My Intervention in the Health and Social Care Workforce General Debate

John Redwood (Wokingham) (Con):
I am alarmed, as my hon. Friend is, about the 9.1% annual loss of staff, which is a high loss rate by any standard and implies that something is wrong with the jobs or leadership. Do he and the Committee think that a lot more work needs to be done on job descriptions, job feasibility and support for people in their roles so that these jobs are perceived to be of greater value by people and they do not want to leave? Otherwise, we have the extra costs of training somebody new.

Steve Brine, Chair of the Health and Social Care Committee:
Yes. There is a part of the workforce plan, which the Select Committee discussed a little yesterday, which talks about how, every year, every member of staff should have a conversation with their employers about their pension arrangements and mental health and wellbeing. That is fantastic. I am sceptical as to how it is remotely possible in an organisation of this size. That does not mean that I do not think the ambition is right—I think that it is right—but it would be helpful to the House if the Minister touched on that in her wind-up.

The other point I make to my right hon. Friend, which I will also make later in my speech, is that we must remember that there are NHS employers, and ultimately the Government are the employer in the widest possible sense, but the direct employer when it comes to hospitals is the trusts, and they have a big role to play in retention and in workforce health and wellbeing. We sometimes duck away from saying that, but I say that here in the House as well as privately to the chief executive of my trust.

I am encouraged by the emphasis that the workforce plan places on prevention, which everybody knows is one of my great passions in life and politics. That will clearly be crucial, given the supply and demand challenges facing the health service at the moment. Prevention is, as colleagues know, a subject dear and close to the work of the Select Committee: we have launched a major inquiry into the prevention of ill health, with 10 workstreams. We have already done the vaccination workstream and have moved on to the healthy places—home and work—workstream. Details of that are available on the Health and Social Care Committee’s website.

Let me turn to some of the specifics in the Committee’s report and what action the Government have taken. One of our key recommendations was that

“the number of medical school places in the UK should be increased by 5,000 from around 9,500 per year to 14,500.”

The plan does that: it doubles medical school training places in England to 15,000 by 2031-32, which is extremely welcome.

108 Comments

  1. Cuibono
    July 14, 2023

    As far a “prevention” is concerned I would have thought that disruption, ceaseless change, apprehension and fear would be the worst culprits for causing ill health.
    Extreme cold isn’t particularly healthy, nor is having to make “cheap” food choices.
    It also isn’t good for health to be cooped up in a tiny house surrounded by roadworks and never ending assorted noise. Forced vaccination is a stressor and as it turns out not such a great idea.
    Those who listen to WEF with rapt attention should know that noise is the new secondhand smoking and that noise is very high up on the list of ill health culprits.
    Yet all of this and more have been foisted on us by successive govts.

    1. Ian B
      July 14, 2023

      @Cuibono You have to be moved on to make way for those criminals the Government is forcing into society after they aided them cross the channel from the EU. Ever wonder why after many years and years of high profile media statements by Government, nothing happens? I think the phrase you can apply after 13 years of the Conservative Government is they are ‘All talk and no trousers’

      1. Cuibono
        July 14, 2023

        +++

  2. Cuibono
    July 14, 2023

    Who will get the places at these medical schools?
    The grammar schools of the 50s and 60s made it very clear that only an absolute genius could win a place at medical school.
    So many decided not to even try, assuming that there was a hinterland of unknown talent ( in other grammar schools) ready to train as future doctors.
    Little did they know that other plans had been made. Fact.
    They say it was to get cheaper staff but could it have been one aspect of the beginnings of what we now see?

    1. Michelle
      July 14, 2023

      If you are suggesting what I think you are, then yes.
      Let’s put our own talent (another excuse used often for the immigration racket) off and out to pasture.

      1. Cuibono
        July 14, 2023

        +++
        Exactly!

    2. Dave Andrews
      July 14, 2023

      The privileged saw jumped-up grammar school people taking the jobs they thought belonged to them, earning them by merit rather than right. The grammar schools had to go.
      Let’s take the hoi polloi down to the same level.

      1. forthurst
        July 14, 2023

        In the North of England where I come from, there was no tradition of middle class parents sending their children to public schools; they sent them to the grammar schools whose entry was based on winning a scholarship, open to all, paid by the local authority at eleven; these schools were not local authority schools but independent, founded by middle class parents. These schools provided an excellent all round education for both boys and girls and trained the future doctors, engineers and scientists which the public schools with their obsolete education systems failed to do. Needless to say, these schools hardly exist any more: the names and buildings but not the quality of the intake, the education or discipline.

        1. Lynn Atkinson
          July 14, 2023

          Great public schools in the North East. Durham Choir School – just over 600 years old; St Bees on the opposite coast, 400 years old. Of course the RGS (Royal Grammar School), the pride of Newcastle still exists. Then there is Mowlem Hall etc etc

      2. Cuibono
        July 14, 2023

        Behold! The politics of envy and “levelling up” ( aka all pigs are equal 
a widespread levelling down as with comprehensives).
        And if that doesn’t work you just dumb down the exams. You cut toes off the ugly sisters so they can cram their foot into a glass slipper
and ignore the ensuing blood.
        Whence the total mess we are in today.

