“Value Nurses” Campaign
The final item of business is a members' business debate on motion S1M-2054, in the name of Margaret Smith, on the Royal College of Nursing Scotland's value nurses campaign.
Motion debated,
That the Parliament supports the Royal College of Nursing Scotland's "Value Nurses" campaign, which highlights the crucial role that nurses play in delivering high quality patient care; welcomes the nursing summit announced by the Minister for Health and Community Care, and believes that the Executive should take action to recruit and retain more nurses and to reward them in a way which demonstrates the value the Parliament attaches to their work.
I am delighted and honoured to sponsor a motion to value and recognise the wide range of work done by Scotland's nurses and to support the RCN's value nurses campaign.
I welcome nurses to the public gallery and thank those who have contributed to our online discussions this week on the Parliament's interactive website forum.
Nurses account for one half of the NHS work force and 80 per cent of the care delivered by the NHS. Nurses are everywhere—in hospitals, schools, industries and care homes. They are in every community in Scotland and are the backbone of a caring NHS. They must be supported and valued by us. They are also crucial parts of professional teams of other NHS staff—of secretaries, doctors, cleaners, porters and lab staff, for example.
Over the summer recess, I took the opportunity to support RCN's campaign by shadowing some of our nursing staff as they went about their work. I shadowed Duneil Macloud, who works with homeless people at The Access Point in Edinburgh. The service is jointly funded by the health board and the City of Edinburgh Council social work department and provides a one-stop shop where professionals in health, social work and housing can help homeless people with complex needs. I sat in on a case conference. It was clear that Duneil and his colleagues dealt with a wide range of issues, from mental health to hepatitis C, safe sex issues, the aftermath of violence and problems relating to drug and alcohol misuse.
I spent a day with Graham Nisbet, who is a community detox nurse in Bannockburn. We visited former drug addicts in their own homes and listened to their stories of how they are coping on methodone programmes. Graham offered advice and support. It was clear that his job is not easy. When the former drug addicts cracked—as many did—he was still there telling them that they were not back at square one as they had been clean for three to six months or a year. He would tell them that it was time to be clean again.
I went to Glasgow for a night shift at the sick kids hospital at Yorkhill. Nurse manager and guide Mary Macauley kept me going. I am glad that she is in the gallery. I spent the night doing ward rounds with her as she dealt not only with clinical needs—such as putting a line into a seriously ill child—but with the infrastructure of the hospital. She dealt with the consequences of a terrible thunderstorm and rain coming through the oncology department roof. I do not think that I will be asked back—I was something of a Jonah.
I also met and talked to dozens of highly trained nurses, many of whom gave one-to-one care to babies in the neonatal wards and intensive treatment units. They told me that they were paid less than £20,000 after 13 years and extra training in their specialist field. In fact, a nurse would have to be a third year junior sister with eight years' experience to earn the same as a police constable who is just out of probation.
I spoke with parents—mums and dads who just sat, watched, waited and wished that their children were well. I wonder whether those parents thought that £20,000 is enough. I do not think that it is and I do not think that they did, either.
I thank the nurses who spoke to me and those who continually speak to me in my role as convener of the Health and Community Care Committee. Nurses speak to me openly about understaffing, pay, training, violence at work and the need for regular shift patterns. Many have thought of leaving, but few will. They are dedicated to their jobs and see that they make a real difference to Scotland every day.
We can make a difference, too. In the face of rising vacancy levels and falling student numbers, we must make a difference. We cannot change salaries—that is up to the independent pay review body—but all of us can lobby hard to ensure that nurses are given above inflation pay increases to help close the gap with other public sector workers.
We have the power to make a difference for nurses in many other ways. The Minister for Health and Community Care has made three welcome announcements in the past few weeks that will impact on nurses. A 10 per cent increase in bursaries was announced in July and £90 million of trust debts are to be written off—that will help to safeguard nursing jobs and many others. In the past few days, the minister announced details of the nursing recruitment and retention convention in November, which she vows—she confirmed this to me a few moments ago—will not be a talking shop, but will
"look at the key issues affecting recruitment and retention, and follow this up with the necessary initiatives to develop local and national actions towards achieving our shared objectives".
