HC Deb 14 April 1969 vol 781 cc806-10
The Secretary of State for Social Services (Mr. Richard Crossman)

With your permission, Mr. Speaker, and that of the House, I should like to make a statement on medical school places.

The Government have now completed their consideration of the recommendations of the Royal Commission on Medical Education about the number of doctors to be trained in our medical schools by the mid-seventies. The recommendations were the result of a careful and comprehensive analysis by Lord Todd and his colleagues. We accept the main finding that, having regard to current shortages and likely future demands, further provision is needed, to produce a substantial increase above the number being trained at present and beyond existing plans for expansion.

The Secretary of State for Education and Science, the Secretary of State for Scotland and I have, in conjunction with the University Grants Committee, considered very carefully what programme for expansion by 1975 can be achieved. The annual entry of pre-clinical students was just under 2,700 in October 1968. While urging the need for a still higher rate of expansion, the Royal Commission reported that 3,700 was the highest practicable figure that could be reached by 1975. The Government agrees this figure as its target.

The plans agreed for reaching this total will be announced separately today by my right hon. Friend the Secretary of State for Education and Science.

I have now received most, but not yet all, of the views of the various bodies I have been consulting on other parts of the Royal Commission's Report, including their recommendations on the development of postgraduate medical education. When these necessarily wide consultations are completed I shall make further announcements as necessary.

Mr. Dean

I should like to add the thanks of the Opposition to Lord Todd and his colleagues for their excellent work. We welcome the right hon. Gentleman's statement that he has accepted what he has called the target. Will he be a little more specific and say whether this is a firm commitment? To complete his statement, will he say a little more about what he intends to do to ensure that doctors who are already trained remain in this country? I am thinking particularly of career prospects and working conditions for junior hospital doctors. Finally, when does he expect to be able to make a statement on the other parts of the Todd Report to which he referred, namely, post-graduate medical education and, perhaps most important, the future of general practice?

Mr. Crossman

There will be a series of statements, because I want each to be made as fast as possible, but all depend on consultations with many different organisations. A statement about post-graduate education may be a possible start. The career structure is a very different issue, and that should be left for further questioning.

The hon. Gentleman's important question was whether this was a firm commitment. The answer is yes. This means that we are already working out our plans for ensuring the extra 1,000 places to be found in existing medical schools and by the creation of new medical schools, and it is these which my right hon. Friend the Secretary of State for Education and Science will be announcing today.

Mr. Woodburn

I welcome the Report and I welcome my right hon. Friend's decision. Will he say whether he had any representations about the curriculum? Many eminent physicians regard the extra year as having been one of the causes of the shortage of doctors, taking the view that the real education of a doctor starts when he has finished his examinations and has begun practical work. These physicians take the view that the year would be far better spent on the practical rather than the theoretical side.

Mr. Crossman

Questions about the curriculum are for my right hon. Friend and not for me. However, I am responsible for the post-graduate stage and I can tell my right hon. Friend that many doctors would disagree with that thinking and would take the view that the eighth year could usefully be spent in research.

Dame Irene Ward

Will the right hon. Gentleman give an assurance that women will have a fair share of the increased number of places based on merit and that they will not be restricted as in the past?

Mr. Crossman

I think that the answer is "yes", but I should like to consult my right hon. Friend to be sure. For my part, certainly the answer is "yes".

Dr. Summerskill

When this increase comes into practice, will we still rely as heavily as at present on Commonwealth doctors for the staffing of our hospitals? Are not those doctors needed more in their own countries than here?

Mr. Crossman

One of the chief advantages of this increase will be that we shall thereby increase by one-third the intake of our own students from our own countries and this will mean that reliance on Commonwealth doctors staying here permanently will be decreased. We are not able to decrease it now, because we do not have the growth in the numbers of our own doctors. This will be one of the main advantages of the increase. Lord Todd expressed that view, and I entirely concur.

Sir J. Vaughan-Morgan

Besides those already announced, how many new medical schools will be involved?

Mr. Crossman

That is a question for my right hon. Friend.

Mr. McNamara

I welcome my right hon. Friend's statement. As the Secretary of State for Education and Science is not now in his place, will my right hon. Friend say where the new schools will be established?

Mr. Crossman

No. It would be a good idea to wait and see what information my right hon. Friend provides and to ask further questions on that basis.

Mr. Lubbock

Does the right hon. Gentleman recall that in the Interim Memorandum of the Royal Commission it was stated that we would be short of 11,000 doctors by 1975 unless corrective action were taken? Can he give a revised figure, taking into account the increase in the number of places in medical schools? Can he say whether the assumptions on which the 11,000 figure was based continue to remain in force, including that of the emigration of junior doctors?

Mr. Crossman

The Government accept the calculations in broad outline. Of course one cannot be certain that they are right, but we believe that they are modest calculations. I re-emphasise that Lord Todd would have liked us to have set ourselves a higher target, but he came down to earth and calculated the maximum we could reasonably expect to train in the time. We have agreed to the maximum Practicable, but the maximum practicable still leaves us quite a distance short of the desirable.

Mr. English

Does my right hon. Friend not agree that 1975 is rather too early for the setting up of new teaching facilities from the start? Does he not agree that in the circumstances, when there are 10 applicants for every place for a medical student with a shortage of doctors at the same time, we could do with many more teaching hospitals throughout the country?

Mr. Crossman

Yes, my hon. Friend is perfectly right. The plan will consist of two parts. The first is the maximum use of existing facilities. I am asking every teaching hospital in London how many extra places can be created in existing medical schools. Only when all that has been done shall we rely on new medical schools. Nevertheless, the sooner we decide to have new medical schools the better, because it takes years to build them.

Dame Joan Vickers

Will every applicant for a place be considered on the ground of merit and not sex?

Mr. Crossman

That question is rather similar to the one asked by the hon. Lady the Member for Tynemouth (Dame Irene Ward). It had better go to my right hon. Friend the Secretary of State for Education and Science, who is an expert in these matters.

Mr. Christopher Price

Is my right hon. Friend aware that regional balance in the supply of doctors is far more important than the actual increase in their number? Is he further aware that many of us on this side of the House felt that it was a grievous mistake to start a new medical school in Southampton rather than in the Midlands and the North where the shortage is greatest? Will he assure us that regional balance will be a major factor to be taken into consideration in deciding where the new doctors shall be trained?

Mr. Crossman

My hon. Friend knows the Todd Commission's Report and the list of places suggested for new schools. That list suggests to me that the Todd Commission recognise the importance of provincial growth and, in particular, of the West Midlands, to which both my hon. Friend and I belong.