    3. Sharon
      July 14, 2023

      I live in a London borough that has five grammar schools. The Greenwich judgement some years ago meant that kids from outside of the borough had equal rights to a place. There is an entrance exam for each which the kids get trained to pass. There was/is even a mini bus paid for by parents to bus them in from Brighton!
      My point is that the girls school closest to me has a very large proportion of Indian, Chinese and black girls. The borough is still mostly white people. I suspect doctors of the future will not be mostly white.

      Ps The only one good thing is the quality of the other high schools is good, don’t know if it’s good old fashioned competition! Trouble is the schools are a draw….

      1. Cuibono
        July 14, 2023

        They did that here.
        So incredibly unfair.
        Destruction of the middle class and aspiring working class
who pay for everything!
        Not allowed to have anything.

    4. Margaret
      July 14, 2023

      They haven’t got the sense to understand that 4 good A levels don’t mean good practitioner’s.Medicine is a job using more skills than exam results.

  3. Mark B
    July 14, 2023

    Good morning.

    I am alarmed, as my hon. Friend is, about the 9.1% annual loss of staff, which is a high loss rate by any standard and implies that something is wrong with the jobs or leadership.

    Or maybe something else ?

    I am reminded of the time I visited my late mother in hospital. I spoke to the staff who were mostly foreign (Portugal, Spain and so on). They all said that the way we do healthcare in this country is all wrong.

    Time to look at how others do it and stop bleating at how wonderful the NHS is. The only wonderful thing about the NHS is that it is FREE to ALL. And I do mean ALL whether they pay for it or not.

    1. Wanderer
      July 14, 2023

      +1. I’ve had extensive user experience with the French and Austrian public health services. Both were miles better than the NHS. Most recently in Austria: you can always see your doctor on the same day if you say it’s urgent; appointments with the specialist of your choice within 2 days to 3 weeks, depending on the specialism and urgency. CAT scans within 10 days. All fully covered by your NI payments.

      1. Cuibono
        July 14, 2023

        I was told by a lefty in tones of utter horror that in a French GP surgery, payment was required!!
        Chance would be a fine thing to even get an appt here
get an answer on the phone even?

        1. John Hatfield
          July 14, 2023

          Ten francs a visit if I remember correctly when I lived there. But that was 25 years ago. Prices must have gone up since.

          1. John Hatfield
            July 14, 2023

            Ah forgot to mention I was non-resident.

          2. Cuibono
            July 14, 2023

            +++
            Oh yes!
            You’re right. I bet that lefty wasn’t resident either.
            I think they realised the way the wind was/is blowing out there and scuttled back here quick sharp.

          3. hefner
            July 23, 2023

            Between €23 in the GP’s surgery and €25 if the GP comes to your place between 8am and 8pm, €45 to €60 if outside these hours depending how long they stay with you. People registered with French SĂ©curitĂ© Sociale get reimbursed of €16.50 (about 70%) by SĂ©curitĂ© Sociale, and for those who have an additional insurance (‘mutuelle santé’) of an additional 20%.
            ameli.fr ‘Tarifs conventionnels des mĂ©decins gĂ©nĂ©ralistes en France mĂ©tropolitaine’, 15/05/2023.

    2. Cuibono
      July 14, 2023

      +++
      I think ( I may be wrong) that non U.K. residents do have to pay. ( Some % of the total cost)
      Recovering the money is problematic and possibly NHS staff acting “beyond authority” aren’t overly keen on exacting the fee?
      But who cares? Soon the whole world will be legit citizens of what was once our country!

    3. Mickey Taking
      July 14, 2023

      but I was treated by a nurse in RBH a couple of years ago, clearly not British. Casually enquiring where she came from I was told Portgugal. So I carefully asked why work here? I was quickly told ‘no jobs in Portugal’.
      End of conversation.

    4. John+C.
      July 14, 2023

      This is absolutely right. We should accept at last that the NHS is seriously deficient, examine other systems and put it right. Instead, of course, we make it the big theme of an Olympic opening ceremony.
      Those whom the gods wish to destroy, first they make mad.

  4. Cuibono
    July 14, 2023

    How on earth can it come as a surprise that people just want to flee their jobs?
    Good grief
Committees have spent the last 40 years destroying workplace sanity and happiness.
    Is any politician aware that people used to ENJOY their jobs?
    Constant meddling and ludicrous Marxist diktats put paid to all that.

    1. Dave Andrews
      July 14, 2023

      For every useful worker there’s an administrator, busy (or not so busy) collecting data so the management can cover themselves in the case of a claim.

    2. Ian B
      July 14, 2023

      @Cuibono – got it in one, Political as you say Marxist diktats taking priority over life, getting on with things, making things happen – run a mile everytime

    3. MFD
      July 14, 2023

      I agree with that CUIBONO, I am now retired but look back on my career with satisfaction and happiness.

  5. Cuibono
    July 14, 2023

    I would have run many miles from some ghastly cosy annual chat with a manager!
    Yuk and double yuk!

    1. iain gill
      July 14, 2023

      yes one of the themes on the freelancer forums, as a motivation for being freelance, is to avoid the charade of having performance objectives, career aims, etc discussed in reviews with managers who are clueless. generally people feel far happier when they are in charge of their own destiny.

      1. Mickey Taking
        July 14, 2023

        I often wonder whether the question I often asked is ever posed: ‘ What is holding you back from better performance that I could try to remove?’
        Sometimes quite practical and easy things could be solved.

        1. Ian B
          July 14, 2023

          @Mickey Taking You would have to be a ‘manager’ to even know that question

  6. Donna
    July 14, 2023

    I wonder how much the “vaccination workstream” has affected staff turnover.

