HC Deb 29 June 1965 vol 715 cc315-9
The Prime Minister (Mr. Harold Wilson)

I apologise, Mr. Speaker, for inflicting a second statement on the House.

Her Majesty the Queen has been pleased to approve the recommendation that a Royal Commission on Medical Education should be appointed with the following terms of reference: To review medical education, undergraduate and postgraduate, in Great Britain, and in the light of national needs and resources, including technical assistance overseas, to advise Her Majesty's Government on what principles future development—including its planning and co-ordination—should be based. In particular, in the light of those principles and having regard to the statutory functions of the General Medical Council and the current review by that Council of recent changes in the undergraduate curriculum, to consider what changes may be needed in the pattern, number, nature or location of the institutions providing medical education or in its general content; and to report. I am glad to be able to tell the House also that the Queen has approved the appointment of the right hon. the Lord Todd as its Chairman. The names of the other members will be announced later; there will be approximately equal numbers of medical and non-medical members.

The appointment of this Commission, under such distinguished chairmanship, marks the importance which the Government attach to a fundamental review of the whole structure of medical education: its organisation, content and claims on resources. Meanwhile, we are carrying out a review of the immediate measures which can be taken in the field of medical manpower, and the appointment of this Commission will not delay any action which needs to be taken as a result of this review.

Mr. Wood

Is the Prime Minister aware that we welcome the setting up of this Commission and, in particular, the willingness of Lord Todd to serve as its Chairman? Is he further aware that we particularly welcome the inclusion in the terms of reference of the general content of medical education? We believe this to be extremely important.

Would the Prime Minister agree, however, that with this most recent statement a clear pattern seems to be emerging that whereas the Labour Party at the election adopted specific positions and made specific promises these have now become, first, the inquiry under his right hon. Friend the Chancellor of the Duchy of Lancaster into certain of the social services, that contrary to public expectation we had the Royal Commission on the trade unions and that with this new Royal Commission we are given something instead of a specific pledge by his right hon. Friend the Minister of Health to set up four new medical schools at least?

The Prime Minister

I thank the right hon. Gentleman for the first part of what he has said. His second part went rather wide of the subject, into a number of other inquiries into which it would not be appropriate for me to follow him at this stage, although I am prepared to do it if that is what the House so desires and it is in order.

I am sure that the whole House feels that the problem of medical education has not been given the priority which it should have had in the past and that there have been too few coming forward, or getting a chance to come forward, for medical education. Therefore, something had to be done. In this case, however, the right hon. Gentleman knows from experience that there are deep feelings, both in the universities and in the medical profession, which, I think, require the establishment of the Royal Commission.

As to immediate action, as my right hon. Friend has made clear, and as I made clear in my statement, the establishment of this Royal Commission does not preclude earlier action; and I referred to what that earlier action might be.

Mr. Lubbock

Have the Government decided that, pending the review by the Royal Commission, no new medical schools will be established? How long will it be before its report can be expected? Will the Prime Minister consider the appointment to the Commission of a representative of the British Medical Students Association?

The Prime Minister

There is certainly no decision that there can be no new medical schools before the Royal Commission has reported. As I said, we are carrying out an urgent review of immediate measures which can be taken, and action here, of course, can be taken without waiting for the Commission. Naturally, I cannot estimate how long the Commission's work will take until the members have met and considered what kind of problems lie ahead.

I shall bear in mind the hon. Gentleman's suggestion for a particular appointment to the Commission.

Mr. Woodburn

I welcome the instituting of this very important study by the Royal Commission, but can my right hon. Friend say whether the terms of reference will include the co-ordination of the already existing many authorities for granting degrees, and will it have authority also as regards co-ordinating internationally, if possible, the standards of medicine which are to be accepted internationally, as many doctors find, when they move from one country to another, that they have to requalify, which seems to be a dreadful waste of effort and study?

The Prime Minister

I said that, among other things, the terms of reference would be to advise … on what principles future development—including its planning and co-ordination—should be based". I have referred also to the vitally important need for securing enough provision for training those who will do their medical work overseas. The question of the recognition of degrees given by overseas bodies is, of course, a matter for the General Medical Council.

Sir K. Joseph

But will the Prime Minister answer my right hon. Friend's question and tell us what has happened to the clear and categoric pledge given by his right hon. Friend the Minister of Health on 27th July last year that a Labour Government would set up four new medical schools at least?

The Prime Minister

As I made clear, my right hon. Friend and the other Ministers concerned are at present reviewing the needs for an urgent expansion. We shall make a statement in due course.

The right hon. Gentleman, who spent half his time at this Box towards the end of the 13 years of Conservative Government saying that nothing could be done, whether on land reform or anything else, is not really in a position to complain that things have not been done in eight months.

Dr. Bray

Can my right hon. Friend confirm that mental health will come within the purview of the Royal Commission, and that the re-education of doctors in the course of their careers will also come under review by the Commission?

The Prime Minister

The answer to both my hon. Friend's questions is, "Yes, Sir".

Sir M. Stoddart-Scott

Does the term "medical education" include dental education?

The Prime Minister

No, Sir; that is not intended.

Mr. Pavitt

Will the Royal Commission have power to command research in depth into the complete needs of medical manpower in the three sectors at present in existence, plus the industrial health service which we hope eventually to see established? Does my right hon. Friend recall that the Willink Committee, set up by the previous Government, made such a mess of this that we are still trying to recover from it?

The Prime Minister

While not necessarily associating myself with criticism of any previous inquiry, I can tell my hon. Friend that the Royal Commission will, of course, have very thorough powers to get all the information needed for its work. Whether it will be decided that the particular point raised by my hon. Friend is required, is a matter for the Commission to determine when it is set up.

Lord Balniel

I warmly welcome the Royal Commission, although, with other hon. Members, I regret the apparent postponement of the building of the promise four new medical schools. Does not the Prime Minister agree that, as important as training for new staff is, the question of retaining existing qualified medical staff? What is happening to the proposed legislation to set up an independent corporation to advance loans to general practitioners for improving their practices?

The Prime Minister

The question of legislation is not a matter covered by the Royal Commission. It is a matter on which my right hon. Friend the Minister of Health has already reported to the House the result of discussions he having with the medical profession.

I thank the noble Lord for his welcome to the Royal Commission. As regards the regret which he expressed, I can only say that he, like so many of his right hon. and hon. Friends, developed a capacity for regret only after 16th October last year.

Several Hon. Members

rose—

Mr. Speaker

Order. We cannot debate this now.