Hansard

I thank nurses, midwives and health visitors for the enormous contribution that they make to patient care and the national health service. I also pay tribute to the Royal College of Nursing for its value nurses campaign. The wording of the Scottish Executive motion that we are debating today is a testament to the effectiveness of the RCN's consistent lobbying on many of the major issues that affect the nursing profession. I congratulate the college on placing the issue of recruitment and retention of nurses firmly on the political agenda.

Recruiting, retaining and rewarding nurses must be a key priority. Today there are 1,000 fewer nurses working in our health service than in 1995. There are 11,500 registered nurses who no longer work in the NHS. There are 2,000 nursing vacancies in Scotland—an increase of more than 500 since March 2000. The drop-out rate among nursing students is 25 per cent.

It is interesting that the minister raised the spectre of local pay bargaining. I spoke to nursing students at lunch time today and they expressed their real concerns about the number of newly qualified Scottish nurses who are lured away to England or further afield by the promise of more money and better career opportunities. That is the reality and the scale of the challenge that we face.

To be fair, the Government has taken some very positive initiatives. The announcement of the free return-to-practice pilot scheme for 150 nurses is a step in the right direction, but the scheme is open to only 1 per cent of the 11,500 nurses who could benefit from it. If we are to avert the crisis that primary care and acute care face in attracting nursing staff, free return-to-practice courses should be available to all nurses who wish to return to the profession.

The pledge to put a nursing director on every NHS board is a positive development, of which I know that nurses in England and Wales are envious. That step marks progress for nursing and the NHS. The minister is to be congratulated on abandoning the somewhat intransigent attitude of his predecessor on that issue.

There are issues on which much more progress needs to be made. If it is clear—and it certainly is—that the public value nurses highly, why do we reward nurses with pay scales that are lower than those of other professions? Their starting salary is 10 per cent lower than that of police constables and 11 per cent lower than that of teachers. When nurses are in education and training that prevents them from supplementing their income with part-time employment, which other students routinely do, why are they expected to survive on bursaries, which, despite increases, are unable to support a decent standard of living?

Why do qualified nurses face often inflexible working patterns with long shifts and unsympathetic rotas, which force them out of the NHS and into agency nursing where they can access the part-time working and flexible hours that they need? Why do many qualified nurses choose not to return to nursing practice?

Only today, the general secretary of the RCN said:

"to attract nurses and keep them for the long term, the government needs to invest seriously in the workforce through pay, careers structure and employee friendly practices."

We must work to increase pay rates for nurses to reward them properly for the work that they do, to level the playing field with other professions and to give us a competitive edge in our ability to recruit and retain nurses. Tackling low pay in the nursing profession is fundamental to addressing the crisis that it and the NHS face. That, and nothing else, is the SNP's agenda on pay—to improve the quality of pay that we give our nurses and to attract more people into the profession.

Nursing is a low-pay profession. A nurse's starting salary of £16,000 remains below the national average of £17,000, and the low-pay culture that exists at the start of a nurse's career continues even as promotion and length-of-service awards come into play. The majority of consultant nurse posts, of which there are fewer in Scotland than there are south of the border, are advertised at the bottom of the pay scale. If valuing nurses is to be more than rhetoric, it must mean tackling low pay in the profession and rewarding nurses for taking on expanded roles and increased responsibilities. I am sorry that the minister has chosen to see a hidden agenda in the SNP's amendment, because it is quite simply about rewarding nurses better for the work that they do. Without that commitment, I fear that the Scottish Executive's commitment is nothing more than rhetoric.

Flexible working is another issue on which the Executive has had too little to say, but which is a huge issue for many nurses who are in practice or seek to return to practice. Trusts find it difficult to offer flexibility, yet many nurses cannot practise without it. The huge increase in the number of agency nurse staff reflects that. Options such as self-rotas, in which nurses organise their rotas collectively to accommodate child care or other difficulties, should be encouraged. In a profession that is 95 per cent female, many nurses need a level of flexibility that is not available. The flexibility initiative is a crucial strand of the facing the future initiative, which must seek meaningful practical solutions to the issue if we are to enable nurses to remain in or return to the NHS.

More must be done to improve opportunities for nurses' professional development. A third of nurses get no financial support from their employer for continuing professional development and nearly half get no time off for training. The fact of the matter is that the NHS needs nurses. It needs their skills, their input and insight, and their invaluable contribution to patient care, and it needs many more of them. Nurses are fundamental to the effective running of the health service. It is the Government's job to make nursing an attractive profession to draw new recruits into and to enable nurses to continue their career where they want to continue it—in the national health service.

Tackling low pay and delivering flexible working for nurses are not options; they are absolutely essential elements of a successful strategy to value nurses and value the NHS. I hope that we can reach some consensus in the chamber this afternoon on all those issues, because we owe nurses a great deal and all of us in this Parliament have a duty to start delivering for them in action, not just in words.

I move amendment S1M-3078.1, to insert at end:

"; notes that a newly registered nurse's salary, at £16,005, is 9.7% less than that of a newly qualified police constable and 11% less than that of a qualified teacher; believes that addressing low pay levels is central to addressing the problem of recruiting and retaining nurses; further welcomes the work of the Scottish Integrated Workforce Planning Group, and notes that the development of an adequately resourced workforce planning strategy is essential if NHS employers are to offer nurses the flexible working patterns and meaningful career paths that they are entitled to expect from a 21st century employer and that will enable them to continue working in the NHS."