    “Vaccination” coercion – or in this case the “vaccination” mandate – certainly affected employees working in the Care Sector and led directly to over 40,000 experienced staff leaving the sector. And if Javid had attempted to do the same in the NHS, I expect it would have had a similar effect there. I personally know one young former GP who left the NHS when a mandated Covid gene therapy jab was threatened.

    People should be offered the chance to have a talk at work about their pension arrangements, mental health and well-being IF THEY WANT TO. Personally, if my manager tried to raise those subjects with me, I’d politely tell him/her to mind his/her own business.

  7. MPC
    July 14, 2023

    Centralises workforce planning for the largest employing organisation in Europe. That’s what the Conservative Party in government has come to and is another reason not to vote for them.

    1. Bloke
      July 14, 2023

      In Norman Fowler’s time, the 1987 government white paper ‘Promoting Better Health’ emphasised health promotion and prevention reforms including systems for GPs to encourage efficiency and boost preventive medicine, leading to changes in the GP contract in 1990. What happened to mess things up?

      If people treated their own bodies with care when younger, so many of those doctors, tablets and other expenses wouldn’t be needed. Today’s fogies would be fitter, healthier and taxed less too.

  8. Lifelogic
    July 14, 2023

    Indeed but you have to retain the doctors already trained, currently 50% leave within two years. Not surprising as it is not easy to live on a take home of about ÂŁ24K when your rent, council tax, interest on your student loans, commuting costs, heat, light, water… might well leave you with negative ÂŁ4,000. This before food, work lunches, clothing, professional fees, holidays, insurance… Are junior doctors really expect to end each year worse of than they started while living in a grotty bedsit and working 46 hours a week? I thought Sunak thinks he is good at maths but cannot do simple sums.

    Meanwhile Sunak warns unions that the circa 6% offer is final, no more talks on pay and no “amount” (sic) of strikes will change this. He does this standing in front of his five pledges:-

    Halve inflation
    Grow the economy
    Reduce Debt
    Cut Waiting Lists
    Stop the Boats

    Is he going hit any of these promises = it does not look like it to me.

    1. a-tracy
      July 14, 2023

      Lifelogic, in which year of the doctor’s training are they leaving? after year 6? Is year 6 of training FY2? Are the doctors leaving UK born doctor trainees or those training here from abroad having completed their superior UK training?

      1. Lifelogic
        July 14, 2023

        Apparently 50% leave either during F1 and F2 or at the end of F2. Many leave medicine altogether other go overseas. A relative, starting his F1 is being paid about ÂŁ33K, this including London waiting with student debts of circa ÂŁ150K his friend from school similar top A levels has ÂŁ40K of debts (a three year economics degree) has already had three years of earnings and now earns ÂŁ105K PA at a bank, he is the same age. So has already clearly his student debts already and has about three times the take home pay. The medic has negative disposable income after rent, rates, council tax, commuting, interest on the student debt & professional fees.

        He would be far better financially of working as a builder or a gardener and this without the student debt and the loss of 6 years of earnings!

        1. a-tracy
          July 15, 2023

          I’ve been looking up the cost of medical degrees.
          Student tuition fee debts for four years undergrad medical training for an English student plan 2 = ÂŁ38,000 in total. A overseas students pays much more for the same training (see below).
          The student could train near to their parents home to save on room hire and take on a job in caring occupations to earn whilst they learn and yes I do know about studying difficult stem subjects.

          It appears that tuition fees are paid by the NHS for the FY1 and FY2 unless you are an overseas student (which is perhaps why they leave in these years), there is also a salary paid for these years of extra training isn’t there?

  9. Mary M.
    July 14, 2023

    The vaccine mandates didn’t help. 40,000 dedicated care workers left the care industry rather than accept a medical intervention still at its experimental stage. Many of the NHS workforce also left, in anticipation of the same mandate.

    1. Lifelogic
      July 14, 2023

      Indeed Javid and Handcock were appalling on this. It was an outrage especially as they knew or should have as early as early 2000 that the vaccine did nothing net positive for anyone under about 60 or anyone who had already had Covid yet still they tried to coerce health workers to take them or be fired. Criminal negligence in my book is there any criminal investigation happening? I assume not.

  10. Lifelogic
    July 14, 2023

    Interesting and very depressing figures from Western Australia on vaccine harms. About 24 times the number reported as for all other vaccines per jab. See the excellent Dr John Campbell videos.

    From the ONS The number of deaths registered in the UK in the week ending 30 June 2023 (Week 26) was 11,763, which was 8.8% above the five-year average (950 excess deaths)

    About 136 a day & yet the government has no interest in finding out the causes (such as which vaccine were doing the damage, what NHS delays, what were the causes and mechanisms for this huge number of excess deaths (mainly cardio vascular it seems), is long covid an issue…) – nothing to see here just move along you guinea pigs please…

    1. Lifelogic
      July 14, 2023

      In the Telegraph today depressing graph showing waiting times for Cardio treatments up 5 to 15 times since the start of the Covid Vaccine programme. Jabbing even young people & children and those who had already had covid – why when this could only every have done far more harm than good? How many of the 140 excess deaths could be saved by shortening these waiting lists?

