London Medical Schools (Hansard, 18 October 2000)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, I am confident in the ability of the merged London medical schools to deliver on their commitments and to make an effective contribution towards the increase in medical student numbers set out in the NHS plan.

§ Lord Clement-Jones
My Lords, I am intrigued by the Minister's confidence. Imperial College has made 120 people redundant, 60 of them medical staff; and Queen Mary and Westfield College is making 90 people redundant. As both colleges have agreed to provide in total a further 100 medical places this year and next year, that does not bode well for medical education in London. Does the Minister agree that the current system of financing for medical schools is rather perverse in that the research assessment exercise provides an incentive to sack medical training staff and to retain and increase the numbers of research staff?

§ Lord Hunt of Kings Heath
My Lords, I recognise the tension between the desire of universities to increase their research ratings and the impact that that can have on their teaching responsibilities and the position of clinical academics. As regards Imperial College, it is my understanding that the changes it is making arise from three factors: first, the merger and reconfiguration of a number of medical schools within the Imperial umbrella, which in itself has caused a fall-out; secondly, a deficit situation; and, thirdly, as the noble Lord suggested, the desire of Imperial to ensure that it has the highest possible research rating.
I have received assurances that this will not impact on its ability to train and teach medical students. It is worth making the point that most teaching is undertaken by NHS staff. I am informed by the NHS trust concerned that it does not think that that will be put at detriment. This has shown the need for better liaison between universities and the NHS to ensure 1022 that when such actions take place the NHS is fully involved and informed and can take the necessary measures.

§ Baroness Gardner of Parkes
My Lords, perhaps I may take the Minister to another part of London. I declare a half interest as a former chairman of the Royal Free national health trust. The Royal Free and the University College medical schools have combined. I believe that, on the whole, it is a happy combination. The Royal Free Hospital has always believed that medical school and hospital should work closely together. Can the Minister assure me that there is no question of empire building between the two branches? Can he further assure me that any academic posts which become vacant are advertised and interviewed in the same way as they would be if they were national health posts?

§ Lord Hunt of Kings Heath
My Lords, it would be very unwise of me to assure the noble Baroness that organisations will not empire build. Clearly it is very important that these mergers are made to work effectively, both in terms of the quality of the teaching and the research undertaken. Perhaps I may write to the noble Baroness with the detail she requires. I suspect that this is a matter more for the university than for the National Health Service. I can assure her that we recognise that, to make the relationship work, much more has to be done in terms of liaison—both at national level between the Department of Health and the funding authority on the one hand and at local level between the individual medical schools and the local NHS community on the other.

§ Lord Winston
My Lords, there are rumours that the Government intend to shorten the medical curriculum, which is currently five years. Can the Minister give reassurances that that is not the case? Clearly, as I am sure he is aware, medical students do not work a normal university term like non-clinical students but work during the summer vacation, the spring vacation and the winter vacation. To further shorten the term would result in doctors who are under-trained when they start work in the NHS.

§ Lord Hunt of Kings Heath
My Lords, I am interested in my noble friend's comments. I am not aware—I will check—of proposals in regard to the point he has raised. I am aware that some medical schools have been investigating whether, for a certain number of students, there may be opportunities for the qualification period to be shortened. I shall be happy to follow up that matter with my noble friend.

§ Lord Roberts of Conwy
My Lords, is the Minister satisfied that the national plan provides for sufficient medical students for the UK as a whole to meet future NHS needs?

§ Lord Hunt of Kings Heath
My Lords, I can speak only for England rather than for the United Kingdom. Certainly the noble Lord will know that we announced 1023 1,000 extra medical school places and doctors in training in the NHS plan, in addition to the 1,126 new medical school places already being implemented. We have made great advances in ensuring that our workforce planning is effective and that this will give us the doctors we require to meet the demands being placed on the service. However, one can never be complacent. We shall keep this matter under regular review.

§ Lord Quirk
My Lords, further to the question from the noble Lord, Lord Winston, would the Minister agree on the importance of intercalated BSc degrees for medical students, whereby they opt out of medical training for a couple of years, finish a science degree and then go back into medicine? Does he further agree that any change to the curriculum that inhibits that very important injection into medical science would be deplored?

§ Lord Hunt of Kings Heath
My Lords, I have heard what the noble Lord has said. In examining the curriculum, we need constantly to ensure that we produce high calibre doctors who are ready and able to work within the National Health Service with a sufficient degree of training across the whole range of sciences. We also need to look at whether we can introduce greater flexibility. For instance, the issue of shortening the curriculum is applicable to mature students, whom it is important to attract to the National Health Service.

§ Earl Howe
My Lords, does the Minister agree that, while the issue raised by the noble Lord, Lord Clement-Jones, is extremely important, there is a need to ensure that a sufficient number of clinical academics are available to teach the increased numbers of students? Is it not also imperative that teaching facilities are improved to accommodate the increased numbers? There is concern among members of the BMA that there is a great deal to be done in that area as well.

§ Lord Hunt of Kings Heath
My Lords, it is certainly our wish that medical students, and indeed other students, are taught in the most effective way. I agree that teaching facilities are important. That applies as much to universities as it does to the National Health Service. But in addition to facilities, the quality of the clinical placement and the supervision and teaching given within NHS hospitals is as important as the teaching and facilities that are available in the universities.