House of Commons
Tuesday 16 July 1996
The House met at half-past Two o'clock
PRAYERS
[Madam Speaker in the Chair]
PRIVATE BUSINESS
Belfast Charitable Society Bill [Lords]
Read the Third time, and passed.
Order for Third Reading read.
To be read the Third time on Thursday 18 July.
Madam Speaker:
I have a short announcement about today's Opposition business. I understand that it is intended that the motions should be dealt with in the following order: the first debate will be on Ministry of Defence housing; and the second debate will be on energy policy. They will not be taken in the order that is shown on today's Order Paper.
1. Mr. Jack Thompson:
To ask the Secretary of State for Health what efforts his Department is making to recruit nurses to the NHS. [35782]
2. Mr. Khabra:
To ask the Secretary of State for Health what recent representations he has received regarding the supply of nursing students. [35783]
The Secretary of State for Health (Mr. Stephen Dorrell):
My Department continues to promote a range of initiatives designed to attract suitable, high-calibre recruits to the nursing profession.
Mr. Thompson:
The Secretary of State must recognise that there is a severe shortage of nurses. Does he recall that, in 1983, 37,000 nurses qualified? His Department predicts that in 1997-98, only 9,000 nurses are likely to qualify. Is that not a disgrace, given the pressure that it puts on nurses in the national health service? Why did he not take notice of the Royal College of Nursing's recommendation two years ago when it warned him of the shortage?
Mr. Dorrell:
First, what I take notice of on the question whether there is a shortage of nurses is the independent
Mr. Khabra:
Does the Minister acknowledge that the drop in nursing student numbers, combined with increased demand, has caused nursing shortages? Is there any evidence that the 14 per cent. increase in commissioning of training places will be sufficient to meet future demand for nurses?
Mr. Dorrell:
I hoped that the Labour party would welcome last year's 8 per cent. increase in the number of nurses going into basic training. This year, there is a further 14 per cent. increase in the number of basic training commissions. That takes us back, as I told the hon. Member for Wansbeck (Mr. Thompson), to roughly the same level of new commissions for basic nurse training as existed in the 1980s. Since then, there has been a dramatic improvement in nurse training because of the introduction of Project 2000, which has led to a reduction in the number of training nurses who drop out of training because they find it unsatisfactory.
Sir Roger Sims:
Is my right hon. Friend satisfied that NHS hospitals can provide not only refresher courses but sufficiently flexible terms and conditions for nurses to encourage the return to the NHS of qualified nurses who may have left to start families and who are now able and willing to give more time to nursing?
Mr. Dorrell:
My hon. Friend is on to a very important point. If we are to ensure that we have the skilled people we need to deliver modern health care, we must of course have a proper level of training, but we must also ensure that NHS trusts are good employers. My hon. Friend suggests some important ways in which we can ensure that we have a well-motivated, fully trained work force. The moves that the Government are making on more locally determined terms for nurses' employment are an important enabling step down the road that he rightly points out.
Sir Anthony Durant:
Does my right hon. Friend welcome the number of nurses who are now working in GP practices that are going in for primary care--a move that takes the strain off hospitals?
Mr. Dorrell:
Yes, I can certainly join my hon. Friend in welcoming the huge growth in primary care nursing over the past 10 years. The number of practice nurses working in primary care 10 years ago was just under 2,000, but it is now 9,000. That is a fourfold increase in the nursing profession's commitment to primary care, which--as my hon. Friend rightly points out--is an important part of the health service.
Mr. Simon Hughes:
Whatever the recruitment figures may have been last year, does the Secretary of State admit
Mr. Dorrell:
The hon. Gentleman is wrong on every one of the points that he made. The Nurses and Midwives Pay Review Body made a specific recommendation, which the Government accepted in full and are implementing. It is not true to say that the Government have introduced a nurses' pay settlement that is below the rate of inflation. The Government have accepted the recommendation of the independent review body that there should be locally determined pay for nurses, with a 2 per cent. floor to ensure that every nurse gets a basic minimum increase.