      ‘The NHS is a catastrophe – the system must change’
      Compelled to write after a waiting-list patient almost died, Jullien Gaer makes a passionate plea for reform

      1. Denis+Cooper
        July 14, 2023

        The London hospital I had been attending for my heart problems became a Covid hospital and stopped everything else, except for remote consultations. That was not because they were too busy vaccinating people against Covid, it was because they were occupied treating people suffering with Covid, most of whom had not been vaccinated, and because they did not want to expose other patients to the risk of infection in the hospital. In some cases there were valid medical reasons why people did not want to risk having the vaccination, and my own sister-in-law had one injection and reacted so badly that she decided not to have any more, but in most cases it was because they believed irresponsible and ill-informed propaganda against vaccination. I would hazard a guess that those who spread that propaganda should be held responsible for more sickness and deaths than those caused by adverse reactions to the vaccine.

        1. Lifelogic
          July 15, 2023

          This is not supported by the statistics indeed vaccinated people seem to have a higher chance of catching Covid not lower and certainly the vaccines have caused hundreds of thousands of cardio vascular issues and deaths worldwide.

          1. Denis+Cooper
            July 16, 2023

            “vaccinated people seem to have a higher chance of catching Covid not lower ”

            Where is your evidence for that claim?

          2. hefner
            July 23, 2023

            Give the references of your statistics Lifelogic so that anybody can check who has established them, where they have been published, and who is commenting on the website you are using.

    2. BOF
      July 14, 2023

      Agree LL. It should be, but never will be, covered by the Covid (whitewash) enquiry.

      1. Lifelogic
        July 14, 2023

        +1 the should have lock down earlier and harder and vaccinated even more people with net harm vaccines that they did not ever need “enquiry”.

    3. Christine
      July 14, 2023

      It’s not just deaths. We see an alarming rise in Parkinson’s Disease, childhood diabetes, aggressive cancers, and heart problems. Yet we see health professionals maligned by politicians and the media if they even ask for these increases to be investigated. Thank goodness for brave people like Andrew Bridgen who put their careers on the line in pursuit of the truth.

      1. Lifelogic
        July 14, 2023

        +1

    4. Denis+Cooper
      July 14, 2023

      On Monday I had lunch with five ex-colleagues, all 74 plus. I was the only one of us who had never had a positive LFT test, and not from want of testing I will add, and the others’ experiences of Covid ranged from not too bad to very bad but not needing hospitalisation.

      On the other hand we all agreed that without the vaccines we would not be meeting up for lunch in the way we were, the way we always used to do pre-pandemic, sitting closely together with no masks, and with no hand sanitising, and the same for the other customers and the pub staff.

      It was an emergency. Initially we had no idea how bad it could get – the Black Death killed at least a third of the population, possibly twice that – and we also had no clear idea how the disease was being transmitted or what precautions we should take. There was no choice but to take whatever emergency steps were available at that time with the limited information, and that inevitably included taking short cuts on vaccine trials.

      Frankly I am fed up with people now being wise with hindsight and complaining that the response was some way short of perfection. What would you do the next time, if you were in charge? Insist that all the normal test protocols must be rigorously observed to ensure the vaccine was perfectly safe – and of course no vaccine is ever perfectly safe – while the deaths mounted and the health system fell apart and the economy collapsed?

      1. Mickey Taking
        July 14, 2023

        I don’t believe there were short cuts in trials, yes the elapsed time was compressed due to alarming contagion and deaths – but grossly inefficient timescales to process through stages were practised prior to the pandemic.
        Define ‘short-cuts’?

        1. Denis+Cooper
          July 14, 2023

          https://wellcome.org/news/quick-safe-covid-vaccine-development

          “How have Covid-19 vaccines been made quickly and safely?”

          “For most diseases, developing a vaccine can take more than 10 years. The development process is expensive, so to keep costs down development takes place slowly, each stage only beginning when the previous stage is successfully completed.

          This has meant a fundamental redesign of the staggered approach of conventional vaccine development, so that Covid-19 vaccine development can safely be done much faster.

          So far, it has been an extraordinary success – a brilliant example of what we can achieve when we work together.”

          However that “so far” referred to January 2021.

          “3. Clinical development involves testing potential vaccines in humans and has three phases:

          phase I: testing for safety – takes 2 years and requires 10-50 (usually healthy) people to take part in trials.

          phase II: understanding the immune response, safety and dosage – takes 2 to 3 years and requires hundreds of people to take part in randomised trials, including a placebo control group and people with the target disease.

          phase III: assessing if the vaccine safely protects against the disease – including prevention of infection and related immune responses – takes 5 to 10 years and requires thousands of people to take part in trials, including a placebo control group.”

      2. Bingle
        July 14, 2023

        Well said!

      3. Lifelogic
        July 14, 2023

        It was known, very early in the vaccination programme, by the government experts (from the trials) that the vaccines did nothing to prevent transmission (so don’t kill granny was a lie) and had very high hasty side effects. Nothing to do with hindsight. It was also known that young people (and people who had had Covid already) were at virtually zero risk. There was no need to vaccinate them anyway. Even had it been safe and effective as claimed.

      4. Donna
        July 14, 2023

        “It was an emergency. Initially we had no idea how bad it could get…”

        Not correct. The Government downgraded Covid to a Low Consequence Infectious Disease about a week before the first lockdown because by then they knew it had low mortality rates. They also knew which demographics were most at risk …. the very elderly/frail and those with several serious co-morbidities.

