NHS: Staffing Levels

Justin Madders Excerpts

Tuesday 11th December 2018 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate my hon. Friend the Member for Batley and Spen (Tracy Brabin) on securing this extremely important debate, and on the tour de force that she presented. She touched on many important issues. Time restrains me, so I will not be able to pick up on all the points that she made, nor on all the impressive contributions made by other Members, particularly those who have had frontline experience, and had practical examples that we need to look into further.

My hon. Friend talked about her local trust being a big employer in her constituency and beyond. Indeed, it employs some 8,000 people, but has a 10% vacancy rate—sadly, very much in line with the national average. She was right that covering the gaps in the rota is an expensive business. I was pleased to hear that so many initiatives were being undertaken by the trust, but the fact that there is still a 10% vacancy rate shows that something is broken with the system.

My hon. Friend highlighted the impact on patients that staff shortages can have regarding closures, and she was right to highlight the nursing workforce crisis and the whole range of specialisms that are at risk. She was also right to raise the uncertainty that Brexit brings to staff, and to highlight the lack of legal powers to require safe staffing levels, and the overall strategy that we need to get the correct staffing levels.

I was also delighted, as always, to hear from my hon. Friend the Member for York Central (Rachael Maskell). She was right that agency spend sucks away vital resources and that recruitment challenges will never be solved unless we get the right framework. That is why we deeply regret the abolition of the nurse bursary, to which I will return.

We know that the NHS workforce is extraordinary. The NHS is one of the biggest employers in the world, and we must pay tribute, as we do every time, to the staff who work so tirelessly, day in and day out. We also have to recognise that there are simply not enough of them. Last month, the King’s Fund, the Nuffield Trust and the Health Foundation joined forces and warned that the staffing crisis in the NHS is deepening so fast that the service could be short of up to 350,000 staff by 2030. That warning is stark. Clearly there is an existential threat to the NHS if action is not taken to address the staffing crisis that we are now being told about.

According to official figures, there were more than 102,000 vacancies across the NHS at the end of September. That means that one in 11 posts in the NHS is currently vacant. The chair of NHS Improvement, Baroness Harding, recently acknowledged that

“the single biggest problem in the NHS at the moment is that we don’t have enough people wanting to work in it.”

However, the issues that we face run far deeper than merely how attractive the profession looks to applicants.

As my hon. Friend the Member for Batley and Spen said, we face a perfect storm of a retention crisis caused by factors including pay and conditions, ongoing uncertainty about Brexit, demographic challenges in many sectors of the workforce and the ongoing impact of the catastrophic decision to scrap bursaries for nurses, midwives and allied health professionals. Although many of those issues are clear and long-standing, there is no credible overarching strategy to address any of them. As the House of Lords Select Committee on the Long-term Sustainability of the NHS found, the lack of such a strategy

“represents the biggest internal threat to the sustainability of the NHS.”

We all eagerly await the publication of the NHS long-term plan, but I would welcome the Minister’s confirmation of precisely when that will happen. I was deeply concerned to hear Simon Stevens’s comments about how the plan will not definitively address staffing problems. Will the Minister confirm whether that is the case? If so, when will we see the comprehensive strategy for the NHS workforce that we so desperately need?

As many hon. Members have said, the workforce crisis has been compounded by the abolition of undergraduate nurse bursaries. When it was announced that bursaries would be abolished, we were told that our many concerns were misguided and that the changes would lead to an additional 10,000 training places being provided. However, just as everyone but the Government predicted, the exact opposite has happened. As of September 2018, almost 1,800 fewer people are due to start university nursing courses in England, while the number of mature students has plummeted by 15%.

In our debate on nursing higher education on 21 November, the Minister said:

“We expect NHS England to clearly set out its commitment to the nursing workforce in the long-term plan, and ensure that there is a clear way for that plan to be implemented…The Government will be consulting on the detailed proposals on future funding for higher education that the RCN has put forward”.—[Official Report, 21 November 2018; Vol. 649, c. 372WH.]

Will he provide greater detail on that point and say when that consultation will take place?

The issues that hon. Members have discussed today are acute, systemic and entrenched, but they have been exacerbated by the Government’s short-term and flawed approach. Any long-term strategy for the NHS will fail if it does not address them. Staff and patients deserve more than a health service in a constant state of crisis. They deserve better than this Government.