Medical Students (Hansard, 21 June 2000)

§ Lord Hunt of Kings Heath
My Lords, in July 1998, the Government announced that the annual intake of 252 medical students in the United Kingdom would be increased by about 1,000 places per annum by 2005. In England, the Higher Education Funding Council for England has announced the allocation of a total of 1,126 additional places. The Government are now considering a further increase in medical school intake in England. The information relating to Scotland, Wales and Northern Ireland is a matter for the devolved administrations.

§ Lord Roberts of Conwy
My Lords. I declare an interest as president of the University of Wales College of Medicine. I appreciate the increase of about 1,000 in the number of medical students. However, are the Government convinced that the number is adequate to meet the needs of the United Kingdom? Bearing in mind that during the past five years only 42 per cent of doctors registering each year for service in the United Kingdom have been trained here, is it not time that the Government changed their target?

§ Lord Hunt of Kings Heath
My Lords, an additional 1,126 places is a considerable achievement. However, I assure noble Lords that as part of our further developments within the NHS we are looking at the number of places over and above the 1,126 which we shall need. As regards the statistics which the noble Lord gave, I understand that 76 per cent of the medical workforce is UK trained. The advice given by the Medical Workforce Standing Advisory Committee in 1997, on which much of the development in medical school places is based, suggested that we needed to stabilise that proportion. I believe that the additional places we have announced will help us to do that, as will any future expansion.

§ Lord Cledwyn of Penrhos
My Lords, my noble friend has given us important information, but is he aware that we could do with many more trained doctors throughout Wales—in the villages, outside Cardiff and Swansea, where they are badly needed?

§ Lord Hunt of Kings Heath
My Lords, I am in danger of trespassing on another country's arena. I pay tribute to the high quality of medical education in Wales, of which I have experience. The new training places allow us to develop links outside traditional medical school centres, both in terms of the new medical schools—for instance, in Norwich at the University of East Anglia and at the Peninsular Medical School in the West Country—and in places where medical schools have been expanded—for instance, in Birmingham through links with other parts of the Black Country. There is no doubt that in ensuring that we have high quality doctors we have to ensure a broad-based education for medical students which enables them to experience all facets of life in the health service.

§ Lord Clement-Jones
My Lords, although the Government's announcement is welcome, the Minister will be aware of comments made by his honourable friend Frank Field pointing out that the number of 253 doctors per head of population in France is 75 per cent greater than in this country; two and a half times greater in Spain than in this country; and three times greater in Germany. Are the Minister and his department examining the question of additional medical students in a sufficiently fundamental way?

§ Lord Hunt of Kings Heath
My Lords, international comparisons can often be misleading. In terms of doctors per 1,000 of population, the UK is comparable with Finland, Norway, the Netherlands and the US. But we accept that we need to do better. We need to expand the NHS workforce as a whole and doctors will be an important component of that. Furthermore, we must break down some of the working barriers between the different professions. By the sensible reordering of responsibilities we can take some of the load from doctors, nurses and other professionals in order to allow them to focus on the most important and serious elements of their work.

Baroness Young
My Lords, does the Minister recognise that we need a considerable increase in the number of doctors? Do the figures he has given mean an absolute increase over and above those who retire every year? Is what we read in the newspapers about the two new medical schools at East Anglia and Exeter true; that they will take in students with lower qualifications who will therefore require a longer training period? Can we be satisfied that they will achieve the correct standard?

§ Lord Hunt of Kings Heath
My Lords, medical workforce planning has proved to be a difficult art. The noble Baroness is right that a considerable number of doctors are coming up to retirement. That statistic needs to be factored into the further development of training places.
It is right that we should consider everything we can to widen access to medical education. I point to King's College, London, whose medical school is working with local schools and colleges in south London to identify potential medical students at a young age, and where alternative tests will be applied to demonstrate a suitability and general aptitude for medicine. However, I do not believe that that or other initiatives will in any way impact on the high quality of medical students and doctors in this country. I believe that the number of applications for places is at a healthy level, enabling us to ensure that high quality students enter our medical schools.

§ Lord McColl of Dulwich
My Lords, is the Minister aware that according to OECD figures, Britain's number of practising doctors per head of population is one of the lowest compared with the majority of OECD countries? Only Turkey, Korea and Mexico have a lower number. At the other end of the scale, will he comment on unemployment among fully trained obstetricians and on last year's cut of 33 per cent in the number of new consultants as opposed to an annual increase under the previous government of 4 per cent?

§ Lord Hunt of Kings Heath
My Lords, so far as concerns obstetrics and gynaecology, the noble Lord will know that the Government have been in discussion with the president of the Royal College of Obstetricians and Gynaecologists. We are looking closely at a range of proposals to address that issue and the way forward. So far as concerns the OECD report, my understanding is that that information was based on 1996 statistics and therefore, I believe, comes under the responsibility of the party of the noble Lord.