Leaving the EU: Health and Social Care

Jim Shannon Excerpts

Tuesday 19th March 2019 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to speak about this issue. I congratulate the hon. Member for Argyll and Bute (Brendan O’Hara) on setting the scene, and I support his request for the Minister and the Government to look at this issue. When I look at my constituency and at Northern Ireland more widely, I understand the criticality of this issue. So many Brexit issues need attention and urgent answers, but over and above Brexit, the NHS requires immediate attention.

I am pleased to see the Minister in his place; he seems to have been a fairly regular presence in Westminster Hall this last while in debates about issues that are his responsibility. It is also nice to see the shadow Minister, the hon. Member for Burnley (Julie Cooper), in her place. I look forward to her contribution, too.

My heart sank when an NHS staff member said to me, “Jim, being in the A&E is like living and serving in a war zone.” That shocked me and underlined the fact that we need urgent changes and more support for our NHS, not simply with respect to Brexit but to ensure the survival of that incredible system, which is overloaded, overworked and underfunded.

I am gravely concerned about the mental health of our NHS staff on the frontline, because of the sheer volume of stress they face. The hon. Member for Henley (John Howell) referred to mental health issues, in which I have a deep interest, as do other Members present. We should consider the mental health not only of patients but of staff. There is a lot of stress in Westminster at the moment because of Brexit, but stress among staff on the frontline of the NHS is at an all-time high.

Nurses are working on their off days; they feel so guilty that colleagues are working on understaffed wards and they are so interested in the job—it is a vocation for them—that they stay on, sometimes without the remuneration they deserve. That may be admirable in the short term, but in the long term it means we have exhausted staff, who work too many hours without enough rest. Their home lives and their family lives suffer as a result. The long-term mental health implications for those who are so focused on helping others that they neglect themselves must be addressed.

To address that, we need better working conditions, less reliance on the bank, and simply more staff working on the floor in wards and taking appointments. We need more GPs, so people can see a doctor when they need to instead of going to A&E because the next doctor’s appointment is not for three weeks. We must ensure that all NHS staff are able to stay in place, or that scenario will worsen. I welcome the Government’s recent NHS long-term plan, which confirmed that the workforce implementation plan expected in April will set out arrangements to help overseas recruitment. The Government have acknowledged the issue and are seeking to act in a positive way. When he responds to the debate, perhaps the Minister will provide some idea of where that is going.

EU nationals make up a sizeable proportion of the health and social care workforce and represent 10% of doctors, 8% of social care staff and 6% of nurses in the UK. They are an integral part of the NHS workforce. It is therefore recommended that the Government take steps to understand any potential impact of ending freedom of movement on the health and social care workforce. There are many options for how best to shape that workforce after the UK leaves the EU, but given our historical reliance on the recruitment of EU workers, it is important that the impact of ending freedom of movement is understood, and we must start a conversation immediately about how best to future-proof the sector. This debate provides us with an opportunity to highlight those issues, and it allows the Minister to respond with, I hope, the answers we seek.

The hon. Member for Argyll and Bute referred to many organisations—there are a large number of such organisations, and it would probably have taken him five or 10 minutes to name them all if he had tried. Specifically, however, Macmillan Cancer Support highlighted that improvements in the diagnosis and treatment of cancer mean that more people are surviving it or living for longer. Some 2.5 million people across the UK live with cancer, and that number is expected to rise to 4 million by 2030. Such figures are great news because they show that there have been significant advances in cancer research, cancer drugs and care, and that our NHS and healthcare system can do lots of good things and help people.

Given the need to support our growing population, we need an immigration system that complements the NHS’s long-term ambitions to improve cancer care across the United Kingdom of Great Britain and Northern Ireland. Across the wider workforce, primary and acute medical and social care staff shortages are impacting on people’s access to cancer care in hospitals and the community. There is a significant variation in vacancy rates, which in many places can be as high as 15% for chemotherapy nurses. In some areas, those shortages in cancer nursing staff are exacerbated by the fact that there is an ageing workforce—the hon. Members for North Ayrshire and Arran (Patricia Gibson) and for Argyll and Bute referred to the fact that the workforce is ageing, and we must prepare for that as well.

In many cancer services, more than 40% of professionals are due to retire in the next 15 years. That issue poses a significant challenge for our current workforce so we should focus specifically on those services, and on those who will be retiring and those who will replace them. That is why this debate is so important. There is a clear need to recruit and train younger staff in specialist and chemotherapy nursing, and that would go some way to countering that shortfall. Will the Minister consider that issue? Will he also consider writing off the student debts of those who serve in local GP clinics for five years? Similarly, the nursing bursary should be reviewed and uplifted, and perhaps we should also consider perks to encourage occupational health therapists to stay in their positions.

I think we have to consider something new when addressing these issues. This is not just about ensuring that immigration fills some of the gaps in our workforce, because we must also address the needs of local people and provide opportunities. Given the nature of our society and jobs, perks can be a methodology for doing that—it is not wrong to offer such measures, because if they bring in the right calibre of staff and help people to stay in their posts, that must be good news. In conclusion, all the issues that I have raised must be priority considerations for the NHS, especially in the light of us leaving the EU, and I seek clarification from the Minister about how they will be addressed.