NHS Workforce: England

Debate between Paul Girvan and Derek Thomas

Wednesday 17th July 2019 Westminster Hall

[Derek Thomas]

I said that in humour, which is why I talked about my own skill—or lack of. It is a curious thing, though, to hear people talking about the crisis in staffing when so many of them are in this place.

On a more important note, we are in a tricky situation with the challenges around the apprenticeship levy. In Cornwall, we hope to train 200 nurses using the apprenticeship levy over the next two years—that would address the shortage—but we have to recognise that funding is needed and I know that the Minister is looking at that now.

[Paul Girvan (South Antrim) (DUP)]

Will the hon. Gentleman give way?

[Derek Thomas]

I will when I have finished this point. Whatever the solution, we must recognise the added pressure on existing staff.

[Paul Girvan]

On that point, it is all very well getting nurses into and through training, but in Northern Ireland the NHS is haemorrhaging nurses who are not leaving the profession, but going into agency work, getting paid two and a half times more than they were and working the hours that they want. Not only is workforce planning impossible when people can just work when they want, but we lose continuity of care in wards.

[Derek Thomas]

I appreciate that valuable intervention. I had a conversation with the former Secretary of State for Health about how, when the student loan was introduced, there might have been a way in which students had all their loan written off if they gave seven years’ service to the NHS. The advantage of that, to be honest, is that people who had done seven years after qualifying would probably have settled down by then, entered into a home purchase and perhaps had family, so they would have been, first, less likely to clear off to another country and, secondly, kind of tied into the NHS where they were.

In part, that addresses the problem the hon. Gentleman raises. Yesterday, I met a newly qualified nurse from the south-west who found that on Christmas day she was the leading NHS nurse, supported only by agency staff. That must stick in the back of NHS staff’s throat, when they know that extra pay is available to agency staff. Efforts have been made to address that, and there must be ways to do so, but that is what we are getting at today—the workforce challenge.

If we have a workforce challenge, other things will happen, such as agencies springing up and the demand for them. We have to get to a place where working for the NHS as a nurse employed by the local trust is the best and most rewarding place to be, and appreciated by all. We simply do not say often enough how great such people are. We can do so many things locally and nationally to rebuild value, trust and appreciation in those people. The challenge for Health Education England is to look at how we fund local innovative ideas, ensuring there is enough money, as well as flexible support, to find solutions. I discussed that with Simon Stevens, and he seemed alert to the challenge.

As I said, I met nurses from the south-west yesterday, and they were concerned about safety on wards and retention of nurses. We have this bizarre circle spiralling downhill: if nurses do not feel safe, they go to do something that might not be nursing. Unfortunately, in places of low unemployment, lots of other work and employment opportunities are available, often paying more.

Solutions are possible. In Cornwall, I have found that people often do not know what is available. The Royal Cornwall Hospitals NHS Trust and other trusts in Cornwall, my local college and I got together to work on an event in the college called “Work for the NHS+”, which included 15 or more different parts of the NHS, as well as some from social care. They came along to tell students and the general public what the employment opportunities were, the pay and training that could be expected, and what kind of career paths were available. In Cornwall, as in many other parts of the country, there are some fantastic members of staff and people in the NHS and social care who can inspire others. This might sound ridiculous in a debate on shortages on a ward, but when we have such individuals, we must find opportunities to get them in front of people who are thinking about which career they should choose.

I do not know much about the other challenging problem raised by the nurses yesterday, but it is right to mention it. They said that although more nurses are training, training placement opportunities are fewer. They suggested that part of nurse training now is off the ward—obviously that has happened before, but they were concerned about whether that virtual training or simulators were the same. I know that the Minister will take seriously all opportunities to get nurses trained in the best possible way, so I will not dwell on a subject that I do not know much about.

I mentioned the issue to do with podiatry, which is a real problem in the south-west. We must find ways to help professionals, whatever they do, whether therapy, physio or all the things that people to do to ensure that we stay well and do not end up in hospital. Podiatry is one of those. We must ensure that people get the training, that they can afford to do so, and that they can have a great career in the NHS or with local authorities. We need to talk to universities about exactly why they are not attracting the kind of numbers they need to justify the courses.

I should have declared an interest at the beginning: I chair the vascular and venous disease all-party parliamentary group. One thing I am being told loud and clear—I have done a lot on this—is that because we have taken the nursing bursary away from older students, they find it difficult to go on the courses that I am describing. That will have a real impact on the numbers of nurses available to do those important jobs. If we do not address that issue, in a place such as Cornwall, where diabetes is a significant problem, the pressure on urgent care will be enormous—if it is not already.

Last week, our general district hospital—the only one in Cornwall—closed to the public, because a spate or outbreak of vomiting and diarrhoea put a lot of people from nursing homes and others into hospital. In that situation, the system rallied and did some amazing work to cope, ensuring that no one who needed care was failed, but it was also an example of why we need to work equally hard, if not harder, to ensure that at the best of times and the worst of times people get the best healthcare available.

The NHS in Great Britain is the envy of the world. We need to be careful always to remember how fantastic our system is. Last week, my brother and his wife came back from Cambodia with stories of trying to get healthcare there—they have two young children—and that reminded me of how fantastic our health service is, as are all those who work in it.