Lord WINSTANLEYMy Lords, I beg leave to ask the Question which stands in my name on the Order Paper.
§ The Question was as follows:
§ To ask Her Majesty's Government what is their estimate of the extent of under-use of NHS facilities for the diagnosis and treatment of cardiothoracic, renal, rheumatic and general surgical conditions brought about by the present shortage of consultant anaesthetists and radiologists; and what steps they intend to take to reduce the rate of emigration to EEC countries of doctors in these two specialties, or to induce those who have emigrated to return to the United Kingdom where they are so urgently needed.
§ Lord WELLS-PESTELLMy Lords, it is true that there are relative shortages of doctors in these specialties. These are due largely to rapid expansion in recent years, though any emigration of doctors in these specialties naturally aggravates the problem. It is not possible to estimate the extent of any under-use of facilities arising from these shortages, but it is believed to be minimal. It is too early to say what the effect of implementing the EEC Medical Directives on freedom of movement will be, but, so far, there is no indication of any large-scale migration to the Continent. There are arrangements for health authorities to pay certain of the expenses of British trained doctors returning to this country.
Lord WINSTANLEYMy Lords, I am much relieved to learn that the Government are seized of this problem. May I point out to the noble Lord, Lord Wells-Pestell—
Lord WINSTANLEYMay I ask the noble Lord, Lord Wells-Pestell, whether he realises that the problem is very urgent in some areas? For example, I understand that three advertisements for anaesthetists in Bolton and Rochdale have produced no applicants; that waiting time for appointments for rheumatic clinics is now in excess of seven months, not because of a shortage of rheumatologists but because of a shortage of radiologists to process and investigate the cases; and that the Regional Manpower Services Committee of the North-West Region has now decided not to establish any new surgical posts because the existing anaesthetic services cannot provide the full cover for the existing establishment. Does the noble Lord realise that these two specialties are unique in that they do not require linguistic ability? In other words, an anaesthetist—
§ Lord WELLS-PESTELLMy Lords, I think I have the noble Lord's point. I was not trying to be facetious. He has raised an important matter and it is not one that we can afford to take lightly. On 30th September 1976 there were nine consultant posts in radiology and 19 in anaesthetics in England and Wales which were vacant for lack of a suitable candidate. I am aware, and so is my right honourable friend the Secretary of State, of the particular problems in the North-West Region. May I say that we have recognised these difficulties in the recent allocations both in finance and in the new consultant posts. In fact, I understand that the North-West Region is slightly better off than average as regards consultant posts in radiology and anaesthetics.
§ Lord HAILSHAM of SAINT MARYLEBONEMy Lords, will not the noble Lord realise that the real trouble about the emigration of doctors and scientists is the penal taxation policy of the Labour Government?
§ Lord WELLS-PESTELLMy Lords, there is not a shred of truth in that. The noble and learned Lord had better look up the reasons why they go abroad. They do not go abroad to any great extent—although I accept that one or two of them do—for more money. Often, there are better facilities there for research, 625 which we accept, and in certain fields they can get experience perhaps more adequately than they can here. But many of them go as a planned purpose to gain a wider experience, and return to this country in something like three years.
§ Lord LEATHERLANDMy Lords, in view of this wise and very valuable Question from the Liberal Benches, can my noble friend tell me what is the average salary earned by these consultants in this country today, both in the National Health Service and in private practice?
§ Lord WELLS-PESTELLMy Lords, I cannot give exact figures and I am not prepared to hazard a guess. There are full-time consultants in the National Health Service and part-time consultants. If my noble friend would put down a Question on this matter I should be delighted to reply, for the simple reason that I think your Lordships would be quite surprised at what the salaries are.
§ Lord DERWENTMy Lords, did not the noble Lord use the wrong word in reply to the original Question when he said "migration" instead of emigration? —because with migration they all return the following spring.
§ Lord WELLS-PESTELLMy Lords, if the noble Lord is speaking in a naturalist sense, it depends on the species.
§ Lord SEGALMy Lords, could not Her Majesty's Government do a little more than hitherto to persuade the medical schools to urge medical graduates to take up these two specialties?
§ Lord WELLS-PESTELLMy Lords, my noble friend will know that there is a plan to increase the number of doctors in this country in the future. With regard to these two specialties, the real problem at the moment is not that there is a shortage of registrars in these two specialties; the difficulty at the moment is getting enough registrars with the adequate experience to become consultants.
Lord HAWKEMy Lords, if there is a shortage of anaesthetists, will Her Majesty's Government import some more acupuncturists from China?