Nurses: Retention and Recruitment (Hansard, 27 October 1988)

§ Lord Hesketh
My Lords, a number of steps designed to improve nursing retention and recruitment have already been taken. These include improvements in pay, which has risen on average by 45 per cent. ahead of inflation since this Government took office, and the new clinical grading structure. Steps are also being taken in relation to training, career development, accommodation and equality of opportunities for women.

§ Lord Molloy
My Lords, I am grateful to the noble Lord for that reply. What he has just said reflects great credit on both sides of the negotiating table. Why then does the Secretary of State refrain from continuing those discussions with the professional leaders, involving issues such as funding, clinical grading appeals and the shortage of nurses in some areas?
Would it not be wise for the Secretary of State to continue the discussions and the endeavours made at the negotiating table where the results which the noble Lord has just mentioned could possibly be improved upon and thereby not in any way arrest the desire of young people to become nurses in the NHS?

§ Lord Hesketh
My Lords, I can assure Members of your Lordships' House that there is no desire by the department to deter anyone from joining the NHS. However, my right honourable friend has declined to see the staff side of the Nursing and Midwifery Staff Negotiating Council because the Government have fully funded the pay award giving nurses an average increase of 17.9 per cent. Further, nurses will now be told their grades.

§ Lord Mellish
My Lords, is the Minister aware that this is a serious question which should be taken seriously? Young girls under training, for example, at the University College Hospital, are receiving 1705 propaganda from America—it is supposed to be an ally—offering them three times the salaries they are now receiving or likely to receive, far better accommodation and free air travel. It urges them to leave this country once they are qualified and join the Americans. That will be after they have had all our training. What is the Minister going to do about it?

§ Lord Hesketh
My Lords, I am grateful for the question asked by the noble Lord, Lord Mellish. I too have read in the newspapers somewhat inflated figures about this subject. However, in the year ended 31st March 1988 the United Kingdom Central Council received 908 requests from nurses for verification of their qualifications to be sent to a registering authority in the United States. That is an increase of 23 per cent. over the previous year. However, a large proportion of the inquiries came from enrolled nurses who do not satisfy the American requirements.

Lord Winstanley
My Lords, in view of the importance of the provision of affordable living accommodation to the recruitment and retention of nurses, can the Minister tell us of any progress which has been made in the matters about which we were told by the noble Lord's predecessor concerning the re-establishment of some of the nurses' homes which have been taken out of commission, and other means of providing affordable living accommodation? What progress has been made in the matters about which we were told?

§ Lord Hesketh
My Lords, a review of the conditions under which staff occupy accommodation is at present being undertaken by the National Health Service Management Board. That review is now at an advanced stage and the board's proposals are being considered in the light of the Housing Bill, one of the purposes of which is to increase the amount of private sector accommodation available for rent. Furthermore, a mortgage package has been introduced by the Nationwide Anglia Building Society. The aim of the scheme is to provide low cost 100 per cent. mortgages to help national health staff cope with high housing costs in London.

§ Earl Russell
My Lords, is the Minister aware that by saying that the current nurses' pay increase has been fully funded he has made a controversial statement? Does he agree that the difficulty in retaining nurses illustrates the difficulties of the present system of funding public sector pay increases; and that that system leaves the Government the proud possessor of more hot potatoes than McDonald's?

§ Lord Hesketh
My Lords, I am unaware of that great store of hot potatoes. I can assure the noble Earl that if one looks at last year's figures for nurses leaving the National Health Service, which might be a good point at which to start, one sees that there were 23,900 leavers, whereas 20,800 newly-qualified staff entered the service. However, what is more important, some 7,200 nurses returned to nursing thus giving a net total of some 28,000 staff going into the health service.

Lord Wallace of Coslany
My Lords, reverting to the question put by the noble Lord, Lord Mellish, perhaps I may once again ask the Government why they do not charge foreign organisations recruiting nurses in Britain and the private sector for the training which is undergone at state expense.

§ Lord Hesketh
My Lords, we live in a free country. Furthermore, last year there were 5,800 nurses who asked for their qualifications to be verified overseas, but 4,177 wished to be qualified in this country from the Community. I wonder whether the question that the noble Lord has asked is being asked in the countries of those who wish to come to work in this country.