What key issues must be addressed? The motion says that we must do all that we can to recruit, retain and retrain nurses. Our nurses face an ad hoc lottery in trying to find a trust that will pay fees for them to do return-to-practice courses. If they undertake retraining, they are expected to do 150 hours of unpaid clinical placement at the end of it.
All in all the cost to the returning nurse is in excess of £1,000—even before transport to work and child care are included. It is essential that Susan Deacon look seriously at following Alan Milburn's example and announce £1,000 for each returner. We need them badly. We need their experience and we have a record number of vacancies to fill. It would be a good investment all round: for us, for the national health service and for nurses.
Nursing levels are at a record low. There are more than 1,600 nursing vacancies right now, including qualified places—accounting for 3.6 per cent of the nursing work force. The number of vacancies has risen by 48 per cent in the past year. We should be seriously worried about that and serious action must be taken to retain the staff we have, to recruit more and to retrain those who have left.
The RCN has shown in the past few days that there are 10,000 nurses who are no longer practising in Scotland. They are out there somewhere; in their homes, in call centres, in offices. One of them is even here in the Parliament. We have to do all we can to reach out to them and bring them back to nursing—apart from the one who is here in the Parliament.
We need greater flexibility in working and shift patterns and to improve the availability of child care. Time is not on our side: a quarter of NHS nurses will be eligible to retire within the next 10 years, yet the number of newly registered nurses fell by 7 per cent last year.
We should be doing more to encourage greater career development. In England, there are 3,000 consultant nurses whereas in Scotland, so far, there are only 12. Time and time again, the policy set out in "Our National Health: A plan for action, a plan for change", which we have all signed up to, relies on nurses for its success. Freeing up general practitioner time, delivering on waiting times, improving public health all rely—as does NHS24—on the flexibility of our nurses. They rely on nurses taking on new roles and taking on greater clinical responsibility than ever before. All that relies on a greater number of nurses—nurses who, right now, we do not have.
We rely heavily on our nurses for the responsibilities that are outlined in "Caring for Scotland: The strategy for nursing and midwifery in Scotland". "Nursing for Health: A review of the contribution of nurses, midwives and health visitors to improving the public's health in Scotland" means that we will rely on them even more in the years ahead.
We must address the needs of nurses, whether they be those of the community nurse who works single-handedly on one of our islands and finds it difficult to access training or they be those of an accident and emergency nurse in one of our urban hospitals who is trying hard to ensure that she is not added to the list of casualties on a Friday night. I know that the Minister for Health and Community Care, the deputy minister and the Parliament value our staff as highly as the rest of us do. Now is the time to turn our admiration into action.
I hope that the minister will act right away and give returners £1,000 towards their return-to-practice costs. I also hope that the nursing convention will address the wider issues that I have mentioned—which we will here more about in the debate—and send a clear message to Scotland's nurses that they are valued by the Parliament and by the people it serves.
I will not be able to call everyone, even with speeches of three minutes, so I am prepared to entertain a motion without notice to extend the debate by 10 minutes, to 6 o'clock.
May I move a motion to extend the business?
Yes.
Motion moved,
That the meeting be extended by 10 minutes.—[Mrs Margaret Ewing.]
The question is, that the motion be agreed to.
Motion agreed to.
I must declare an interest—I am a member of Unison. As the only nurse in the Scottish Parliament, I feel qualified to contribute to the debate. Margaret Smith talked about the valuable role of nurses in delivering high-quality patient care. I am sure that no one is in doubt about that.
I am proof of the fact that nurses leave the profession. The average age of nurses in Scotland is 47, which indicates that the profession has major problems with recruiting and retaining young people. I support fully actions that enable us to do that and to offer former nurses, such as me, a chance to retrain and return to nursing without financial penalty. As Margaret Smith said, that facility is available to our colleagues in England and Wales and I urge the Executive to implement a similar scheme in Scotland.
Nurses are a valuable group of people, but without doubt they are part of a bigger team. I am sure that the nurses who are in the public gallery will agree that they could not do their job without porters, cleaners, catering staff, clerks, secretaries, laboratory staff and many others whom time precludes me from mentioning. This week, I too lodged a motion that acknowledges the role that those groups of staff play in the health service. They make up the health care team. It is vital that we acknowledge that every member of that team plays a valuable part.
