Editorial: The NHS Workforce Plan is Long Overdue

Currently, the NHS in England is facing its toughest times. Public satisfaction has hit an all-time low since it began being measured 40 years ago. The staff morale is in shambles, with the problem of retaining employees growing. With over 112,000 vacancies in a workforce of 1.26 million full-time equivalents, the situation is dire. Moreover, waiting lists have reached an unprecedented high. In light of this alarming scenario, the recently launched workforce plan by the Prime Minister is a long-awaited and welcome initiative. However, it’s important to recognize that it is not a definitive solution.

The plan, which includes a commitment to allocate £2.4bn over five years, fulfills a promise made by Jeremy Hunt, the former Health Secretary, back in 2017. The necessity for a strategy to train an adequate number of professionals to care for the aging population was evident at that time. Nevertheless, centralized workforce planning doesn’t align well with the Conservative party’s ideology, which favors market-driven approaches over public administrators. Consequently, despite the mounting crisis, the government repeatedly refused to take action.

The current government, under Mr. Sunak, has finally come to acknowledge this mistake. Doubling the number of medical school places to 15,000 per year by 2031 and increasing the number of trainee nurses by 92% is a sensible approach, considering demographic projections that indicate a rising demand for care. The commitment to rely more on domestically qualified staff and reduce dependence on overseas recruits brings the UK in line with other countries. A figure of 50% of NHS doctors being trained in other countries by 2021 is too high, as it raises ethical concerns regarding the recruitment of healthcare professionals from low-income countries by high-income ones. Additionally, the proposal to require new dentists to treat NHS patients is a sound measure, given the existing gaps in dental care provision.

While a robust workforce strategy is desperately needed, it cannot compensate for past failures. Aging populations present a global challenge, and the UK’s track record in social care policy is particularly unsatisfactory. There is a genuine risk that this plan may exacerbate that situation. Care managers are particularly alarmed by the commitment to recruit an additional 204,000 NHS support workers, as their staff may be enticed to join the NHS instead.

Pay is another aspect that requires attention in the policy. An upcoming five-day strike by junior doctors will further hinder efforts to address a waiting list that currently stands at 7.4 million people. This week, consultants voted to strike for the first time in 50 years. Ministers must accept the recommendation from the independent pay review body for a 6% pay rise, with an additional £1,000 for junior doctors. If pay levels remain unchanged, any talk of retaining staff will ring hollow. It is sensible to consolidate the increased role of pharmacists, following their successful involvement in the vaccination program. However, other reform proposals, such as an apprenticeship route into medicine, raise more questionable implications.

Mr. Sunak’s pledge is a step in the right direction, and this fact should not be overshadowed by a public dispute with a resigning minister. Nevertheless, the evolving nature of illness, including the growing number of individuals with multiple health issues or “multimorbidity,” presents a public policy challenge that extends beyond the NHS itself. This challenge encompasses the impact of poverty, inequality, inadequate housing, and unhealthy food on individuals. As the NHS approaches its 75th anniversary after 13 years of Conservative government, both the institution and the people it serves are not in good health.