead.

[Maria Eagle (Garston and Halewood) (Lab) [V]]

NHS staff feel betrayed by this Government on pay. In July, the Secretary of State—who really ought to be in the Chamber today answering for his responsibilities—said the following:

“We absolutely want to reward NHS staff for what they have done.”

That is what he said, so can the Minister tell me how on earth delivering a real-terms pay cut meets that very clear promise from the Secretary of State?

[Helen Whately]

As I say, this discussion is against the backdrop of many people receiving a pay cut in parts of our economy, people losing their jobs and a wider pay freeze in the public sector. Against that backdrop, we recognise the enormous work that the NHS workforce have done, and that is why they are exempt from the pay freeze and will be getting a pay rise.

[Mr Tobias Ellwood (Bournemouth East) (Con)]

I thank the Chancellor for the scale of economic intervention that he has provided for businesses and livelihoods in these unprecedented times, and I join others in paying tribute to our incredible NHS staff; the nation owes them a debt of gratitude for what they have done and continue to do. I understand that no decision on NHS pay will be made until May. Will the Minister wait for and heed the advice of the independent pay review body before confirming the scale of the pay rise that NHS staff can expect?

--- Later in debate ---

[Helen Whately]

Absolutely. We submitted our evidence to the pay review body last week, which included the affordable pay envelope from the Government. The Pay Review Body will look at a wide range of evidence, and we will look at its response when it comes back to us.

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

This pay proposal for NHS staff has managed to be both wrong and unpopular. Over two thirds of those surveyed, including nearly 60% of Conservative voters, think that a 1% pay rise is less than our NHS staff deserve, and I believe that the Secretary of State should be in the Chamber answering this urgent question about it. Does the Minister agree that NHS staff are worth a real-terms pay increase? Does she consider that the billions wasted on ineffective or undelivered personal protective equipment could have been better spent on giving our NHS heroes a pay rise?

[Helen Whately]

It is absolutely right that we invested in ensuring that we could supply PPE to the NHS and the social care workforce during this extremely challenging time. There was a global shortage of PPE, so it is right that we spent money on that. As we look ahead at the pay deal for the next year, it is right that we exempt NHS staff from the wider pay freeze for the public sector and ensure that they get the recognition they deserve for what they have done and are still doing.

[Bob Blackman (Harrow East) (Con) [V]]

I thank my hon. Friend for the answers she has given thus far. Clearly we have to await the results of the independent pay review body, but can she explain to the House the basis on which the Government have put forward the proposal of 1% and how that compares with the commitments that were made to dramatically increase salaries, particularly for nurses at the start of their careers?

[Helen Whately]

We have delivered on the commitments in the multi-year pay deal for “Agenda for Change” staff, including nurses. That includes the 12% pay rise for newly qualified nurses, bringing the starting salary for a new nurse to almost £25,000. We are now going into a new pay settlement for the forthcoming year. As part of the spending review, the Budget will set the envelope to cover pay costs for that pay settlement, but there are extra pay costs for the growing number of staff as we increase our staff in the NHS, particularly nurses—as I said, we are on track to have 50,000 more nurses in the NHS by the end of this Parliament.

[Jack Dromey (Birmingham, Erdington) (Lab) [V]]

Together with my right hon. Friend the Member for Birmingham, Hodge Hill (Liam Byrne), I met nurses—members of the Royal College of Nursing—in the west midlands, and Catherine, a young intensive care nurse told, with tears in her eyes, how she had worked for months to save lives. She told how she went off for a week’s holiday because she was exhausted, and when she came back, three of the four people she had been caring for had died and a member of staff had died. Does the Minister not begin to understand the dismay and despair on the part of tens of thousands of nurses like Catherine that, having endured purgatory to save lives, their reward now is effectively a pay cut?

