Steve Barclay
MP for North East Cambridgeshire · Conservative · United Kingdom
“I speak to my brief exchange earlier with the Minister. As the previous speaker, the hon. Member for Harpenden and Berkhamsted, said, the draft regulations are fairly benign and very welcome to help people who are struggling with their bills.”
“The issue is not the lack of will; the issue is the alignment between procurement, regulation and clinical leadership, particularly in the colleges, as well as the ability to scale innovation—it is not about having more ministerial pilots.”
“Just to localise it to my own constituency, the Cambridgeshire and Peterborough ICB alone paid out £14 million in redundancies last year. It merged with a number of other ICBs to form the Central East ICB, yet we know hear from the Government that it should align with metro mayors, which means going back to exactly what it was before: the…”
“My right hon. Friend is absolutely right: the Government are spending millions of pounds and there is no plan. The measure was announced without working that out, it came as a surprise to many within the system, and it has had a chilling effect on many decisions. That is not isolated.”
“I rise to speak to clause 1 on the abolition of NHS England and clause 6 on promoting innovation. What characterises the first of those is an announcement without any clear plan. That is what has driven the cost and confusion that a number of Members across the House have spoken about.”
“All this is around 18 months on from the actual announcement. The confusion seems to extend to the Government themselves, because they seem unable to answer pretty straightforward written parliamentary questions. Given the time limit, I will give just a few examples.”
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“Friend the Member for York Outer (Julian Sturdy) recognised it in expressing his frustration with one or two meetings and asking whether decisions on property are aligned with the place-based approach. The first point I will make to the hon. Member for Bristol South is that the long-term plan and the future discussions about the NHS give us the opportunity to look at wider system changes around integration and place-based healthcare, and how property aligns with that—for example in York, which has been discussed—as an enabler of change in a more holistic approach. As such, her remarks are timely as part of that wider debate. The hon. Lady mentioned Knowle West health park, which, if I am honest, I looked at for the first time when preparing for the debate; I was not as sighted on that as I might have been.”
“It is a pleasure to serve under your chairmanship once again, Ms Dorries. I pay tribute to the hon. Member for Bristol South (Karin Smyth) for bringing such an important issue before the House. The hon. Lady opened by saying that property may not be the most exciting of topics but, as her speech set out, it is integral to the healthcare service offered in local settings. The substance of her remarks was whether we can better align the property estate with a place-based approach to healthcare. As we move to a more integrated and place-based approach to health, I think there is cross-party consensus that property has an important role to play as an enabler of that. The hon. Member for York Central (Rachael Maskell) kindly recognised that that is very much the approach that I have taken in my post, and my hon.”
“She is absolutely right—Government Members and other Opposition Members also recognised this—about the centrality of property to the place-based approach that we seek to take. I am happy to have a separate discussion with her on Knowle Park to check whether that is now in the right place or whether further work is needed. I look forward to further discussions with her on how we should utilise the property estate in the most effective way. Question put and agreed to.”
“It is an enabler, and it often results in people getting paid more for a role, although there may be other, less favourable terms and conditions to offset that. I merely point out that those were exactly the arrangements reached for Members, and I do not remember too many press headlines suggesting that Members were being exploited by that change. Secondly, I remind the hon. Lady that, as I am sure she is well aware, legislation introduced by the last Labour Government enabled wholly owned subsidiaries. Again, I do not recall Labour Ministers, when taking that legislation through the House, suggesting that it would provide a way of exploiting NHS workers or privatising the NHS. I commend the hon. Lady for the points she raised. This is a timely debate given our discussions with the NHS leadership on the long-term plan.”
“However, I am mindful, as I know he will appreciate, that these are often independent bodies making independent decisions, and we need to look at how they fit into the system. A further point raised by the hon. Member for Bristol South, although it is slightly outside of the scope of the debate, was about wholly owned subsidiaries, which she also raised in more detail in the estimates debate. I make two points. First, as she knows, subsidiary companies actually give greater flexibility to trusts that want to compete in a local market and perhaps offer higher salaries offset by changes to pensions. That is one way in which trusts are empowered and enabled to hire in a competitive market, for instance in the case of maintenance staff.”
“Friend the Member for York Outer, and has been inherent in points made by the hon. Member for York Central in our previous discussions. Property does not sit in a silo but is inherent in the wider service offering, and it also plays into reconfigurations. A key part of clinically led reconfigurations of estates to drive productivity will be what property there is to enable that and how to utilise it. The point on which there is a degree of cross-party consensus, as my hon. Friend the Member for Henley (John Howell) recognised, is that decisions need to be accountable. Likewise, I am happy to pick up on the point he raised on behalf of his constituents about there being no accountability. That is an absolutely fair challenge to the Department and one that I am very happy to look at.”
