Therefore, the next item is a Member debate under Standing Order 11.21(iv) on nurse staffing levels. I call on Helen Mary Jones to move the motion. 

Motion NDM7215 Helen Mary Jones, Dai Lloyd, David Rees

Supported by Delyth Jewell

To propose that the National Assembly for Wales:

1. Notes the Royal College of Nursing Wales's report, Progress and Challenge: the Implementation of the Nurse Staffing Levels (Wales) Act 2016.

2. Notes more nurses leave the NHS than join.

3. Calls on Welsh Government to set out how the Welsh NHS will increase the opportunities for flexible working as part of a national nursing retention strategy.

Motion moved.

Diolch yn fawr, Llywydd. I'm very pleased to move this motion on behalf of myself, Dai Lloyd and David Rees. It's being supported by Delyth Jewell, but I'm sure it would have been supported by more Members across the Chamber had we had more time to table it.

I'd like to commend the Royal College of Nursing report to this Chamber. It contains robust research. It highlights progress in the implementation of the Act, where that has been delivered, but it also calls out, questions, where things are not going as well as they should. It sets out a series of questions for each health board with regard to their implementation of the Act, and nine detailed recommendations for the Welsh Government covering a number of issues, including the need for more robust implementation monitoring, more support for front-line nurses raising concerns about the effective implementation of the legislation, and the development of a national IT pathway to support the implementation.

The report's recommendations also focus on retention, and this, of course, is reflected in our motion. Now we have, of course, and must acknowledge that the Minister has made, some progress with regard to nursing recruitment and with the nursing workforce—more training placements, for example. But retention continues to be a really serious issue, and this report calls for the Welsh Government to require all health boards to have a retention strategy as part of a national retention strategy. That national retention strategy needs, they say, to include a national approach to flexible working.

We must have a long-term approach to the retention of our nursing staff. We've been talking for 20 years, to my knowledge, about the need for flexible working. Of course, there are challenges, and it's very important to keep nursing settings effectively staffed. But flexible working is the norm in most professions now, and local health boards have not acted and we need national leadership. There are, of course, bodies of good practice. But, once again, we face this issue that good practice is not being effectively shared.

The Deputy Presiding Officer (Ann Jones) took the Chair.

I don't want to take up too much time in this debate, Dirprwy Lywydd, because the case is set out clearly in the report, which I know is available to all Members. But I do hope that the Minister, in his response, will accept that, while we have, as the motion says, more nurses leaving our NHS than joining it, often going to work in agencies and in fact returning to the same settings that they've left, while we have that happening—and the nurses do that because they get better terms and conditions and very important flexibility—and while we have an estimated 1,600 unfilled nursing vacancies, we do have a crisis as things stand in our nursing workforce. I specifically hope that the Minister will accept the need for a national nursing retention strategy so that the good approaches, where they do work, can be rolled out, and we can ensure that we don't train these valuable members of staff only to lose them.

Members will have received communication from nurses in their constituencies. We've all had, I think, a number of postcards urging us to support this motion and support the calls for action in the report. They're asking us to support, among other things, a national retention strategy, and this is needed because, as one nurse from Llanelli said in her postcard to me, we need to retain staff, reduce staff burnout, and above all, keep patients safe.

I commend this motion to the Senedd. I look forward to the debate, to the Minister's response to the motion and to David Rees's response to the debate. I commend the motion to the Senedd.

I'd like to thank the Members who have brought forward this debate today, because I think it is extremely timely. I think it is worth rehearsing just a couple of the facts: that every week, nurses in Wales give the NHS extra hours to the value of 976 full-time nurses. If you say it quickly, it doesn't mean that much, but actually, if you slow it down and really think about it, you're talking about 976 extra bodies that our nurses just give freely of their own volition, because they have a commitment to the duty that they believe that they must discharge. So I'd like to thank all of those nurses for all that they do.

We know the Welsh NHS demonstrates a heavy reliance on the nurses' willingness to work overtime, but of course, endless work and endless overtime creates endless stress, and instead of incentivising our nurses to stay, instead of looking at how we might alleviate this, one of the things I have found particularly odd is that NHS Wales tries to discourage nurses from leaving by measures such as refusing to hire agency nurses who also work for health boards or trusts, or allowing nurses to move around. So you get this really perverse incentive where you might have a nurse, for example in Hywel Dda, who needs to earn a few extra hours but can't do them in Hywel Dda. He or she has to go across a border into another health board where they are registered to do those extra hours. To me, that seems absolutely illogical, especially when the health board that they are leaving is usually then going out to pay even more money to agency nurses. So much better to actually just pay people overtime to recognise the contribution that they give, to allow them to continue to work in the place where they feel the most comfortable.