--- Later in debate ---

[Helen Whately]

I disagree with the hon. Member about what he just said—as I said, we are committed to giving NHS staff a pay rise—but he actually made a really important point when he talked about Catherine and other frontline staff, who have been through incredibly difficult times. I speak to nurses and other healthcare workers all the time, and one of the things I have heard many times in recent weeks and months is how badly staff need time off, and many staff have not been able to take holiday because they have been putting in extra hours to help with the pandemic response. It is absolutely vital in the weeks and months ahead that staff get the annual leave they need to rest and recuperate, and I am working with the NHS to make sure that happens.

[Richard Fuller (North East Bedfordshire) (Con)]

Hundreds of thousands of people have lost their jobs during this pandemic and will be looking to the Government to support them so they can start earning again for their families. Millions of people in this country are on furlough and are living with pay cuts of 10% or 20% and will be looking to the Government to continue to support their businesses through extension of the furlough programme. Thousands and thousands of small businesses have seen the value of their businesses evaporate over the last 12 months and will be looking to the Government to support the economy to rebuild their businesses. So will my hon. Friend remind us that it is the Government’s job to balance all of those calls on the taxpayer, and it is the job of the pay review body to come back with a recommendation?

[Helen Whately]

My hon. Friend is absolutely right. So many businesses have been so hard hit by the pandemic, and it is vital that we support not only the livelihoods of individuals who work in the businesses that have been hit, but those businesses themselves, because they are what will help us come through this and recover from the economic pain of the pandemic. He is right that the Government are having to balance these enormous demands on the public finances, and we also need to take steps ourselves to recover those finances so that we have a strong economy for the future.

[Jeremy Corbyn (Islington North) (Ind) [V]]

Does the Minister realise that there is a sense of the most enormous anger all across the country? Nurses have seen us through this crisis and have saved many lives, yet they are offered a pay cut as a result of it. Some are already having to resort to food banks to survive, and a third are thinking of leaving the profession unless they get a decent pay rise. Surely to goodness, if £37 billion can be found to pay Serco for a failed track and trace system, the money must be available to pay NHS staff properly. You cannot clap for them, and cut their pay at the same time. Surely we should just pay them properly, so that we can have a national health service that we can all be proud of and all rely on for all time in the future.

[Helen Whately]

Actually, talking of anger, it is probably not very helpful for many of those on the Opposition Benches to be fuelling a level of anger by calling a pay rise a pay cut. We are being absolutely clear that NHS staff are getting a pay rise. I also say to the right hon. Member that we need an NHS Test and Trace system to control the virus and we need NHS staff.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

I draw the attention of the House to my entry in the Register of Members’ Financial Interests and to the fact that my wife works in the NHS. NHS staff pay is and always will be a highly contentious issue—it was contentious during the junior doctor contract debate and we do not need the back end of a pandemic for it to be so at the moment—because of the mere existence of national pay contracts, pay awards and review bodies. As part of the implementation of the changes proposed in the future of health and care White Paper, will my hon. Friend view alternative models that allow decisions on individual staff pay to be set by local employers, such as NHS trusts themselves, so that they can be best suited to the employees and the services they work for?

[Helen Whately]

I thank my hon. Friend, who makes a really important point. The balance between nationally set pay and local pay has been a point of much debate over the years. There are pros and cons to both ways. We do not want to have trusts competing directly all the time for workforce, but on the other hand there are higher costs of living, for instance, in some areas. That is why there is some flexibility in the system for different levels of pay according to different areas, as he will well know, and some extra support in areas where it is hard to retain staff. I always to listen to his expertise, which I really value.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

Earlier this year, Baroness Harding defended giving £1,000 per day to private sector consultants on the failing test and trace programme. Now, the Minister says we cannot afford to give our NHS heroes a real-terms pay rise. Given that covid will be with us for years to come, given the outstanding non-covid backlog in treatment, and given the incredible pressure on NHS staff, the existing 100,000 NHS vacancies and the resulting reliance on expensive agency staff, can we really afford not to?