“I was trying to make the point that greater transparency on the true cost of the estate drives behaviour to use the estate more effectively. Part of the difficulty has been that, because the estate was not adequately charged market rents in some areas, moving to a fairer and more transparent assessment of market rents—these things are independently assessed, I hasten to add—is a difficult adjustment. However, a consequence of correctly assessing the value of the estate is the unlocking of efficiencies where the estate is not being utilised, and that money can then be reinvested into the system. I absolutely agree with the hon. Lady’s wider point, which I took as the substance of her remarks, that property is the enabler of system change. That also came out in the points raised by my hon.”
“That is a real win-win, and the demographics of the Island offer an opportunity in that regard.”
“As patients present with multiple conditions and as we move away from silos of care to a more holistic approach to patients and their wellbeing, the Island offers a huge opportunity for greater integration. On my hon. Friend’s point about data, I had an interesting meeting yesterday with the chief executive of the Christie in Manchester, which is one of our outstanding trusts. I was struck by the fact that 19% of its patients take part in medical research programmes. The chief executive set out how that is hugely beneficial to the trust and to the patients, who get access to cutting-edge drugs and the latest thinking. He has also been able to attract some of the world-leading figures in research because he has a population that researchers can work for, which is very attractive to them.”
“That funding recognised some of the Island’s specific geographical challenges. Although geography can be, and is in certain areas, a disadvantage and a driver of cost, it is also a driver of opportunity, as my hon. Friend set out. The Island has a strong sense of place and identity, and there are strong personal links between key decision makers and stakeholders. As the shadow Minister rightly said, the move towards greater integration between health and social care—as is reflected in the name of the Department—is also an opportunity to drive integration between the council and health services. My hon. Friend alluded to the bureaucratic obstacles to that, and I am happy to work with him to overcome them.”
“Those decisions are common to other areas, but they need to be made in respect of the Island. If my hon. Friend wishes, I am happy to facilitate a meeting with NHS England so the funding pressures pertaining to the demography of the Island can be raised. He will recognise that the setting of the funding formula is an independent process. There are specific issues about the geography that my hon. Friend raised very well, not least about maternity services and paediatrics. The Island needs to supply those services and that will have an impact on its funding. I am happy to look at those issues. Integration is one way that headroom will be facilitated to meet those challenges. As he said, the Island was a vanguard site that has received £8.4 million of extra funding since 2015 to facilitate the transformation of services.”
“Alongside that, NHS leaders are drafting a long-term, 10-year plan on services, which will look at many of the issues he cited in his speech. As we start that journey with NHS leaders, bringing the issues of the Isle of Wight front and centre is timely and helpful. I would segment the funding formula issue into two: the challenges that the Island has in common with other parts of the country, such as those posed by the over-80s and by the significant number of constituents with dementia, and those that are unique to it. Indeed, few hon. Members feel that their constituents’ circumstances do not merit being higher up the funding formula than they currently sit. It is valid to raise those issues, and NHS England will look at them on the advice of the Advisory Committee on Resource Allocation, which advises on the funding formula.”
“It is a pleasure to serve under your chairmanship, Mr Hanson. I pay tribute to my hon. Friend the Member for Isle of Wight (Mr Seely) for raising the issue in the way that he has. He has used Westminster Hall exactly as it should be used—to bring the concerns of his constituents front and centre before the House. He set out not only the challenges faced, but the ways forward and a number of solutions for different issues. In short, he raised issues of funding that relate to population and geography, travel, the potential for further integration, and also a way forward involving digital and data. I will address each of those in turn. This is also a timely debate, as the shadow Minister mentioned, following the Prime Minister’s announcement at the Royal Free Hospital last week of a significant funding boost to the NHS.”
“As part of the workings of the long-term plan, those leaders will need to look at what they need, and whether much of the integration—I know that the Mayor of Manchester supports the integration that is taking place in Manchester—can be done under existing legislation, or whether changes are needed, and if so, what those are. That will be part of the discussions with Simon Stevens and others in the weeks and months ahead.”
