Pathologists (Hansard, 4 July 2000)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, we are taking action to alleviate the shortage of pathologists across the workforce. We are continuing to invest in more higher specialist trainees. In addition, the medical workforce planning review, launched in April this year, will look at the staffing needs of different care groups to meet the needs of patients.

Baroness Sharpies
My Lords, I thank the noble Lord for that Answer. However, can he tell us the shortfall? As it takes a qualified doctor another five years to become a pathologist, is not this shortfall of great concern?

§ Lord Hunt of Kings Heath
My Lords, there is no doubt that pathologists have an extremely valuable role to play in the National Health Service. There have been concerns in relation to shortages, especially in 1382 relation to histopathologists. We are dealing with this as rapidly as we can. We shall increase the number of specialist registrar training places from 888 at the moment to 1,300 by 2006; that includes 40 extra specialist registrar training posts this year. That will go a long way towards dealing with the shortages. We shall keep the matter under annual review.

§ Lord Taylor of Blackburn
My Lords, is my noble friend aware that we are dealing in a very competitive area, in which salaries in the private sector are far higher than those in the National Health Service? With all the good will in the world, unless an adjustment is made to that particular salary scale it will be extremely difficult to fill many of the vacancies.

§ Lord Hunt of Kings Heath
My Lords, my noble friend raises a number of issues. Clearly consultant pathologists receive the same salary as other consultants in the health service; they are also eligible for discretionary points. So far as concerns the pay levels of staff generally, I believe that, through the pay body recommendations and other awards that have been given to staff, we have fully recognised their value. For example, we have taken into account the recommendations of the pay review bodies, and have thus ensured that the amounts recommended have been paid in full. That is in contrast to the staging system with which the previous government so disenchanted members of staff. We have to do much better in terms of the support that we give to staff, including professional development and other support measures.

§ Lord Clement-Jones
My Lords, the Minister referred to the number of training places that are being created—and, of course, they are welcome but, as his own consultation document, A Health Service of all the talents: Developing the NHS workforce, acknowledged, the rule whereby 50 per cent of the cost of those training places must be borne by the trusts is one of the key problems in manpower planning at the moment. What can the Minister say about that? What has been the result of the consultations, which were due to finish in mid-June?

§ Lord Hunt of Kings Heath
My Lords, in essence, a national levy provides 50 per cent of the basic salary costs for senior house officers and specialist registrars. NHS trusts have to find the remainder of the costs. I recognise that this is a particular issue and that there have been concerns that some trusts were not prepared to fund the extra number of specialist registrar places. I am glad to say that trusts have indicated that they wish to take up the 40 extra places which will be coming on-stream this year. We shall, of course, keep the situation under review. We have made it clear to NHS trusts that we expect them to invest in these posts.

§ Baroness Trumpington
My Lords, forensic pathology plays a very important part in dealing with crime. Is there a shortage of forensic pathologists?
1383 Does that impact on the National Health Service? I should declare an interest as an honorary Fellow of the Royal College of Pathologists—why I do not know, except that I feel it may have designs on the two kippers that I call my lungs.

§ Lord Hunt of Kings Heath
My Lords, the royal college has certainly chosen well. The main shortage is in relation to histopathologists, whose role is to examine human tissues and undertake post mortems. I am not aware of the statistics in relation to forensic pathologists but I shall be happy to look into the matter further. My understanding is that the key problem is in relation to histopathologists, where we wish to see a large increase in the number of specialist registrar posts.

§ Lord Turnberg
My Lords, does my noble friend agree that the major problem concerns recruitment into histopathology? There are currently more than 100 unfilled histopathology posts in the UK, which is 10 per cent of the total. The problem goes back to recruitment into the training grade posts and the funding issue to which my noble friend referred. Does the Minister agree that the Government should focus their efforts on enhancing recruitment into the specialty and on ensuring that the trusts fund those posts?

§ Lord Hunt of Kings Heath
My Lords, I do not disagree with any of the points raised by my noble friend. Certainly the increase in the number of specialist registrar training places is based on the assumption that they will be funded by NHS trusts—which I fully expect them to be. That will mean that more people will be coming through in the future to fill consultant posts. Equally, I accept that we need to attract medical students into considering pathology as a suitable specialism for them to enter. We are working well with the Royal College of Pathologists. We need to work together to show medical students the attractions of the pathology profession. I believe that pathologists have a very important role to play in the NHS.

§ Earl Howe
My Lords, last year the Government announced a £10 million capital fund for modernising pathology services in the NHS. Can the Minister say whether all that money has been allocated and whether he thinks that £10 million is adequate?

§ Lord Hunt of Kings Heath
My Lords, we need to invest in pathology services. At the moment the National Health Service has a high level of pathology services, but there has been under-investment. Certainly in the future we need to look at ways to ensure that resources are made available in order to develop those services and to ensure that the quality of the kit and the actual facilities are of a high standard. In terms of future investment, within the national plan 1384 we are in the process of developing proposals for services. Inevitably we shall be looking at pathology developments within that.

Baroness Sharpies
My Lords, the noble Lord did not answer me when I asked him about the shortfall.

§ Lord Hunt of Kings Heath
My Lords, I do not have specific figures for a shortfall. Those are issues which fall to be dealt with locally. But I have said that I believe that the increase in the number of specialist registrar training places will enable us to overcome many of the problems that undoubtedly are occurring at the moment.