      5. Sir+Joe+Soap
        July 14, 2023

        I’d look out of the window 2 weeks in. If nobody lying dead in the street, I’d venture out. Wander through town. Still nobody keeling over? So it can’t be SO bad. Hundreds of other folks, not looking too bad for wear. No hugging but I wouldn’t be cowering in a corner listening to announcements telling me to stay in 23 hours a day either.

  11. BOF
    July 14, 2023

    I doubt there is any question that the majority of staff, as is the case outside of the public sector, want nothing to do with WOKE and DIE (diversity, inclusion and equity). This alone would make many want to escape.

    Ban these abominations from all sectors of health care for a happier staff. How individuals live and what they want to believe in their private lives should never intrude in their working lives.

    1. Ian B
      July 14, 2023

      @BOF – (diversity, inclusion and equity) active Political Discrimination to the exclusion of to a first rate health system. It says and states that Government believes that Heath workers are not part of the Human race and have to be indoctrinated with the Socialist Political will of Government. Or to the real world, be warned do not enter brain washing in progress

      1. BOF
        July 14, 2023

        +1 Ian B

    2. iain gill
      July 14, 2023

      yes but anyone who questions it can be easily “cancelled”. there is no belief in free speech.

    3. Lifelogic
      July 14, 2023

      +1

  12. formula57
    July 14, 2023

    Despite your clear pointer “and implies that something is wrong with the jobs or leadership” Mr. Brine has little to say on leadership beyond stating of trusts that they “have a big role to play”. Tell us something we do not know!

    And “a conversation with their employers about their pension arrangements and mental health and wellbeing” seem very dubious. Most (all?) pension funds write annually with details, including payment projections.

    Demanding an annual “conversation” to discuss “mental health and wellbeing” overlooks that those characteristics arise constantly not annually and formalizing consideration risks encouraging the raising of concerns that might not arise naturally.

    (You may recall a while ago I disclosed that I had consulted my therapist after a comment here did not emerge from moderation: will you want a conversation with me soon?)

    1. Ian B
      July 14, 2023

      @Formula57 – ‘their pension arrangements and mental health and wellbeing’ politics above service, platitudes as a substitute to doing something

  13. Michelle
    July 14, 2023

    I have a relative in the nursing profession. This was her passion from a very small girl. She has become very disillusioned by the constant interference of management in its various layers.
    Often new directives come down that are unworkable, they are time consuming box ticking affairs that eat into actual quality hands on nursing.
    This I have heard from many other nurses. It seems to be a great source of distress in the job which can’t be a good thing for anyone, staff or patients.
    The view of many older nurses and retired nurses (one I know quite well who was a ward sister for many years) is the new all singing all dancing nursing degree is bunkum.
    I fear we may be missing out on a lot of dedicated quality staff, just because they are not academic/university material. Those with the passion for it will have the drive to learn and succeed, regardless of academic ability.
    I would like to see those hospitals with large sums of money owing in compensation to patients investigated.
    Something is clearly wrong in the running and staffing of such places.

    1. Ian B
      July 14, 2023

      @Michelle – High over paid management with ever expanding departments know better than the experianced Matron

  14. Enigma
    July 14, 2023

    What about the 40000 care workers sacked for refusing to be jabbed?
    Apologise, compensate, reinstate

    1. Sharon
      July 14, 2023

      In the USA those sacked for not being vaccinated have now been re-employed and compensated! Our turn next?

    2. Mickey Taking
      July 14, 2023

      What about the deaths in Care? Will you want to ‘Apologise, compensate, reinstate’.
      The latter might prove difficult.

    3. Lifelogic
      July 14, 2023

      +1 and investigate & charge the “experts” & people who, in what was surely an act of gross negligence, pushed this appalling policy. This when, very clearly, it was almost certainly going to do more harm than good. This was, or most certainly should have been, clear to them at the time they were pushing it.

  15. Ian B
    July 14, 2023

    ‘A plan’, a ‘Select Committee’ that’ll make things right(sarc)

  16. Ian B
    July 14, 2023

    ‘the Government are the employer’ but refuses to manage. ‘but the direct employer when it comes to hospitals is the trusts’ – yet pay etc. (Management) is down to Central Government – they need to make their mind up.

    Why then are Government involved in direct discrimination, as opposed in the ‘best of the best’. Diversity and inclusion is a political act to enforce discrimination on society. Is it the ‘Trusts’ involved in Politics, or is it Government enforcing their political will? How and what has these political view points to do with creating a first class medical/health service?

  17. Ian B
    July 14, 2023

    ‘ UK should be increased by 5,000’ when, how? When this Conservative Government is intent on fighting against the economy that could fund it/

  18. Peter Gardner
    July 14, 2023

    “There is a part of the workforce plan, which the Select Committee discussed a little yesterday, which talks about how, every year, every member of staff should have a conversation with their employers about their pension arrangements and mental health and wellbeing. That is fantastic. ”

    Why is that fantastic? It is perfectly normal, if not essential. Every organisation I have wroked in has annual reviews – the Armed Forces, all commercial organisations, MI6, and not only in the UK.
    That it is regarded as fantastic rather indicates that mangement practice in the DHSS and NHS is backward, dilatory, slack, poor.
    If people are leaving it is because they are disenchanted with the organisation. The reasons are probably many, of which ‘not feeling valued’ could be the major one but not necessarily. Has there not been a survey of staff to find out specific reasons for low morale and for leaving?
    I have talked with British medics in Australian hospitals. It is usual for them to say they left the NHS to work in Australia because the NHS is such a shambles, bureacratic, impersonal, and performs badly in terms of health outcomes by international standards. Who wants to work in a lousy organisation with low performance when they could work in a high performing one? Sure, the pay is better in Australia. That is not the main reason for leaving the NHS. But, having decided to leave, it is one of the reasons for choosing to go to Australia.
    Somnebody needs to survey the staff and find out why morale is low. And don’t ask the managers: they won’t know. If they did they would have fixed it or would be able to answer only that they don’t know how to fix it..