“I am very happy to follow up this debate by meeting my hon. Friend, and to facilitate a discussion between him and NHS England, to ensure that we deliver what he has campaigned passionately for—the best healthcare for residents of the Island—and that the significant investment set out by the Prime Minister is maximised for his constituents. The shadow Minister quite reasonably asked whether we were open to changes to the legislation. As he will be aware, the Prime Minister said to the NHS leadership in her remarks at the Royal Free Hospital that we are open to such suggestions if NHS leaders feel that changes are necessary.”
“Friend has set out that the Isle of Wight is ideally placed to be at the vanguard of the NHS’s approach as we move forward with the 10-year forward view, in embracing digital and integration and in looking at how to deliver place-based commissioning most effectively. There are some specific challenges with regard to its population and its geography in terms of travel. The interplay of those two things is another challenge in terms of efficiencies of scale and the services that are considered essential on the Island, which may be dealt with at a larger-population level elsewhere. In the NHS more widely, as we move to a hub-and-spoke model and to more flexible population sizes, and as we look at place-based commissioning, the Isle of Wight has huge potential to be at the forefront, as my hon. Friend has set out.”
“Again, the challenge of distance is not unique to the Island, but as he mentioned, there are certain features of travel to the Isle of Wight and the Scilly Isles that pose challenges. As my hon. Friend will be aware, the NHS healthcare travel cost scheme provides financial help for travel costs for patients on low incomes who are referred. The scheme is part of the NHS’s low-income scheme, under which people are also entitled to free prescriptions and glasses. Under the scheme, the full cost of transport can be reimbursed by the NHS to eligible patients. Schemes are in place, but I hear the wider points that he has raised and I am happy to discuss them with him. In short, my hon.”
“That offers significant scope. On travel, I heard my hon. Friend’s remarks about the cost and its wider impact on families. There is a correlation with a separate debate we have had about car parking charges. Clearly, there are specific challenges related to travel, but as he also set out, it is quite complex, because there are already arrangements with the ferry companies and national schemes for subsidies and assistance that can be given to people who are financially challenged. It is a question of looking at how we can fit in with the existing schemes and what agreements can be reached with the companies concerned. I am happy to meet him to pick up on that specific point to better understand our current approach and what can be done, given the challenges.”
“I recognise that if the clinical commissioning group is in deficit, finding the headroom to invest in that technology becomes a trade-off and a challenge, but that is one of the opportunities that will be opened up by the Prime Minister’s investment in the NHS and it is an area that the 10-year forward view will specifically examine. In terms of timing, the Island has a chance to look at how it can become a leader, what has been done with digital enablers and early adopters in the NHS, and in which areas it can lead on in technology. I will come on to the challenges of travel, but reducing the need for journeys is a more sustainable solution than seeking to subsidise them. Our starting point should be how we can use technology to reduce the need for as many journeys, rather than how we can subsidise more journeys.”
“I do not know what percentage of its patients are taking part in research, but that may be an area for him to explore and for the Department to work with him on. My hon. Friend also raised the potential of digital. He will be aware that the Secretary of State has asked Dr Eric Topol, one of the world leaders on the use of digital in healthcare, to undertake a report for the Department. My hon. Friend is right that rather than a patient having to be physically present in all instances, as was traditionally the case, there is scope to use digital much more for them to see a consultant online and for information to be sent digitally.”
“I am keen to work with my hon. Friend on that, because the Government have prioritised their research and development budget, as I know from my time at the Treasury. A significant investment has also been made in health R&D. The NHS has an opportunity to combine its patient data with our world-leading universities and R&D to attract researchers, drive forward the most innovative approach on healthcare and translate that cutting-edge research into day-to-day care. That can be a frustration for our constituents; it is fine to have the research, but we need to roll it out to scale in a way that is meaningful for patients. The challenge of the Island’s geography is also a huge advantage to it.”
“While any such changes should pay due regard to the fact that autonomy in appointing executives is an important NHS foundation trust freedom, I assure the House that I will be working with NHSI to ensure that the irregularities regarding this appointment do not occur in the future. The hon. Gentleman has done the House a service in highlighting the clear irregularities in respect of this appointment. I hope that my response goes some way to reassuring him that NHSI will work with the Department to ensure that further irregularities do not occur. Question put and agreed to.”
“After 2006, there were no personal or professional links until the Chair was appointed as the Chair of the University Hospitals of Morecambe Bay NHS FT (2014-2018).” It is clearly difficult to reconcile the involvement of chief executives in the process of selecting chairs with principles of good governance. This appointment took place under the system of foundation trust autonomy put in place under successive Governments, and is a matter for the foundation trusts themselves. However, NHSI recognises that the role it plays in board appointments, both executive and non-executive, is not sufficiently clear and that there would be benefit in reviewing and codifying its oversight and support arrangements.”
