I thank the Minister for his comprehensive response to this debate, which the noble Baroness, Lady Harding, suggested was probably the most important that we have had and will have in Committee on the Bill. Staff are absolutely central to the delivery of health services.
Unfortunately, in this debate we have heard about a great deal of failure. We have failed the staff because we have not provided them with enough colleagues for them to be able to do their work without feeling stressed, being worried about risk to patients, feeling burnout or wanting to reduce their hours or retire early. We have failed to provide enough GPs; we were promised 5,000 or 6,000 extra, but, as the noble Lord, Lord Patel, said, we have fewer than we had in 2015. We rely on 30% of doctors from abroad—an enormous number. Although I absolutely accept what the noble Lord says about the appropriateness of temporary training placements, opportunities and remittances going back to the countries from doctors and nurses coming here, it sounds a little excessive to me. Perhaps we need to do better in planning our own workforce.
9.15 pm
It is not just doctors and nurses: the noble Baroness, Lady Finlay, highlighted the allied health professionals, whom I mentioned only briefly in my introduction. They are very important too, and there is a lot of shortfall there. She also mentioned CPD, which is vital, particularly as health technologies, practices and opportunities for treatments change.
There is a great deal more to do. The Minister is quite right that those of us who have been talking about these issues will undoubtedly get together over the next few weeks and, I hope, have discussions with him. The noble Baroness, Lady Cumberlege, has put forward a comprehensive measure that could be put in place—I was so pleased that she agreed with me on
this—not just for normal service but for the unexpected needs of the health service. I can assure your Lordships that there will be some.
The noble Lord, Lord Stevens, gave us a woeful litany of failures. My husband always says that the family motto is, “Who can we blame?”. The noble Lord, Lord Stevens, fairly and squarely blamed the Treasury, so I hope it is listening. Doing what needs to be done will cost more money, but if we do not do it there could be a total disaster in our health and care services. In fact, in social care there already is.
I was surprised, and I think the noble Baroness, Lady Verma, was probably surprised, to hear the Minister say that care homes are paid a fair rate for publicly funded patients in social care. I do not think we would have private payers charged more if that was really the case. Perhaps her managers might agree with that.
One noble Lord—I cannot remember who—said that we need a system-wide understanding of what is needed and the right way to go about providing it. The noble Lord, Lord Warner, and others mentioned that we have a very competitive global market in all the health professions, and therefore we need to be very clever about recruiting enough for this country while at the same time fulfilling our obligations to the rest of the world and lower and middle-income countries.
I turn briefly to my two amendments. I accept what the Minister says about the fact that duties exist to train enough staff to provide safe staffing levels. However, this whole debate has proved that those duties are not being carried out. Employers are not able to carry them out, because there is not enough of a pool of the right staff in the right places at the right training level to enable them to carry out that duty. That is why it is perhaps a good idea to restate it.
This has been an excellent debate, and I know that the Minister has heard what we have to say and that there will be more discussions. In that light, I beg leave to withdraw my amendment.