Peers voted 171 to 119 to publish independently verified workforce projections at least every 2 years

A stressed male doctor with his head on his hands behind a pile of work.

The Government was defeated in the House of Lords by a rebel amendment to the Health and Care Bill, which would oblige the Health Secretary to produce a regular assessment of the workforce needs of the health and social care system in England.

Peers voted 171 to 119 to publish independently verified workforce projections at least every 2 years.

The amendment was tabled by Baroness Cumberlege, who said: ‘Without improved planning, we will fail to tackle the growing backlog, not only in procedures but in appointments within the NHS.

‘We will not know whether we have the right people in the right place at the right time.

‘We will not provide a sustainable work environment for the dedicated staff currently working so hard within our services.’

Staffing projections for the next 20 years 

The amendment built on a proposal by the former Health Secretary, Jeremy Hunt, who failed to get the measure approved in the Commons.

The amendment to clause 80 of the Bill, which would require the assessment to be based on projected health and social care needs of the population for the next 5, 10, and 20 years, was vital to ensure long-term planning, Baroness Cumberlege argued.

She said: ‘Let us in turn have numbers of staff that we need, carrying out the roles that we need, in the locations where they are needed. Let us reduce the excessive reliance on expensive temporary cover and, in turn, let us generate cost savings that can be ploughed back into high-quality care.’

Baroness Watkins of Tavistock, fellow of the Royal College of Nursing, said that it was ‘absolutely clear to me that, without the right staff in the right place, you cannot give the right care.’

Department of Health’s track record ‘appalling’ 

Backing the amendment, former Health Minister Lord Warner said that ‘the track record of the Department of Health on long-term planning is appalling.’

Replying for the Government, Health Minister Lord Kamall declined to support the amendment, although he agreed that ‘the workforce is at the heart of our NHS and social care’, and that it was ‘right to ensure that we have the workforce that we need for the future to keep delivering world-class, safe and effective healthcare.’

Responding to the Government defeat in the upper House, NHS Providers described it as a ‘step closer to creating the robust system for long-term workforce planning that our health system desperately needs.’ The Deputy Chief Executive of NHS Providers, Saffron Cordery, commented: ‘This important vote could not have come soon enough for the NHS. Today we learnt the NHS has a staggering 110,000 staff vacancies. For far too long we have asked the impossible of our workforce with large numbers of staff regularly working extra unpaid hours, and far too many of our colleagues reporting illness due to work related stress.’

Staff shortages dodged for too long

Richard Murray, Chief Executive of the King’s Fund, said that he believed that the House of Lords had sent a message to the Government that it must face up to chronic staff shortages across the NHS and social care system. He said: ‘Poor planning, weak policy, and fragmented responsibilities for the health and care workforce mean that staff shortages have become endemic, leaving staff exhausted, services struggling to cope, and people waiting longer for the care they need, even before the pandemic.

‘Successive governments have dodged the issue for fear that providing the staff needed to meet people’s health and care needs will prove too expensive. In truth, the failure to plan is a false economy, as services resort to expensive agency staff and paying overtime to fill rota gaps.’

The Bill will return to the House of Commons, where MPs will consider the amendments.

Dr David Wrigley, British Medical Association Council Deputy Chair, said: ‘We urge the Government to heed the message sent from peers today, as well as the expert voices within the 100 health and care organisations, think tanks, and charities who have consistently backed this amendment, and for MPs to keep it within the Bill as it progresses through Parliament.’

That sentiment was echoed by Dr Camilla Kingdon, President of the Royal College of Paediatrics and Child Health, who said: ‘Recovering from the pandemic will take an extraordinary effort, and we now strongly urge the MPs to vote for the amendment.’

This article originally appeared on Medscape, part of the Medscape Professional Network.


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