“I have had a personal assurance from the chief executive that there has been no contact between her and the chair of Salford Royal NHS Foundation Trust, and that she has not in any way tried to influence the decision-making process leading to the chair’s appointment. The chief executive’s letter to me, dated 27 June—it might be helpful to the House if I quote it—goes on: “I did know the new Chair on a professional basis prior to his appointment. We have worked within the same Health Economy for a number of years and attended the same strategic meetings and events. For clarity, the Chair was the Chief Executive of the Strategic Health Authority (2002-2006) whilst I was the Chief Executive of Blackpool PCT.”
“Gentleman, I will read directly from that letter to me: “I would like to reassure you that we had already taken a decision to review our Constitution to remove any ambiguity in respect of the appointment of the Chair and Non-Executive Directors.” I will happily share that letter with the hon. Gentleman. The independent assessor on the panel was the chair of Salford Royal NHS Foundation Trust. He agreed as to the candidate recommended by the nominations committee’s interview panel to the council of governors, and has not raised objections about how the process to recruit the new chair was run.”
“Gentleman’s letter to the trust of 17 May referenced the trust’s council manual, pointing out that it did not include any reference to the chief executive sitting on the nominations panel. This document sits under the constitution of the trust, and I am satisfied that the explicit rules addressing this matter in the constitution have been followed. I have today received a personal assurance from the trust chief executive, Wendy Swift, that the trust will review its constitution to remove any ambiguity in respect of the appointment of the chair and non-executive directors. Just to reassure the hon.”
“The email did not include the closing date for applications, further hampering MPs’ ability to contribute effectively to the process. I understand that the recruitment process began in February and concluded in May, with the new chair in post from 1 June. The recruitment company has confirmed that this process was run to a standard timeframe. That raises the question of why the local engagement, an important part of the overall appointments process, appears to have been rushed in this instance. There are clearly lessons to be learned, and I will be working with NHSI to ensure that its guidance is refreshed, and that it is clear in its advice to foundation trusts and trusts about the importance of local engagement. The hon.”
“Gentleman’s letter of 3 May, which fails to refer to its own guidance regarding the need to ensure that the chief executive is not permitted to vote on the appointment of a chair to whom he or she will be accountable. That is regrettable, and I understand that NHSI will write again to him to apologise for that error. The third irregularity highlighted is the speed of the process. The nominations committee engaged recruitment consultants GatenbySanderson to provide professional services during the recruitment process. Part of that process involved emailing local MPs to inform them that the recruitment process was taking place. However, as the hon. Gentleman has highlighted, there was little time between that email being sent and the closing date for applications—10 working days over the Easter holiday period.”
“I have been informed that guidance on this topic is being refreshed by NHSI as part of the review of NHSI’s role in board appointments following Dr Kirkup’s findings in relation to Liverpool Community Health NHS Trust, to which the hon. Member for Blackpool South referred, and I have asked for the lessons learned to be fed into that refresh. The chief executive did voluntarily stand back from the process after concerns were raised by the hon. Gentleman regarding her involvement. That was before the final interview was held for any of the candidates. Though it might be fair to ask whether involving the chief executive in the recruitment of the chair was the wisest course of action, it was within the trust’s constitution. The second irregularity is the response from NHSI to the hon.”
“While she did not breach the guidance, it is clear to me that if a chief executive should not vote on the appointment of the chair, it follows that a chief executive should also not be involved earlier in the appointments process, given the relationship of accountability that exists between chief executives and chairs of NHS trusts and foundation trusts. However, I recognise that that instruction was deep within guidance dating from 2012, and there have been other pieces of NHSI guidance for foundation trusts regarding their governance arrangements that did not contain similar advice. There is an expectation that advice and guidance given to NHS trusts is clear and understandable.”
“The process followed by Blackpool is explained in the trust’s own constitution, which sets out the make-up of the nominations committee responsible for senior appointments. That committee is made up of six individuals, including the chair, or another senior role if the chair is the position being recruited for, as well as three governors and the chief executive. The sixth member is an independent assessor—in this case, the chair from another foundation trust, Salford Royal. This is where the first irregularity arises. NHS Improvement guidance states that a foundation trust’s chief executive should not be permitted to vote on the appointment of the chair to whom he or she will be accountable. However, in this case, the chief executive was on the nominations committee for this role.”
