My Lords, I congratulate the noble Baroness, Lady Cumberlege, on the way she introduced Amendment 80—it was masterful. I point out that she took this amendment from the right honourable Jeremy Hunt, who unfortunately failed to get it through the House of Commons. In doing so, he expressed his regret that, when he was Secretary of State, he was not able to put in place a structure such as the noble Baroness proposes today.
The noble Lord, Lord Stevens, and the noble Baroness, Lady Harding, have both commented that it is self-evident that we need a workforce adequate to meet the demand. To do that, we need to anticipate increasing demand, changes in demographics, population growth and changes in practice. Crucially, we need to put in place resilience to health shocks. If we do not do that, we will continue to struggle to reach the OECD average of 3.7 doctors per 1,000 people, which is reasonable. To get there, we actually need 50,000 more doctors.
However, as the noble Baroness, Lady Jones, pointed out, this is not just about doctors. It is also about nurses and, as we have heard from the noble Lord, Lord Bradley, and the noble Baroness, Lady Whitaker, it is about allied health professionals. We need to train them all in a timely way, given, as the noble Lord, Lord Stevens, pointed out, how long it takes to train all these health professionals.
The Prime Minister claimed in the House of Commons recently that we have 45,000 more people working in the health service than before the pandemic. Unusually, that may be true, but it was not clear whether they were full-time professionals. However, that number bears no relation to the demand. There is no point in quoting raw figures if they are not related to the rise in demand. Moreover, there are fewer GPs than before the pandemic, and that is where people’s access to the NHS begins. If someone cannot get to see a GP, they cannot get a diagnosis or a referral, and their disease gets harder and more expensive to treat. Having too few GPs is not a cost-effective strategy, so I support Amendment 111, tabled by the noble Lord, Lord Hunt, and also his Amendment 168.
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Having too few staff means more staff leaving the service because of stress and burn-out and the realisation that staffing levels are too low to be safe for patients or staff. Staff also know that even before the pandemic bed occupancy levels were too high to allow for the resilience we need in the system, and so they leave.
The amendment also refers to social care staff and public health staff. On social care, a couple of weeks ago we talked in this Chamber about ambulance response
times, and noble Lords all know that the reason why ambulances are too slow to go to patients is that they have to stand outside A&E because they cannot move their patients into A&E. A&E cannot move patients into the main hospital, and the main hospital cannot move its patients into social care because there are not enough staff and placements to give appropriate social care. That is why it is very important that the amendment covers social care staff too. The pandemic has shown us how important public health staff are. That is why that reference is there.
We know that this amendment alone will not solve the staff shortage, but without it we will never reach safe staffing levels. We will continue to have disruptive and expensive staff turnover, we will fail to reach OECD average numbers and we will certainly never tackle the backlog of procedures built up during the pandemic. For health and care staffing to be sustainable, we need a rolling plan of needs assessment and training. Without an independent assessment of the need, how can anybody possibly plan for the health and care staff that we need? It is just not possible.
As the subject of nurses has been so powerfully addressed by the noble Baroness, Lady Jones, I shall also say something about that. I believe that Amendment 80 will serve nurses just as well as it will serve doctors and all allied health professionals. We on these will focus our votes on Amendment 80 in the hope that the noble Baroness, Lady Jones, is reassured and will not feel the need to move Amendment 82.