It is also important that we recognise that all groups of staff must have input into the new unified NHS boards. That will be done by having the chairs of each staff partnership forum and local area clinical forum on the boards. That will enable all groups of staff who are part of the team to be represented on the new boards. I welcome that.
As a former staff side representative, I have been involved in representing staff. It is important that we ensure that the voices of all those who contribute to the team are heard. The new board set-up will allow that.
Although I value very much the role of nurses and hope that I, in my time as a nurse, played—and will play at some time in the future—that valuable role and was valued by the community, we must remember that nurses are a crucial part of a team that contains a lot of other staff, who are also valuable.
I congratulate Margaret Smith on securing the debate and Janis Hughes on her contribution to it. I am sure that there will not be a great deal of controversy about anything either of them has said. We all value nurses—that is the aim of the RCN's campaign. We all want action to follow the campaign. The most obvious specific measure that the RCN has advocated is the implementation in Scotland of a policy that is already in place in England and Wales—funding for the £1,000 return-to-practice course.
Whatever else we get from the debate, I hope that the minister will respond clearly to that. It is one thing that we expect of him. I say that with regard to the fact that £700 million has not been spent this year. Why could that money not have been spent on the one simple measure that I mentioned—along with many other measures that have been proposed?
Many other members wish to speak. I will make one more point. I will visit the Royal Northern infirmary tomorrow as a putative shadow nurse. I do not think that they could have made a worse choice, but there we are. I look forward to the experience. I will learn more about some of the things that I have heard about the practical, day-to-day difficulties of being a nurse in the Highlands. Nurses there face difficulties such as paying for their own travel. Kim MacLean mentioned that she uses up to £700 a year from her own pocket. Nurses throughout Scotland, but particularly in the Highlands, have the difficulty of paying for their own training, which is quite insulting in this day and age.
I will learn about the difficulties for nurses, doctors and those in professions allied to medicine—such as physiotherapists, occupational therapists and podiatrists. We rarely mention PAMs. Sometimes, those in such professions feel left out because we tend to talk only about nurses and doctors. Ancillary workers are also neglected.
I look forward to hearing what other members have to say in the debate. I was slightly surprised to be called to speak at such an early stage. I hope that the minister will give us specific assurances.
I congratulate Margaret Smith on securing the debate, which I welcome. Well motivated, happy nurses are key members of our Scottish health team.
Two weeks ago, I visited Lorne and Islands district general hospital in Oban. I am grateful to the nurses there, who took the time and trouble, despite being busy, to spend so much time with me.
The stress of working in the NHS is overwhelming. The nursing sector is at the sharp end and bearing a heavy load. It was put to me that nurses are practitioners who deliver 80 per cent of the care for patients. The undeniable facts that four out of 10 nurses wish to leave the professions in the next five years and that one in three would leave now if they could, show the state of morale and the grave danger that the NHS would face if those figures were to turn into reality.
Nursing is a vocational profession. It is a profession of extreme worth and value. That it be recognised as such is essential. Nurses are the people on whom patients rely when they are terrified and in pain. Because of chronic short-staffing, many nurses are working excess hours without recompense. It is their natural reaction to give help where it is needed and always to answer the call, but it is obscene for such efforts to be taken for granted.
That said, the nurses' low morale is only symptomatic of a declining NHS. The fact is that patients are waiting far too long for admissions. Because they are more ill than they should be by the time they receive any treatment, the treatment has to be more intensive. The nurses' job becomes much more difficult and much less rewarding as they see too many people needlessly suffering and dying. It is no good producing small parcels of money that everyone is chasing. Such a sticking plaster will not cover the deep wound.
The whole NHS system needs to be better funded and organised. In Germany, for example, nurses are happy. They work in clean hospitals and see patients being admitted and treated immediately—and getting well as a result of good nursing. That contrasts with the situation in the NHS, where all too often nurses bear the brunt of patients' complaints from delays, denied treatment and a rationing of resources. Germany puts only a small percentage more public funding into its health service than we do. The gap is filled by private funding and the result is a clean, efficient and happy work force providing patient-oriented, flexible care that covers the needs of a grateful public. Does not Scotland deserve the same?
