KEELE UNIVERSITY (MEDICAL SCHOOL) (Hansard, 27 January 1967)

§ Mr. Jack Ashley (Stoke-on-Trent, South)

I welcome this opportunity to elucidate upon and advocate the need for the establishment of a school of medicine based on Keele University and the hospitals of the Stoke-on-Trent Group.

I recognise the temptation of the Government, in times of economic difficulty, to minimise their financial burdens by allocating limited capital resources to the extension of existing schools, but I am confident that they will resist that shortsighted approach.

The fact that the Royal Commission on Medical Education and the University Grants Committee are considering the problems of new medical schools is an indication that the Government will maintain their forward-looking and enlightened approach.

2032 The siting of a new medical school on Keele University and on the Stoke-on-Trent Group of hospitals offers advantages not only to the immediate area but to the whole North Staffordshire region. It also provides facilities which are indispensable in establishing a modern, vigorous and progressive medical school. No Government have been more sensitive to the needs of the regions than the present one. But by siting the next medical school in North Staffordshire, they will help to redress the maldistribution of doctors, which is partly caused by the preponderance of medical schools in the South of England.

Some regions have suffered more than others from this maldistribution of doctors, and I must record the fact that a very serious situation has arisen in the Stoke-on-Trent area, where the average doctor's list of patients is as many as 200 over the national average. I regret to have to tell the House that some doctors have as many as 2,000 patients over the national average, thus, instead of an average of 2,500, some doctors in North Staffordshire have between 4,000 and 4,500 patients on their books.

When general practitioner posts are advertised in Stoke-on-Trent, there are sometimes no replies to the advertisements, and as a consequence patients have to be spread between the already overburdened doctors in the area. This is an intolerable situation. It is bad for the doctors, it is worse for the patients, and it is contrary to the Government's avowed policy of fair shares for the regions. I want to give the Government a clear and categorical warning that unless they act quickly in the short term, and unless they plan for the long term, they will face a chaotic situation in North Staffordshire.

The establishment of a school of medicine in Stoke-on-Trent would not only ameliorate the short-term problem, but would help to solve long-term problems, not just for this great city, but for the whole of North Staffordshire. It is an established fact that doctors who are trained in a particular area tend to practise in that area, so a medical school in Stoke-on-Trent would be a firm foundation on which the future of the North Staffordshire medical profession could rest, and, given the right decision 2033 by the Government at this stage, the impending chaos could be replaced by orderly progress.

The region of North Staffordshire is well defined, and has a sphere of influence covering a population of about 650,000, but the impact of the new medical school would be felt far beyond this sphere, reaching a total population of about 1,200,000. I believe that it is indefensible to deprive such a large section of our community of the benefits of a new school, no matter how capably the existing hospitals may be dealing with the problem.

Not only is the North Staffordshire centre dealing with current problems; it is also trying to plan for the future. A medical school based on Stoke-on-Trent has exciting potentialities as a training ground for the whole of the Midlands and for the north of England. The existing framework into which a medical school could be fitted could not be better. The existing hospitals of the North Staffordshire hospital centre stand in 120 acres of land, all of them linked by a new road, and with 40 per cent. of the site area available for development. There are 50 acres of land in public hands available for teaching departments, hostels, and administration. This is an advantage which cannot be overlooked, nor can it be overestimated. Its availability is a tribute to the far-sightedness of all those concerned. They planned for the future in an imaginative way.

By 1972 a large part of the centre will be housed in buildings only 10 years old or less. Design and function are as advanced as modern planning techniques can make them and top priority has been given to the suitability of the buildings for clinical teaching. The hospital centre has a fine tradition of research activity extending over an extensively wide area.

It now has an impressive schedule of over 50 research projects, covering such diverse subjects as experimental cardiac surgery, advanced tissue grafting procedures, pneumoconiosis, electrocardiography and blood viscosity—a tremendously wide area of research. Discussions are now in hand for the use of the centre as an experimental field for the application of computer techniques to all aspects of hospital activity.

2034 Research is not something that the North Staffordshire Hospital Centre has suddenly discovered, when it has asked for a medical school. It is and always has been an integral part of the life of the hospital centre. It is not only research into the 50 or so specific medical problems which I have just mentioned; it is research into all the problems confronting the medical profession. It is research into the function and performance of the out-patient department; it is research into the demand for local health, welfare and hospital services; it is research into the field of epidemiology organisation and administration in the National Health Service.

These are but some examples of the diversified work done by the North Staffordshire Hospital Centre. It is cooperating closely with Keele University, with the Tavistock Institute and the Midlands Faculty of the College of General Practitioners. It has won for itself a high reputation as a centre with its feet planted firmly on the ground but with its eyes on the future.

As the Prime Minister said only this week in Strasbourg, in another context, "This is blowing one's own trumpet." Why not? There is something to blow about in Stoke-on-Trent and North Staffordshire. The Centre even raised £100,000, largely by local subscription, to build one of the finest medical institutes in the country. Its excellent lecture theatre, library and other facilities would be an invaluable asset to any medical school. The group is already active in post-graduate education, and in association with Birmingham University it has conducted courses in advanced medicine, a Commonwealth School symposia, and clinical and pathological conferences. It has close associations with Keele University, and their joint resources are devoted to new projects like the establishment of a Department of Medical Physics.

Keele University is an ideal choice for initiating an experiment in medical education. The university was essentially an educational experiment itself, and as the oldest of the new universities it has much experience in educational experimentation. It is ideally placed to set up a medical school and a school of human biology.

