Agency Nurses: Percentages (Hansard, 4 July 2000)

§ Lord Hunt of Kings Heath
My Lords, no data are collected on the number of agency staff working in London at any one time. But the Government have already indicated in their response to the Health Select Committee that the NHS needs to reduce its dependency on temporary staffing. We are ensuring that it takes action to do so.

§ Baroness Masham of Ilton
My Lords, I thank the Minister for that rather inadequate reply. Does he agree with me that sometimes agency nurses with inadequate training are placed on highly specialised wards? Does he further agree with me that this puts patients in a vulnerable position? The nurses feel inadequate. When will sisters come back to work on the wards to give this much needed instruction?

§ Lord Hunt of Kings Heath
My Lords, sisters play a vital role in leadership in wards. The Government are determined to give as much support as they possibly can to their work. I fully accept the noble Baroness's point. We must ensure that when agency nurses are placed in ward situations they are suitably qualified and are able to accept the responsibility placed on them. Part of the work that we are undertaking, both at national level and in London, is to ensure that we develop good practice so that trusts use agency nurses appropriately where they have to be used, and to ensure that we have other mechanisms by which trusts—perhaps through nurse banks, sharing services between different trusts—can reduce the need for agency nurses.

§ Lord Campbell of Alloway
My Lords, may I respectfully direct the Minister to the Question and ask him whether he would be good enough to answer it and refrain from bamboozling this House with verbiage?

§ Lord Hunt of Kings Heath
My Lords, I think that I did answer the Question. I said that no data have been 1385 collected on the number of agency staff working in London at any time. The issue is a serious one. An analysis of the amount of money spent by NHS trusts on agency staff indicates that in London it varies as a percentage of employee costs from between 2 per cent and 15 per cent, with an average of around 9 per cent. It is the Government's contention that while there will always be a need for agency nurses, that figure is too high and we need to reduce our dependency; hence the work both in London and nationally to deal with the problem.

§ Lord Morris of Castle Morris
My Lords, can my noble friend kindly explain why an efficiently run National Health Service needs to use any agency nurses except in cases of dire emergency? Could it be the result of bad planning in the past?

§ Lord Hunt of Kings Heath
My Lords, the party opposite has a good deal to answer for. It has a good deal to answer for as regards its decision in the 1990s to reduce the number of nurse training places. Noble Lords will know that we have reversed that trend and increased dramatically the number of nurse training places. In answer to my noble friend I would say that there will always be a need for some agency staff—to cover increased demand for staff when it is uncertain how many staff one needs, periods of high activity and to cover holiday periods and sickness. I would say also that when nurses return to work as nurses, which we want to encourage, there is some evidence that many of them prefer to return through agency nursing programmes. The way to tackle this issue is: first, to increase our efforts to recruit more nurses—and that is happening—secondly, to increase the number of nurse-training places—and that is happening—and, thirdly, to increase the use of nurse banks—and that is happening. In combination, I think that we can reduce the number of agency nurses.

§ Lord Clement-Jones
My Lords, the Minister referred to the success of the nursing recruitment drives. The fact is that in the past year the cost of agency nurses has increased on a national basis from £264 million to £344 million. It was recently reported that we are recruiting nurses from as far afield as China. Surely the Minister cannot claim that that is a success.

§ Lord Hunt of Kings Heath
My Lords, the national nurse recruitment campaign has been successful. For instance, nearly 14,000 qualified nurses and midwives have approached their local education consortia for information about either becoming nurses or returning to nursing and 3,845 nurses and midwives have already returned to employment in the NHS in England. A further 2,000 are preparing to join them after completing refresher training. With regard to the recruitment of overseas nurses, the health service has always recruited nurses from overseas. That has been beneficial both to the UK and to those countries. It has 1386 enabled links to be maintained. It helps our health exports. It is done on an ethical basis. I see no problem with that.

§ Lord Roberts of Conwy
My Lords, with regard to returning nurses, is it not a fact that when nurses leave the NHS and return at a later stage they take up their jobs at a lower salary than when they left? Would it not be extremely helpful in terms of keeping up NHS nurse numbers if that problem was looked at?

§ Lord Hunt of Kings Heath
My Lords, I know that it is an issue which has been raised. It has also been raised in relation to nurses who, for instance, have perhaps left the NHS, gone to work abroad for some time and enhanced their experience and leadership skills but have then found it difficult when they came back to the NHS to be employed at their old grade. This is an issue which needs to be tackled both by individual trusts and by the various strategies we have in relation to nurse pay and conditions. There is no doubt that the quality of our nursing workforce is very high. We must reward them for that.