[Helen Whately]

The hon. Lady talks about the NHS workforce. One of the fabulous things we have seen throughout the pandemic—I am really grateful to all those who work in the NHS for this—is a reduction in the leaver rates, so more people are staying and sticking with the NHS, which is truly phenomenal. We have to make sure we look after those people, and I talked earlier about some of the support for the NHS workforce as we recover. It is also fabulous to see such extra interest in careers in the NHS; for instance, over a third more people are applying to become nursing students this year compared with last year. I also want to make this point on the test and trace question: it is not either test and trace or the NHS workforce. We need to have a test and trace system, and, of course, pay our NHS workforce.

[Sara Britcliffe (Hyndburn) (Con)]

I had several bits of correspondence about NHS pay over the weekend. Can my hon. Friend confirm whether any decision has been made specifically about nurses’ pay and what the total allocation for NHS pay rises is in the Budget? Will she ensure that those on lower pay bands are prioritised in any pay awards?

[Helen Whately]

I thank my hon. Friend very much for her question. Nurses are just a part of the workforce being considered in the pay review, which involves over 1 million staff. About 300,000 of those are nurses. The cost of a 1% pay rise is about three quarters of a billion pounds, but we will absolutely look at the recommendations from the pay review bodies when they come through later in the spring.

[Julie Elliott (Sunderland Central) (Lab) [V]]

The Minister has today said that she is grateful to NHS staff for their hard work during the pandemic, yet the reward the Government have suggested is a real-terms pay cut. Does the Minister feel that that is the right response, both morally and economically?

[Helen Whately]

In our submission to the pay review bodies we said we have a funding envelope to enable a 1% pay rise for NHS staff. As I have said to other Members, the pay review bodies will look at a wide range of evidence and at factors including inflation. They will also look at what is happening to pay levels across the economy.

[Robert Halfon (Harlow) (Con) [V]]

My hon. Friend will be aware of the heroic efforts made by NHS staff at the Princess Alexandra Hospital and across Harlow during the pandemic; they put their health and lives at risk looking after Harlow residents. While absolutely recognising the economic constraints and the £2 trillion debt that our country owes, will she reconsider and at least propose a larger increase for lower-paid NHS workers?

[Helen Whately]

I completely agree with my right hon. Friend about the heroic efforts of NHS staff at hospitals and primary care and community trusts across the country, including the Princess Alexandra Hospital. As I have said, we have submitted to the pay review body our envelope for funding—the 1% that the Government say they can afford—and we will look at its recommendations when they come back. I should also say that there was a commitment in the spending review to ensure that lower-paid staff would get at least a £250 pay rise, and that applies to those in the NHS as well.

[Steve Brine (Winchester) (Con)]

We heard this weekend about nurses in particular wishing to leave the profession, so does the Minister have any figures on departures in recent years? Does she agree that the elephant in the room is not pay across the board but low pay in the NHS? Even a 10% pay rise on not very much is not very much. Do we not really need a grown-up conversation about what we pay those who do some of the least glamorous jobs across health and social care day in, day out, every single year?

[Helen Whately]

My hon. Friend is absolutely right that we should be thinking about the whole workforce. As the Minister with oversight of social care, I have many conversations with that sector about the pay levels for people working in social care. I want to see us appropriately rewarding and recognising staff across our whole health and social care system, not only in pay terms but in the wider package of support that people get, and making sure that each day at work is a good day. That is something that I will continue to work on in this role.

[Clive Efford (Eltham) (Lab) [V]]

It has not taken the Conservatives long to revert to type and forget the contribution that our NHS staff have made to fighting this pandemic over the last year. Since 2010, “Agenda for Change” staff have seen their pay cut in excess of 10% on most of the spine points on the column. What assessment has the Minister made of the effect that this pay increase will have on the retention and attraction of high-quality staff into the NHS? Surely, we need to attract those people into the NHS, and this will not do it.

[Helen Whately]

The hon. Gentleman makes a really important point about the retention of staff. I am working to make sure that we have another 50,000 nurses in the NHS by the end of this Parliament. On one hand, that is about making sure that we have more newly qualified nurses graduating with nursing degrees; on the other, it is about making sure that we keep the nurses and the other NHS workforce that we have. We have seen an improvement in retention, but I want that to be maintained. That is why I am working with NHS England on making sure that we have the greatest possible package of support, including mental health support, for staff who have been through a really tough time.

