Academic GPs: Remuneration (Hansard, 27 January 1998)

§ Baroness Ramsay of Cartvale
My Lords, the Richards report was commissioned by the Committee of Vice-Chancellors and Principals which, I understand, is considering at present its recommendations. The report has not been formally presented to the Government for a response and it would be premature for me to offer a view on any specific recommendation at this stage, including the recommendation regarding the remuneration of academic GPs, which raises complex issues as the report itself recognises, and about which I know the noble Lord, Lord Walton, is well aware.

§ Lord Walton of Detchant
My Lords, I thank the Minister for that reply. Does she accept that since the introduction of mandatory vocational training for general practice, the clinical academics who teach general practice and primary care are accepted as being in a specialty like any other clinical specialty; and that this is the only clinical specialty in which teachers in the universities are not at present eligible for distinction awards?
Is the Minister aware that there is at present a major recruitment problem in this field? If, as the Government wish, we are to have a primary care-led NHS, is it not important that incentives should be introduced to improve recruitment, in particular, since these are the people who will be teaching primary care to our medical students and doctors in the future and the BMA General Services Committee, while opposed to distinction awards for general practitioners who are independent contractors, now supports their availability to this group of clinical academics?

§ Baroness Ramsay of Cartvale
My Lords, the Government accept the importance of academic general practice given our commitment to a primary care-led 96 National Health Service. We would not wish to see disincentives to able individuals entering academic general practice. However, pay is only part of the picture and access to the NHS consultants' distinction awards is only one option which could be looked at in addressing any perceived disparities in pay.
Introducing distinction awards for university employed general practitioners raises complex and difficult issues. Sir Rex Richards acknowledged this in November in evidence to your Lordships' Select Committee on Science and Technology which the noble Lord, Lord Walton, chairs. It is not new, but a longstanding issue to which there is no simple solution. However, we shall ensure that these issues are fully considered and possible solutions addressed. The Department of Health and the Department for Education and Employment look forward to working with the Committee of Vice-Chancellors and Principals to address the issues raised in the Richards report. We shall seek to ensure that there are no disincentives to entering academic general practice. We shall take careful note of the points made in both the Richards report and by the noble Lord, Lord Walton.

Earl Howe
My Lords, perhaps I may take this opportunity to welcome the noble Baroness to the Dispatch Box and to wish her well as one of the members of the health team on the Government Front Bench.
Is not the difficulty at the heart of the Question the fact that there are simply not enough medical graduates choosing to enter general practice? Does the Minister also agree that because of the shortage of GP trainees, the GP trainers often cannot be retained in the academic loop?
The noble Lord has proposed one answer to the problem. But what plans do the Government have for eliminating the shortage of trainee GPs?

§ Baroness Ramsay of Cartvale
My Lords, first, I wish to thank the noble Earl for his kind and courteous comments to me.
The Government very much recognise the importance of teaching general practice best practices to medical undergraduates and young doctors. However, as I understand it, Richards recommended that there should be discussions about the need to ensure that the terms of academic general practitioners match those of their academic colleagues in hospital practice. I accept that in the report there is acceptance of the fact that hospital colleagues with honorary NHS consultant contracts are eligible for distinction awards. But no other group of GPs receives distinction awards. We need to be clear about whether there is a disparity and, if so, how that might be addressed. We cannot assume that the issue is simply one of distinction awards. For example, a separate scheme could be more closely tailored to clinical academic GPs; or other changes could be made to the remuneration of clinical academic GPs which could also address the problem. We are planning detailed discussions with the Committee of 97 Vice-Chancellors and Principals about all the implications and options arising from the report, and possible options for any necessary funding.

§ Lord Hunt of Kings Heath
My Lords, will my noble friend agree that, while we cannot look to the Treasury for a monopoly of all wisdom on matters concerning the NHS, its evidence to the Royal Commission on Doctors' Remuneration of 40 years ago still stands? It argued that distinction awards should be abolished as a blot on the landscape of public finance. Will my noble friend further agree that, while we must do everything we can to ensure that GPs who take part in academic medicine do not suffer financially, we should not seek to extend the range and scale of distinction awards?

§ Baroness Ramsay of Cartvale
My Lords, the Treasury may well have said that, but I could not possibly comment!

§ Lord Winston
My Lords, does my noble friend agree, in the light of recent evidence based on research by Dr. Hetherington and his colleagues about the perceived difficulties of ethnic minorities in consultant practice, that this is an issue the Government might wish to re-examine?

§ Baroness Ramsay of Cartvale
My Lords, this is indeed an important issue for the Government. Department of Health officials have recently held discussions with the Commission for Racial Equality regarding the number of awards granted to consultants from ethnic minorities. A number of measures are being introduced in the 1998 awards round to secure better data, monitoring of outcomes and representation of ethnic minority consultants on awards committees. Some changes to the criteria for awards were also suggested by the commission and accepted for implementation in the 1998 awards round. Those measures were welcomed by the commission. We are considering what further action might be taken to assist in addressing this issue.