  19. Berkshire Alan
    July 14, 2023

    The suggestion for an annual chat sounds a bit like the introduced annual appraisal, a simple tick box assessment exercise which really benefits no one, because no-one is really honest in filling it in for fear of being a target. If managers cannot manage on a day – day basis, then they are not managers or fit for purpose.
    A decent manger should have a general but friendly chat with all of their staff on a very regular daily/weekly basis during the normal meeting up and greeting process, that way you learn about personal/family health problems, relationships, possible worries and concerns, as well as problems with some work processes. etc.
    When in manufacturing management I used to walk the shop floor every morning, just to say a cheery hello to everyone, for two reasons, to also let them know that I was also at work on time, and as a common courtesy, you would be amazed at the things I was informed about which helped both me as a manger, to manage people better, and to make their tasks perhaps more easy by sometimes changing processes.
    The suggestion box idea was also sometimes useful for feedback, even if some were anonymous !
    WHY WAIT A YEAR ?

  20. glen cullen
    July 14, 2023

    Why does a vocational nurse require an academic degree – get rid of degrees and allow vocational gifted young people to enter the NHS

    Why does a junior doctor require a 5-7 year general academic degree – allow junior doctors to enter a specialised route 3-4 year degree with continued development throughout their career

  21. Ian B
    July 14, 2023

    Paraphrasing Sir Lindsay Hoyle when he accused the Government of being “disrespectful” to the House and its members.
    The ministerial code says: “It is of paramount importance that ministers give accurate and truthful information to Parliament, correcting any inadvertent error at the earliest opportunity.”

    It is not just your contributors here that have noticed, but there is a great divide being created by this Conservative Government – between what is needed(the deed) and what they say they have done(just Socialist WEF Statements).

    Government isn’t about interfering it is about creating frameworks so there is no interference. More so Political interference and indoctrination – that’s just a Dictatorship.

  22. agricola
    July 14, 2023

    Social care needs to be fully integrated with NHS medical care so that for the patient that needs it the transition is seemless. It should be part of the rethink of what the NHS is to be, how it is to be done, and how it is to be financed. Taxation, insurance or a combination of both, there being systems out there in other nations that are more effective than ours.
    We cannot continue to penalise thrifty property owner by confiscation of assets to pay for end of life care. It is immoral and not at all Conservative. We do not need a Royal Commission, far too ponderous, a one year think tank is long enough.

  23. Wanderer
    July 14, 2023

    +1. I’ve had extensive user experience with the French and Austrian public health services. Both were miles better than the NHS. Most recently in Austria: you can always see your doctor on the same day if you say it’s urgent; appointments with the specialist of your choice within 2 days to 3 weeks, depending on the specialism and urgency. CAT scans within 10 days. All fully covered by your NI payments.

  24. IanT
    July 14, 2023

    All this focus on the NHS and no one seems to give any thought to our Armed Forces, who are going to get just 5%. Let me quote from the Forces Watch Briefing…

    “Employment in the armed forces is unique in placing severe restrictions on rights and freedoms
    that are available to the rest of the UK population. The armed forces are also the only employers
    in the UK who legally require their employees to commit themselves for several years, with the risk
    of a criminal conviction if they try to leave sooner”
    Of course there is no right to strike. I might also mention that the career prospects aren’t that good either when numbers are being constantly reduced. I’m not sure military accomodation is too wonderful these days either.

    Chuck in long unpaid hours, a chance of getting killed or seriously injured at work and that really puts the whinging health and teaching unions into perspective. But frankly no one in government gives a toss because they don’t have to. These are the people who are always the last resort when we need then, be that during strike, disaster or conflict – and frankly no one in Government gives a toss.

    PS Maybe we should insist that the 62,000 Civil Servants at the MoD are trained as back-up to our service people. Maybe they would start to find ways to better equip them if their lives might depend on it too?

  25. a-tracy
    July 14, 2023

    How many years has there been a 9% attrition rate?
    How many of the leavers were because they refused to have covid jabs?
    How many were over 60 years of age choosing to retire early after the covid scare? I know a couple personally and wonder if that was countrywide.
    How many were from foreign countries (inc the EU) that decided not to return after covid?
    How many apprenticeships does the government have in Health & social care?

    1. Mickey Taking
      July 14, 2023

      a-tracy: How many of your excellent questions are going to be answered?
      (deathly silence follows).

      1. a-tracy
        July 15, 2023

        Well thanks for reading MT. Hopefully some browsing journalist out there will be interested enough to get to the bottom of it. Nothing can be changed from one person and their department in government, all they can do is express the public’s wishes and set goals for the service that we pay for (it’s not free). My expectations are from the NHS managements and senior teams they seem to think they can obviate blame for everything to government, that is toxic and very poor management, they can’t continue to do this, its time the public WAKE UP and it is time we hold these highly paid people to account as they have been given plenty of extra money.

