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Health and Care Bill

My Lords, I begin by welcoming Motion B, which puts in place government Amendments 30C to 30K, laid in another place. They relate to the Secretary of State’s role in major NHS reconfigurations and are a credit to the Minister, his ministerial team and the Bill team. They have listened to the strong arguments from across this House, led so ably by the noble Lord, Lord Stevens of Birmingham, who is unable to be with us tonight. I thank the Minister for agreeing—eventually—that the powers originally proposed in the Bill were excessive, disruptive and unnecessary.

Unfortunately, we have not had such a fruitful consensus on the matter of workforce planning. We do not agree with the Commons that our workforce amendment, Amendment 29B, was unnecessary because appropriate measures already appear in the Bill. If that were so, and if the sector had had confidence in the Government’s track record in planning for adequate and safe staffing levels in health and care services, we would not have had more than 100 organisations

backing our earlier attempts, led so well by the noble Baroness, Lady Cumberlege, to put in place a mandatory system for reviewing the available workforce and predicting what will be needed in future. However, here we are, with the Government having set their face firmly against any compromise on or serious discussion about the matter. One has to ask what the Government are afraid of.

Any effective workforce strategy must be based on reliable information, be regularly refreshed and have numbers in it. This House and the whole sector have no confidence that what the Government are proposing will do that. I understand that the Treasury has had a hand in the Secretary of State’s determination to just say no. Perhaps the Treasury is unwilling to foot the Bill, which will prove to be essential when all is revealed.

I put it to the Minister one last time that our proposal would be cost-effective. Staff shortages are a false economy. Missing staff are often replaced by very expensive locums and agency staff, and the stress of unsafe staffing levels causes valued staff to leave the service. Training and recruiting staff to replace them also costs money. High staff turnover is not an effective strategy for any business or service, and poor treatment for patients often has to be done again or leads to greater and more expensive needs further down the track. No efficient shopkeeper would fail to do a proper stocktake or take account of what people are buying and therefore what he needs to order to replenish his stock—but that is what the Government are doing if they fail to plan effectively for safe staffing. It is much more serious than empty shelves, because it is playing with people’s lives, as was recently demonstrated so clearly by the Ockenden report.

If the Government are determined not to carry out the reviews and consultations in Amendment 29D, I would like to ask the Minister whether they would be happy for some other organisation, such as NHS England, to do so and whether they will take note of the results of that investigation. Amendment 29D from the noble Baroness, Lady Merron, in Motion A1, is not a silver bullet; it will not solve the current staffing crisis in the NHS and care services. But it would provide a strong foundation for future safe and cost-effective staffing, which would be to the benefit of the whole population. It is our duty to ask the Government to think again—again.