“I therefore welcome the opportunity to focus on these irregularities and will address each in turn. The previous chair of the trust resigned in January 2018 to take up the role of chair in another, nearby foundation trust, University Hospitals of Morecambe Bay. That caused a recruitment process for the chair of Blackpool Teaching Hospitals NHS Foundation Trust to commence in February this year. Autonomy in appointing executives is an important NHS foundation trust freedom. As a foundation trust, Blackpool Teaching Hospitals NHS Foundation Trust has the freedom to determine many of its own policies and procedures, including those relating to the appointment of a new chair.”
“May I begin by thanking the hon. Member for Blackpool South (Gordon Marsden) for securing the debate? I am pleased to see my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) in his place, and I know that both my hon. Friend the Member for Fylde (Mark Menzies) and the hon. Member for Lancaster and Fleetwood (Cat Smith) have expressed an interest in the issue. The issues raised by the hon. Member for Blackpool South are clearly a cause for concern. While the CQC has not identified any governance issues in the trust, it is clear that the recruitment process for the new chair had a number of irregularities. One of the defining features of our approach to the NHS since the Francis report has been a willingness to face up to difficult issues.”
“In short, the proposed amendments to the 2001 order give the Nursing and Midwifery Council statutory responsibility for regulating the nursing associate profession in England and extend its powers and duties under the order to nursing associates in respect of the key functions of registering nursing associates in England and setting the standards of proficiency, education and training, and continuing professional development and the conduct of nursing associates in England.”
“I beg to move, That the Committee has considered the draft Nursing and Midwifery (Amendment) Order 2018. It is always a pleasure to serve under your chairmanship, Mr Evans. Health Education England’s “Shape of Caring” review made a series of recommendations to strengthen the capacity and skills of the nursing and caring workforce. A key recommendation was to explore the need for a defined carer role to act as a bridge between the unregulated healthcare assistant workforce and the registered nursing workforce. The amendments that we are proposing to the Nursing and Midwifery Order 2001 put in place provisions to regulate a nursing associate role that satisfies that recommendation.”
“I am grateful to the hon. Gentleman for raising that point. I think we can all see the value for children in school that teaching assistants offer alongside teachers. They are a good example of how, in education, the need for a diverse workforce has developed, and that is exactly what today’s order addresses. It is a response to what employers have said they want, which is more flexibility in their workforce, to ensure progression for staff who want to progress into nursing, but who in the past might have felt trapped in a healthcare assistant role by having young children or otherwise been constrained from going to university. Our proposal gives them a ladder between the two roles, as part of a flexible workforce that responds to employers in the way that happens in education, as the hon. Gentleman correctly said.”
“The hon. Gentleman is right to probe on this, because that is the essence of the Government’s proposal. The nursing associate role is a stepping stone. Some people will progress to nursing associate and stay in that role, but some, having done the foundation year of their degree, might want to do the following two years and become a nurse. We want to respond constructively to that aspiration, which his constituents will have, as do mine. Some will start as healthcare assistants, gaining valuable experience in that role, but some will want to progress to nursing associate and some will want to become a registered nurse. The draft order is about ensuring flexibility in the workforce to enable that.”
“Yes, I am, and it is helpful of the hon. Gentleman to raise this issue. The qualifications that nursing associates will undertake are to be set by the NMC, so people will need to go on courses that satisfy the NMC. However, they will also gain valuable hands-on experience alongside their foundation training. Our proposals are about creating a ladder from the nursing associate role. Some will stay at that level, because they feel that, educationally, that is the level they have attained, and they want to continue as a nursing associate—”
“I will just finish my point and will then happily take one further intervention, after which I will make some progress. Quite rightly, some people will want to continue as a nursing associate, playing a valuable role on a ward and freeing up those who have done three years at university level to focus more on skilled roles. That is part of the flexibility that employers have asked for. Others, having had a taste in the foundation year, will want to do a further two years. The system allows that progression, which I am sure the hon. Gentleman’s constituents will want.”
“Gentleman touches on a point slightly beyond the scope of today’s order, which is whether someone could gain a nursing qualification without a degree—I think that was within his question. That is not what this legislation does. It requires—”
“I am grateful to the hon. Gentleman. I see exactly what he is driving at, and I have a great deal of sympathy with that point. It is slightly beyond the scope of this legislation, which covers those who satisfy the foundation-course level after their first year. If they want to become a registered nurse, they will need to satisfy, as now, the three-year-degree level. The legislation does not say that people do not have to reach the educational attainment of a registered nurse. Rather, it allows them to continue to earn, to gain hands-on experience and to do that in stages, which may provide flexibility to, for example, those with young children or other caring responsibilities. It allows that stepping stone. The hon.”
