THIS week I tried unsuccessfully to persuade the government to change the new Health Bill to deal with the workforce crisis in the NHS.
As health secretary I came to realise that extra money for the NHS and care system will never have the intended results unless there are enough trained staff to do the work needed.
Given it takes seven years to train a doctor and three years to train a nurse, this cannot be solved overnight: you need long-term planning which is all-too-often absent from our system.
My amendment did not require the government to spend a penny of extra money, but just to publish regular, independent estimates of the number of doctors and nurses we should be training in every specialty.
It was rejected on the basis it was ’not necessary’. The facts tell a different story: the Royal Colleges say we need 500 more obsetetricians, 1,400 more anaesthetists, 1,900 more radiologists, 2,000 more midwives, 2,000 to 2,500 A&E consultants, 2,500 more GPs and 39,000 nurses - and we need them right now.
Overall we have 93,000 vacancies in the NHS.
Our brilliant front-line staff are starting to leave their jobs because of what is called ’burnout’ - and the more that happens the worse the problem gets for the people left behind. The pressure, particularly in emergency care and general practice, is now unsustainable.
Some will quite reasonably ask whether I could not have done more on the issue when I was health secretary.
The answer is I did, setting up five new medical schools and increasing the number of doctors, nurses and midwives we train by 25 per cent, the biggest single uplift ever.
But that decision, announced in 2016, has not yet led to a single additional doctor on the front line because of the seven-year time scale involved.
That is why we need a better approach.
Inevitably in spending negotiations between the health secretary and the chancellor, the number of doctors we have in a decade’s time is less of a priority than immediate challenges such as the Covid backlog.
Exactly that happened this autumn when even after the budget the settlement for Health Education England, which funds training, was not settled.
So we need a new discipline in the system to make sure we are always training enough doctors and nurses for the future.
In the past immigration was a ’get out of jail’ card on this one but no longer: the World Health Organisation says there is a global shortage of two million doctors and 15 million nurses. We are not the only country with a backlog.
Some in government are worried it will cost more if the new body recommends a big increase in the number of doctors we train. The truth is the opposite: we spend about the same as France as a proportion of GDP on health as France and Germany but with many fewer doctors per head because we pay through the nose for locums.
This is the only way we will finally bring down our annual £6billion bill for locum and agency staff.
I have pressed the case in parliament with the prime minister on three occasions now. I have tried to amend the Health Bill. The change has been recommended in countless select committee reports.
To say I am feeling frustrated is an understatement.
But I am not giving up. The House of Lords will now have a chance to amend the Bill again to make this vital change and I have total confidence I will win in the end because it is the right thing to do.
We cannot solve the workforce crisis in the NHS overnight - but we can at least give hope to front-line staff that a long-term solution is in place. Surely after the two years we have just had, that is the very least we can do.
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