[Mr Gagan Mohindra (South West Hertfordshire) (Con) [V]]

May I first wish the House a happy Commonwealth Day and International Women’s Day? Will my hon. Friend outline how many pay rises we expect to see through pay progression by raising pay bands?

[Helen Whately]

My hon. Friend is absolutely right that, in addition to the pay settlement that we will reach through this pay review process, there are many staff who will be eligible for pay progression. About 40% of the staff we are talking about are eligible for pay progression, so many of those will get a pay rise in addition to the figure that we get to through this process.

[Paul Blomfield (Sheffield Central) (Lab) [V]]

The Minister was right when she talked about the amazing people who work in the NHS who have, in her words, “gone the extra mile” for the country. Does she understand why they will see this real-terms pay cut as a kick in the teeth? She justified it by reference to the pay freeze for other key workers, but that was a decision of this Government. Should they not recognise that they have got it wrong on both counts, review the pay freeze and give NHS staff the pay rise they deserve?

[Helen Whately]

I must remind the hon. Gentleman of the difficult times that we are living in: many thousands of people have, sadly, lost their jobs through covid and others have had pay cuts. We are in times of great economic uncertainty, and against that backdrop the Government have to make very difficult decisions. They have made the decision that there will be a pay freeze for much of the public sector, exempting those on the lowest pay and the NHS from that pay freeze—so the NHS workforce will get a pay rise.

[Kevin Hollinrake (Thirsk and Malton) (Con) [V]]

Every 1% increase will cost the taxpayer £750 million, but I did not hear the shadow Health Secretary say by how much he would increase pay or indeed which taxes he would increase to pay for that. Does my hon. Friend the Minister agree that one way to increase resources for health and social care and remuneration for our care workers is by means of a German-style social care premium?

[Helen Whately]

I thank my hon. Friend for his question. I am smiling, because it is not the first time that he has mentioned to me a German-style social care system. I absolutely appreciate the work he has done to look into that and say to him, as I have before, that we will bring forward proposals for social care reform. He is absolutely right that we also need to look at the whole health and social care system as we consider these difficult questions.

[Ben Lake (Ceredigion) (PC)]

The efforts of NHS staff during the pandemic have been nothing short of heroic, and, although deserved, recognition and good will are no substitute for proper pay and investment. Given the current level of vacancies and the fact that the use of agency staff in Welsh health boards costs nearly £70 million a year, does the Minister not agree that a substantial pay award would not only be fair but would constitute an investment in the NHS workforce that could help recruitment and retention of staff, thereby reducing reliance on agency staff?

[Helen Whately]

I am absolutely committed to increasing the NHS workforce. As I mentioned in my statement, we already have 10,000 more nurses than a year ago; and 6,500 more doctors and over 18,000 more health support workers. We saw fantastic growth in the number of students starting nursing degrees last autumn—nearly 30,000—and nearly 50,000 have applied to study nursing this autumn. I am absolutely determined that we will continue to increase the size of our NHS workforce to meet the healthcare needs of the population.

[Dr Jamie Wallis (Bridgend) (Con) [V]]

I thank the Minister for the answers she has given today, but will she set out in more detail the process of the pay review body?

[Helen Whately]

The process begins with the Secretary of State sending the pay review body a letter to set up its remit, which was done in December. We then submitted our evidence to the pay review body last week, which covered the point about the pay envelope as well as a whole load of information about, for instance, retention and staff levels and support for the workforce. The pay review body will consider that, along with other evidence from the NHS, trade unions and others, and will report back to us in late spring. We will carefully consider its recommendations and come to a decision.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

By the end of the year, £37 billion of taxpayers’ money will have been spent on the Serco Test and Trace programme, which is not even fit for purpose. That is on top of the Government spending £10 billion more on PPE contracts than they should have spent. Given that waste, how do the Government justify the view that most of the 300,000 NHS nurses are worth only a £250 a year pay rise?