There is a concern over training, but I am going to leave others to talk about that. I just did want to touch on how few registered nurses we have in the care home workforce in Wales, and I think that this is an area that's absolutely vital. Not only do we not have very many nurses in care homes—and as more and more care homes are dealing with people with more and more complex conditions, there's more need for nurses and more need for those medical professionals—not only do we not have enough of them, they're not even paid the same amount of money that a nurse in a hospital would be paid, or a nurse in the community would be paid, who is not in a care home. Again, I think we have to say that if you have reached this level in your nursing career, if you've got his much training under your belt, if you're in this band, then whether you're in this situation or that situation, there should be far more equity in the pay that you receive.

So, Minister, I wondered if you might be able to give us any information on what might be being considered in terms of those two main questions—question 1: how do we keep nurses and pay them overtime to do the overtime in the health board to which they belong rather than forcing them to travel and add to their stress, with travel hours to get to another heath board so that they could earn that extra money? And question 2: how do we make sure that nurses in care homes are not disadvantaged unfairly?

Finally, Deputy Presiding Officer, I just wanted to talk about flexible working, because there's been a really interesting report produced for London NHS Trust by Timewise, and it talks about putting in flexibility into a shift-based environment, and how it's affected by the variability or predictability of the schedule, the degree of input or control that an individual can exercise over that schedule, and the amount of advanced notice. And flexible working is really key. NHS Wales needs to find a way of tackling all of these three elements if we're going to attract and retain the staff we need to work in our shifts.

The top five causes of job dissatisfaction for UK hospital doctors and nurses very clearly said that for nurses, work-life balance came first for those aged under 35—much more important than pay—and second, for those who are 36 and over. It was second after pay. Flexible working could be a practical way to ease into retirement, and it could help to keep experienced staff on board for longer.

The project that was carried out in two English hospitals in 2017 looked at creating a team-based rostering process, and it looked at not just childcare, but all of the work-life balance needs, and their lead team collaborated, not just on rota production, but also on communicating and negotiation with groups. So, Minister, I believe that improving work-life balance and access to flexible working could have a direct impact on retention, particularly for younger clinical professionals whose expectations are very different to those of an older generation. So, I'd like to understand what concrete steps the Welsh Government are taking to improve work-life balance, and I would like to encourage you to look at this trial, this pilot, that was conducted in London, because it has been successful, and there may be positive lessons that we can learn to help retain these very, very valuable and hardworking people in our NHS.

May I congratulate Helen Mary Jones for bringing this debate forward and for her wonderful opening remarks, which set out all the decisions that need to be taken? I also congratulate the Royal College of Nursing on this wonderful report on implementing the nurse staffing levels 2016. In terms of the progress made, there has been some progress made, as Helen said, but certain challenges remain. We had a debate last week on the health committee report on nursing and community nursing and many of those factors are also relevant here. May I also pay tribute to the cross-party group on nursing and midwifery, chaired by David Rees, which has led the way and led to the report published by the health committee that we discussed last week?

We all know of the challenges in our health service, particularly from the perspective of nurses. There aren't enough of them, first of all. There are vacant posts. We need to double the number of nurses undergoing training. We have a system that’s under pressure and our staff are under pressure. Our nurses are under pressure and are overworked and are often away from work because of the stresses and strains that they face. Of course, there are new demands, new medical developments, and we're asking more of our nurses, particularly in the community, who now deal with people in the community who used to be on hospital wards but now are treated at home.

We also need to safeguard whistleblowers who express concerns about the system. We're still not particularly effective at doing that, and as others have said, we need to be far more flexible with rotas and shift hours in order to ensure that nurses remain within our NHS. And, yes, we need to implement this legislation, the nurse staffing levels legislation. May I remind you why this was necessary in the first place? Well, because this legislation protects patients. The research has shown, as this report says, that poor staffing levels have led to an increase of up to 26 per cent in terms of wards where there are better staffing levels. So, not having enough nurses leads to people actually dying and an increase in the number of degree-level nurses relates to a reduction of 7 per cent in patient deaths. And, of course, naturally, we don't only need safe staffing levels in some wards, we need them in all health placements, in the community, in children wards, not just on the specialist wards that we have now.

