§ 2.43 p.m.
§ Lord Walton of Detchant asked Her Majesty's Government:
§ What is their response to the proposal of the joint planning advisory committee of the Department of Health that the number of neurosurgical career registrar appointments at the National Hospitals for Neurology and Neurosurgery should be reduced from five to nil in 1995.
§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)My Lords, in these professional matters, the department is advised by the joint planning advisory committee which in turn is advised by the special advisory committee of the relevant Royal College on the appropriate distribution of available posts. In the usual way we accepted this advice and our response was issued in guidance to regional health authorities in March 1990. It was also included in the report of the joint planning advisory committee published in September 1990.
§ Lord Walton of DetchantMy Lords, I thank the Minister for that not unexpected reply. Perhaps I may make the point, in asking the Minister to clarify the issue further, that the Royal College of Surgeons of England is now very seriously concerned about the position with respect to these registrar appointments at this centre of excellence for training in neurology and neurosurgery. Does the Minister agree that to remove all registrar training posts from this very 1108 important centre, while being of benefit to the training of visiting registrars from overseas, will have a seriously detrimental effect upon the training of young British neurosurgeons?
§ Baroness HooperMy Lords, the joint planning advisory committee reviews all specialties regularly. Where a specialty is expanding, numbers in the training grades are adjusted to ensure that there is a sufficient supply to match future consultant vacancies. It was felt in this case that the training requirements of the career registrars were more appropriately dealt with if they were spread about the country. As I understand it, the national hospitals still have three senior registrars in post who are not affected by this recommendation; but, as in all other cases of this kind, JPAC reviews regularly, and if necessary it can be asked to carry out an urgent review.
§ Lord CarterMy Lords, can the Minister confirm that JPAC is prepared to discuss this problem before the next review term, which I think is 1995? Are the Government satisfied that the decision will not have a detrimental effect on the future training of neurosurgeons and neurologists?
§ Baroness HooperMy Lords, on the latter point, as with all cases of specialty, we take advice from the professional bodies concerned. I believe that that is the appropriate way forward. I can tell the noble Lord that the next review of this particular specialty is due in June 1993. But, as I said, if the circumstances justify it, JPAC is prepared to undertake a more urgent review. We would most certainly look at such a review.
§ Lord SmithMy Lords, is the Minister aware that the president of the Royal College of Surgeons of England, at least one past president and the fellowship of the college are appalled by the prospect that British neurosurgeons may become, in effect, debarred from holding these very key training appointments?
§ Baroness HooperMy Lords, I could understand such concern if I thought that it was justified.
§ Lord Walton of DetchantMy Lords, I have one further question. In agreeing to draw to the attention of JPAC the concern of the profession about the situation, will the Minister also draw to the attention of that committee—which I wholly accept is a professional committee—the anxiety about the interrelationship between, on the one hand, the number of training posts in the registrar grade and, on the other, future senior registrar vacancies? Will the noble Baroness also bear in mind the devastating effect that the reduction in registrar posts of an honorary nature will have upon the future of research in our National Health Service?
§ Baroness HooperMy Lords, I am certainly happy to say that the department will do whatever it can to bring together the special advisory committee and JPAC in the matter; and will draw to their attention the points made by the noble Lord about the interrelationship between the various grades of post and the training requirements that lie behind them.