Health secretary Sajid Javid has dismissed a call for the health and social care bill to mandate the publication of independent annual reports on workforce shortages in the National Health Service – and projections of its future staffing needs.
MPs on the Health and Social Care Committee made the request following the publication of the government’s health and social care white paper earlier this year, but ahead of the bill’s introduction into parliament last week.
They said the bill should require Health Education England to publish annual reports that not only spotlight current problem areas for staffing but also project workforce requirements five, 10 and 20 years ahead.
MPs said the reports by HEE, an arm’s-length body that is part of the NHS, should also cover the social-care workforce. Last week, the Home Office commissioned an independent review on the impact of the end to free movement on the social care sector.
But in a letter responding to the report, Javid dismissed the need for such long-term projections “in order to continue to invest” in the NHS. He said the government would set an overall workforce strategy for the NHS through its mandates to NHS England and HEE.
“How this all comes together on the ground is what’s key in making a difference for our colleagues on the front line delivering the care,” he said.
Committee chair Jeremy Hunt – who was health secretary from 2012 to 2018 and is the nation’s longest-serving holder of the post – said he was “very concerned” by Javid’s response, which he said appeared to misunderstand the purpose of the proposed reports.
Hunt noted that Javid claimed the government is making “good progress” towards the Conservative Party’s 2019 general election manifesto pledge to recruit 50,000 additional nurses by the end of the current parliament.
But Hunt said that without the kind of long-term staffing projections MPs are seeking, “we don’t actually know if that is enough nurses, too many or the right amount”.
He added: “If government does, they have not shared the projections this is based on so there is no way for parliament to scrutinise or hold them to account on this figure. Our recommendation would rectify this situation.”
Hunt called Javid’s stated reason for rejecting the proposed independent reporting on workforce-planning “disappointing”.
“It is obviously not needed to continue to invest, but such a duty would mean the government and parliament would know if we are investing the right amount,” he said.
“I would urge you to reconsider this recommendation. If you do not think this is the right solution I would be happy to see alternative proposals that will address the long term workforce issues facing the NHS.”
Elsewhere in his response to MPs, Javid said the health bill includes transparency requirements related to powers allowing the health secretary to make directions to NHS England – a measure sought by the select committee.
“Directions must be made in writing, be published as soon as is practicable and with a statement that the secretary of state considers it to be in the public interest,” Javid said.
He added that changes to procurement rules that will give NHS staff more leeway to decide when to use a competitive process to commission services will be backed up with new monitoring and guidance.
“There needs to be appropriate transparency and scrutiny of the decisions made and the contracts awarded under the proposed new provider selection regime,” Javid said.
“The provider selection regime will set out expectations about what and where decision-making bodies need to publish in relation to the contracts they have with providers.
“Commissioners will be expected to make decisions in the best interests of the patient, taxpayer and local population. To assist them in this, the new regime will also include a list of criteria that should be taken into consideration when deciding how and with whom to arrange services, this includes value for money and quality.”
MPs had advised DHSC to establish a framework to monitor new contracts on an annual basis.
When the government floated its NHS reforms in February, then-health secretary Matt Hancock said the relaxation of procurement rules was an example of “less burdensome bureaucracy” that the NHS itself had been calling for.