Mr. Harry Greenway:
Does my right hon. Friend recall the days of that nurse of all nurses, the matron? Will he advocate the return of the matron to hospitals when it is possible and appropriate?
Mr. Dorrell:
My hon. Friend is right to point out the importance of professional leadership in the nursing profession, and the matron is one element that, in some trusts, has been found to be a means of achieving it. The most direct answer to the questions of my hon. Friend and of the hon. Member for Southwark and Bermondsey (Mr. Hughes) is to remind them and the House that, since 1979, nurses' pay has risen by more than 70 per cent. in real terms. That reflects both the commitment to nursing that my hon. Friend seeks and the commitment to proper pay for which the hon. Member for Southwark and Bermondsey argues.
Mr. McLeish:
Will the Secretary of State now accept that a real crisis is facing nursing in Britain? Will he explain to the House why nurses' morale has slumped, why nurse recruitment has collapsed and why the Government are still spending more new money on bureaucracy than they are on nurses? Will he also tell the House why uncertainty in the workplace is driving more NHS nurses away from providing valuable services? Today, will he announce that he will launch a national recruitment campaign to tackle the problem? Will he initiate talks with the Royal College of Nursing and nursing unions about the immediate crisis? Will he stop squandering the most precious asset of the NHS--its human resources? Nurses deserve better from the Government, and surely they should be getting some action from the Secretary of State.
Mr. Dorrell:
The hon. Gentleman has to square his rhetoric with reality. He talks about declining recruitment in nursing. In 1994-95, the figure for recruitment into nurse training was 11,400 commissions; this year, there
Health Authorities (Market Testing)
3. Mr. Michael Brown: To ask the Secretary of State for Health if he will make a statement on market testing by health authorities. [35784]
The Parliamentary Under-Secretary of State for Health (Mr. John Horam): Market testing by trusts has proved very successful in generating savings for the national health service. Approximately £1 billion has been saved since it started. Health authorities are increasingly using the same techniques, although the available alternative would normally be an NHS trust.
Mr. Brown: Can my hon. Friend confirm that South Humber health authority intends to submit the ambulance service to market testing? While I accept and acknowledge that savings can be made, will he confirm that the health authority has no preferred option until the Humberside ambulance service has had an opportunity to ensure that its service is tested so that the benefits so far obtained can be acknowledged by the health authority?
Mr. Horam: I can confirm that there is no preferred option. I am concerned to ensure that, in such instances, there is absolutely fair play. I have gone into those and other instances carefully. Accusations of unfair play are usually made on behalf of the bidder, not the existing provider. I assure my hon. Friend that the regional office will ensure that there is fair play in the case that he mentioned.
Mr. Corbyn: Does the Minister recognise that a consequence of market testing at Hillingdon hospital in west London is that 54 cleaners, some of whom have worked there for 30 years, have been dismissed by the Pall Mall Services Group for refusing to take a pay cut of £35 a week? Does he not think that market testing is responsible for poverty wages for loyal workers within the national health service? Should not those 54 cleaners be reinstated on national health service conditions and repaid for the whole period for which they have been out of work because of the Pall Mall group's determination to make profits at the expense of loyal workers in the NHS?
Mr. Horam: On the contrary, the Pall Mall group, which adequately resources all the services that it provides, gives the workers in question rates that are above the nearest comparator--Heathrow. In the circumstances, they are well paid for the work that they do. In addition, they all received a lump sum to do away with the work restraints that they were putting on the service.
Mr. Tredinnick: Will my hon. Friend confirm that the money saved through market testing is in addition to the extra money that the Government have made available for the health service? Will he also confirm that the Opposition have pledged not a penny of additional money for the health service?
Mr. Horam: My hon. Friend makes a fair point. The £1 billion that has been saved since 1983 as a result of
successful market testing, which has not only saved money but improved quality in many cases, should be set against the paltry £100 million which the Opposition allege that they could save and thereby transform the health service. They should make it plain what we would lose through that "efficiency" if ever there were a Labour Government, not what they would hope to gain.
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