My Lords, the graduate guarantee creates additional temporary registered midwife roles and enables newly qualified midwives to apply to join the NHS workforce. This supports the transition from education to employment. Since September, over 850 of these roles have been created, backed by £8 million. This includes part-time and full-time jobs. NHS England is working closely with universities and employers to align graduate numbers with vacancies through improved workforce planning, enhanced support for students and co-ordinated local recruitment.
I thank the Minister for her Answer. The graduate guarantee is very welcome but, already, 31% of newly qualified midwives do not have a job or are on fixed-term contracts. First, how will the Government ensure that workforce planning is aligned to the number of posts available so that the skills of newly qualified cohorts are not wasted? Secondly, given the concerns about unsafe workloads in midwifery and maternity services, how will midwives have the time to discuss with their clients health issues such as diet and vaccination?
On the second point, the noble Baroness is quite right: it is important that midwives have that time. That is what we anticipate will be the case—I refer her to the forthcoming workforce plan, which will improve the situation. With regard to the position that the noble Baroness describes, I agree that this needs sorting out, and I recognise the figures that she has shared. That is why we have brought in the graduate guarantee scheme—so that we can get people from their training and education into the NHS and can ensure that midwives are recruited on the basis of looking to the future rather than of the existing headcount. So we are future-proofing this.
My Lords, the graduate guarantee applies also to nurses but, sadly, the provision is quite patchy. What steps are the Government taking to support employers to recruit newly qualified nurses?
Through NHS England’s student movement tool, forecasting on the workforce and national analysis are being undertaken to assess the areas of risk—my noble friend is right to raise those concerns. That is shared with NHS England’s regional teams so that they can manage and monitor workforce positions directly with providers.
My Lords, I welcome the comments made by the Minister. However, she will be aware that, as well as having a shortage of midwives in place—and we have seen the terrible effects of poor service delivery in antenatal and postnatal care—we have a significant shortage of health visitors, who give advice regarding immunisations, development, feeding and so forth. Some of those health visitors have caseloads of up to 1,000 families. That is not sustainable and, frankly, is quite dangerous. What are the Government going to do to address this?
Again, I refer to the forthcoming 10-year health and care workforce plan, which will take a multidisciplinary approach. I certainly share the noble Baroness’s views about the value of health visitors. As we move services into the community and develop the neighbourhood health service, that will require the greater use of roles such as health visitors. Ultimately, this is a local matter about local employment of staff to meet local need.
My Lords, given the concerns about unsafe workloads in maternity services, how do the Government justify a situation where qualified midwives are available but not being brought into permanent roles?
That is the very reason why we have brought in this guarantee, because it provides an immediate route into employment for those who are newly qualified. A number of things about that are important, including reducing the risk of graduates leaving the profession because they cannot find jobs. The reason why there are an additional 850 time-limited or temporary roles is to get people in under existing budgets but also to get staff to enter the workforce where there are not immediately permanent vacancies. It is a strong way to address the point that the noble Baroness raises.
My Lords, as we have heard from other noble Lords, we have two situations. One is that 31% of newly qualified midwives have been unable to secure posts; the other is that we have well-documented shortages. The Minister talked about the graduate guarantee, but are there any other initiatives available to midwives and nurses who may wish to take up these jobs? Other noble Lords have talked about the number of hours that midwives have to work. How do we make sure that we retain existing midwives so that some are not leaving by one door as others are coming in by another?
I was about to answer the noble Lord’s first question by talking about retention and then he helpfully raised retention. Retention rates for existing midwives are improving, as is the number of midwives. That includes a mentoring scheme, strengthening advice and support on pensions, flexible retirement options, and publication of menopause policies and guidance to support midwives to stay in work. We also have unit-based retention leads to focus on this and provide support to midwives. I think that is a really important initiative.
My Lords, given that the National Health Service is always short of nurses and midwives, do the Government have any plans to bring in any overseas nurses and midwives to fill the jobs?
The issue is more a misalignment of numbers than a straightforward shortage, as the number of midwives has increased. There was a 2.6% increase in January 2026 compared to the year before, so the trajectory is good. The misalignment, as I have explained, is that we are dealing with a situation where midwives are being trained but they cannot get jobs. That is what we have to bring together and what we are doing through the graduate guarantee scheme.
My Lords, does the noble Baroness share my concern that there is an increasing trend towards encouraging women to give birth in large hospital centres further from their homes and does she agree that an increase in midwives—as well as in obs and gynae professionals of all sorts—would enable us to behave more like France and Germany do, for example, and aim for units of between 2,000 and 4,000 births a year?
Obviously, what matter most are patient safety and patient satisfaction, and I am very much looking forward to the independent report from my noble friend Lady Amos in this regard, because she is focusing on that. I am sure that she will consider the best place. I cannot comment on whether the noble and learned Baroness’s assertion will be the best option here, but there was a separate call for evidence under the workforce plan so that we could hear directly from maternity and neonatal staff.