My Lords, as this is Report, I declare my interests, which are that I am employed by NHS England to implement my report on maternity, Better Births.
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I shall speak to Amendment 80. I want to thank the noble Lord, Lord Stevens of Birmingham, and the noble Baronesses, Lady Walmsley and Lady Merron. I am really grateful for their cross-party support.
I have had a lot of support for the amendment not only from the whole House, which is very welcome, but from 100 organisations including 16 royal colleges and many important charities. I shall mention just two charities out of the large number from which I have received support: National Voices, which speaks for patients, and YoungMinds—because it is their future that we are talking about. A huge number of patient groups, think tanks and professional bodies have also supported this amendment.
We spoke in Committee about workforce planning. I say to my noble friend the Minister that the strength of feeling on this matter has been great. I make no apology for bringing back this amendment today. Workforce is the single greatest problem facing the NHS. Without improved planning, we will fail to tackle the growing backlog not only in procedures but in appointments within the NHS. We will not know whether we have the right people in the right place at the right time. We will not provide a sustainable work environment for the dedicated staff currently working so hard within our services. We will not meet the public’s expectations when they turn to the NHS for care and support.
In Committee, my noble friend the Minister said that we had a record number of people working in the health service. I do not doubt him for a moment, but it begs the question of whether we have enough to meet demand. Staff numbers may be rising, but so is the backlog. The current NHS waiting list stands at 6.1 million and is rising. We need workforce capacity that can meet not only today’s demand but that of the future. As we all know and have discussed in this Chamber, it take many years to train nurses, doctors and health professionals. We need a long-term view. Without that, we are flying blind.
The NHS is relying more and more on bank and agency staff. Not only is that expensive but it is a sticking-plaster solution. We need a workforce strategy. The Secretary of State told the Health and Social Care Select Committee recently that he had commissioned NHS England to undertake a long-term workforce strategy but, again, that begs questions. We do not know whether the strategy will cover both healthcare and social care. That is essential if we want to improve integration within those services, which, after all, is the very purpose of the Bill—it is not called the Health and Care Bill for nothing.
We do not know what period the strategy will cover, or whether it will be regularly refreshed. We do not know whether it will include numbers of staff needed
based on population demand. A workforce plan without numbers simply does not add up. We need clear, verifiable, objective data and analysis to underpin such a strategy, and to enable us to check at regular intervals whether that strategy is working.
When I spoke in Committee, I fear that I may have bombarded your Lordships with numbers—for unified staff vacancies, unfilled staff vacancies, retirement projections and so on. I used all those numbers to illustrate the workforce challenges faced by the health and care system, but I am sure that your Lordships will be grateful that I shall not repeat those today. I want just to say that the numbers are as telling now as they were in Committee; they are not getting better. They underline the need for a long-term plan, backed up by the data and analysis that Amendment 80 would bring. The longer we wait, the worse the situation becomes.
I have mentioned reliance on bank and agency staff. I need to say a very few words about that, because my sense is that behind the Government’s hesitation about this amendment is a concern about the cost complications that it could trigger. Training more healthcare staff will of course cost more money, but not training more staff costs money too. The mismatch between staffing levels and patient demand is leading to significant locum spend to plug the gaps. In 2019-20, £6.2 billion was spent on agency and bank staff in hospitals in England. The latest figures up to September 2021 show that agency and bank spending has increased still further. Projections show that it is expected to go on increasing next year and the year after. That spend can be reduced if we have a proper long-term workforce plan, which must be underpinned and verified by the provisions set out in Amendment 80.
Let us have the numbers that enable the health and care system to plan properly for the long term. Let us in turn have numbers of staff that we need, carrying out the roles that we need, in the locations where they are needed. Let us reduce the excessive reliance on expensive temporary cover and, in turn, let us generate cost savings that can be ploughed back into high-quality care. Rarely has the phrase “strength in numbers” been more apt.
In moving Amendment 80, I look forward to the debate in your Lordships’ House and to my noble friend the Minister’s reply. I hope he will recognise the strength of feeling in the House and in this country as a whole. If the amendment is not acceptable, I am afraid that I will be forced to test the opinion of the House. I beg to move.