NHS Nursing Strength (Hansard, 14 May 1990)

Barones Blatch
My Lords, there is no national shortage of nurses in the National Health Service. A survey by the Office of Manpower Economics showed that at 31st March 1989, 3.2 per cent. of all qualified nursing posts in Great Britain had been vacant for three months or more, compared with 3.3 per cent. in 1988. The number of nursing staff employed in the National Health Service rose by 13.2 per cent. between 1979 and 1988. Even after allowing for the change in working hours from 40 to 37 ½ in 1980–81, the increase is still over 6 per cent.
Obviously there will always be recruitment difficulties in particular areas and specialties. However, the declining numbers of school-leavers over the next few years has implications for the National Health Service.

§ Lord Molloy
My Lords, does not this flurry of figures constitute a hopelessly inadequate reply to a question about the chronic shortage of nurses in the 9 NHS? I am willing to challenge the Minister to say so if I am incorrect, but I believe that this shortage can be testified to by the Royal College of Nursing and the major royal colleges, which are all woefully aware that there is a chronic shortage of trained nurses. The Government's response is to try to get agency nurses, which costs £33 million more per year. They go to EC countries and non-EC countries, and is the noble Baroness aware that they even go as far as Hong Kong? Many of the so-called nurses recruited are far below our standards; some of them have no proper salary. All this constitutes a threat to the National Health Service.

§ Baroness Blatch
My Lords, the facts simply do not bear out anything that the noble Lord has just said. I shall deal with just one inaccurate figure that the noble Lord gave concerning agency staff. Of all staff employed in the National Health Service only 1.5 per cent. are agency nurses and of that figure 83 per cent. are employed in Greater London. As I said in my initial Answer, there will always be particular difficulties with specialisms in certain areas, but the facts that. I gave in that Answer do not bear out anything that the noble Lord has said.

§ Baroness Ewart-Biggs
My Lords, is the Minister aware that the National Health Service loses married nurses with children because of the low rate of child care and creche provision that is made? Will the Minister say what the Government think about that?

§ Baroness Blatch
My Lords, it is true that nurses leave the health service for retirement, pregnancy, family reasons and other reasons. However, the figures again show that there has been a net gain to the nursing service. Some 24,200 nurses a year leave nursing in England but in 1988 to 1989 that figure was mors than covered by 16,400 new nurses qualifying. In addition, 9,700 nurses returned to nursing. That made a total of 26,100 nurses. That represents a net gain to the nursing service.

§ Lord Dormand of Easington
My Lords, what are the specialties in which there are shortages and what are the Government doing about that?

§ Baroness Blatch
My Lords, I can list a number of things the Government are doing as regards improving recruitment and retention of nurses. A massive advertising campaign is being conducted and has already produced 170,000 inquiries about nursing as. a career. There are a number of district health authorities which are targeting mature entrants and re-entrants to the service. Pay has increased in real terms by 43 per cent. There is a pilot scheme of flexible pay arrangements which enables more money to be paid for particular specialisms and scarce specialisms. There are local initiatives, flexible working, job sharing schemes and child care schemes. The Department of Health is supporting the Open College's return to nursing project which is offering a package of resource materials that will be launched in September. I could go on.

§ Lord Dormand of Easington
My Lords, my main question was: what are the specialties in which there are shortages? May I have an answer to that question, please?

§ Baroness Blatch
My Lords, I referred to particular shortages. I have described some of the ways in which those shortages are being addressed by different district health authorities. A considerable amount of work is being carried out in this respect.

§ Lord Ennals
My Lords, is the Minister aware that I am amazed by her Answer? If there is no shortage of nurses, why has she referred to a massive advertising campaign to recruit more nurses? Further, has the Minister seen the report that was published today which showed that in every single region there is a grave shortage in the number of nurses being recruited? This is more serious in some regions than in others. Did the Minister also see the statement made by the general secretary of the Royal College of Nursing which emphasised the problem of the shortage of nurses and the need to improve conditions, not just pay but also creche facilities and opportunities for part-time work? Those facilities have proved to be absolutely inadequate. I am amazed by the Answer the Minister gave.

§ Baroness Blatch
My Lords, I have read the press reports published today. I believe they did a great disservice to the amount of work that is being carried out in many district and regional health authorities. I checked one of the reports concerning a health authority which was deemed to be the fourth worst in the country. I must report that that authority had 9,644 qualified staff in post at the end of March this year. That is 225 nurses up on the previous year. That figure represents the highest number of qualified staff at the end of the year. If one asks health authorities whether they are having difficulties in recruiting nurses, the answer is yes. However, if one asks them whether nurses are in post after many of the efforts that I have outlined have been made, the answer is that the nurses are in post.

§ Lord Auckland
My Lords, I have recently travelled in the Nordic countries, Australia and New Zealand. Is my noble friend the Minister aware that those countries have a far smaller population than this country but our nursing recruitment is much better per capita than that in those countries which have a nursing shortage, particularly in rural areas? Is she further aware that as regards exploitation.—

§ Lord Denham
That is two questions!

§ Baroness Blatch
My Lords, I believe I have covered the particular difficulties experienced by some local authorities. I have also outlined the enormous efforts that are being made by many district health authorities to improve recruitment and to face up to the difficulties that will occur when a shortage among the people available for nursing arises due to the fall in the numbers of 16 year-olds in the population.

Lord Wallace of Coslany
My Lords, will the Minister say what effect the payment of the poll tax by nurses has had on recruitment?

§ Baroness Blatch
My Lords, it is much too early to give a specific answer to that question. However, eventually all nurses will be trained under the auspices of Project 2000 and will receive the maximum relief for the community charge. If a special case were made for nurses it would discriminate quite considerably against many young people who earn the same as student nurses.

§ Lord Molloy
My Lords, will the noble Baroness be kind enough to consider contacting the Royal College of Nursing, the Confederation of Health Service Employees and the Royal Colleges of Physicians and of Surgeons to seek their views on what they feel is a chronic situation as regards the shortage of nurses? I think that is a fair proposition.

§ Baroness Blatch
My Lords, the department is in touch with all those bodies all the time. I believe that that is right and should continue. However, I also prefer to deal in facts.

§ Lord Mellish
My Lords, is the noble Baroness aware that some of us were intrigued by the statement in the Question that foreign nurses who are being employed to make up the shortfall may be exploited? As far as I can judge, the reply that the Minister gave has not resolved that problem. Is she further aware that if I had any evidence that such exploitation was occurring I would go direct to the Minister and would not waste my time putting down a Question?

§ Baroness Blatch
My Lords, I believe the remarks of the noble Lord were comments rather than a question. However, had that part of the Question been addressed, I could have proved that there was no exploitation of these young people.