This election campaign has long since descended into a contest to see who can spray around the largest sums of cash. So it should come as no great surprise that the Conservatives promised an eye-catching initiative to outdo Labour on nurse numbers. Jeremy Corbyn wants to provide an extra 20,000 new nurses but Boris has now promised an extra 50,000 - topping the Labour leader (until tomorrow morning, of course, when Corbyn can be more or less guaranteed to up his offer to 100,000 nurses).
We seem to be heading for the NHS equivalent of a military state. Instead of seeing people in military uniforms on every train, bus and street corner, we will have a Benny Hill-esque society where every other person is in a nurses’ uniform. But are the numbers remotely credible? If you paid 50,000 nurses £50,000 a year the bill would come to £2.5 billion a year. Given that the Conservatives are promising an extra £34 billion a year for the NHS by 2023/24, it is not such an outlandish commitment. Within the government’s budget, there should also be some money left over for a few beds and doctors as well.
But how do you find 50,000 nurses? According to the Nursing and Midwifery Council, in March of this year there were 653,444 nurses on its register of those qualified to practice in Britain. According to the Nuffield Trust, only 306,996 of these nurses were working in the NHS. So, notionally, there are quite a few nurses sloshing around out there already - although some of those, of course, might not be looking for work, and others might not be in the country. The Conservatives are promising new bursaries for trainee nurses, which might help to tempt school-leavers into switching from media or gender studies (for which the employment opportunities are somewhat limited) to an area of study where there certainly will be jobs at the end of it. But even so, training nurses takes time.
Could we recruit the nurses from abroad? The number of nurses coming here from the EU has plummeted in the past four years, from 9,389 to just 968 this year. But they have been partly made up for by the numbers coming from outside the EU, which rose from 665 to 6,157. Still, it is hard to see how 50,000 nurses are going to be recruited other than via a vast overseas recruitment campaign. The Conservatives are proposing a new ‘NHS visa’ to cope with this. But there will arise an ethical question: are we simply stripping developing countries of qualified nurses who are desperately needed in their own systems?
In spite of the nurses pledge, the amount of extra spending promised by the Tories is modest when compared with Labour. And at least this time – in contrast to its fatally-flawed manifesto of 2017 – they have included a costings document. By 2023/24, according to this document, the Conservatives plan to be spending an extra £2.9 billion a year in day-to-day spending and £8.1 billion in extra capital spending.
Labour’s manifesto proposes an extra £82 billion by the same year just in current spending, excluding the billions the party would need for its renationalisation programme. And that was before Labour promised to bail out the Waspi Women, who complain they had been unfairly affected by the equalisation of the retirement ages– an uncosted promise which McDonnell wants to stuff on the nation’s credit card. That is the vast gulf between the two main parties, which shouldn’t be forgotten in the great melee of spending promises.