Nursing Workforce Shortage: England

Scott Mann Excerpts

Tuesday 3rd March 2020 Westminster Hall

[Mohammad Yasin]

My hon. Friend is right. Cuts to bursaries have impacted hugely on the recruitment of new staff. The Welsh Government did the right thing in a difficult situation. If we do not look after our staff, it will be hard for them to stay in the profession. That is why we have a shortage of nurses.

As a father of four children, I believe that financial barriers to education must be removed so that everyone who wants to go to university can do so, particularly those who want to become nurses. We should encourage young people to train in these critical professions. Why are the Government putting up barriers to young people who will go on to contribute such vital services to society and saddling them with huge debts before they have begun working?

This problem has been years in the making. Such stark shortages do not occur out of the blue. In England these shortages are due to the complexities of political decisions and structural issues.

[Scott Mann (North Cornwall) (Con)]

As has been mentioned, these issues are compounded in rural areas, where we have problems with recruitment and retention. A cottage hospital called Stratton in my constituency has just had its minor injuries unit closed overnight due to nurse shortages. What more can we do to promote staff retention across the whole of the UK?

[Mohammad Yasin]

The Government must listen to nurses and the Royal College of Nursing. They are pleading for the Government to act now. Getting nursing bursaries back in action might help, but the problem is now so deep that we must take urgent action to tackle it.

This problem has been around for a long time. It is not a short-term problem. It will affect us in the long term unless we act now. Who is responsible for the health and care workforce? It is shocking that no one is. There is no clarity in law on the role of and responsibility and accountability for growing and developing our health and care workforce, or the various layers that drive our health and care services.

A nurse walking on to a short-staffed shift has no option but to carry on. The buck stops with them. They carry the professional, physical and emotional impact. Nurses have no power to recruit more staff. That is true of all professionals in our taxpayer-funded health and care services, including nurses, medics, physiotherapists, psychologists, social workers, support workers and many others. The Government should be accountable for the provision of the labour market that staffs our health and care services. The taxpayer must be assured that the services they have paid for are safe and effective.

The former MP for Wolverhampton South West, Eleanor Smith, who is also a nurse, was here last summer setting out the same concerns. This is the 37th debate on workforce issues in health and care services since 2017, and it will not be the last. In recent responses to parliamentary questions, the Government have considered the merits of safe staffing legislation and ways to close the workforce accountability gap. The Royal College of Nursing has been campaigning, along with several other health organisations, for accountability to be secured in legislation, so the Government’s consideration is welcome.

The long-term plan Bill is the way to make progress on that agenda, but it must include an explicit framework for the role of and responsibility and accountability for workforce supply and planning at all levels at which decisions are made across the system, including the Government. Achieving accountability in law provides an opportunity to safely staff our health and care services in the future. I hope the Minister will commit to safe staffing legislation for England and update us on what her Department is doing to ensure that the NHS long-term plan Bill is forthcoming. Will that Bill explicitly provide for accountability for workforce provision?

I suspect the Minister will want to discuss the Government’s promise of 50,000 more nurses over five years. We have heard a lot about that commitment but not in detail. How will 50,000 more nurses be recruited, especially when the Government appear to be ramping up the hostile environment rhetoric and making the UK as unattractive a place as possible to come and work? The loss of many NHS workers from the EU is a tragedy.

Bedford Hospital had to recruit 237 nurses from Australia, India and elsewhere to fill vacancies left largely by EU nurses who left because of their fears for the future and the ill treatment they received in the UK. It is a testament to the hard work of the hospital’s chief executive, Stephen Conroy, that, despite those staffing difficulties, the hospital is projected to reach full recruitment of band 5 nurses for the first time in many years, but that will be achieved only by recruiting nurses from overseas.

We also need to increase capacity in clinical placements, to support nursing students at universities. How will the Government achieve that? How many nurses do the Government expect to retain? When will the Government publish their plan in full? Will the Secretary of State report on progress made in this Parliament?

This year, the World Health Organisation is celebrating the first ever year of the nurse and the midwife, at a time when the spotlight is on the nursing profession across the globe. As their elected representatives, we must stand with them and celebrate this diverse and dynamic profession. I will do everything possible to ensure that our health services are staffed safely. It must be a priority for us all. The problems are well known. The evidence continues to mount. We need decisive action, but we are not getting it from a Government drowning in Brexit uncertainty. Nursing staff need action now, as do their patients. We cannot wait any longer.

--- Later in debate ---

[Jim Shannon]

I thank the hon. Gentleman for his intervention, and that is exactly what I am saying. I know that the Health Department in Westminster does not have responsibility for recruiting nurses in Northern Ireland. The Minister in Northern Ireland now has, and he has made the first step towards addressing that issue. It is hoped that over the next couple of years the number of vacancies—over 2,100 nursing posts, as well as 400-odd nursing assistant posts, making about 2,500 vacancies in total—will be addressed. We hope that the cost of agency staff and the extra financial burden created by the fact that agencies are profit-making organisations—this is how they make their money—will be addressed in a way that helps to reduce the shortcomings.