“The hon. Gentleman absolutely sees my enthusiasm for this order, and that is why I hope that colleagues on both sides of the Committee will support it. Alongside the apprenticeship levy, it offers an alternative to a student loan and what we might see as a more conventional degree. That is not to say that we will not continue with that route, because obviously it will remain a main pathway into nursing, but it is good to give flexibility to employers and to school leavers and others who see the opportunity to go into nursing. We are conscious that, currently, many people who want to do nursing are rejected when they apply, so having different pathways is a key part of the system.”
“I did say that I would make some progress, but I am conscious that I have not taken an intervention from the hon. Gentleman, so I will take one more and then, with the leave of the Committee, I will make some progress.”
“In summary, these are important changes to the governing legislation of the Nursing and Midwifery Council that will see the nursing associate role regulated. Nursing associates will support nurses so that they can focus on the more clinical aspects of patient care, and will support the increase in nurse numbers by providing a clear pathway into the nursing profession, which the hon. Member for Huddersfield alluded to.”
“The Department carried out a full public consultation across the United Kingdom on the proposed amendments and received 373 responses. There was broad agreement on the proposed legislation to regulate nursing associates in England. Health Education England has established two pilot groups of 1,000 nursing associate trainees, who are due to complete their training in early 2019, and the Health Secretary has announced plans for up to 5,000 additional nursing associates to commence training via the apprenticeship route in 2018, and up to 7,500 a year thereafter. The draft order will insert a new provision in the Nursing and Midwifery Order 2001 to allow applicants who have started or completed a nursing associate qualification through either the HEE pilot or the apprenticeship route by 26 July 2019 to have their qualifications recognised.”
“The draft order makes provision to allow admission to the register to those who complete or commence their training by 26 July 2019 through the pilot courses run by Health Education England or through an apprenticeship route. It excludes nursing associates from being given temporary prescribing rights in a time of national emergency, such as a pandemic flu outbreak. It also removes the screener provisions from the 2001 order, as they are now redundant. The draft order makes consequential amendments to the Nursing and Midwifery Council’s rules and to other legislation, and closes sub-part 2 of the nurses part of the register by amending the Nurses and Midwives (Parts of and Entries in the Register) Order of Council 2004, which determines the parts of the NMC’s register and the titles that may be used by those included in that register.”
“To take GPs, for example, it is important to look at whether all the activity that they are currently doing is necessary or whether some of those tasks could better be performed by others, if there were a wider skills mix. However, that is slightly beyond the scope of today’s deliberations, so I will make some progress. The draft order amends the offence provisions in the Nursing and Midwifery Order 2001. The amendments provide that a person commits an offence in connection with the nursing associate part of the register, nursing associate qualifications or the use of the nursing associate title when not entitled to. The offences were drafted to reflect the fact that nursing associates will be regulated in England only.”
“The hon. Gentleman raises an important point, because continuing professional development is key. When two thirds of what we spend on the NHS goes on staff, how we effectively train them is key. That is in part why my right hon. Friend the Prime Minister made the commitment she did on Monday on the funding settlement—again, that is slightly beyond the scope of today’s deliberations. It is also why the Government have committed to, for example, 1,500 new doctors being trained, opening five new medical schools and other initiatives, including, as I said a moment ago, the apprenticeship levy, as other vehicles. One piece of feedback that I get from nurses when I go out to visit hospitals is the importance of CPD, which I am looking at very closely, because of the need for a wider skills mix.”
“The Health Committee’s estimate of 11% is at odds with the actual working vacancy rate of 1%—obviously, if one factors in places filled by agency and bank staff, one gets a different number. However, that is an interesting point, because the whole draft order is about how we get additional staff into the workforce to support nurses—it is about how we provide more resource to work alongside nurses. If the hon. Gentleman’s point is that we need more nurses in our workforce, that will be achieved both by increasing the clinical profession, which the Government have done—we can run through how many more people there are in the profession compared with 2010—and by creating new pathways into nursing. That is what the draft order does, and that is why I commend it to the Committee.”
“Too many such cases sadly come before the House, and I know there is consensus on both sides of the House that we must ensure that the right staffing and the right regulatory system are in place.”