HC Deb 20 January 2004 vol 416 cc1195-7
1. Dr. Richard Taylor (Wyre Forest) (Ind)

If he will make a statement on the ranges of expenditure in 200–02 by (a) acute trusts and (b) primary care trusts on salaries to non-NHS nurses, midwives and health visitors. [148784]

The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson)

Expenditure on non-NHS nurses, midwives and health visitors by NHS trusts in 2001–02 ranged from nil to £17.7 million, with an average of £2.1 million. The range for PCTs was nil to £2.1 million, with an average of £150,000.

Dr. Taylor

Does the Minister agree that a high spend on agency nurses carries with it a possible adverse effect on the continuity of care, and therefore on the standard of care? Is it not therefore unwise to have included in the list of trusts for foundation status the two with the highest spend on non-NHS or agency nurses?

Miss Johnson

We recognise that there is a continuing need for agency staffing as a result of the fast expansion in NHS services, but it is also important for the NHS to Supply—

Mr. Speaker

Order. The hon. Member for Bosworth (Mr. Tredinnick) must be seated.

Miss Johnson

It is also a matter for the NHS to supply more staff itself. We are therefore working to reduce the costs involved, and to increase the role of NHS professionals in this regard. Currently about 40 per cent. of trusts are involved, and many more may see the advantage both to standards of care, as the hon. Member for Wyre Forest (Dr. Taylor) says, and to the cost benefits of using NHS professionals in future.

Mrs. Alice Mahon (Halifax) (Lab)

On the question of agency midwives, there is a shortage of NHS midwives across the country. Will my hon. Friend consider the suggestion from the Royal College of Midwives to provide midwives with a £10,000 bursary? Will she also consider giving graduate midwives maternity pay, because when they are on a bursary, they do not get it? The midwives who deliver other people's babies are therefore not getting any money for themselves when they go on maternity leave.

Miss Johnson

I agree that it is important that there should be more midwives, and I recognise that there are still needs in that area of the NHS. Lively discussions are taking place on the arrangements in further and higher education, and perhaps it would be best to get through those discussions before we move on to the suggestions that my hon. Friend has made. We will, however, bear them in mind when considering future developments.

Mr. David Tredinnick (Bosworth) (Con)

Does the Minister agree that it is not only expenditure on health visitors and midwives that we should be looking at? We should also consider expenditure on a whole range of integrated health care services, given that 75 per cent. of the population want a wider range of services, including herbal medicine, acupuncture, osteopathy and chiropractic, which is effectively in the mainstream now. What is the Minister doing to ensure that, in this new world of greater consultation, she is listening to what the patients want?

Miss Johnson

I hope that the hon. Gentleman will accept that it is also important to see big increases in expenditure and doctors in the NHS as well as recognising a wider role for other services. I am sure that he will want to congratulate staff in his own constituency, where there have been big increases in numbers and in the projects that have been built in the acute sector, along with the completion of new hospital facilities. We all owe NHS staff many thanks for the work that they do.

On the hon. Gentleman's wider question, of course it is important that other facilities should be offered to patients, but I am sure that he would agree that the 23 NHS-run treatment centres, the two independent sector centres and the 42 walk-in centres—which are a novelty—are also an important part of the development. We see a lot of development taking place in primary care as well as in the acute sector, and I hope that he recognises the advantage of that.

Mr. John Baron (Billericay) (Con)

The Minister will be aware that last year, for the first time, more than half the new entrants to the nursing work force were from overseas. The Government will also be aware that their own code of practice on ethical recruitment, although adhered to by NHS trusts, has not been signed up to by all the agencies that the NHS uses to recruit nurses from overseas, and that, partly as a consequence of that, Britain has taken about 7,000 nurses from South Africa since Nelson Mandela first pleaded with us in 1997 not to do so. If the Minister accepts that poor countries need their nurses even more than we do, and given the current reliance on agency nurses in the NHS, when will the Government stop poaching nurses from developing countries and ban the NHS from dealing with agencies that do not sign up to their own rules?

Miss Johnson

The hon. Gentleman is barking up completely the wrong tree. We only use agencies that have signed up to the protocol and code that we support, which involves recruiting staff only from countries that are happy to supply surplus staff in conditions under which the code operates. What the hon. Gentleman alleges is therefore completely untrue. The only staff working in the NHS are working under those arrangements.

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