Lord Wallace of Coslany
My Lords, I am not asking for the nurses to be charged; I am asking that the organisations recruiting those nurses be charged.

§ Lord Hailsham of Saint Marylebone
My Lords, how could such a charge possibly be enforced?

§ Lord Prys-Davies
My Lords, further to the supplementary question asked by my noble friend Lord Molloy, will the Minister assure the House that if it emerges that the nurses feel that they have been unfairly or unjustly treated his right honourable friend the Secretary of State would be prepared to have discussions with the leaders of the nursing unions to resolve the difficulties?

§ Lord Hesketh
My Lords, there can be no better sign of faith than the commitment that the Government have made to nurses' pay. I must remind the House that the Administration that preceded this Administration reduced their pay by 25 per cent. in real terms.

§ Lord Auckland
My Lords, is my noble friend aware that I have been critical of nurses' pay and conditions under both Administrations? However, is it not also fair to point out that many nurses go to the Commonwealth, especially Australia and New Zealand, to further their training and that many nurses come from Australia, New Zealand and elsewhere to nurse here? Therefore is it not necessary to get those figures into proportion before we are too critical of the present situation?

§ Lord Hesketh
My Lords, I am grateful for the point made by my noble friend Lord Auckland, because I had hoped to point out in an earlier answer that to a great extent there is a two-way traffic in this affair.

§ Lord Cledwyn of Penrhos
My Lords, my noble friend Lord Prys-Davies asked the Minister a question which he appeared not to have heard. Will he be good enough to reply to it? Are the Government now ready to meet the nurses' unions once again to discuss the matter?

§ Lord Hesketh
My Lords, I can only repeat what I said earlier. My right honourable friend has declined to see the staff side again on the basis that the Government have fully funded the award of some 17.9 per cent.

§ Baroness Masham of Ilton
My Lords, will the Minister accept an invitation to visit the female orthopaedic ward at Leeds General Infirmary where he will find very old out-dated beds, lumpy mattresses which give the patients pressure sores, inadequate washing facilities and frustrated nurses who feel that they could do a better job if there were better patient facilities?

§ Lord Hesketh
My Lords, it is always a privilege to answer a question from the noble Baroness, but I feel that it is slightly wide of the Question on the Order Paper. If she would like to put down a Question on that point I should be more than happy to answer it.

§ The Countess of Mar
My Lords, does the noble Lord agree that the conditions under which nurses work are almost of equal importance as their salaries, and that many of the failings are the result of their feelings that management does not care about them? They rarely see management on the wards. They have the impression that it does not know what they are doing. That feeling was further reinforced during the summer when questions were being asked and DHSS officials said that they had to visit a hospital before they could assess what sisters were doing.

§ Lord Hesketh
My Lords, I am well aware of what the noble Countess is saying. Pay is not the only point. One of the keys of the clinical regrading is to increase career prospects for nurses in the clinical wards. Management, pay and prospects are the three great things needed to make for an even better National Health Service.

§ Lord Molloy
My Lords, is the Minister aware that the question is not merely one of pay? Is he aware that there is grave discontent among nurses, health visitors and midwives, especially on the issue of clincial grading which I mentioned? The fundamental steps have been taken. They now want to sit around the table. Is that a terrible thing to want to do? If the unions had been accused of not being prepared to come to the table to discuss such matters Members opposite would have been outraged, and so would everyone else. Under the leadership of Mr. Hector MacKenzie, who is an expert on these matters, they are willing and prepared to talk to the Minister. Will the Minister try to convince the Secretary of State that he would be helping all Britain's nurses if he were to talk to their professional leaders?

§ Lord Hesketh
My Lords, I believe that it is fair to say that after the pay award has been completed there will be a different point of view.

§ Lord Leatherland
My Lords, does the Minister agree that one of the reasons why there is often a shortage of nurses is that their hands are so eagerly sought in marriage?

§ Lord Hesketh
My Lords, I can only say that we now have a record number of nurses in the health service.