NHS: Staff

Lord Pendry Excerpts

Thursday 30th November 2017 Lords Chamber

[Lord Pendry (Lab)]

My Lords, the Motion before the House, so ably moved by my noble friend Lord Clark of Windermere, is indeed timely. As the House knows, the National Health Service is probably going through its most difficult time since its inception, yet the Government’s attitude seems to be one of utter complacency.

When the Government—or, more specifically, Jeremy Hunt, the Secretary of State—hint that staffing in the health service is a priority and they are investing in what they call the “front line”, it hardly squares with the facts. At a time when more people than ever are using its services, it seems obvious to almost everyone except the Government that the fall in the numbers of nurses and health staff will result in a shortage of these essential workers, which is estimated to be in the region of 42,000 in the near future. Problems are especially acute in spheres of nursing such as district nursing practice and nursing in psychiatric care, where there has been a reduction of some 12% since 2010.

That these shortages cause pressure is borne out. For example, two-thirds of the respondents to UNISON’s annual survey reported that wards were so understaffed that nurses did not feel that they could guarantee safe, dignified and compassionate care. One must consider that those were among the main reasons why most nurses wanted to work in the National Health Service in the first place—it was certainly not for the pay they would receive. It is a fact that, on top of receiving inadequate salaries—we know that is the case—many in the health service find that the pressure can often produce physical dangers for both patients and staff. UNISON’s survey of mental health workers revealed an increasing risk of attacks on staff, driven in part by shortages.

We are now witnessing a vicious circle in which shortages of staff lead to them having to take on extra workloads. That leads in turn to fears for their own safety and that of their patients, which is having a damaging impact on their morale, and hence staff leave the service in great numbers. Therefore, pay by itself is not the reason for the staff shortages; low morale remains an enormous barrier to recruitment and retention, and it must be addressed by the Government.

The fiscal policies of this Government remain a major factor, about which my noble friend has already spoken. The recent attempt in the Budget to loosen the purse strings was but a half-hearted measure. Despite all the warm words from the Tory party before and during the general election, nothing of real substance has emerged since. In truth, most National Health Service workers have failed to receive a pay rise worth speaking of since 2010, due to the pay freeze and the pay cap of 1%. It is no wonder that the Royal College of Nursing has reported a “growing number” of nursing staff using food banks, taking on additional jobs and accruing personal debt.

Jeremy Hunt’s latest revelation in the Health Service Journal showed that staff could potentially lose extra amounts for working anti-social hours under his so-called “more professional” pay structure. That prompted the Royal College of Midwives to accuse him of being “ill-briefed”, and Sara Gorton, head of health at UNISON, went so far as to say that talks between the Government and her union would be,

“a very short set of talks indeed”.

It is not right that both Scotland and Wales can give their health workers a living wage, yet their counterparts in England cannot.

Of course, all the problems aired in today’s debate have been compounded by the uncertainty and possibly larger problems which could be awaiting the National Health Service with our possible exit from the EU. For instance, there was the revelation in January 2017 that there had been a drop of 92% in the number of EU nurses registering with the Nursing and Midwifery Council. Surely that alone should have been a wake-up call for the Government to recognise the serious consequences for recruitment that could lie ahead. The number of nurses from the EU leaving the NHS increased by 38% last year compared with the previous 12 months, and a mere 46 nurses registered with the Nursing and Midwifery Council in April this year.

It is a fact that in some areas the National Health Service is dependent on workers from the EU, especially in London and the south-east. It is obvious—is it not?—that reassurances should be given. It is not enough for the Government to say that they are confident that EU workers in the NHS will be able to stay, with the rights that they currently enjoy; instead, they should give a concrete assurance that those staff will definitely be able to continue to work in the NHS post Brexit. After all, did not that same reassurance come from the mouth of Jeremy Hunt in his speech at the Tory party conference?

At the risk of being accused of repetition—I know that the Minister believes that I bring party politics into this—the reason one cannot take the Secretary of State’s word as gospel is that, in the same speech, he made a colossal blunder by stating that the NHS was the child of the Tory party and a certain Minister in the coalition Government, a Mr Willink, who introduced what he called a consultative document in 1944. This was issued before Nye Bevan introduced a comprehensive National Health Service, which was approved by 187 votes in 1947. Tory luminaries such as Sir Winston Churchill, Sir Anthony Eden, Harold Macmillan, Rab Butler and other notable Tories were against it, including the man whom Mr Hunt named as the founder of the National Health Service, the hapless Mr Willink.

With those words, I merely ask whether the Secretary of State can expect nurses, the nursing world and the National Health Service to believe his words and his authority when he tells EU workers that they are safe in his hands and his assurances about their rights to stay after Brexit. I doubt it.