Conservative policy to increase nurses by 50,000 called into question
Following the outcome of the December 12 general election which secured Boris Johnson’s Conservatives a sizeable majority, attention is now turning toward the outcome of his party’s policies, none more so than within the NHS.
Aside from the furore surrounding whether or not the Health Service could be part and parcel of a future trade deal with the United States, one pledge that Johnson made during the election campaign which raised eyebrows was his plan to increase the number of nurses by 50,000.
There are around 100,000 vacancies in the NHS in England, with roughly 40,000 of those being nurses. During his election campaign, Johnson pushed this policy as the first step in addressing the recruitment shortage.
The number of 50,000 extra nurses according to the policy will be achieved through focussed foreign recruitment, along with policies for more effective retention of nurses.
The recruitment plan includes 14,000 new nursing places, 5,000 nursing apprenticeships and an attempt to recruit 12,500 nursing professionals from abroad.
As things stand, there are just under 300,000 full-time or equivalent nursing positions. Under the policy, the Conservatives will look to train more nurses by bringing back maintenance grants for nursing students, ranging between £5,000 and £8,000 per year.
The scrapping of such maintenance grants two years ago under his predecessor Theresa May proved unpopular and has been blamed for the shortage of nurses, with a fall in applicants for nursing courses following. It is a U-Turn for the Tories, but the policy will not see free tuition for nursing students reimplemented, as was the case before 2017.
It is much needed intervention too. The Guardian claims that a copy of the government’s plan to tackle staff shortages showed that the NHS could be short of around 70,000 nurses within five years.
However, doubt was first cast on the policy and the 50,000 figure during the election campaign, when Johnson was interviewed by Sky News’ Sophy Ridge.
Johnson was asked which proportion of the 50,000 would comprise of newly recruited nursing staff, to which he responded that only 31,000 would be new recruits.
Following this, Conservative sources, according to The Independent, confirmed that the overall figure also includes roughly 18,500 existing nurses who will be encouraged to remain within the NHS, or enticed back into the profession having left previously.
Speaking to Ridge, Johnson said: "I have explained this many times so far. It is very important, the problem we have in the NHS is there are 19,000 nurses who would leave the system unless we put the investment in now and that’s what we’re going to do.
“What we are saying is that we would be down by 19,000 if we hadn’t put this investment in, we’re going to have 31,000 new. As a result of the investment we’re making we’ll have 50,000 more nurses. We are also going to have, as I say, 40 new hospitals, 20 hospital upgrades and 6,000 more GPs.”
With Johnson's words in mind, the 50,000-nurse figure will, therefore, be generated by 31,000 new nurses, with better retention measures to keep on 19,000 more.
Notably, the party held back from going into detail as to exactly what these retention measures might look like, and notably the heightened focus on recruiting foreigners comes at a time when the charge for foreign staff to use the NHS is being increased and there has been an “Australian style points-based immigration system” mooted.
The Conservative party outlined plans to increase the NHS surcharge from £400 to £625 a year for all non-EU migrant workers and extend it to all EU citizens migrating to the UK post-Brexit. The fee is payable for each member of a family migrating, meaning larger families will need to pay considerably more. Any measures to entice foreign recruitment, therefore, will need to be offering something reasonably lucrative if it is to persist with this policy.
In terms of the financial viability of the pledge, the current starting salary for a nurse is £23,000 per year, with the Conservative manifesto budgeting £879 million for the policy. Divided between 50,000 nurses, it would allow for £17,580 per year. At a glance, this would not seem to add up.
However, when divided among 31,000 new nurses, then the figure becomes £28,355 per year each, which is more than likely more along the figures Johnson had in mind. Assuming all of the new nurses begin on the £23,000 starting salary, there is a surplus of £5,355 per nurse per year which can then be invested into recruitment measures. A surplus £5,355 from 31,000 nurses would see that total surplus figure up to £166,005,000.
Divided between 19,000 nurses targeted for retention, this would amount to £8,737 each. It is, of course, unclear as to whether this money will be required to pay full salaries for 19,000 nurses staying on or not.
For certain, there will be a great amount of interest in the outcomes of these proposals and indeed whether or not it will deliver an outcome near the proposed targets.