I hesitate to introduce a partisan element to the debate, but Mr McGrigor has prompted me to do so. I take it that, at some point in this year zero speech, he will recant his party's contribution to the health of the NHS. I seem to remember Conservative spokespeople clutching their wallets whenever the British Medical Association or the RCN approached them. Will he apologise for their words during this debate?
I regret to say that the Conservative health spokesperson is currently recovering from a very bad car crash, and I am sorry that she is not here today. I do not have the time to answer that question.
Finally, when will the Executive implement the proposals outlined in "Agenda for Change: Modernising the NHS Pay System"? If serious steps are to be taken to tackle the recruitment and retention issues that face us, nurses in Scotland will need to be aware of their career prospects and opportunities, and know that they will be matched by appropriate financial rewards.
In this brief speech, I will use my experience of the health service over the past few months to highlight two things we should do if we value our nurses.
First, we should give them decent training. An elderly, deaf neighbour spent the last months of her life in hospital with terminal cancer. There were extreme difficulties with communication. Furthermore, in hospitals nowadays, earpieces are used to take patients' temperature; people removed the woman's hearing aid to take her temperature and forgot to put it back in. When her daughter asked them whether they could not write "Mrs Polson is deaf" on the board behind the bed to ensure that such mistakes did not occur, the member of staff rounded on her and said, "That would be stigmatisation." That makes me think that although that member of staff probably had disability awareness training, the quality of the training was perhaps not all that it should have been.
Secondly, I should like to mention the protocols within which nurses work. Earlier this year, the elderly aunt who lives with us broke her leg and spent some weeks in hospital. To my knowledge, a nurse took her history four times during those weeks, which meant sitting down with a clipboard and going through a list of questions. It is ridiculous that that information could not have been gathered once, or indeed that it was not already known in this technological day and age when data are held in central databases. That nurse's time would have been far better spent just chatting to my aunt. The experience would have been better for the nurse and my aunt if there had been time and space to communicate without a clipboard full of questions between them; the nurse would have received far more valuable information and the personal contact would have been better.
We should give our nurses quality training and sensible protocols to work within.
I too congratulate Margaret Smith on securing this debate, and on making an excellent opening speech. In no way do I want to be partisan, but I think that this is one debate the Minister for Health and Community Care should have attended, to demonstrate beyond doubt that the Executive values our nurses.
Let us go back to first principles. What are we all trying to achieve? We are trying to achieve shorter waiting times for operations, shorter waiting lists, national targets on cancer, heart disease and stroke, and a range of other objectives. We cannot do those things unless we not only value our nurses, but put our money where our mouth is. It is not enough for us to stand here and give lip service to the nurses; the Parliament must be committed to action.
A lot is said about nurses' care of patients—quite rightly—but from recent personal experience I can tell members that the care given to relatives is often as important as the care that is given to patients: the kind word, the cup of tea at 3 o'clock in the morning given to someone waiting for an elderly relative to die or the wee pat on the back for comfort. That is the role of the nurse, as well as looking after the patient. Where would our health service be without the professionalism and dedication of the nursing profession? Nurses' dedication is as important as their professionalism—the two are essential features of the profession.
Specific issues have been raised. For example, Fergus Ewing and Janis Hughes mentioned the special plight of returning nurses. I will mention one particular issue: student nurses. It is a question of numbers. If the current prospect is that about a quarter of nurses will retire in the next 10 years, if about a quarter of nurses in training do not finish their training course, if there is a further reduction in the number of nurses because more are leaving the profession than are coming into it, we will face a crisis, particularly given the fact that the average age of the population is to increase substantially over the next 10 to 15 years.
It is not just a question of having to attend to the problems of returning nurses and serving nurses; we also have to turn our attention to student nurses. In particular, as well as increasing the bursary, as the RCN is calling for, let us ensure that every nurse in training, not just some, receives a bursary.
The Parliament needs to be prepared to raise tax if that is what it takes to look after and really value our nurses. Without our nurses, there is no national health service.
