NHS Workforce Expansion

We now come to the first Opposition day motion, on the subject of expanding the NHS workforce. I have to inform the House that Mr Speaker has not selected the amendment.

I beg to move,

That this House condemns the Government’s failure to train enough staff to tackle the worst workforce crisis in the history of the National Health Service with a current shortage of 9,000 hospital doctors and 47,000 nurses; notes reports that the draft NHS England workforce plan calls for a doubling of medical school places to address this crisis; calls on the Chancellor of the Exchequer to use the upcoming Spring Budget to end the 200-year-old non-domiciled tax status regime; and further calls on the Government to use revenue generated by ending that regime to adopt Labour’s plan to expand the NHS workforce by doubling the number of medical training places, delivering 10,000 more nursing and midwifery clinical placements, training twice the number of district nurses each year and delivering 5,000 more health visitors.

To anyone who has needed medical care in recent months, it is blindingly obvious that the NHS is desperately in need of more staff. Doctors and nurses are overworked, hospitals are understaffed and the staff are burnt out. Patients are waiting longer than ever before, and 13 years of the Conservatives’ failure to train enough staff has broken the NHS, leaving patients to pay the price. In the words of the right hon. Member for Gainsborough (Sir Edward Leigh), Labour has a plan; where is the Government’s?

The point I have been trying to make in recent months is that we should try to learn from the experience of Europe, where they have very effective social insurance systems and much more effective outcomes, so when the hon. Gentleman says he has a plan, I think we would all like to know what the plan is. Is it radical reform, or is it just more and more taxpayers’ money thrown into the NHS?

I am grateful beyond words for that intervention. I will outline Labour’s plans immediately and return to the right hon. Gentleman’s challenge—proposing a social insurance system—a little later in my remarks.

The point of this debate is that there is a serious shortage of staff. Labour has a plan to address that shortage, whether that is measures for retention of the staff we have or our plan for the biggest expansion of the NHS’s staff in history. The Conservatives have no plan, so let me outline what Labour’s plan is. We will double the number of medical school places so that we train 15,000 doctors a year. We will train 10,000 new nurses and midwives every year. We will double the number of district nurses qualifying each year and train 5,000 more health visitors. In a formula that will become familiar in the run-up to the next general election, we are clear about how we would pay for it, too. We will pay for it by abolishing the non-dom tax status, because patients need doctors and nurses more than a wealthy few need a tax loophole.

Does the shadow Secretary of State agree that it is not just about cash; it is also about the huge recruitment issues? For example, the North Middlesex University Hospital has 800 patients a day into accident and emergency, and it is suffering because even if there is the budget, there simply are not the staff to employ to put on the frontline?

My hon. Friend is absolutely right, and it is why current staff in the NHS are right to say that retention is urgent and that we need measures from the Government immediately to deal with retention. By definition, if we have a shortage of staff, retention is not enough, and that is why Labour has put forward a fully costed, fully funded plan for the biggest expansion of NHS staff in history.

Does my hon. Friend agree that the £1.3 billion that the NHS spent on agency staff last year could have been used to recruit proper, full-time NHS staff?

I wholeheartedly agree. It is why we are in the worst of all situations: the shortage of staff means not only that patients are receiving poorer care, but that we are paying over the odds as taxpayers for the Conservatives’ failure to recruit and retain the staff we need.

We are not alone in thinking that the biggest expansion of NHS staff in history and doubling the number of medical school places is the right solution. Amanda Pritchard, the chief executive of NHS England, has rightly said that we need greater investment in training to stop excellent British students being turned away. The Royal College of Physicians has called for medical school places to be doubled, and now the NHS is formally asking the Government to fund it. Why are the Government refusing to fund a doubling of medical school places, which the NHS and the Royal College of Physicians say is necessary, and which patients can see through experience is desperately necessary?

Perhaps the hon. Member can tell us.

