The King's Fund's response to the Health and Care Bill workforce vote in the House of Lords

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In the past few minutes, members of the House of Lords have defeated the government by voting to require the regular publication of health and care workforce projections. Commenting on the vote, Richard Murray, Chief Executive of The King’s Fund, said: 

‘Members of the House of Lords have sent a message to the government that it must face up to the chronic staff shortages that bedevil NHS and social care services.  

‘Peers have successfully amended the Health and Care Bill to require the regular publication of NHS and social care workforce projections. These projections can provide the basis for robust health and care workforce planning, something that has been sadly lacking for many years. 

‘Poor planning, weak policy and fragmented responsibilities for the health and care workforce mean that staff shortages have become endemic, leaving staff exhausted, services struggling to cope and people wating longer for the care they need, even before the pandemic. Successive governments have dodged the issue for fear that providing the staff needed to meet people’s health and care needs will prove too expensive. In truth, the failure to plan is a false economy as services resort to expensive agency staff and paying overtime to fill rota gaps. 

‘Workforce shortages are at the heart of many of the challenges facing health and care services. A lack of staff will be the rate-limiting factor in the government’s ambition to reduce the NHS elective care backlog. To ensure the NHS and social care have the staff required to meet the needs of patients and service users, I urge ministers to resist the temptation to overturn this important amendment.’ 

Notes to editors

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The King's Fund is an independent charity working to improve health and care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible health and care is available to all.

  • Members of the House of Lords defeated the government 171 to 119 to require the regular publication of independently verified health and care workforce projections (amendment 80 to Clause 35 of the Health and Care Bill). 
  • The amendment was tabled by Baroness Cumberlege and has been championed in the Commons by Jeremy Hunt MP. 
  • MPs may seek to overturn this decision when the Health and Care Bill goes back to the House of Commons. 

Other important votes on the Health and Care Bill are expected today (extended powers for ministers to intervene in the NHS) and next week (regressive changes to the social care cap). 

The King’s Fund supports much of the Health and Care Bill, however there are four priority areas we believe require amendment. 

  • Reconfiguration powers: Extensive new powers for the Secretary of State to intervene in local service reconfigurations bring the risk of a decision-making log jam and dragging national politics into local decisions over services. These powers should be removed from the Bill or, at the very least, safeguards should be added to limit the circumstances in which the Secretary of State can intervene, require appropriate consultation, and introduce a time limit on decision-making.  
  • Powers to direct NHS England: To provide confidence in the operational and clinical independence of the NHS, parliament should seek further safeguards over the new powers for the Secretary of State to direct NHS England.  
  • Cap on social care costs: The change to the social care cap is regressive and will mean that the main beneficiaries of the government’s reforms will be people with higher assets, while the benefit to people with low to moderate assets will be marginal. To protect people with lower assets from catastrophic costs, the change to the care cap should be removed from the Bill. 
  • Workforce: The measures in the Bill to address chronic staff shortages remain weak. A new duty should be added to the Bill, requiring the regular publication of independently verified projections of the current and future workforce required to deliver care to the population in England. 

 Read our latest briefing on the Health and Care Bill.