That is the case for a new medical school based on Keele University and 2035 the hospitals of Stoke-on-Trent. The detailed financial estimate prepared by the group clearly illustrates that such a project offers a low-cost opportunity for a significant increase in medical manpower. The difficulties created by the Government's failure to give a clear answer to the question whether to have a new medical school are immense. I appreciate the need for the University Grants Committee and the Royal Commission to examine various proposals, but vital decisions on the redeployment of staff and resources are being help up and are creating confusion. A definite answer is needed in the immediate future.

I do not want an answer today, but I would appreciate an assurance that there will be a definite answer in the immediate future. The land, the resources, the facilities, the skill and the experience are all there awaiting a clinical school on which so much of the future depends.

But there is something more than that. There is a kind of vigorous enthusiasm which adds the extra dimension to any project such as this. It is the kind of spirit the Government have been asking, nay pleading for, up and down this land, and it has to be seen in North Staffordshire to be believed. If the Government dissipate this enthusiasm by undue procrastination, there are many people who will want to know why. It will be a failure that will not be forgiven lightly. But if they harness this enthusiasm to the resources and the facilities which have been so painstakingly collected and prepared, they can rest assured that in Stoke-on-Trent and in Keele University they will have a medical school of which the whole nation can be proud.

§ The Minister of State, Department of Education and Science (Mr. Goronwy Roberts)

My hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) has developed with care and cogency the case for a new medical school in his area. I am sure that he will expect me first to refer briefly to the question of Departmental responsibilities in relation to establishing and financing the development of medical schools.

Building work for the provision of accommodation for the pre-clinical departments of medical schools is the 2036 responsibility of the universities; the capital required is allocated by the University Grants Committee from the amount available for the universities' building generally. Teaching hospitals are the responsibility of my right hon. Friend the Minister of Health, who determines priorities within the hospital building programme, although the universities' share of the cost, for example for specialist teaching and research, is found from the Vote for universities and colleges administered by the Department of Education and Science. Although this part of the cost does not count against the individual university's application. it is subject to approval by the U.G.C., and, in the case of more expensive projects, by the Department of Education and Science and also by the Treasury. This means that any proposal for a new medical school or the enlargement of an existing school is a matter on which the University Grants Committee advises my right hon. Friend.

The University Grants Committee is responsible for the allocation between universities of the recurrent and capital funds placed at its disposal. For this purpose it considers the national needs, the circumstances of particular universities and the other claims on its funds. Naturally, it maintains close contact with the Ministry of Health in the matter of overall numbers of medical school places needed. For priorities as between medical school projects, it consults the Ministry so as to ensure that clinical facilities in the appropriate teaching hospitals can be matched to the pre-clinical provision in the universities concerned.

We are all, I think, fully conscious of the urgent need to expand medical education. My hon. Friend had some sound things to say about that. If there is one respect in which the Robbins Report might be criticised, it is that perhaps it did not direct very forcible attention to what is now seen to be a major problem of higher education. That has now been remedied by the establishment of the Royal Commission under Lord Todd which my right hon. Friend the Prime Minister announced in June 1965, among other things, that Royal Commission was specifically asked to report on what changes might be needed in the pattern, number, nature or location of the institutions providing 2037 medical education. It is already far advanced in its work.

In the meantime, things have not stood still. I listened with great interest and basic agreement to what my hon. Friend said about the need for more doctors not only in his area but in similar areas throughout the country. We are making progress in making more doctors available for such areas. The intake of students into our medical schools has risen from 2,020 in 1960 to 2,444 in 1965 and to over 2,500 last October. That is an increase of 24 per cent. in six years.

Further major expansions are already planned for the next few years. The U.G.C. has made capital allocations for the years to 1970 amounting to over £7 million, which will add another 500 to the student entry when those schemes are complete. Those numbers of entrants may sound modest, but taking into account the length of the course, one must multiply them all by six to arrive at the number of students for which the developments will provide.

Most of what I have described is based on expansion in existing medical schools. The exception is Nottingham, where a new school is planned. The U.G.C's view has been that the way to get rapid expansion was by enlarging on the existing base—if need be, by improvisation and more intensive use of facilities. Expansion by the creation of new schools is far slower. The school must be planned in relation to its associated hospital; a new organisation must be created. Between the decision to have a new school and the day it produces its first doctor there is a gap of perhaps nine or ten years, and may be longer.

I now come to the proposal for a new medical school at Keele, which is one of 15 or so in which universities and 2038 colleges from every part of the United Kingdom have expressed an interest. Some of these have reached the stage of putting detailed proposals to the U.G.C., and they are being examined. It is clear that all the plans cannot have priority, and that projects involving the expenditure of many millions of £s must be studied carefully from every point of view, including the comparative contribution each will make to the national framework of medical education. Nor would it be right, given the terms of reference of the Royal Commission, for any decision to be made about a new medical school without consulting it.

Although this is not the time for me to discuss the merits of the case put forward by my hon. Friend, I assure him that what he has said today will be noted by those advising my right hon. Friend on this matter, both in the Royal Commission and in U.G.C. My hon. Friend would not expect me to go further. As I have indicated, there is a number of claims to be assessed, and the implications of that assessment are a highly expert matter with far-reaching academic and financial consequences.

What I can say with confidence is that steady progress and substantial provision are being made, and that while we all look forward with great interest to the overall recommendations which the Todd Commission will make, we do not exclude major individual advances even before its full report is published early next year.

My hon. Friend asked us to act in the short term and to plan for the long term. I believe what I have said indicates that this is in fact what we are doing in this vital field.