I endorse what Alex Neil said and I thank Margaret Smith for securing the debate and for the quality of her speech. Nurses are undoubtedly the Henrik Larssons and Claudio Caniggias of the NHS football team. From some of the hairstyles I see in the public gallery, I see that some nurses have mimicked those players. Unfortunately, however, the rewards made to our nurses are pitiful compared with those made to our top footballers. Is it not incredible that we read newspaper reports telling us of the £25,000 or £30,000 a week that footballers are paid, while some senior nursing staff with 12 or 13 years' service get less than £20,000 a year? This debate about valuing nurses comes from that perspective.
All the other points that have been made—about training, support staff, options and career structure—are valuable, but what matters most is whether nurses can pay the mortgage or the rent and whether they can afford to support their families. On the wages they receive at the moment, that is simply impossible. It is not good enough that we continue to value our bankers and financial analysts more than we value the nurses in our health service.
I call on the Deputy Minister for Health and Community Care to address that point in his reply to the debate. Yes, there are independent salary review boards. There is no doubt that they investigate salaries. The problem is that they investigate salaries from their current level. The difficulty is that salaries are too low to begin with. I appeal to the minister to consider establishing a wide-ranging NHS pay commission that would examine pay scales across the whole NHS team. As well as paying the Caniggias and the Larssons properly, we need to pay the porters, the domestics and the medical secretaries a decent wage. Would it not be valuable for this Parliament to conduct a full review of wages and salaries in the health service, with a view to making solid recommendations? If higher taxes are needed to deliver that, let us have higher taxes. Until we have a well-paid, well-resourced health service, we will not have a healthy health service.
I welcome the nurses, who come from a virtually all-female profession, to the Scottish Parliament. It is worth noting that the vast majority of nurses, midwives and health visitors are women. I say that because there are issues to do with conditions of employment that need to be addressed. I am referring to shift patterns and other matters that concern nurses.
I declare an interest in this issue, in that I cut my teeth as a union official for the GMB. Few members may know that the GMB organises nurses. I welcome the campaign by the Royal College of Nursing, but it should be recognised that other trade unions are also working to improve conditions for nurses.
I want to make a few points about what has been done wrong in the past and about the way in which the morale of nurses, midwives and health visitors has been damaged. The clinical grading exercise of 1989 was damaging to the profession. In that process, every nurse had to justify their existence and what they did. The exercise set nurse against nurse and midwife against midwife. I hope that we can move on from that and that we can give nurses their true place, on the basis of what they do in the health service.
I am pleased that we have abolished two-stage pay offers for nurses, midwives and health visitors. I am also pleased that we are not considering performance-related pay, which featured under the previous Conservative Government. There is no place for performance-related pay in the nursing profession.
I want to say a few words about the plight of enrolled nurses. In my time as a union official I represented many enrolled nurses, and I believe that they are a particularly important part of the profession. In the past, enrolled nurses have been asked to pay their own way in order to retrain as first-level registered nurses. It is not acceptable that any nurse—particularly an enrolled nurse—should have to pay for their development and training. I hope that that issue can be investigated.
I believe whole-heartedly that the nursing profession is able to take up many of the challenges of the NHS. This is not just about pay; it is about conditions and about giving nurses their rightful place in the health service, so that they can deliver more skilled care. That would help us to retain nurses in the health service.
It is no longer good enough to rely on the good will and commitment of nurses. We need a strategy that will support them financially and in their studies. If we get that right, we will retain the nurses, midwives and health visitors who make up an important part of our health service.
I will be brief, to allow other members an opportunity to speak. I thank Margaret Smith for securing this important debate.
As part of the RCN's value nurses campaign, I recently spent some time at Ninewells hospital in Dundee shadowing a charge nurse in the acute surgical admissions ward. That was certainly an eye-opener for me. The charge nurse was a wonder woman. She spent most of the day managing beds, people and everything else. I tried to keep up with her, but at the end of the day I was absolutely exhausted. Yet she does that work day in, day out.
