HC Deb 19 April 1983 vol 41 cc145-7
1. Mr. Christopher Price

asked the Secretary of State for Social Services what reports he has received about students initiating treatment on behalf of doctors in hospitals.

The Minister for Health (Mr. Kenneth Clarke)

Under long-standing arrangements agreed with the medical profession and the universities, final-year medical students may assist in hospitals when a house officer is absent on leave. I have received a very brief report from the representatives of junior hospital doctors outlining nine cases of alleged abuse of these arrangements. In only one case is it alleged that a student initiated treatment. I have asked the British Medical Association for further details.

Mr. Price

Is this not a scandalous situation? Has the Minister received the letter that I sent to the Secretary of State on 13 April, in which an experienced state registered nurse in my constituency alleges that it is common practice in Lewisham hospital for students to be given the bleeper of the houseman who is meant to be on duty, and in that way final-year students are made responsible for patients who in many cases are very ill? What will the Minister do when he receives the BMA report? Will he stop this practice once and for all?

Mr. Clarke

There are very clear arrangements which closely limit the extent to which final-year medical students take part in treatment. We shall take seriously any allegations that the arrangements are not being followed. At the moment, all that I have received from the junior doctors is a short account which does not give dates or names and which does not identify any units. As soon as we have identified cases that can be investigated we shall of course follow them up arid make sure that the perfectly straightforward and well accepted arrangements are followed in every case.

Mr. Viggers

Is it not a fact that students, under proper control, have always taken care of patients, and that, without that opportunity for students to gain experience, it would not be possible for them to qualify properly as doctors?

Mr. Clarke

That is entirely right. In the practice of medicine it is not possible for someone to be turned overnight from a student who has never had contact with patient care into someone who carries some responsibility as a house officer. That is why final-year medical students are allowed to take over some duties when a house officer is on leave. No one has ever objected to that, and if anyone gives us particulars of the arrangements not being followed or being abused in any way, we shall step in to make sure that the proper arrangements are followed.

Mrs. Dunwoody

Are not nearly 1,500 doctors unemployed in this country? Does the hon. and learned Gentleman agree that there should be no occasion on which a student is left in sole control for a day or a night?

Mr. Clarke

With respect, the first part of the hon. Lady's supplementary is not relevant to the question.

Mrs. Dunwoody

Yes it is.

Mr. Clarke

There is no incentive to a health authority to adopt any arrangement to use final-year medical students. The financial and staff savings to the health authority are minuscule. We are talking about an arrangement whereby final-year medical students are allowed to cover very restricted duties for a house officer when he is on leave. They remain under the supervision of a consultant. I await any evidence of a case where that practice has not been followed properly, and once we have that evidence we shall step in to make sure that it is followed. The 1,500 unemployed doctors are difficult to find. They tend largely to be in the south-east, and they are not people whose qualifications are relevant to the house officer duties about which we are talking.

Mrs. Dunwoody

Will the Minister examine the instances in which junior and senior house officers who are on holiday are not replaced because the health authorities are faced with extra bills and cuts in their budgets? That is what is happening and that is why students are occasionally left on their own.

Mr. Clarke

The number of doctors employed in the hospital service has greatly increased in the past three years. The hon. Lady is entering into local disputes about whether locum cover ought to be provided for junior doctors, and making from the few incidents that she has encountered and complaints that she has heard a general case that Britain is short of doctors. That is not so.