Examination of Witnesses (Questions 957-959)
LORD HUNT
OF KINGS
HEATH, MS
CLARE CHAPMAN
AND MR
NIC GREENFIELD
25 JANUARY 2007
Q957 Chairman: Good morning. Could I
welcome you to what is now our eighth evidence session, we think
our final evidence session, on our inquiry into workforce planning.
I wonder if I could ask you, for the sake of the record, to introduce
yourselves and the position that you hold.
Ms Chapman: Clare Chapman, the
Director General of Workforce for the NHS.
Lord Hunt of Kings Heath: Lord
Hunt. I have ministerial responsibility for workforce planning.
Mr Greenfield: Nic Greenfield.
I am the director of education, regulation and pay and was the
acting Director General of Workforce for the last eight months.
Q958 Chairman: Welcome, and welcome
back, I think, in your case, Lord Hunt. You are back into the
fold of the National Health Service as a Minister now. I am sorry
you are in at the deep end. I know you have not been around for
the vast majority of our inquiry. Nonetheless, I have no doubt
you have been well briefed on what sessions we have had up-to-date.
Can I begin by looking at the issue of the workforce since 1999?
The NHS Plan and the major growth in the NHS budget
led to what has been unprecedented workforce expansion between
the years 2000 and 2005. Was the cost of the rapid expansion of
the NHS workforce explicitly assessed at national or regional
level?
Lord Hunt of Kings Heath: Could
I, first of all, thank you, Chairman, for your warm welcome. I
am looking forward to working with the Select Committee again.
I think my last appearance was about four years ago when we discussed
the issue of NICE, so some things do not change. Of course, the
huge increase in staff that we have seen in the Health Service—over
300,000 more people now working in the Health Service—has
been an absolute integral part of the implementation of The
NHS Plan. Without it we would not have been able to develop
services or reduce waiting times and all the other new developments
that are taking place in the Health Service, so, clearly, that
has to be seen as an integral part of the overall planning. I
think, if the implication of your question is the extent to which
workforce planning and actual planning and service planning are
all integrated, my answer to you would be (and I am in my third
week, so I am giving you a general view of how I think things
have gone) that historically the NHS has found it very, very difficult
to integrate those functions. I think, if you look back over 20,
30, 40 years, historically what has happened with the workforce
is that there has been a see-saw effect: at times in history you
have expanded training places, large numbers of staff coming in,
the Health Service did not have the money to employ them, the
tap was switched off and then you went from one situation to another.
I have no doubt that the Select Committee will want to ask about
some of the challenges that we face with the workforce at the
moment, but the fact is that we are much better balanced than
I believe the Health Service has ever been. We have addressed
the issue of the large-scale shortages that were apparent in the
NHS in the 1990s. Of course there are issues and challenges, and
the whole point about workforce planning, the work that is going
to be done, is being done at the department and also at the local
level, is trying to make sure that we do match, as far as is possible,
supply and demand of staff with the finance available and the
service developments. I am not saying that we do not have some
issues and problems at the moment, but I do think overall, compared
with where we have been, we are in a much better position to deal
with them.
Q959 Chairman: I do not dispute at
all, I do not think anybody would, that the recruitment (a) was
probably necessary and (b) did go ahead. What we really would
like to question is in the National Health Service Plan
there was a plan for job growth, if you like, or employment in
different grades. I have got in front of me a comparison of targets
growth in The NHS Plan 2000 and the actual
growth (and this is between 1999 and 2004) for consultants was
actually under target in that particular year. The projected new
staff was 7,500 and it was actually 7,329. All the others—GPs,
nurses and allied heath professionals—were over recruited,
GPs by over 100% more than what it said in The NHS Plan,
Allied health professionals 69% over target and nursing 340% over
target. If we had a national plan that said we want growth in
National Health Service jobs at the level The NHS Plan
did, who is responsible for these over-recruitments (for want
of a better expression), certainly well above target, that did
actually take place as opposed to what we assume was planned to
take place? Is it the responsibility of Richmond House, SHAs,
foundation trusts, hospitals or PCTs? Where is the responsibility
in meeting these targets on jobs and increasing staff.
Lord Hunt of Kings Heath: Chairman,
clearly different parts of the system have different responsibilities.
At a national level, ministerially I now have that responsibility.
The team that you see before you is clearly responsible for strategic
direction and overall leadership. Equally, a lot of these decisions
have to be made at local level, and that is why we think that
the role of the new Strategic Health Authorities is going to be
so important in the future. They have to look at long-term trends,
they have to work with individual trusts to see what the likely
demands for future staff are. They then have to work with higher
education institutes and they do have to take a long-term position.
The job that the Department of Health has in relation to leadership
is to monitor the work of the SHAs, making sure that it all adds
up to coherence and that we do get the right number of staff in
the right places. I would have to say, Chairman, that my experience
again at the NHS is that, whilst you will never get an absolutely
perfect match, what we are trying to do is to make sure it is
as good as possible.
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