But, specifically the nursing staff in Wales is facing a national crisis. There are high levels of vacancies, as I’ve already mentioned—at least 1,600 according to the RCN estimate in terms of vacant nursing posts—and there is also a dire shortage in the care home sector, as Angela Burns has already mentioned.

So, there is a significant challenge facing us and as this motion says, we need flexibility in the short term in order to retain staff. Yes, we can talk about training staff now and for the future, but we also need to retain the staff that we have on our wards and in the communities at the moment, and the Welsh Government, therefore, needs to set out how the NHS in Wales will increase opportunities to work flexibly as part of a national strategy to retain nurses, as Helen and Angela have already said, because there are many nurses in Wales who are responsible for other things in their lives and they need that flexibility as well as needing the job and the salary. They are responsible for young children, older parents, and they choose to work for an employer where they can manage their working hours. That’s why they go to work for private agencies, and so on and so forth, and, therefore, the health service also has to make the same kind of provision so that we can retain nurses in our national health service. Thank you.

I thank Helen, Dai and David for tabling this debate. As I've said many, many times before, nurses are the backbone of our NHS. Unfortunately, successive Governments have failed to recruit and retain enough nurses, and Wales has an abysmal record on workforce planning, and we are seeing the results, because there are more nurses leaving the profession than joining.

The fact that we needed to introduce legislation to ensure that wards have sufficient nurses on hospital wards to allow time to care is damning enough, but the fact that the law doesn't apply to all wards and all health settings is a travesty. The nurse staffing levels Act was introduced to improve patient safety. It is a fact that low nursing numbers can contribute up to a quarter more patient deaths.

Here in Wales, we spend nearly 12 per cent of our GVA on health, our health spending—second only to Scotland at £2,310 per person—is nearly £200 more per person than in England. Yet, we wait longer, and we have had to pass legislation to ensure that we have safe staffing levels, not because we don't invest enough in our NHS—half the Welsh budget is spent on health. And this legislation of safe staffing levels was introduced by an opposition AM, precisely because mismanagement had led to unsafe practices in hospitals across Wales. A lack of nationwide workforce planning and botched reorganisation has left the Welsh NHS in a state of disarray. Health organisations and clinicians have complained about the different approaches taken by local health boards. National policies get implemented in seven different ways, with patients facing an ever-increasing postcode lottery of healthcare.

We can see this clearly in how the nurse staffing levels Act is being implemented, because local health boards are all at differing levels of compliance with the Act. Betsi Cadwaladr states that compliance with the Act is high risk and not cost effective within its existing model. In my own region, Cwm Taf has no retention plan and, despite being ruled as compliant, wards at the Princess of Wales Hospital in Bridgend have staff shortages, which will impact upon patient safety. Swansea Bay has had 11 falls, resulting in serious harm or death, in which a failure to maintain staffing levels was considered to be a factor. This is simply not good enough.

Our constituents deserve and demand safe levels of staff in our hospitals. Welsh Government has to accept that the buck does stop with them. The nurse staffing levels Act has to be fully implemented in every health setting. We need a well-planned recruitment and retention strategy that makes nursing appealing to every person who wants to train as a nurse, in order to address the fact that nurses are leaving the profession in droves.

We have a safe staffing levels Act in place for a reason. We need safe staffing levels across all healthcare settings and not just on certain wards. How many more patients have to be seriously injured or lose their lives because of bad management and poor planning? So I urge colleagues to back this motion.

Thank you. Can I now call the Minister for Health and Social Services, Vaughan Gething?

Thank you, Deputy Presiding Officer. I'd like to thank Members who have brought forward today's debate and the opportunity to discuss the implementation of Wales's landmark nurse staffing legislation. It's good to see the fellow of the Royal College of Nursing who was the Member in charge of that piece of legislation in the Chamber today as well.

Together with colleagues from across the Chamber, I recognise the critical role that nurses play within our multidisciplinary teams, delivering healthcare right across Wales. The delivery of safe and sustainable services relies on our ability to train, recruit and retain nurses, together with other NHS staff, within our publicly run healthcare system here in Wales. Ensuring that we have the nurses that we need is a challenge here in Wales and much more broadly across the UK and beyond. In England, for example, the vacancy rate is nearly double that in Wales in the nursing workforce. But, in Wales, we have chosen not to dilute the nursing workforce by introducing nurse associates, as they are doing in England.