On top of her other work, she also had to manage a budget, of which 80 per cent was devoted to staffing. Managing that budget was no mean feat, given the round of cuts in Tayside, which, I hope, will be alleviated following the deficit write-off. However, when a member of staff went off sick or went on maternity leave, no cover was provided. The staff were working shifts that I did not think were possible. In fact, I wondered whether those shifts breached the new working time directive. I was shocked to learn that staff were working long shifts day after day without a break in shift patterns that were nine or 10 days long. The figures show that the number of nurses employed in Tayside has fallen by 6 per cent since 1996. Fewer people are doing more work, and that position cannot be sustained.
Although we welcome the nursing summit as a step forward, much more has to be done to address the problems of recruitment and retention in nursing. A few months ago, I had the pleasure of addressing the RCN conference in Harrogate, at which delegates made clear what they wanted and gave the Minister for State at the UK Department of Health a hard time.
I hope that the minister will endear himself to the nurses who are in the public gallery by responding positively to the demands of the value nurses campaign.
I congratulate Margaret Smith on raising this extremely important debate. We should all be grateful to Scotland's nurses for what they have done over countless years.
I wish to put a specific question to the minister. At a time when waiting lists in Scotland have increased, when there are fewer beds and more bedblocking and when there are fewer nurses, will he explain why the Scottish Executive has decided on a policy of providing no central funding for nurses who wish to return to nursing? Is he not aware that nurses who wish to retrain in Scotland are likely to have to pay around £250, yet central funding is available for retraining in England and Wales, along with an allowance for support while nurses are on retraining courses? How can that discrimination against Scotland's nurses be justified, particularly given the fact that it is contrary to the RCN's wishes?
I believe that the Scottish Executive's policy is wrong and I hope that today the minister will undertake to re-examine it. Janis Hughes and Fergus Ewing were right to raise that point and to ask for nurses to receive more sympathetic treatment in Scotland. I believe that they should be given more sympathetic treatment. Nursing should have a high priority in order to maintain the highest possible standards in patient care.
I call Jamie Stone, to be followed by a 60-second speech from Kenny Gibson.
I also congratulate Margaret Smith on securing this debate. On behalf of the Liberal Democrats, I welcome our friends in the public gallery. Although the turnout of MSPs may seem sparse, the debate is actually well-attended for a members' business debate.
I cannot pretend to be a health expert. I have never been a member of the Health and Community Care Committee and, because I am bogged down with my work on the Holyrood project, I am not very knowledgeable about the subject. However, I know that nurses are held in the highest esteem in our country. They are at the opposite end of the spectrum from people such as journalists and politicians.
I also know that I strolled along through life, sublimely believing that it could never happen to me and that health should be taken for granted. Then, as many members know, one day my wife was taken very ill. Those black days are etched into my family's memory. My wife had to go to Aberdeen royal infirmary—she was ill to the point where she nearly died. Alex Neil talked about the cup of tea at 3 in the morning or the pat on the back, and I have been there, as has my family—not for a day or a week but for many months.
In that situation, had it not been for those people who bolstered me and gave me a bed for the night, I would have come very close to the point where I did not know my own mind. What they did was wonderful. From that experience, I know that my family and I value nurses and that nurses have a vocation. If there are angels on this earth, they are nurses. Many nurses soldier on, when many other professionals would not work for such money and would walk away. Nurses soldier on because they have a vocation. Politicians must not cynically take advantage it.
We only have time for the briefest of contributions from Kenny Gibson.
I thank the Presiding Officer for accepting my plea. I do not consider nursing to be a female profession but a caring profession. Although there are many things I would like to say, I will touch only on one issue that has not been mentioned.
The safety of nursing staff has caused great concern to a number of members over the past few months. Assaults on nursing staff have been accelerating each year. Every day, nurses go into hospitals thinking not only about caring for and treating patients—or even making a cup of tea for a distressed relative—but wondering whether they will be physically or verbally abused during their shift. In this day and age, it is totally unacceptable that nurses have to go through that. I urge the minister to address that issue in his response.
I congratulate Margaret Smith on securing today's welcome debate. I also add my support to the RCN's value nurses campaign. The minister and I are joining the RCN for dinner later this evening, so if the minister wants hot soup, he should reflect carefully on his comments.
