NHS Staffing Levels

Jim Shannon Excerpts

Tuesday 22nd November 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in this debate. I thank the hon. Member for Wirral West (Margaret Greenwood) for leading the debate. Like her, I acknowledge and appreciate the incredible work of all our NHS healthcare professionals in all areas of our health system over the last number of decades, especially throughout the pandemic, when we appreciated them even more than normal. I place on the record my genuine thanks to them for their commitment and their efforts through the covid crisis, which will continue to have impacts on the efficiency of our NHS for some time.

Our national health service is one of a kind and we must do everything in our power to protect it and ensure that it is given what it needs to ensure its success. Just yesterday in the main Chamber, I asked the Chief Secretary to the Treasury about retaining our nurses. How we do that is quite simple: we pay them the wages that they need. There is something drastically wrong if someone can become agency staff and get better wages for doing the same job. I am always respectful to the Minister, and I do not say that to chasten or to be aggressive, but we really do need to pay our nurses what they deserve. Perhaps the Minister can get back to us on that point.

It is very challenging to cover all the issues about NHS staffing. The NHS is one of the largest employers in the world, with more than 1.3 million staff, with 13,000 of them working back home. There is no secret that there are staffing issues for many different reasons. I have heard before from younger people that the educational process to becoming a nurse is purely based on exam results. I understand the need for training. Nursing, mental health nursing, medicine and dentistry require degrees from universities. Many universities refuse to take students who do not achieve high grades in their entry requirements. Perhaps it is time to look at whether, if the grades are not achievable for them but they have an interest in the subject matter, they should be given training to deliver that. We do not always have to aim for the gold star ones. There are people who might not achieve all of the grades that they should, but could still be darn good nurses and do well. I ask the Minister if he could give us his thoughts on that.

The hon. Member for Westmorland and Lonsdale (Tim Farron) mentioned GPs. Back home, GPs are really important. If one or two fall away from the local health clinics and surgeries, we automatically have a crisis among our GPs. So, let us encourage more GPs to come in. To do that, we will probably have to pay them better too, so that they do not wish to go anywhere else—overseas or wherever. We have all heard about the horror stories that illustrate their reasons for doing that.

I heard from a constituent just last week who was in a car accident. Her car was written off, but, luckily, there were no life-threatening injuries. However, the ambulance came and she waited in the ambulance queue for eight hours. She was not allowed to move from the stretcher, was not able to use the toilet, and had no water to drink. That is just an example of some of the crises we have. That is not the Minister’s fault—it is a devolved matter and I understand that—but it is just an illustration, and I suspect that other Members will have their own examples.

I would make a plea on behalf of the Royal College of Psychiatrists, which has stated that, over the past year, the number of full-time-equivalent consultant child and adolescent psychiatrists in the NHS has declined, while referrals to child and adolescent mental health services have increased by 24%. We have countless debates in this place relating to better provisions for children’s and teenagers’ mental health, and the RCP tells us that there are simply not enough psychiatrists. Again, I am throwing this at the Minister at very short notice, but I know that his responses are always very helpful. I ask for some help in raising that.

I am also aware of the challenges that the staff face. I thank each and every one of them—I thank them and I praise them. They go home after their shifts, tired and disheartened. The hon. Member for Wirral West (Margaret Greenwood) mentioned that earlier on. It is the truth. With that in mind, we must do more.

I very much welcome the additional money allocated in the autumn Budget, and the Barnett consequentials mean that we will get £650 million. That is a massive help, and I understand that. I certainly hope that that will shield the NHS from inflammatory staffing pressures, but I hope that the Minister can undertake discussions with the devolved Administrations on this issue, and on how we can do it better together. I am always very conscious that the Minister is a gentleman and responds well; I very much look forward to his reply.

--- Later in debate ---

[Will Quince]

The hon. Gentleman is right that that is happening and I will come on to that matter in more detail. I would be happy to meet him, because it is an issue that I know needs gripping not just at the national level but by local integrated care boards too.

As hon. Members have pointed out, training the doctors, nurses and allied health professionals of the future takes time. We have to plan for the next decade now, as the hon. Member for York Central (Rachael Maskell) said. Despite the challenges, we have a growing NHS workforce. We have record numbers of staff working in our NHS. There are record numbers of doctors and nurses. The NHS now has over 1.2 million full-time equivalent staff. In the last year alone, there were over 15,800 more professionally qualified clinical staff in trusts, and 129,800 more hospital and community health service staff than in 2019. Nursing numbers are 29,000 higher than in 2019, which means that we are on track to meet the 50,000 extra nurses manifesto commitment.

However, as the hon. Member for Wirral West pointed out, we face challenges. There are over 132,000 vacancies, including, as she rightly said, 40,000 nursing and midwifery vacancies, and vacancies for around 10,000 doctors. As the hon. Member for South Antrim (Paul Girvan) rightly pointed out, that means an over-reliance on bank and agency staff. They have their place, but they come at a significant cost, of which we have to be mindful.

We have a long-term workforce plan, which is an NHS England-commissioned project that will set out what workforce we need across the next five, 10 and 15 years. As the Chancellor said in the autumn statement, it will be independently verified. It will look at recruitment, retention and productivity. It will look at where the challenges and the gaps are. As the hon. Member for York Central, who is no longer in her place, rightly asked, what do we need the NHS to look like? Do we need specialists? Do we need more generalists? Do we need a mixture of skills, where people are specialists but also retain generalist skills so that they can do other work? The plan is for the project to report back by the end of this year—very soon—and that independent verification process will then take place. Integrated care boards will need to do the same, or a similar, piece of work at local level.

I am also aware that there are specific challenges. The hon. Members for Strangford (Jim Shannon) and for Westmorland and Lonsdale rightly raised mental health services. An extra £2.3 billion is going in, and our plan is to recruit an extra 27,000 staff, but it is a challenge, which is why we have the advanced bursary in that area. We have increased staff in the area by an extra 5.4%. I know that is not enough, and I know the challenges on local mental health services, so we have to do more.

There is a similar challenge in rural and coastal communities, which the hon. Member for Westmorland and Lonsdale has raised with me many a time. We have to look to expand the apprenticeship route and blended learning programmes so that people do not have to travel to big towns and cities to undertake their training. That work is being done, and there is an extra £55 million for additional placement capacity.

Investment in training is also important. We funded an extra 1,500 medical school places—a 25% increase—last year and this year. That was an investment in five new medical schools. The £5,000 non-repayable grant for nursing, midwifery and allied health professionals has been in place since 2020. There is also additional funding for certain courses, and for things such as support for childcare, dual accommodation, and costs and travel.

[Jim Shannon]

Will the Minister comment on what the Royal College of Psychiatrists has said about staffing shortages?