This situation means that nurses cannot simply work their 37.5-hour working week. They are called in on days off and asked, “Can you do the twilight shift? Can you give me a couple of hours?” That is not the fault of the ward sisters; they need the floors covered and are under pressure. It is simply that we do not have enough full-time working nurses in the NHS. That means that conscientious nurses, who do not want to leave the ward or the district short, are working additional hours themselves, and not in the short term to save money for a holiday or a renovation of their house. Instead, they are consistently working overtime to help on the wards, and so they are not getting their family time, their social time and—more importantly—their rest time

I have had glimpses of this situation. Some 6,500 nurses live in my constituency, so I have regular contact with them. I got a brief glimpse of the work of a nurse during my surgery and was in awe of how they stayed on their feet, and remained both sharp and compassionate —as they do. Doing all that with no rest is simply unsustainable. So, for a better system and a better caring system with better nurses, who are more able to work within that system, we need to address the shortage of nurses.

It used to be the case that bank nurses were only used in an emergency, but now they are used ever more frequently and their use is becoming the norm. They are no longer just used in the emergency. Using them is now just the fall-back position: “Let’s just do it”. That is not good either for morale or for finances—the current finances clearly indicate that it is not. It is more costly to have agency staff in than it is to have nurses on full-time pay.

I will give another example, of a nurse who approached me in my office and asked me to clear up rumours about nurses, their employment and so on. She is a young nurse in her early 20s who has been working at the Ulster Hospital in Dundonald—the main hospital in my constituency—but she has been left as a staff nurse in charge at night on numerous occasions. What she said to me was simple; she just said to me, “Jim, keep the pay rise and please give me an extra nurse per shift.” That was her initial reaction, because she can feel the pressures of delivering this system, and was saying, “I physically can’t do it all for much longer”.

This is a lovely young girl who is dedicated and good at her job, but who knows that when she has kids she will not be able to work 60 hours a week. She is asking me to do something about that, and today I am on the path towards doing something; I am highlighting this issue. I am very happy to do so.

[Scott Mann]

The hon. Gentleman is making an excellent point about that young lady. There is one way that the NHS might be able to support her. NHS Property Services owns huge amounts of land around the country on the public estate, and I know that the Government are putting together a key worker policy, for there to be a 30% discount for local people in the housing policy, like a local homes discount. Does he think that if we included nurses within that category that we might be able to address some of the challenges that we face, by giving people discounts and getting them into the profession?

[Jim Shannon]

I thank the hon. Gentleman for that intervention. I was not aware of that proposal until now, but it certainly seems like a way of incentivising people—for some people. Let us be honest; it will not suit everybody’s circumstances, but it will suit some people’s. Whatever we can do to incentivise nurses to stay in the profession is good. I will give a third example, if I may, of the reasons why nurses are not staying in the profession, but some of the things that the hon. Gentleman referred to would be helpful.

I met one woman in her 30s in my office who wanted to go into nursing, but she could not do so because her tax credits would not allow to stop work while she got her national vocational qualifications and other qualifications. So, reluctantly, she gave up and we lost her. She is not the only one we have lost; we have lost many more than that.

I know that in Northern Ireland this issue is not the responsibility of the Minister who is here today, the Minister for Care, the hon. Member for Faversham and Mid Kent (Helen Whately); I understand that. However, will she ask the Minister who has the portfolio for tax credits to review the circumstances around tax credits and the circumstances of those nurses who are trying to get their NVQs, and have to stop work to do so? If we are losing nurses because of an anomaly in the system, let us try to address that anomaly, to allow us to retain the nurses who want to be retained.

My mother was a nurse. That was a long time ago; my mother is coming up to 89 now. I know that for her nursing was a vocation, as it is for many other people. In today’s busy life, it is important that we try to help those who want to be in nursing for the rest of their lives to retain their position. However, that was a young girl in her thirties in my office who wanted to go into nursing and unfortunately we lost her.

We lost someone who wanted to train as an intensive care unit nurse, because the current system could not work with her and her four children. Can we do better in helping mature people to come out of retail and enter education, while still having their children cared for? There are many such people across the nation and across my constituency. There are also a great many people who are former nurses, and we should try to recruit them back into the system as well. There comes a time in their life, perhaps when their children are a bit older and they find themselves with a bit more time on their hands, so what are we doing to attract the more mature nurse into the profession that they once wished they were in?

There must be a way of doing that. I believe that it is up to us in this House to address these two issues, which are so closely linked: getting more nurses; and making a clear way forward to allow mature people to choose nursing, not simply as their job but as their vocation and their calling.