Queen’s Speech

Baroness Watkins of Tavistock Excerpts

Thursday 29th June 2017 Lords Chamber

[Baroness Watkins of Tavistock (CB)]

My Lords, before I commence, I should draw attention to my registered interests and remind the House that I am a mental health nurse and a lifelong member of the Royal College of Nursing.

I have welcomed in this House initiatives to widen participation in healthcare higher education, such as higher apprenticeships, the regulation and standards for nursing associates and accelerated postgraduate programmes targeted at mental health and learning disability nursing. To meet the Government’s commitment to increase healthcare student numbers by 10,000, we must continue to focus on monitoring what is happening in the higher education sector, and government must support sustainability and growth.

Following the changes to the funding of higher education in nursing, midwifery and allied health professions in England, we have experienced an average 23% reduction in student applications, although it is fair to say that in some areas the reduction is much higher. Universities are reporting a diverse picture across England, with some feeling confident that they are receiving better-quality applications from highly motivated and committed student applicants, while in other areas there are concerns about the viability of specific programmes such as learning disability and podiatry. Although the university sector has welcomed the funding reforms, it is clear that three areas that are fundamental to the success of higher education healthcare courses remain to be resolved.

First, universities need urgent clarification on the situation of placements in England. To enable growth and ensure student choice, the best model for this would be for placements to be linked to the student and for universities to be involved in the selection and quality of the placements, rather than serving the areas in the NHS where there might be care needs. But if students are paying for their placements, they will expect the right level of supervision.

Secondly, the success of education depends on the expertise of healthcare academic and practice staff. This is a wider UK issue, although the situation seems to have worsened in England recently. We must resolve the issue, with nearly 50% cuts to continuing professional development funding announced in March 2016 by Health Education England for each of its 13 local education and training boards across the country. As a result, some regions have faced cuts of more than 45% to CPD budgets, with further reductions expected this year. It is crucial that there is continued investment in building the clinical expertise of the nursing workforce to ensure that staff remain up to date with changes in healthcare, including technology. These cuts are an extremely short-sighted move, as it is only by equipping nurses in health and care environments with professional development, training and support that our existing workforce can help drive service transformation, particularly in mental health, including mental health in schools. Both the noble Baroness, Lady Cumberlege, and my noble friend Lady Masham have outlined the need to invest in mental health, especially in women’s intensive care. We know that recently patients from the south-west have had to travel more than 300 miles for in-patient mental health services. Clearly, we need to resolve these problems. Without continuing professional development, it will be particularly difficult.

Thirdly, nursing, midwifery and allied health professions are evidence and research-based professions. Research outcomes contribute to patient safety. With Brexit negotiations starting this month, we need to find a way to ensure that our universities across the UK continue to participate in EU research funding and networks, while we look at measures to increase research capacity in the healthcare disciplines. Researchers in these areas include less than 1% of the workforce—a figure that needs to improve dramatically.

Finally, since 2011 there has been a real-terms drop in earnings of up to 14% for NHS nursing staff. In May this year, RCN members voted overwhelmingly to take action on nursing pay. Over the summer, members will be protesting to scrap the cap. The cap forces good nursing staff out of the profession and leaves those who remain overstretched and undervalued. This has a profound and detrimental effect on the standards of care provided. While I am aware of the vote in the other House yesterday, I urge the Government to consider further over the summer whether removing the cap would be positive in retaining and attracting NHS staff, helping to resolve the workforce shortage so well outlined by others, and ensuring patient care. I also believe that this would reduce the need for nurses to join agencies to increase their salary and therefore increase the cost to the NHS.

It is estimated that there is currently a vacancy factor of about 11.1%—or 40,000 registered nurse vacancies in England. Under these circumstances, it is understandable that many nurses in the EU do not wish to come and work in Britain because of the extreme, increased workloads and the stress and fatigue that ultimately result from working in areas where there are insufficient staff to deliver high-quality care to patients. Without better pay and conditions, we will fail to secure the nursing and other healthcare workforce for the future. I urge the Minister to consider the issues raised, protect nursing education and enhance morale and recruitment. Even if this requires an increase in taxation, I believe that the majority of our citizens would support this idea.