[Helen Whately]

The pay conversation that we are having at the moment is indeed about nurses—who are a fabulous part of our NHS workforce, and I cannot thank them enough—but it is also about the wider NHS workforce, which includes paramedics and health support workers, and this pay settlement will also include some doctors. More than 1 million staff are being considered in this process, and that is why the cost is closer to £1 billion than the figure the hon. Lady mentioned; it is around £750 million. The Government were absolutely right to invest in PPE to protect staff in health and social care during the pandemic at a time when there was a global shortage of PPE, and we are absolutely right to have invested in a world-beating test and trace service, which is doing a phenomenal job and is essential to our country’s recovery from this pandemic.

[Mr Speaker]

We now come to the final question, from Nigel Mills.

[Nigel Mills (Amber Valley) (Con) [V]]

Will the Minister confirm that the public sector pay review body can take into account the exceptional service and sacrifice of our nurses and medical staff over the last year, and that if it recommends a higher pay rise than 1%, the Government will look at funding that from new resources and not have to scrimp and save elsewhere in NHS to fund the difference?

[Helen Whately]

I agree: our NHS workforce—in fact, our whole health and social care workforce—have done a phenomenal job through the pandemic and, we should not forget, continue to do so. I will not pre-empt the recommendations that we will receive from the pay review body, but I assure my hon. Friend that we will absolutely consider them carefully before coming to a decision.

[Mr Speaker]

I will now suspend the House for three minutes to enable the necessary arrangements for the next business to be made.

International Recruitment of Health and Social Care Personnel: Code of Practice

Helen Whately Excerpts

Thursday 25th February 2021 Written Statements

[The Minister for Care (Helen Whately)]

I am announcing today the publication of the revised code of practice for the international recruitment of health and social care personnel.

The new code represents an important step forward in the UK’s approach to ethical international recruitment. It takes account of the latest World Health Organisation advice on ethical international recruitment and promotes effective, fair and ethical international recruitment practices, which should be embedded across every part of the health and social care systems. This is an important step as the Government’s manifesto commitment for 50,000 more nurses by 2024 will see a significant increase in the number of nurses who will come from overseas alongside the growth in UK-trained nurses.

The code represents part of the UK’s contribution to international health worker mobility that offers benefits to migrants, their country of origin and to the UK. With a projected 18 million more health workers needed to achieve universal health coverage in low and lower-middle income countries, the code sets out the UK’s approach to supporting international health and social care systems, alongside safeguards on active recruitment of staff from countries with the most pressing health and social care workforce needs.

The code clearly sets out responsibilities for recruiters, employers and the Government on how to maintain ethical recruitment on an ongoing basis.

[HCWS800]

Safety of UK Plasma for Fractionation to Make Immunoglobulins: Revised Advice

Helen Whately Excerpts

Thursday 25th February 2021 Written Statements

[The Minister for Care (Helen Whately)]

I would like to inform the House that the Government have decided to allow the use of UK sourced plasma for the manufacture of immunoglobulins.

In the wake of the bovine spongiform encephalopathy (BSE) epidemic in the 1990s, a number of extra precautionary safety measures were introduced to protect patients from exposure to blood products that may increase their risk of developing Creutzfeldt-Jakob disease (vCJD). This included the advice in 1998 of the then Committee on Safety of Medicines, that no UK plasma should be supplied for the manufacture of fractionated plasma-derived medicinal products. This has meant that over 250,000 litres of plasma are incinerated or not used for patient care each year.

Over the last 15 years, accrued scientific evidence has indicated that the risk of vCJD through the transfusion of UK plasma is much lower than initially thought; there have been no known transfusion transmissions of vCJD from any blood components since 1999. The Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) evaluated the risk of transmission of vCJD and recommended that the current risk reduction measures be withdrawn.

In 2020, the Medicines and Healthcare products Regulatory Agency (MHRA) undertook a comprehensive review of the safety of UK plasma to make immunoglobulins. The Commission on Human Medicines (CHM) considered the evidence and recommended that UK-sourced plasma can be used for the manufacture of immunoglobulins subject to several risk-mitigation measures.