  26. Mike Stallard
    July 14, 2023

    Professionals love the job because we have a vocation to do it. We like to make a professional judgement, based on our knowledge and experience. We like to feel free to do this and also we love to see the results. We like to feel free to take risks and also to fail.
    My question: do all the vast number of bureaucrats and lawyers who run the NHS allow professionals to make their own judgements in UK?
    If not, the professionals turn into employees who do other people’s will and are paid accordingly.
    (This is especially true of the Church of England as well where the churches are permanently locked, empty and irrelevant.)
    In other countries, freedom is allowed, hence the exodus.

  27. Christine
    July 14, 2023

    “the number of medical school places in the UK should be increased by 5,000 from around 9,500 per year to 14,500.”

    UK citizens must have priority when applying for these places. We need to get rid of the practice whereby foreigners get the places because their tuition fees aren’t capped and greedy educational institutions push out our own people.

    1. a-tracy
      July 14, 2023

      Christine, I’ve been wondering about this with all the strikes currently and anger amongst British medical trainees.

      How much does the British government pay the University on top of the ÂŁ9250 annual student tuition fee loan per UK student for a medical degree? Is each universities overseas student numbers capped below 15% of each year’s trainee intake or is it in the UK universities’ interest to take their funding from the UK government and have half overseas and half English? Does Scotland pay the English rate or do they get their training free in England too?

      Are the UK and subsidised medical trainees tied into UK NHS work? Esp. Important if we increased placements as you suggest or buy themselves out if they go elsewhere as we’re told a lot of them want to do (Australia, NZ or America).

      Warwick, for example, charges around ÂŁ27,290 to foreign medical students for year 1, then ÂŁ47,580 per year for years 2,3 and 4; that’s ÂŁ170,030! And UK medical grads are angry they pay ÂŁ37,000 rather than grateful the UK provides these fee subsidies for them as years 5 and 6 fees are paid by the NHS plus a NHS/DoH bursary of up to ÂŁ4,491 plus an NHS Grant of ÂŁ1000.

      Oxford University overseas students pay between ÂŁ39,740 pa years 1,2 and 3 and fees for years 4 to 6 called clinical years ÂŁ52,490. Oxford is quite generous to some UK students, with 1 in 4 students receiving an annual non-repayable bursary (I wonder if that is tied to several years of UK NHS work? Or if they are meant to pay a bit back in later working years)

      I also wonder how many EU, EEA and Switzerland medical trainees the UK trains at home fee arrangements and whether they’re tied into a certain number of hours work for the UK NHS.

    2. forthurst
      July 14, 2023

      The problem is not greedy educational establishments but the parsimonious Tory Party that refuses to fund medical and other science-based education better than that for the useless courses in Arts subjects that lead by default to careers in the maladministration of the country by Tory politicians and the civil service who get tripped up by every issue where a knowledge of science is essential to its understanding.

      1. a-tracy
        July 15, 2023

        Forhurst, you are not counting the amount of money that goes into medical schools from the government to top up the student’s tuition fee, the student tuition fee element wasn’t to pay for the whole cost of the course it was a contribution in the case of medicine £9,250pa x 4 years in comparison to a trained overseas student undergrad level of £170,000, they also have to pay the tuition fee in FY1 and FY2 they don’t get it covered by the NHS which is maybe why some leave after stumping up their £170,000.

        What is grossly unfair in our Union is that ONLY English kids pay!

  28. glen cullen
    July 14, 2023

    Let’s give the public sector 6% pay rise and they might vote us back in, and if they don’t the pay budget is labours problem 
..not sound government or judgement (..and Hunt says that public sector pay rises aren’t inflationary ?)

    1. glen cullen
      July 14, 2023

      Hunt probably believes that the costs of net-zero aren’t inflationary

      1. Lifelogic
        July 14, 2023

        Indeed net zero is not going to happed if it did it would cost trillions that we do not have. We do not even have any technology that could realistically deliver this. EV cars, for example, nearly always increases CO2 compared to keeping you old ICE car for longer.

  29. Denis+Cooper
    July 14, 2023

    Off topic, I have this little letter in our local newspaper today, which they have headlined:

    “Grace and politeness really would not hurt”

    “Firstly, I think James Aidan may come to regret some of the disparaging language that he used about senior citizens in his last letter (Viewpoint, July 7).

    Secondly, he may be interested in a proposal recently put forward by the Resolution Foundation, which he can find by googling for: “Delivering a ‘UK Protocol’, building on the agreement for Northern Ireland, would deliver the benefits of both the EU customs territory and single market for goods, and could boost GDP by as much as 1 to 2%.”

    I may fit into Mr Aidan’s category of “declining elderly”, but I can still see that a one-off GDP boost of maybe 1 to 2 per cent would be of marginal significance in an economy with a trend growth rate of 2.3 per cent a year.

    Taking the central projection, the UK economy would grow naturally by 1.5 per cent over just eight average months, and nobody would be caring about missing out on that extra 1.5 per cent in ten years’ time.

    Would this really be worth the fresh disruption inevitably entailed in ‘fundamentally revisiting our relationship with the EU’, as the originators of the proposal, and it seems also Mr Aidan, want?

    I would politely suggest that it is time for him to accept the result of the 2016 referendum and adopt a more constructive approach.”

    1. Mickey Taking
      July 14, 2023

      I am amazed that you show not the slightest trace of impatience.