The actions needed to meet the challenges we face extend well beyond the nurse staffing Act. However, the RCN's report that has been highlighted does recognise a number of the positive effects of the Act so far. For example, we know that, following the implementation of the Act, more than £17 million of additional funding was invested in increasing our nursing workforce in adult acute medical and surgical wards. That is an immediate and tangible benefit for our front-line nurses, the staff that they work with and, above all, for the patients that they care for.

We hear regularly from nurses, right up to the most senior levels, that the Act has made a clear difference to the weight attached to their professional judgment when they have what can be difficult conversations about nurse staffing levels with their colleagues. This was one of the key reasons for passing the legislation in the form that it took, and it has been really reassuring to hear that that is already making a difference.

Overall, I'm positive about how quickly our health boards have adapted to their new duties, and this Assembly should be genuinely proud of the legislation that we passed unanimously three years ago. And I was certainly proud to announce last week that this Government will extend the Act's second duty to paediatric in-patient wards before the end of this Assembly term. 

My officials work closely with staff from each health board through the all-Wales nurse staffing programme. In this way, we have identified and started to address several of the issues that are included as recommendations in the RCN report. I recently allocated funding for two informatics posts within National Wales Informatics Service to work with the all-Wales nurse staffing programme to take forward a national IT solution. And that will support health boards to meet their reporting duties under the Act.

We also recognise the need to be able to accurately gauge the impact of this trailblazing legislation. And, with imitation being the sincerest form of flattery, it's good to see that Scotland have followed our lead, and there are serious conversations in England too. And I look forward to a future Government following our lead in England.

On evaluation, I will commission a robust independent evaluation that is scheduled to coincide with the conclusion of the first three-year reporting period in April 2021.

We are, however, far from complacent, and I do want to address some of the points made about numbers, but also about retention. It is tempting to point out, say, that we've retained an extra 1,900 nurses over the last five years or so because of our efforts and, therefore, when you think about it, rather than having a small fall in this last year, we've actually increased nurse numbers over five years. But I think we should leave the doublespeak to other people, because the truth is that, within this whole Assembly term, we've increased the number of registered nurses and members of the nursing family working with our national health service. But, last year, for the first time, we saw 65 more nurses leaving NHS Wales than joining.

Members, though, will be aware of the significant investment that we have made in health professional education and training, which has seen nurse training places increase from 1,053 in 2014 to 1,987, following my recent announcement on investing even more in nurse training. That investment also includes 140 places on return-to-practice programmes for nurses. And this year, 970 nurses graduated in Wales, compared to 778 in 2018. So we are making deliberate and definitive progress in training more of our own nurses. I'll happily take the intervention.

Thank you. 

I just feel that you might be being a tad sensitive on this, because I don't recall anybody's contribution particularly saying that the Welsh Government weren't doing plans to improve retention. I think what we're trying to say is that there is such a shortfall in nurses that what more can we do, how else can we actually improve this and keep the nurses we've got, as well as recruit more, which is why I brought forward to you the pilot that's currently being run in the London hospitals and the work that they've done about flexible working. 

And I'll be coming to retention later in my contribution. 

But the NHS remains the only part of the public sector that has continued to increase staff numbers despite a decade of austerity, and that's a point that is difficult for other members of public services to recognise. Our colleagues in education, our colleagues right across local government recognise that health has been the big sector that has been invested in. But today's debate shows the appetite to further increase numbers is undiminished. To reach the levels we all wish to see across the UK will require significant and sustained investment from every UK nation, a different approach from whoever is the new UK Government to health and social care investment and, in particular, a different approach to recruitment from Europe and the scrapping of the nonsensical and damaging salary cap proposal, to have a real impact on our ability to recruit more staff.

Last week in my statement to the Chamber, I highlighted the positive interest generated by our 'Train. Work. Live.' campaign; there'll be more to come in 2020, which is the Year of the Nurse and Midwife. But, of course, we do need to do more to retain our skilled nursing workforce. That means providing service models that meet the expectations of our current and future workforce, an effective health and well-being offer, and flexible working options to provide a positive work-life balance, as a number of speakers have referred to. And I'm interested in what's being done both here in Wales and across the UK on doing just that. I want to see career and education opportunities, and ensure that NHS Wales is a great place to work.