The CHM’s recommendation is available online at:

https://app.box.com/s/jv487awvqzzsrdql0o34h9gg350ceyd4/folder/109651850203

Upon receiving this expert advice, the Secretary of State for Health and Social Care has approved these recommendations, as have the Ministers in the devolved nations. This means that for the first time in over 20 years, UK plasma can again be fractionated to increase the availability of immunoglobulin medicines for the benefit of NHS patients in the UK.

This also means that convalescent plasma could potentially be fractionated and used, as part of a clinical trial, to produce hyperimmune globulin as a potential treatment for covid-19 patients.

The Secretary of State for Health and Social Care has directed NHS England and NHS Improvement, NHS Blood and Transplant (NHSBT) and the MHRA to begin preparations to appoint a fractionator(s) through a competitive process. The aim is to secure a domestic supply of immunoglobulins, starting with circa 250,000 litres of plasma that NHSBT is already collecting and not using for transfusion. We expect the first UK-sourced immunoglobulin product to be available for NHS patients in 2022.

The Secretary of State for Health and Social Care has also directed the MHRA to introduce a condition in new and existing authorisations granted to blood establishments, that plasma collected in the UK (including convalescent plasma) should be used for the benefit of UK patients, at least until domestic demand is met.

The Welsh and Scottish Governments and the Northern Ireland Executive have also directed their respective blood services to take forward work on this.

[HCWS797]

Oral Answers to Questions

Helen Whately Excerpts

Tuesday 23rd February 2021 Commons Chamber

[Catherine West (Hornsey and Wood Green) (Lab)]

What steps he is taking to help enable face-to-face family visits to care homes.

[The Minister for Care (Helen Whately)]

Throughout the pandemic, we have had to strike a balance between protecting people from this cruel virus and social contact. Nowhere has this been harder than in care homes. That is why I am so pleased that, from 8 March, we will be enabling care homes to open up carefully to more visiting. Our guidance will set out how residents can have a named person for repeat visits, with testing and PPE so that those visits can be indoors. We look forward to enabling more visiting as soon as it is safe to do so.

[Emma Hardy [V]]

I welcome the new guidance on care home visits, but I am concerned about this phrase:

“With the agreement of the care home.”

Does the Minister share my concern that that may allow some care homes to disagree with the guidance, therefore decide that the risk is too high and prevent the physical contact that residents in care homes are so desperate to have with their loved ones?

[Helen Whately]

The hon. Member makes an important point. We have been clear that we want to see care homes enabling visiting. We recognise that care homes are having to strike a balance between giving residents access to visitors and making sure that those residents are safe. Our guidance will provide further support to care homes on how they can make sure that those visits happen.

[Catherine West]

Care homes for older folk and disabled people are a basic human right. Given that care home residents—either in the care homes themselves or perhaps in hospital—account for a third of all deaths from covid, should the Government not be trying just a bit harder to provide the staffing that is often required for those extra visits? When will the Government lay out their plan to address social care, which is so clearly lacking and has been promised for about 10 years now?

[Helen Whately]

The hon. Member is right to say that visiting at the moment involves extra staffing—for instance, staff to supervise visits and to support the testing that we will be bringing in with the new visiting guidance. We have already provided funding to the social care sector that can be used to support the cost of visiting, and there is additional funding for extra workforce costs.

[Mike Wood (Dudley South) (Con)]

What steps he is taking to ensure an adequate supply of covid-19 vaccines.

--- Later in debate ---

[Kevin Hollinrake (Thirsk and Malton) (Con)]

What steps his Department is taking to increase funding for adult social care.

[The Minister for Care (Helen Whately)]

During the pandemic, the Government have provided over £1.1 billion for infection control, £149 million for rapid testing costs and £120 million to boost the workforce in adult social care, and that is in addition to £4.6 billion to local authorities. For 2021-22, we are meeting our commitment to an annual uplift of £1 billion for social care and will provide councils with access to an additional £1 billion.

[Kevin Hollinrake [V]]

Does my hon. Friend agree that the best long-term funding solution for adult social care is a German-style social care premium?

