My Lords, to state the obvious, without a workforce plan we cannot have a workforce. Amendment 170 certainly seems to get to the heart of the issue, which was so well introduced by the noble Baroness, Lady Cumberlege, and my noble friend Lord Stevens.
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Others have spoken about the medical and nursing workforce, and therefore I will not repeat those comments. I want to put a plea in for the allied health professionals, because many of them work outside the NHS, so, while we talk about NHS planning, we will undersupply chronically if we do not recognise where else they work. Some 25% of physiotherapists work with other providers such as the military, prisons, hospices and occupational health services. Some 50% of podiatrists work outside the NHS, and speech and language therapists often work with people in education as well as in the criminal justice system, social enterprises, and in the voluntary and third sectors. That is why I tabled Amendment 172.
In Amendment 214, I have tried to address the problem that Clause 79 abolishes local education and training boards. As the noble Baroness, Lady Harding, said, without access to education, time for CPD, funding of courses and backfilling, we will not get the rapid movement of our staff into different areas as the provision changes. Such local assessment could then feed into national planning processes, as outlined in Amendment 170.
I will give a few bits of data to support Amendment 174 on social care, to which I added my name. Skills for Care found that 24% of the adult social care workforce are employed on zero-hours contracts. That means that they cannot get mortgages, et cetera. Care workers represented the highest proportion of workers on zero-hours contracts, at 35%. Those on slightly higher
grades are more likely to have full contracts. In the community, a Community Integrated Care study found a gap of £7,000 between equivalent roles in social care and the NHS. With that large gap, it is hardly surprising that social care does not retain its staff. There is no joined-up recruitment yet, and there is no local or national training planning that covers health and social care.
This group of amendments is absolutely essential, and it would be a dereliction of our duty to ignore the messages from this debate.