I am grateful to the shadow Secretary of State for bringing me in on this point. Training is really important. As someone who has been a medical student, I know that one of the most important things to look at is how many people will be on one’s firms. We do not want 12, 15 or 20 people all coming into a cubicle to see a patient. Although I welcome the idea of expansion, can he talk me through what the ratio will be on ward rounds for medical students being trained?

I am glad that finally Government Members have noticed that Labour has got a plan and are asking how it will work; I wish that Government Ministers would join in. The proposal we set forward to double the number of medical school places is based on modelling put forward by the Royal College of Physicians, which understands perfectly well the points the hon. Member makes. I have had excellent meetings with university vice-chancellors, who are keen to roll up their sleeves and help. The reason we set out a plan this far from a general election was for two reasons. First, we want to give medical schools and NHS employers time to prepare for the expansion. Secondly, we hope that the Government adopt this plan to give the next Labour Government a head start. I very much hope, as this motion says, that the Chancellor will take our plan and incorporate it into his Budget, and I will cheer him if he does so.

I will tell the House how ludicrous the situation is today. There are medical schools in England today that are exclusively training international students, many of whom will leave upon graduating, while at the same time we are turning away thousands of straight-A students from our own country who want to help the NHS. Brunel University is training 100 new doctors, with not a single UK student. Chester University has deferred the launch of its medical degree by a year because the Treasury will not give it a penny. Local NHS trusts and charities have chipped in to fund 20 UK medical student places at Three Counties Medical School at Worcester University, because the Government are refusing to fund a single domestic student. Despite pleas from the NHS, the Minister for Skills, Apprenticeships and Higher Education, the right hon. Member for Harlow (Robert Halfon), has threatened to fine medical schools if they increase their offers to applicants next term.

I am almost certain that the hon. Member for Wellingborough (Mr Bone) will not agree with his universities Minister.

The hon. Member is making an interesting speech. On the point about retaining people from overseas going into medical training, who he said will then qualify and leave, does he think there is an argument for having an arrangement of the sort they have in the airline industry, whereby someone who is trained here then has to work here for a certain number of years, or otherwise repay the cost? Does he think that would help the situation?

There are a couple of challenges with that approach. First—I want to be clear about this—having international students come to study at UK universities is a wonderful thing. It is wonderful for British students who mix with cohorts drawn from across the world, and it is wonderful because they contribute to the cultural and intellectual life of our universities, and of the towns and cities in which they live while studying here. It is a wonderful thing because they often return to their countries with fond memories of Britain, which is an extension of our soft power and diplomatic influence. Those are all great reasons why we should cherish, embrace and welcome international students, and it is why I hope the Home Secretary does not win the argument inside Government to restrict further access to international students. Finally, I should say that international students also pay an enormous amount to come and study here in the UK, and they subsidise home students.

I want to be clear about how much I welcome international students, but it is an absurdity that people are coming to this country to study in medical schools that have no British students. It is an absurdity, when we have a chronic shortage of doctors, nurses, midwives and allied health professionals, that we see straight-A students from our own country being turned away, while university medical schools are being told they can only recruit international students. That is the depths of stupidity that this Government are plumbing.

I commend the shadow Minister for his thoughts. The poaching of junior doctors by Australia, for example, for better pay and working conditions, as opposed to fractured shift patterns here, is a major issue. It is not just about expanding the workforce, to which he has referred; it is also about having a careful and concerted campaign to retain staff here. Does he agree that has to be part of the thrust of this debate?

I wholeheartedly agree with the hon. Member. I will talk about this later in my speech, but it is why the Government have to resolve this pay dispute with existing NHS staff. The danger is not that they walk out for another day of strike action, but that they walk out of the NHS altogether for countries that treat them better. What an absurd position to be in. It is also absurd, by the way, that we still have doctors retiring early for no other reason than that the pensions rules create an active financial disincentive to work up to normal retirement age, as many of them would like to do. It is completely absurd.