The motion raises some hard issues that we must address. To put it simply, we are facing a crisis of morale and recruitment in the nursing profession. We have heard many of the statistics already this afternoon: there are 1,000 fewer nurses in our hospitals today than there were four years ago; vacancies are up by 50 per cent in the last year alone; a quarter of our nurses are set to retire in the next 10 years; the same proportion of student nurses drop out before the completion of their courses. Many more students who complete their courses will go abroad or south of the border where they think, quite rightly, that nurses' conditions are better.
To avert the impending crisis, we need action now. I welcome the fact that the date for the nursing summit has at last been set, but at this stage we need not more words but practical policies. We need to bring more young people into the profession. We need more flexible nurse training opportunities and measures to tackle student poverty. The increase in bursaries that the Deputy Minister for Health and Community Care announced earlier this year was welcome but did not go far enough. The average debt of student nurses is nearly £4,000. We also need policies to bring back into the health service some of the 10,000 qualified nurses who are not currently working. We have heard a lot tonight about return-to-practice courses, which are a simple but important measure that the Government could commit itself to.
We need policies to retain nurses within the profession and give them more career development opportunities. There are thousands of nurse consultant posts south of the border, but only 12 in Scotland. We need more opportunities for nurses to progress in their careers while staying within clinical practice. Tommy Sheridan is right that we need action to tackle low pay within the nursing profession. The Government could and should adopt such practical policies to solve the problem before it gets out of hand.
However, politicians can do something more. They can do something that is perhaps less tangible than the practical measures that I have mentioned. Quite simply—if I may use the title of the RCN campaign—we can value nurses. We can make it clear that we value nurses. That would mean valuing in its entirety the contribution that nurses make. As Alex Neil said, the contribution that nurses make goes way beyond clinical practice. It also means never falling into the trap, or rising to the temptation, of berating nurses or other health professionals simply because they point out the problems that they face day in, day out. Politicians can contribute. This is not rocket science; it is just common sense. A crisis faces us; but if we take action now we can avert that crisis and send a loud and clear message to our nurses that we value them.
Without wanting to break the spirit of consensus, I have to say that it would have been the most positive of gestures to our nursing profession had Susan Deacon been present in this debate this evening. However, let us stop talking. Let us take the things that we have talked about tonight and let us put them into practice. The time for talking is over; the time for action is now.
I begin by congratulating Margaret Smith on securing the debate and by welcoming nurses to the public gallery. I applaud the enormous contribution that they make to patient care, both in the community and in hospitals. The Scottish Executive is determined to promote nursing as a valuable occupation and to demonstrate by our actions that nurses are valued.
As in other related areas, I believe that we should balance the positive initiatives that have been taken against the various problems that certainly remain. Those problems must not and will not be swept under the carpet. That is why we need to come together to address them positively and constructively.
On Tuesday, as several members have mentioned, Susan Deacon, the Minister for Health and Community Care, announced arrangements for the nurse recruitment and retention convention, which will bring together key players in the nursing and midwifery professions in Scotland and overseas to address long-term recruitment and retention issues. The convention will be held on 19 November. Invitations have been issued to a wide variety of people who have an interest in the future of nursing in NHS in Scotland—staff representative bodies, directors of nursing, providers of nurse education and nurses themselves—to come to the summit to discuss and investigate innovative ways of addressing recruitment and retention at all grades in the nursing profession.
The convention will not be a talking shop or a one-off event. Instead, the round-table discussion will give all parties an opportunity to look at the key areas that affect recruitment and retention and to follow that up with the necessary initiatives that will develop local and national actions towards our shared objectives.
The value nurses campaign began with six demands. I am pleased that the first of those was met in July when I announced a 10.4 per cent rise in student nurse bursaries from 1 September this year. I hope that that will help to some extent to attract nurses and keep them in training. Since 1996-97, student intakes have risen by 15 per cent and 10,000 more nurses will qualify in the next five years. That is 1,500 more than was originally planned. There are also 450 more qualified nurses now than there were in 1997. However, as we know, there are vacancies—albeit fewer here than there are in England. The number of vacancies that last over three months is 0.6 per cent. At the convention, we shall certainly give serious consideration to the RCN's proposals on return-to-practice courses. The possibility of more flexible return-to-practice courses will also be considered at the convention.
