I declare my interest as a nurse who is still on the Nursing and Midwifery Council, or NMC, register. I speak, therefore, with first- hand experience about having to deal with staffing shortages during more than 20 years of working in the NHS. Staffing problems have always been there, but I welcome the debate that Tracy Brabin has secured because we must recognise the issues that many hospital trusts and community services are experiencing.
I welcome last month’s NMC figures, which show an increase of more than 4,000 nurses joining the register in the past 12 months, a significant percentage of whom were UK-trained nurses. There was also an increase of 3,000 UK nurses compared with this time last year. I welcome those figures, but that is not to say that there is not a staffing problem across the NHS.
I want to focus on some of the solutions from my experience that would make a real difference out there in the workforce. I understand the sentiments of the hon. Members for Batley and Spen and for York Central (Rachael Maskell) about the bursary scheme, but I trained on that scheme myself and it is far from the panacea that has been portrayed in recent years. We were paid a pittance—£400 a month—for the three years of our training. Yes, it paid for travel and expenses, but not for much else.
Someone training as a nurse has to do the minimum hours to get on to the register, so it is very difficult for them to have an additional job, as other students would. Often times they are mature students and have other commitments, such as children and family responsibilities, and an additional part-time job is almost impossible to hold down. Life on a bursary was tough, and it often explained the high drop-out rate during the three years.
The system I would prefer, and have always advocated, is the degree apprenticeship route. During my time in this place, I have been doing bank shifts at my old hospital with student nurses who are now on the degree apprenticeship route: it is a far better system, and we need to upscale it as a matter of course. Not only are student nurses earning while they are learning; they are part of the workforce, which is a point that the bursary scheme missed completely. Student nurses were university students, but not necessarily part of the working environment, and often found it tough to move into that environment, because they were not seen as key members of the workforce.
The degree apprenticeship route also means that when students work for hospitals or community trusts during their degree apprenticeship, they are often being paid by those trusts, which are then able to accurately predict the number of students coming through the system. That was different under the bursary system: trusts just had to wait and see which newly qualified nurses applied for their vacant posts. For long-term workforce planning, having those student nurses as part of the team means that trusts have an idea of who is likely to come forward when they qualify. There are a number of positives, and I push for the Government to roll out that degree apprenticeship system—maybe not just in nursing, but in other healthcare professional specialities.
I will briefly touch on flexible working. We are under the misapprehension that internal rotation and a shift-based system means there is flexible working for staff in the NHS, which there absolutely is not. In most areas, people are forced to do internal rotation, whether in the community or in the hospital-based system, and that is increasing as we move towards a seven-day-a-week service. If young parents with children are all of a sudden put on a week of nights with a week’s notice, and have no childcare provision, that makes it almost impossible for them to hold down their job.
In the good old days when I first started, people were able to do a permanent nights system, to do permanent weekends, or to choose to work evening shifts. That is all gone now: they are forced to do internal rotation. I say to the Minister that the NHS needs to look at a flexible working system for its staff, because if it does, it is more likely to hold on to the excellent staff who keep the NHS going.