    2. Denis+Cooper
      July 14, 2023

      Somebody else who does not accept the referendum result – why and how did he become “Lord” Adonis?

      https://www.prospectmagazine.co.uk/politics/62086/keir-starmer-rachel-reeves-labour-party-safety

      “The other obvious and huge economic win would be to reverse Brexit. This too needs to start by stealth immediately after taking office, with changes to Boris Johnson’s Brexit deal to promote trade and pan-EU travel and business, if not residence.

      The problem is that stealth alone cannot achieve transformational change on Brexit, and Labour’s manifesto is likely to rule out anything really transformational like rejoining the single market.”

      Thess people are totally delusional, still believing that EU membership was important for our economy.

  30. Roy Grainger
    July 14, 2023

    Is there any other country in the world where the Government puts an annual numerical limit on the number of people who are allowed to train as doctors ? I don’t know the answer but it seems a very odd Soviet-style central planning idea. As a follow-up question, how many foreign-trained doctors are recruited into the NHS each year ? If it isn’t a number close to zero doesn’t that mean the limit on UK trained doctors is too low ?

  31. Kenneth
    July 14, 2023

    Why on earth would somebody want to discuss their mental health every year?

    No wonder the NHS is in trouble if that is the way its bosses think.

  32. JoolsB
    July 14, 2023

    Interesting the Scots Government can afford to give their Junior Doctors 12.4% and they don’t have any tuition fees either unlike Junior Doctors in England with up to £100K of debt hanging over them. They are now saying they will be happy if the UK Government offers them something similar to Scotland yet Sunak is saying 6% is all they are getting. When is this craven Government and its mostly useless MPs sitting in English seats going to question the Barnett Formula which gives Scotland £12 billion of ENGLISH taxes every single year. Imagine what that could do to services in England. It’s not even as though the Scots are grateful.
    It seems Sunak can talk tough to English Junior Doctors yet is totally weak on the EU and the boats etc. but then why should he care when the Junior Doctors leave the NHS to seek alternative better paying careers or take their services to Australia. It won’t affect him or his family who don’t use the NHS anyway. Plus he’ll be off to America soon and good riddance.

    1. Mickey Taking
      July 14, 2023

      Taking a job, or as part of a magnificently paid World speaking tour?

    2. Mark B
      July 15, 2023

      +1

      Beautifully put, JoolsB especially your last sentence.

  33. Denis+Cooper
    July 14, 2023

    On topic, I’m not sure that a 9.1% annual loss of staff is unusual these days.

    Searching my files for “churn” I find many past references, including for example this from six years ago:

    http://johnredwoodsdiary.com/2017/08/02/overseas-firms-back-city-by-signing-for-new-offices/#comment-882347

    “… the massive annual “churn” of jobs in the UK economy, which dwarfs the total number of jobs which could conceivably be at risk from Brexit even in the Remoaners’ invented apocalyptic worst case scenarios.

    https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/32244/11-1326-job-creation-and-destruction-uk-1998-2010.pdf

    “JOB CREATION AND DESTRUCTION IN THE UK : 1998-2010”

    “Just over a quarter (28.0 per cent) of all jobs in the private sector were either destroyed or created over a typical 12 month period”… “

    1. Mickey Taking
      July 14, 2023

      I wish I could remember the technology company some years ago who promoted and hoped to act upon annual reviews prior to sacking the least performing 10% of staff.
      (found it : Leader of GE, Jack Welch.)

  34. glen cullen
    July 14, 2023

    We’ve given £80.2 million overseas development assistance (ODA) funds (not foreign aid) to India since 2015, and millions in other bilateral assistance, accept hugh numbers of immigrants one way 
.and today they’ve launch a rocket & module to land on the moon 
.glad we could help

  35. glen cullen
    July 14, 2023

    I wish you’d intervene with the BBC met office, its like a wet & stormy February outside and they’re telling me that a climate changing heat-wave is on its way !

  36. BOF
    July 14, 2023

    It should be pointed our to government every day, the harm that was done to the NHS, not by Covid, but by the idiotic response by government, scientists and so called health experts for a disease with at least a 99.8% survival rate and almost zero risk to anyone under fifty.

    The harm to business, children’s education and mental health, the harm to general health with lack of diagnosis.

    The sinister harm to democracy and free speech and freedom of movement. Now being compounded with draconian legislation to control the population.

    We should fear for the future.

    1. Mark B
      July 15, 2023

      +1

      They have no shame.

  37. Mike Wilson
    July 14, 2023

    Anyone, like me, who has paid taxes (lots of them) all our lives, should be refunded ÂŁ10k by the government to be spent on private healthcare. I.e. We should all be given a ÂŁ10k healthcare voucher. If the NHS can’t provide treatment, there are plenty of private providers that can. This should not, of course, affect our right / ability to access NHS services – IF THERE ARE ANY!

    1. Mark B
      July 15, 2023

      We do not need to get anything from the government, which in truth will come from the taxpayer. Plus any money that gets handed out will be swallowed up by fraud.

      We just need to make having private healthcare provided by an employer non-taxable. I am sure many will take it up.

  38. Margaret
    July 14, 2023

    We have many rough sleepers and homeless immigrants with scabies ,a highly infectious problem and guess what.. pharmacists cannot get hold of the appropriate treatment of permethrin or malathion ,so our prescriptions are useless. Have you got any sway in asking why John?

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