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Lord Rotherwick: My Lords, does the Minister agree that it is not correct to seek to benefit our national health system by recruiting nurses from countries such as the Philippines, which has been done over recent years? Surely it is wrong that such countries should be denied the benefit of using their own highly skilled nurses, who have been trained using only the scarce resources that are usually available?
Lord Hunt of Kings Heath: My Lords, I agree with the general proposition that recruiting from countries overseas would not be advisable if that action would have a detrimental effect on the home healthcare systems of those countries. That is why, in November last year, the Government published guidance to the NHS which stressed that, while international recruitment should be valued for its contribution to this country's health services, it is a viable proposition only when, first, its benefit to an individual NHS organisation can be demonstrated and, secondly, such recruitment into the NHS will not have a negative impact on the home country's healthcare system. I am confident that NHS organisations are recruiting internationally according to those guidelines.
Lord Taylor of Blackburn: My Lords, is the Minister aware that, even when experienced people do decide to return to the service, they are often placed at the lower end of their grading for pay? That is the case even for those with great experience. Does the Minister agree that this does not serve to encourage experienced staff to apply for posts?
Lord Hunt of Kings Heath: My Lords, my noble friend usually tells me what he wants me to know. I agree that it is important that experienced nurses who are attracted back into the National Health Service after having moved away from their careers for some time should be given every support and encouragement. As regards the issue of grading, of course such matters must be left to be decided by each individual NHS trust. However, I agree with my noble friend that, when reaching such decisions, it is important to take into account the valuable past experience of nurses who have been away from the profession for some time.
Baroness Northover: My Lords, does the Minister agree that, while the recruitment of nurses is clearly urgent, of much greater concern is the retention of staff? Does he further agree that if he were to tackle low morale, inflexible working arrangements and low pay more effectively, that would help to solve the recruitment problem?
Lord Hunt of Kings Heath: My Lords, I certainly agree that the retention of nurses is very important. In regard to pay, our decision to accept without question the recommendations of the pay review body has been a considerable improvement on previous practice. I also agree that introducing more flexible working practices is a way of encouraging more nurses to stay in the National Health Service. There are now many examples where NHS trusts have recognised the need for better HR strategies and improved support. This is paying dividends. We are seeing more nurses coming back into and staying in the service. We have to redouble our efforts, but I am convinced that we shall achieve the 20,000 extra nurses we require in accordance with the targets set in the NHS plan.
Lord Hunt of Kings Heath: My Lords, as I said, we have 10,000 more nurses working in the health service now as compared with two years ago. In relation to the specific campaigns, 3,000 nurses returned last year; nearly 2,500 have returned since March; and another 2,200 nurses are preparing to return to the health service. We are running another campaign in certain
The Parliamentary Under-Secretary of State, Foreign and Commonwealth Office (Baroness Scotland of Asthal): My Lords, the Government have made clear on a number of occasions that we are prepared to look pragmatically at extending the areas subject to qualified majority voting where this would benefit Britain, while ruling it out for areas of key national interest. As at Amsterdam, we believe that in the interests of a more efficient Commission the larger member states should be prepared to give up their second Commissioner provided that a satisfactory agreement is achieved on the re-weighting of votes in the Council. We have made clear that there must be substantial re-weighting in Britain's favour if we are to give up one of our Commissioners.
Lord Renton of Mount Harry: My Lords, is not this an issue on which the Government will have to come rather more off the fence, and fairly quickly? Clearly the question of the extension of qualified majority voting is highly emotive. Does the Minister agree that, arguably, it could be the fault line that divides those who, in the famous words of the treaties, want an ever closer Union from those who want a more effective Union but do not want it to be any closer? Will there
Baroness Scotland of Asthal: My Lords, perhaps I may first thank the noble Lord for his kind compliments on my return, and all noble Lords who have generously asked after my health. I am very glad to be back.
As to the noble Lord's supplementary question, the Government have not been on the fence. We have taken a balanced and realistic view of what is in the best interests of this country. The noble Lord will know that the majority of decisions in Europe already are taken by the use of qualified majority voting. We have been clear that where qualified majority voting will inure to the benefit of Britain, we will contemplate change. Where it will not, we will not. That has been our position for some time. It is a sound position and one which we propose to continue.
Lord Harrison: My Lords, does my noble friend agree that by the judicious extension of QMV we can make the single European market more open to British business? This will provide more opportunities for British firms and will translate into prosperity and jobs.
Baroness Scotland of Asthal: My Lords, I agree with my noble friend that judicious extension of QMV may inure to our benefit, as I said to the noble Lord, Lord Renton. We shall be vigilant to ensure that it is only on occasions when it will inure to our benefit that we will give it consideration.
Is it not correct that some extension of qualified majority voting and some reduction in the number of Commissioners is crucial to the enlargement of the Union, a goal shared by many of us on all sides of the House? Can she say whether, with the extension of qualified majority voting, the Government would support, as a broad general rule, co-decision making by the European Parliament in order to strengthen the democratic accountability which is so crucial to the success of the Union in future?
Baroness Scotland of Asthal: My Lords, I join wholeheartedly with the noble Baroness in saying that the Government are committed to the enlargement of the European Union. We have been at the forefront of that, and quite rightly too. So far as concerns qualified majority voting, I repeat what I said earlier. That must remain the case. The issue of co-decision making is being looked at by a number of parties and we have said that we shall consider the matter. But the noble Baroness perhaps pushes me to go further than the Government are minded to go at the moment.
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