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Wed 2 December 2020

A new report by the National Audit Office reveals there were 43,000 vacancies for nurses at the end of last September. What is the Prime Minister’s plan to fill these and how will his new points-based immigration system help?

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Boris Johnson has said that “the NHS will always be my top priority”, so what is he going to do about the findings in a new National Audit Office (NAO) report today which show that the NHS does not have the number of nurses it needs?

According to the report, while the number of nurses working in the NHS rose by 5% overall between 2010 and 2019, there were still more than 43,000 vacancies reported by NHS trusts in July to September 2019.

The Prime Minister has repeatedly promised extra funding, resources and staffing for the NHS, including 50,000 more nurses. But, there is no evidence to suggest that he actually intends to delivering upon his repeated pledges. Indeed, in the days before the 2019 General Election, he admitted that only 31,000 of his 50,000 more nurses would be additional, new nurses. This is far short of the 43,000 vacancies identified in the NAO report up to last September.

Johnson’s NHS Long Term Plan Funding Bill aims to enshrine in law an extra £33.9 billion a year by 2024 for the NHS, but is arguably little more than a smokescreen. If this cash injection is considered in real terms, the actual increase would be an extra £20.5 billion a year for the NHS – exactly the amount announced by his predecessor Theresa May in the summer of 2018. At the time, the Health Foundation warned that this amount was “simply not enough to address the fundamental challenges facing the NHS or fund essential improvements to services that are flagging”.

The recruitment of new nurses will be further complicated by the Government’s plans to introduce a points-based immigration system, with skilled migrants only to be allowed to come to the UK if they have a job offer worth more than £25,600 in income a year. Points will be also awarded for key requirements such as having a job offer from an approved sponsor, an ability to speak fluent English or having a job offer that is at a ‘required skill level’. Thousands of potential migrant nurses wishing to work in junior posts in the UK could be immediately ruled out as the majority of junior nursing positions range in income per year from £18,000 to £25,000.

Johnson is leading a Government in danger of cutting the pipeline supply of new nurses through a regressive immigration vetting criteria. Considering the potential mounting pressures faced by the NHS with any escalation of the Coronavirus, demand for additional staffing within an already stretched NHS could lead to an unprecedented NHS staffing supply crisis.

Out of the G7 countries, the UK’s health spending per person is now the second lowest, way behind France and Germany. With GPs acting as gatekeepers to expensive hospital treatments, the NHS is being driven to providing a fragmented service at a low cost, with long waits for A&E care, cancer treatment and operations and beds.

England currently has one of the worst hospital beds per 1,000 people ratio – 2.3 – according to the Organisation for Economic Co-operation and Development, compared to 13 in Japan; 12 in South Korea; eight in Russia and Germany; six in France; 4.5 in Switzerland; 4.3 in China; 4.2 in Scotland, 3.8 in Australia; 3.6 in Italy; 2.97 in Spain; 2.96 in Ireland; and 2.77 in the US.

The UK now has fewer doctors and nurses per head than almost any developed country (OECD figures). The UK ranks second worst. The UK has 2.8 doctors and 7.9 nurses per 1,000 population- both well below the average for the 21 countries that were analysed.

When one considers the looming healthcare threat of Coronavirus, spot the problem for the NHS in England.

During the 2016 EU Referendum, the public was told by high-profile Brexiters that immigrants were filling up GP surgeries and hospitals. They are – as the UK’s doctors, nurses, cleaners and health scientists. Migrant healthcare workers are coming over here and saving people’s lives and, without them, the NHS would be ill-equipped and under-resourced.

According to a 2019 report by the Health Foundation, nurse vacancies numbers could spiral to 100,000 in a decade – this will be particularly likely if the amount of migrant nurses reduce due to a new prohibitive immigration system implemented by the Government.

The NHS in England has no chance of training enough GPs and nurses to solve the shortages it faces. A report by the Nuffield Trust, Health Foundation and King’s Fund has predicted that, in the next five years, nurse shortages will double and GP gaps will nearly treble, without radical action. International recruitment, student grants and innovation is needed.

When Boris Johnson talks about his prioritisation of the NHS and his pledges to adequately fund and resource it, the only thing we can arguably believe in is to believe in the opposite of what he actually says. The question is: how much longer will the Teflon Prime Minister’s empty rhetoric on one of the most vital issues of important to us all avoid scrutiny and accountability?


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