So, our national workforce strategy being developed by Healthcare Inspectorate Wales and Social Care Wales will support the future sustainability of both the health and the social care workforce, in particular how we plan our workforce models for the future, identify the staff that are required with different professional groups and, importantly, how we support and develop our staff. So, I will be asking the NHS Wales partnership forum to consider together what further actions we could and should be taking both locally and nationally to support the retention of staff, including our nurses. That will consider current practice, including the best practice to spread that exists already in health boards and, of course, identifying best practice to introduce further flexible working.

I'll take the intervention before I finish.  

Thank you. I'm very grateful to you, Minister, and I think we have acknowledged, as Angela Burns said, that there has been some real progress, but do you agree with the Royal College of Nursing that we do need a national retention strategy, because while there are some pockets of good practice, I think what they're asking for is for that practice to become the norm? As I said, we have been talking about the issues of retention for a very long time now, and do you feel that it's time that all that good practice that is out there is pulled together and becomes the norm? 

Well, I had this conversation today with the Royal College of Nursing and, as I've just said, I'm asking the NHS Wales partnership forum, bringing together the staff trade union side, the Government and NHS employers to do just that, as I've just said, to look locally and nationally at what exists and what should exist for the future as well. 

This Government will abstain today, as we normally do on Member debates. However, regardless of the voting outcome, there is much to be proud of here in Wales, and much more to do. I look forward to working alongside our nursing family to provide the care and the work environment that we would all want to see, with, of course, the right numbers of staff to provide the right care at the right time and in the right place. 

Thank you. Can I now call David Rees to reply to the debate? 

Diolch, Dirprwy Lywydd, and can I thank all Members for their contributions this afternoon? Before I go on to look at the discussion and Members' contributions, can I also join in thanking the Cabinet member, the Minister for Education, because it was her who took this Bill through the last Assembly, driving it forward, and you will remember the discussions we had in committee on many occasions? I think she should be proud of the Act as it is now, and the progress it is making. I think we should put on record our thanks to her, because it is critical that that Act is now delivering for patients.

Can I start with the contribution from Helen Mary Jones, who opened it up and outlined the important issues that this report brings to light and to our attention, particularly to assess the implications of this Act and what we as Assembly Members can do in our own health board areas to ask questions of those health boards in relation to how they are implementing the Act, where they're going? If you look at the various questions, you will see some common themes coming through those questions as well.

Helen also highlighted the retention and recruitment strategy, which is one of the big common themes, and raised the concerns about it. Particularly, I think, she mentioned one thing. We talk very often about retention and stress, but we also forget sometimes it is staff burn-out that exists amongst many of our staff, because they put in, as Angela said, the extra hours above and beyond what they normally do and what they're contracted to do. And that helps—well, it does help them burn out, because it adds more to their commitment. They come home tired, they're spending longer hours there, because of their desire to protect and help patients. It is something we need to address.

Angela highlighted again the question of flexible working. Can we look at ways in which we can look at nurses? Can we encourage health boards to look at a flexible approach to employment? They're good, agencies, because agencies offer flexible working. Can we, as an NHS, actually offer the flexible working that agencies offer and look to ensure we can keep them within the national health service, because retention is one of the critical elements in this report? We often talk about—. We've got a general election going on and we've heard the numbers from Boris Johnson saying 50,000—20,000 of which will be retention. So, even they recognise that retention is critical to ensuring that we have a proper workforce available to deliver care in our hospital settings, in this case, and in other settings as well. You're right: is it bank nursing, is it agency nursing? Why can't we give them overtime? Why can't they just work in the place where they normally work—their regular place of work? I think we need to address this matter.

Dai Lloyd reminded us of the challenges that remain. Progress has been made but challenges remain. And I think, again, this report highlights that. It says that we are looking at the fact that health boards are discussing this Act, and they are discussing the implementation and where they're meeting their duties within this Act. But there are still many challenges to go because the workforce strategy is critical in all of these discussions. He also highlighted that the purpose of this Act is to improve care and outcomes for patients, not to improve, necessarily, nurses' lives, which is what it will do, but it's actually about the patient. Because if you get the nursing levels right, you get the outcomes for patients right, and that's of critical importance.

Caroline reminded us again of the workforce planning and I will ask her sometime, in terms of some of the comments she made, to please look at the discussions we had in committee during the progress of Stage 1 and Stage 2 of the Bill. They may answer some of the points she raised, because many of those issues were raised and I think the Member who led the Bill did it for other reasons than were properly highlighted. And there are different levels of compliance across the health boards. That is an issue. We have to address that. Because compliance was one of the issues we raised as a possibility to look at, to make sure there is consistency across Wales.

