Hansard

I am grateful for the opportunity to bring forward this debate on international nurses day. The importance of our hard-working nursing staff, particularly in the past two years, cannot be overstated. They have been at the front line of the global pandemic, acting selflessly to provide essential healthcare in the most difficult of circumstances. It is fitting that this day is celebrated on the birthday of Florence Nightingale, a nurse who showed similar strength, compassion and commitment. To our nurses, from the retired to the newly qualified, from palliative care to paediatrics, we take this opportunity to say thank you.

However, it is not enough to stand here today to thank nurses or, indeed, to clap on our doorsteps each week. Nurses are experiencing unprecedented levels of burnout and there are record numbers leaving the profession. Vacancies are also skyrocketing. Nursing staff are reporting increasing concerns around a lack of flexible working and a lack of effective workforce planning and are expressing disappointment that the Health and Care (Staffing) (Scotland) Act 2019 has not yet been implemented.

I recently attended a Royal College of Nursing round table at which I met nurses from across Scotland to hear some of their concerns; the cabinet secretary was there too. Hilary Nelson, an NHS Forth Valley intensive care unit nurse, explained how difficult it is for staff to come to work every day knowing already that their wards are understaffed. Nursing and midwifery vacancies in NHS Scotland reached a record high of 9.3 per cent, according to the latest workforce statistics, which were published on 1 March 2022. That is 6,674 vacant posts.

We know that the work that nurses do is not easy, but it is made yet more difficult by staffing shortages that force one nurse to do the work of many. This is unfair and unsafe for staff and patients alike. The Royal College of Nursing has repeatedly called for the Scottish Government to increase investment in the workforce and respond to the record high vacancy rates at the same time as implementing its own safe staffing legislation. The Health and Care (Staffing) (Scotland) Act was passed by the Parliament in 2019, but we are still no closer to seeing it being implemented. While the Scottish Government delays any meaningful action, nurses such as Hilary remain overburdened due to understaffing.

The Government says that it values nurses, and I believe that it does, but national health service staff—nurses—deserve action, not just words. With more and more people leaving the profession, not enough work is being done to replace the ageing workforce. The RCN has identified high levels of forced retirement of nurses in their 50s, causing already overstretched staff to take on extra workloads. Many of those nurses, such as Joanna Maloney, who was a senior nurse in mental health, would have stayed in their jobs if offered flexible working, but no one was interested in retaining her skills and experience—a loss to the profession.

Therefore, we need to tackle both recruitment and retention. I know that the Government talks about having more nurses than ever before, and that is probably true, but there is no mention of the fact that there are more patients being treated, there is more pressure on the system and capacity is truly stretched. We need to see a commitment to increasing the number of nursing student places in line with workforce modelling rather than simply affordability, as well as the urgent implementation of the 2019 act, to allow our NHS to function well.

Let me give you an example. In Scotland, the ratio of whole-time equivalent specialist cancer nurses to cancer incidence is lower than in England for most tumour types. It is crucial that the current Scottish Government consultation on workforce ensures that the cancer nurse workforce is fit for purpose for the constantly rising cancer incidence in Scotland that comes with an ageing population. Further, the overall number of stoma nurse specialists across Scotland has declined by a staggering 50 per cent over the past 10 years, despite the number of patients with a stoma increasing by 1 to 2 per cent per annum. Patients with a stoma rely heavily on the in-depth knowledge of those specialist nurses, and health boards should be providing the resources that are needed to support that vulnerable group of patients and support nurse specialists.

It is hard to recruit new nurses when the level of pay on offer does not reflect the demands of the job. In fact, there has been a real-terms pay cut over several years. Shirley Robertson, a school nurse, spoke passionately to us about the effects of low pay when we met earlier this year, along with the cabinet secretary. We all know that the cost of living crisis is here now, but this year’s NHS pay award is five weeks, six days and 17 hours overdue, and we are still counting. Nursing staff are waiting for the Scottish Government to act. Those delays come after years of underinvestment from the Scottish Government. To continue to withhold fair pay, particularly after the events of the pandemic, is frankly insulting.

In response to that, I am sure that the Scottish Government will argue that on average nurses in Scotland are slightly better paid than staff elsewhere in the United Kingdom. Let me tell you the reality of that. The reality is that the difference is meagre. It is about £8.60 a week for a newly qualified registered nurse. That is then offset by higher taxes paid by those working in Scotland, and in recent years pay for nurses has simply failed to rise in line with inflation.

It is, therefore, no surprise that, of the six in 10 nursing staff thinking of leaving their jobs, 54 per cent cite low pay as one of the main reasons for wanting to leave. Our nurses love their jobs, but they are being asked to work long hours for low pay, often doing the job of two people for the price of one. Nurses and NHS staff were there for all of us over the past two years. Now is the time to acknowledge that work.

In the meantime, we must continue to support and boost our nursing staff in any way that we can. I am delighted that today the RCN has launched the inaugural RCN Scotland nurse of the year awards, which will take place on St Andrew’s night later this year. The awards will shine a spotlight on the best of nursing and will highlight and celebrate the dedication and outstanding professional care of nursing staff across Scotland. MSPs can nominate constituents, and I encourage all of my colleagues to do so.

Let me finish by once again thanking nurses for the work that they have done and continue to do. I certainly will—and I know my party will—continue to fight for better pay and working conditions alongside the RCN, Unison and all health service trade unions. I understand that kind words and tokens of gratitude do not pay the bills. On this international nurses day, I am reminded of a trade union rallying cry: “What do we want? Fair pay! When do we want it? Now!”