NHS Staffing Levels

Paul Girvan Excerpts

Tuesday 22nd November 2022 Westminster Hall

[The Minister of State, Department of Health and Social Care (Will Quince)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I am grateful to the hon. Member for Wirral West (Margaret Greenwood) for raising this important issue. I join her in thanking all NHS staff for everything they do for us. The workforce are the beating heart of everything our NHS does and stands for. I hugely value the work of everyone who works in health and care, from consultants to care workers, nurses to neurosurgeons, and porters to physios. I thank all hon. Members from across the House who have taken part in this important debate. In the time available to me, I will try to respond to as many of the themes raised as possible—I have been franticly scribbling throughout the contributions.

I have only been in post for a handful of weeks, and in that time I have seen the very best and the future of our NHS with cutting-edge technologies and innovation. For example, it was only earlier this week when I saw genuinely world-leading world genome sequencing. Innovation and technological advancement is only as good as the highly trained and qualified clinicians who operate it or, importantly, who interpret the data. Health is a human business. I know this from my own family’s experience of the NHS, and I am sure hon. Members know that too. Only caring NHS staff can provide the patient-centred and compassionate care that we all hope and expect when we interact with our NHS. That is why I am personally passionate about supporting our health and care staff, particularly when we are in challenging times. Last week, the Chancellor announced an additional £3.3 billion a year in the autumn statement to assist in this endeavour.

I turn first to workforce pressures, which were raised by the hon. Members for Batley and Spen (Kim Leadbeater), for Westmorland and Lonsdale (Tim Farron), for Bradford West (Naz Shah) and for Birmingham, Erdington (Mrs Hamilton)—I am particularly grateful to her for sharing her 25 years of nursing experience. I am acutely aware that the workforce remain under sustained pressure. Staff worked tirelessly through the pandemic and they have my huge thanks and gratitude for doing so.

I know that every day hundreds of thousands of NHS staff provide high-quality care under considerable challenges. As well as the pressures we see every winter, in the summer, which is usually—I am told in the NHS you cannot use the Q-word, which stands for quiet—less busy, we had covid waves where we would not ordinarily. There is also the recovery of elective care and the 7 million people on waiting lists, including the 400,000 who have been waiting over a year, as the hon. Member for Wirral West rightly pointed out. There is the rising number of covid and flu cases—I take this opportunity to make a public health announcement encouraging people to check their eligibility and get their covid and flu jabs if they have not already done so.

Of course, it is vital that we support the workforce, not just now but for the future. The NHS workforce have grown since last year, with an extra 3,700 doctors and 9,100 nurses, but I understand that—this point was made eloquently and articulately by hon. Members—demand is growing significantly, too.

[Paul Girvan (South Antrim) (DUP)]

In the light of workforce planning, somebody seems to have taken their eye off the ball. We have doctors who decide they want to be locums and get three times the shift rate. We have nurses who leave the NHS and sign up with the agency, costing three times more. When will we grasp the nettle of workforce planning and deal with it?

[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.