[Helen Whately]

I agree that we need a sustainably funded social care system. I know that my hon. Friend is very well informed of the options. We are committed to taking forward social care reform, and will be publishing proposals later this year.

[Jo Gideon (Stoke-on-Trent Central) (Con)]

What progress his Department has made on improving the health service capital estate.

--- Later in debate ---

[Karl MᶜCartney (Lincoln) (Con)]

What steps his Department is taking to support the health and social care workforce during the covid-19 outbreak.

[The Minister for Care (Helen Whately)]

Our health and social care workers have been simply extraordinary during the pandemic, caring for people in the most challenging circumstances. We have done our utmost to support them every step of the way and we will continue to do so. We are recruiting extra staff and we are on track to have 50,000 more nurses in the NHS. We are funding things that help when working long hours, we are funding social care providers to provide full pay for staff who are isolating, and we have put in place a package of mental support for health and social care staff.

[Karl MᶜCartney [V]]

I thank the Minister for that detailed answer. Ensuring that we take care of our NHS is critical, as I know here in Lincoln. Therefore, we must be at the forefront of fighting all aspects of this disease. At what stage did the Secretary of State and his officials become aware that vitamin D helped to fight covid symptoms for certain sections of our society, for how long was this information suppressed or ignored, what steps have subsequently been taken to take appropriate action, and what other drugs have also not been fully utilised so far, such as hydroxychloroquine?

[Helen Whately]

I thank my hon. Friend for his question. I can tell him that the National Institute for Health and Care Excellence published a guideline on vitamin D for covid in December. Its expert panel supported current Government advice to take vitamin D supplements through the autumn and winter. However, there is insufficient evidence that taking vitamin D mitigates effects of covid-19. I can also say that hydroxychloroquine is not recommended or authorised for the treatment of covid outside of trials.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

What recent assessment he has made of the effect of the covid-19 outbreak on cancer care and treatment.

--- Later in debate ---

[Tracey Crouch (Chatham and Aylesford) (Con)]

What plans he has to improve liver disease treatment pathways.

[The Minister for Care (Helen Whately)]

The NHS is working to improve care for patients with all types of liver disease. Development and improvement of clinical care is supported via NHS England’s hepatobiliary clinical reference group. This clinical reference group has started work on the development of liver networks in England to enable quicker access to specialised liver services, as well as providing clinical advice on disease prevention and referral practice.

[Tracey Crouch [V]]

Liver disease has become one of the major causes of premature mortality in the UK, and covid has highlighted the susceptibility of people with liver disease to more serious cases of the virus. With that in mind, what plans does the Minister have to include improvements to liver care in the NHS recovery plan?

[Helen Whately]

Last autumn’s spending review included £1 billion of funding to address backlogs, tackle long waiting lists and support up to 1 million extra checks, scans and additional operations in the NHS. As the NHS recovers, for liver care, as for other areas of treatment, we will look to not only recover backlogs but continue to improve the care provided and help people to live healthier lives to prevent illness in the first place.

[Liz Twist (Blaydon) (Lab)]

If he will make a statement on his departmental responsibilities.

Oral Answers to Questions

Helen Whately Excerpts

Tuesday 12th January 2021 Commons Chamber

[Karl MᶜCartney (Lincoln) (Con)]

What progress his Department has made on rolling out community testing for covid-19.

[The Minister for Care (Helen Whately)]

Community asymptomatic testing is an important tool in the fight against covid-19. We have delivered more than 5 million lateral flow tests to the 117 local authorities that have already gone live with testing their communities, and we are rapidly expanding the programme to all remaining local authorities in England, as well as working with devolved Administrations on their plans.

[Alexander Stafford [V]]

Ninety-four-year-old Tom Drury-Smith from Todwick was the first to receive the vaccine in Rother Valley at the Anston medical centre, thanks to the amazing work of the Rotherham CCG and the primary care network. Does my hon. Friend agree that the key to both community testing and vaccine uptake is to ensure that people do not have to travel far to access centres, especially those who are older and do not have access to cars? Can she assure me and others that vaccine centres and community testing centres will be sited as appropriately as possible, including in Rother valley areas such as Swallownest and Maltby?