She mentions she wants an Act in every health setting, but one of the arguments we put forward on that was the evidence coming forward to support which areas of health settings were actually being focused upon. It is important, if we're going to do this, that this is evidence led. The adult acute medical wards was evidence-led, and the paediatrics is being evidence-led, so I want to look at where you're going next—where is the evidence leading us to next? Is it maternity, is it mental health, is it community nursing? We need to understand the areas you're looking at, what their priorities are and where the evidence will come from, to ensure that we are using this as an evidence-led base to ensure that the settings are right. So, that's what we have to do. It's not just the whole lot, because it sounds good to say the whole lot, but we need to make sure it's right and it goes in the right places.

The Minister has clearly indicated that he is very proud to include paediatrics. We are also very pleased to see paediatrics come along since the Bill, because one of the things we said was that we wanted more areas to be included, and that's why the regulations were put in, to allow you to do that without having to do any more additional legislation. So, that's important. Clearly, we want to go further and further. I'm very pleased to hear you're going to a robust independent evaluation for April 2021, to coincide with that, so we can actually look very carefully at that evaluation, as well as the three-year evaluation that will be taking place.

And you're right, Minister, it is good to see that you've increased the numbers from 1,053 to 1,987 since 2014—very welcome, but we need more, because one of the concerns we had when the Bill went through was do we have enough nurses to deliver in all settings, or the settings that we required. We need to train more. And I'll give an example why we need more nurses. A family friend's grandchild was having a cleft palate operation, which required two surgeons, plus theatre staff. Five minutes before that surgery was to take place, it was cancelled, because the specialist nurse that was required to be with that child after the operation had to be transferred to another part because of the skills she had. Now, you can understand that's a need, required because an emergency came in, but we therefore need more specialist nurses to ensure those things. But that's a cost to the NHS, because you had a whole team already allocated, waiting there, that then had to cancel and switch off. So, we do need to look at the number of nurses. We need more specialist nurses.

So, I'm very pleased to see 1,987, but I want more; simple as that. We need more, and we need to retain more. That's an important point. And I do agree with you, by the way, about the possible implications of an immigration policy that may impact upon recruitment from overseas. It's diabolical that anything like that could affect our NHS, and we should be fighting it every inch of the way, and I expect all Members from all parties to challenge such immigration policies, which impact upon the care our patients have in the NHS. 

I can reassure you, Minister, that every one of us in this Chamber is proud of our NHS. And we are proud of the staff in our NHS; you're not alone in that. 

Now, I'm very pleased also that the nursing bursary is still here in Wales. That's critical, because that encourages more to come along. Thank you, and keep on going with that—never ever lose it, because I think that's a benefit to encouraging more nurses to come into the profession. But we must ensure that, once they're in the profession, they're given a healthy environment to work in, a safe environment for their patients, and a stress-free, as much as possible, environment, so that they do not burn out. And that is critical. And that is what the RCN are trying to achieve and will continue to lobby on. And can I put on record my thanks to the RCN for the work they do in this area, because they have produced not just this report on the implementation of the safe staffing Bill, but also the report on workforce numbers and community nursing? They are driving an agenda to look at the nursing profession and to ensure that it grows and it actually is there to support patients. Therefore, it's critical that we continue to listen to them and work with them. 

Deputy Presiding Officer, I've never had so much time at the end of closing a session—

You don't have to use it all. 

So, I won't make up words, but I think it is important that, as we move forward in this agenda, we actually remind ourselves of the real people we are there for, and that's the patients. And if we can do everything we can to make the patient care better, we should be able to do that. And if the nursing staff level Bill, Act—I've got to remember to get it right—is to actually deliver that, then we need to make sure that we are able to produce a sufficient workforce strategy that retains and recruits an appropriate number of nurses, health support workers and other allied professions that will help deliver on that, because we did talk, at one time, not just about nurses, but other staff on the ward who work with nurses as part of the team that delivers that. And, if that can also be built, it's really important that we deliver that. 

So, can I thank all Members this afternoon? Can I urge the Government, therefore, to continue its progress, to ensure that it's driven by evidence, and to ensure that nurses are able to come into the profession and do what they want to do, and that's to deliver care for patients?

Thank you. The proposal is to agree the motion. Does any Member object? [Objection.] Therefore, we defer voting under this item until voting time. 

Voting deferred until voting time.