Care Bill [HL]

Debate between Baroness Wall of New Barnet and Lord Willis of Knaresborough

Tuesday 4th June 2013 Lords Chamber

[Lord Willis of Knaresborough]

I speak to Amendments 15 and 36 in my name and those of the noble Baroness, Lady Emerton, and the noble Lord, Lord Patel. On Amendment 15, one of the most daunting tasks for Sir Keith Pearson and his staff at Health Education England is the challenge of workforce planning. I do not believe that anybody has done that right in the health service since its creation. The noble Lord, Lord Turnberg, rightly pointed out that it takes a good five years to get a junior doctor. It takes 10 years to get a consultant. For senior consultants, we are probably talking about 12 to 15 years. For anyone to sit down in Richmond House or elsewhere and start to plan what is going to happen in 10 to 15 years is an incredibly difficult task, and no one has managed it yet.

Secondly, looking ahead, if 10 or 15 years ago you were planning a workforce, you would have automatically said that we need a supply of certain groups of professionals and that, provided we can get that supply, we will be reasonably okay. We can bring in a few from abroad, usually the Commonwealth, and often denude the poorest countries in Africa of their health staff and get the nurses from the Philippines. That enabled us to get by.

What we are doing now—I think that the Minister is acutely aware of this— is planning for a health and care service the like of which we have never seen. There will be research developments, especially in areas such as genomics and regenerative medicine, which will create cures for major debilitating diseases and, at the same time, give us innovative ways of dealing with people’s long-term chronic illness in their homes by self-management. Therefore, the professionals and the care support workers for those professionals working within the NHS have to be of a calibre and to have a flexibility the like of which we have never seen.

We have tabled Amendment 15 because HEE needs all the support that it can get in obtaining representation to support it to look ahead. By that, I am talking about the research base. We have to consider what medicine will look like, what cures will look like and what the demographic requirements will be in 10 or 15 years’ time—or even in five years—to plan the workforce. I hope that in reply, the Minister can reassure the House that there is that sort of long-term planning for a workforce not like today’s. We are not planning the workforce of yesterday with different numbers, we are looking at a totally different workforce for the future.

Amendment 36 is a probing amendment to gain assurances from the Minister that HEE will receive representations from organisations other than the medical royal colleges. The Explanatory Notes to the Bill specify only medical royal colleges in paragraph 515. We therefore ask that that be updated to reflect all royal colleges.

In the Francis report, one of the criticisms of the Royal College of Nursing—I refer to it specifically—was that there was a conflict between its role as a trade union and its role as a royal college. The Government and Health Education England have an opportunity to challenge it on that role and to make sure that it steps up to the mark as a royal college. Only by doing that will it actually serve the nursing workforce to its true extent. We have seen that with the medical royal colleges, and, by including royal colleges in this particular amendment, which would include the Royal College of Nursing, we are sending out a challenge to the RCN that it, too, must be part of this game rather than a bystander.

[Baroness Wall of New Barnet]

My Lords, I, too, support Amendment 36. I just want to pick out something that the noble Earl mentioned a little while ago in response to another question from me. He mentioned the work being done by Skills for Health and Skills for Care. Certainly in the context of this amendment—which, I agree, is a probing amendment—alongside the royal colleges and the other professional bodies, the work that Skills for Health and Skills for Care are doing is hugely important. Can the noble Earl enlighten me on what relationship Health Education England will have with those bodies? For instance, the noble Lord just referred to what the future looks like and what Skills for Health in particular is doing alongside Skills for Care. It is looking at what provisions there are for apprenticeships inside the health service, which is hugely important and allows people to develop from smaller roles to bigger roles over time. I wonder how, in the scheme of things, that relationship exists, how close it is and what influence Skills for Health and Skills for Care have, so that they are not working in opposition but are working integrally with what HEE is doing.