§ 46. Mr. K. Robinson
asked the Minister of Health if he will now make his promised statement on the senior registrar problem.
§ 51. Sir K. Joseph
asked the Minister of Health whether he will make a statement following his discussions with the Joint Consultants Committee.
§ Mr. Walker-Smith
I apologise for the length of this Answer. The Joint Consultants Committee and I have agreed to set up a joint working party to study, in the light of experience of the hospital service since 1948 and of all other relevant considerations, the principles on which the medical staffing structure in the hospital service should be organised.
I have concluded that—pending and without prejudice to the Working Party's report—the current arrangements for senior registrar posts should be modified in certain respects, in view of the fact that some senior registrars have long completed the normal tenure of their posts but have not yet succeeded in obtaining a higher post. I am satisfied that these senior registrars should be given an opportunity of remaining in the hospital service whilst they continue to compete for higher posts, and hospital boards are being asked where necessary to offer extended contracts pending the working party's report.
Also without prejudice to the working party's report, I am asking hospital boards to submit proposals for designating a limited number of senior registrar posts—mainly from among those already existing—which will provide responsible work commensurate with that which is 615 normally expected of a fourth year senior registrar; will carry a higher rate of pay; will offer security of tenure; and will be available to senior registrars who have completed the normal period of appointment in the grade. The senior registrars selected for these posts will of course be free to continue to compete for higher appointments. I will emphasise to boards that these senior registrar posts are not to be regarded as a substitute for additional consultant posts.
My right hon. Friend the Secretary of State for Scotland is discussing with the Scottish Joint Consultants Committee the application of these arrangements to Scotland.
§ Mr. Robinson
Is the right hon. Gentleman aware how glad I am to have a reply on this question at the eighth time of asking? Is he further aware that the interim arrangements which he has announced may be a satisfactory solution to the short-term problem, but that the only tolerable solution to the long-term problem is a considerable expansion of consultant posts? Why is it necessary to set up a working party to come to that very obvious conclusion?
§ Mr. Walker-Smith
The hon. Member must have regard to the fact that we have to look at the number of consultant posts which are desirable in the light of the staffing structure, and also of the economic context. I hope that we shall get a quick and valuable report from this working party, and I prefer to wait for that.
§ Sir K. Joseph
May I welcome my right hon. Friend's constructive solution to this very intractable and complex problem, without prejudice, as he says, to the recommendations of the working party? Will he note that it is not commonly accepted that the only long-term solution is an expansion of the consultant force, since the economics of the service to the public and the location of the consultants in relation to the public demand that those factors must be examined most carefully?
§ Dr. Summerskill
After waiting many months and continually pressing the 616 Minister for an answer on this subject, as my hon. Friend said, all that the Minister has said today is that the matter is to be postponed once more, and that the anxiety of these senior registrars is to continue for an indefinite period. Is he aware that these men are being offered excellent opportunities in the United States of America and that if there is to be another postponement, we shall lose some of the best doctors in the country?
§ Mr. Walker-Smith
From the right hon. Lady's purported precis of my Answer. I am afraid that either she did not hear or did not understand what I said. If she will be good enough to read it, she will find that there is a great deal more for the senior registrars than she has said.