NHS Workforce: England

Debate between Karen Lee and Derek Thomas

Wednesday 17th July 2019 Westminster Hall

[Derek Thomas (St Ives) (Con)]

I congratulate the hon. Member for Wolverhampton South West (Eleanor Smith) on securing this debate on an issue that she and I have discussed—her office is near mine in Norman Shaw North—and both care deeply about.

I am glad to see the Minister in his place. He knows my constituency well and understands the challenge of getting to it. In fact, he was the first MP ever to visit me in the heady days before 2010, when I stood as a parliamentary candidate because I thought that coming to Parliament would be a great way of changing the world. I have since learned that that is probably not the case.

The credit should really sit with the people who work in the NHS. In particular, I pay tribute and send my thanks to those who work in West Cornwall Hospital in Penzance, Helston Community Hospital—or cottage hospital, for those of us who grew up there—and other places where NHS staff and others do a fantastic job in really difficult situations, as we have heard. They make sure that people who arrive for whatever reason get the best possible care.

I was keen to take part in the debate because I recognise that things need to be done. We must take responsibility for the way things are at the moment, and although I understand what the legal responsibility is and the reason for the debate, I want to understand a bit more about the solutions, too. I have never thought that all the solutions can be created, thought up or delivered here in Westminster or in any Government Department. Although real progress in integration and improving services on the ground needs to be enabled through legislation, support and encouragement, people in health and social care in Cornwall have got together and worked extremely hard for many years to deliver a system in which pathways and integration are much better than when I welcomed the Minister off the train.

One problem of many is the workforce, which is undoubtedly a challenge. There is also no doubt that the NHS 10-year plan is a fantastic document, but it depends heavily on workforce. I know that the Minister will agree and will want to ensure that we have people in place. We may not participate in this Chamber, but across Parliament, the bunfight, debate and arguments about the NHS go on, and have been taken up by people in local campaigns and the media. That has created an environment in which people choose not to nurse or do anything else in the NHS because they are misinformed. I know of lots of people who would have gone into or considered going into nursing or social care, but will not do so because the NHS is a political hot potato.

[Karen Lee (Lincoln) (Lab)]

On the hon. Gentleman’s point about people not joining the NHS to nurse, the lack of bursary is a significant issue. If someone wants to train, the bursary is really important.

[Derek Thomas]

I am addressing the point the hon. Member for Wolverhampton South West made about the importance of working cross-party, as we will in this Chamber. I will come to the bursary later.

Actually, I will come to that part of my speech now as the hon. Member for Lincoln (Karen Lee) has mentioned it. I was one of the MPs who signed a cross-party letter requesting a royal commission for the 70th year of the NHS, because I believe that although we do not have all the solutions, we should set the tone. That would help to open the door of opportunity for those who work in the NHS. I will come to the bursary, which I have already raised with the Minister; I asked him to look in particular at the impact on mature students. Podiatry in Plymouth, for example, will not be taught from September onwards. In the south west, where the incidences of diabetes and other vascular problems are significant, we need podiatrists, so that is a major problem. The reason given is that most people who go into podiatry do it later on in their careers, and one of the challenges arising from the removal of the bursary and introduction of student loans—I voted for that and regret doing so—is that those who take out the loan immediately lose all welfare and can no longer get housing benefit.

For someone with a young family who wants to study, the student loan, or the grant available for mature students, is just not enough. The Minister is aware of my view because I have raised it before, and there is work to do on that. It is not about financial incentives; it is about making it affordable for people to go and do a fantastic job. As the hon. Member for Wolverhampton South West rightly said, some people bring so much to health and social care and we need to ensure that we take away every possible barrier without creating unintended consequences. I am sure that the Minister will be pleased to address that point later.

I will talk briefly about how Cornwall is responding. I have been very keen to see what we can do in Cornwall to make sure that people can turn up, get training and work and train on the job. For people in Cornwall, most opportunities for training are outside the area, but as we know, people who go into some professions, including in the NHS, tend to stay where they train. That has always been a problem for Cornwall, which has struggled to recruit the people we need. We have set up a health and care academy using the apprenticeship levy. The academy can offer people training and jobs as healthcare assistants. There, they can do 12 hours per week working and studying through the Open University, and will become qualified nurses after four years. As they are already settled in the area and have family there, they are very likely to work for the NHS for the rest of their careers.

That is really positive, but there are some challenges and I have met the Minister to talk about them. One of the challenges is that for hospitals—in this case Royal Cornwall Hospital—to provide that kind of support, they need extra cash. It is not just about the apprenticeship levy, which they want to use and not repay, but about staffing 100 nurses and 100 healthcare assistants at a time, and providing pastoral support and other elements that come with training up staff on a ward or in a hospital. An added pressure is that for a hospital without the staff that it needs, really excellent healthcare assistants are no substitute for fully qualified nurses with a wealth of experience.

There is a problem in this place. I am a skilled craftsman in the building trade but I have put my tools away, despite the desperate need for skilled craftsmen in Cornwall. In this Chamber and across the House, we have lots of GPs and talented nurses. For some reason, we decided to pitch up here instead of continuing in our valuable jobs. I think that we are part of the problem. I am not suggesting that we should all pack up and go home, although we might get more done if we did, so we should consider it.