Family-friendly policies are very relevant to recruitment and retention, as Margaret Smith reminded us. We already require all NHS employers to meet, or exceed, best-practice guidance on family-friendly policies as part of the new staff governance standard. In order to help employers, guidance on family-friendly policies was launched recently, including guidance on flexible working, child care and career breaks. We shall ensure that those policies are implemented. Further discussion on those issues will take place at the convention.
This year, for the third year in a row, we have implemented in full the recommendations of the independent nurses pay review body. The latest pay award means that pay for all nurses has increased by 20 per cent in cash terms since 1997. I note that Tommy Sheridan called for a Scottish pay review, but I know that the RCN supports a UK approach to the matter.
We know, however, that the current NHS pay and grading structure does not meet the needs of today's NHS. That is why the health department, along with the other UK health departments, is playing a full part in discussions on "Agenda for Change", which Jamie McGrigor asked about and which sets out proposals for modernising the NHS pay system. The proposed new system will underpin better career progression and modern conditions of service and it will ensure that all NHS in Scotland staff are rewarded fairly, according to the work that they do and the contribution that they make, rather than according to their job titles.
I have heard many of those comments before, sometimes in the House of Commons where I served as an RCN panel member. Will the minister give one concrete example of action that will be taken by the Executive in response to the many points that have been raised by members?
I made an announcement in the summer in response to one of those demands and I have stated clearly that the other demands—some of which I have yet to deal with in my speech—will be addressed fully by the convention. I know that Margaret Ewing wants me to give assurances, but I can say only that we are taking the demands very seriously as part of a process. We are not limiting ourselves to those specific demands, but we are addressing the issue on a broader front.
On NHS boards, we want to ensure that all staff have the opportunity to contribute appropriately to decision making in the NHS in Scotland, without one profession being favoured over another, which is the point that Janis Hughes made. That is why we are giving a stronger voice to area partnership forums and asking NHS boards to carry out a major overhaul of their area professional advisory committees, including the establishment of new area clinical forums in each board area. The chairs of the area clinical forums and the area partnership forums will be on the boards, and either or both of those chairs could be nurses.
There are two other parts to the campaign. The first is the protection of time off for, and the provision of more money for, training. That issue must be addressed because some trusts find it difficult to release staff and because the money for training is not always spent on that. That issue will be addressed. We expect, as part of that, that the new special health board for education and training that will be created in April will take a role in co-ordinating and overseeing educational support for health care staff, including nurses.
The second part of the campaign is the empowering of senior nurses to direct quality patient care. Trust directors of nursing have been asked to ensure that every ward sister and charge nurse in their organisation has access to a leadership development opportunity within a five-year plan, commencing this year. That is why the Scottish Executive has invested £1.75 million in areas such as ward sister/charge nurse development. That is regarded as a key priority in the modernisation of the NHS in Scotland and the empowering of staff. We have also issued guidance on nurse consultant posts. The number of posts—13—is totally inadequate, and we are determined that trusts will employ more nurse consultants.
Those latter proposals are part of the extension of the role of nurses. Many recent initiatives have reflected the new roles that nurses are adopting, including the role of nurses in NHS24, a service that will provide 24-hour access for patients to health advice from nurses. However, we have also heard the announcement of funding for 80 public health practitioners and the Executive is involved in the family health nurse project. That project is being tested as a means of delivering community nursing in remote and rural areas of Scotland and is a World Health Organisation pilot project. Other initiatives that I have heard about recently include the role of nurses in endoscopy services, which reflects the way in which roles throughout the NHS are changing. We are committed to extending and expanding the role of nurses in the NHS in Scotland.
I conclude by reaffirming the Executive's commitment to valuing our nurses. Much has been done, but the main point is that more remains to be done. I know that some people will be disappointed that I have not been able to make specific announcements tonight, but I have clearly indicated the direction of travel. I am sure that everyone is looking forward to the convention, in which answers to many of the questions that members have asked will be given. I look forward to listening to nurses at the dinner tonight and at the conference tomorrow, and I leave it to them to decide whether my soup will be hot or cold.
That concludes the debate. It remains for me only to thank those who have participated, the representatives of the nursing profession in the gallery, those who followed our proceedings by webcast, and those who have input ideas and comments via the participation pages on the website.
Meeting closed at 17:55.