[Helen Whately]

It is great to hear about the work of the Rotherham CCG and my hon. Friend’s primary care network, which are clearly on the front foot in this vital work of vaccinating people who are at high risk in his community. As he may have heard from the Secretary of State earlier, we are making sure that everybody is able to access community testing as they need it and has a vaccination centre within reach.

[Mrs Wheeler [V]]

Will the Minister join me in welcoming the opening of community testing centres around Swadlincote in recent weeks, paving the way for greater testing capability and coverage right across Derbyshire? Will she also confirm that the rapid lateral flow tests being used are accurate and reliable and are an important tool in tackling asymptomatic transmission of the covid virus?

[Helen Whately]

I join my hon. Friend in welcoming the opening of community testing centres in Swadlincote. Asymptomatic testing enables us to pick up cases in high prevalence areas that otherwise would go undetected, which means that we can break chains of transmission. There has been extensive clinical evaluation from Public Health England and Oxford University, which shows that lateral flow tests are appropriate for that use. They identify over two thirds of all people who have covid-19 but often do not have symptoms and, importantly, they catch the vast majority with a high viral load.

[Karl MᶜCartney [V]]

What can be done to provide schoolteachers in Lincoln and across the country with readily available rapid lateral flow antigen tests, to enable them to carry on teaching, schools to stay open and maybe exams to be taken?

[Helen Whately]

I can assure my hon. Friend that most secondary schools and colleges have already set up testing sites and have begun weekly testing, using lateral flow devices for staff currently in school. Staff could also participate in daily contact testing on site, and primary schools will shortly be receiving test kits for weekly staff testing and also for daily contact testing.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

We can have all the testing in the world, but it will not be effective if people do not self-isolate after a positive result. We have repeatedly said that compliance with self-isolation rules is not good enough; with only one in eight people qualifying for the self-isolation payment, that is not surprising. Can the Minister ensure that everyone is properly supported to self-isolate from now on and explain why those who test positive after a lateral flow test cannot apply for a payment and do not even enter the national test and trace system?

[Helen Whately]

We absolutely recognise not only the importance of self-isolation, which is critical in breaking the chains of transmission, but that it is not always easy for people to do. We recognise, for instance, the cost of self-isolation, and that is why we introduced a payment of £500 for those who are on low incomes and unable to work from home while isolating. We will continue to make sure that people have the support they need to self-isolate.

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (SNP)]

What the evidential basis is for the use of Innova lateral flow tests for covid-19 in the asymptomatic population.

--- Later in debate ---

[Mr Clive Betts (Sheffield South East) (Lab)]

What recent assessment he has made of the effectiveness of covid-19 contact tracing at (a) national and (b) local authority level.

[The Minister for Care (Helen Whately)]

I am pleased to report that the strong recent performance of the contact tracing service has been maintained, even with the significant growth in cases. The latest weekly data show that the service made contact with almost 700,000 people: 85% of positive cases were reached and provided details of their close contacts, and 92% of those close contacts—that is almost half a million people—were then reached and told to self-isolate.

[Mr Betts [V]]

I was asking the director of public health in Sheffield the other day about the figures for contact tracing. He says that in the NHS Test and Trace system—not the Public Health England one, but the NHS one—the current figures are 59%, and the 40% not contacted are passed on down to the local level, the city council’s contact tracing service, which is then contacting 75% of the people the national system could not contact. Why, then, do the Government not give more resources and more responsibility to the local council and the director of public health? In that way, we could contact more people at far less cost than the national system.

[Helen Whately]

The hon. Member has described, in fact, what is a really important partnership working between the national NHS Test and Trace system and local partners such as local authorities, as indeed is happening in his own area of Sheffield, where it is that combined working that enables us to contact the maximum number of people and therefore to get more people to self-isolate and break these chains of transmission.

[Mr Andrew Mitchell (Sutton Coldfield) (Con)]

What plans he has to improve the evidence base for future debates on the options available for terminally ill people at the end of their life.