Academic Medicine (Hansard, 20 January 2005)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Warner)
My Lords, we acknowledge the concerns expressed by the BMA but we are acting to secure a strong academic base in medical education and research. We are supporting implementation of the new consultant contract for clinical academics with investments of an extra £15 million this year and nearly £18 million extra next year. Since 1997 there has been a 30 per cent increase in NHS consultants with honorary contracts undertaking teaching and research.
We will be expanding academic medicine capacity through our "Modernising Medical Careers" initiative led by Dr Mark Walport, and our investment of an extra £100 million a year by 2008 in health R&D will expand opportunities in academic medicine. We have expanded consistently the number of medical students and the autumn 2004 intake of medical students in England was the highest at more than 6,000—nearly 70 per cent up over 1997.

§ Earl Howe
My Lords, I thank the Minister for that reply. Does he agree that the situation in clinical academic medicine is potentially very serious indeed? The most recent survey shows that there has been a 23 per cent reduction in junior academic staff in the past three years and an increase in vacant professorial posts at a time when, as he said, medical student numbers are projected to rise by 40 per cent? Will the Minister undertake to keep under continual review the incentives that exist for attracting young doctors as potential academics and make sure that the new contracts and the new career structures are properly implemented and evaluated?

§ Lord Warner
My Lords, the noble Earl is right in some ways but I do not accept that good progress is not being made. The figures I gave on medical student intake do not suggest that medical schools are in crisis. We need to work with the initiative being led by Dr Mark Walport of the Wellcome Trust on improving the pathways for younger doctors to work their way through academic medicine while keeping in touch with their clinical work. The new consultants' contract will help in that direction.

§ Baroness Neuberger
My Lords, given that there have been excellent but disturbing reports from both the Council of Heads of Medical Schools on clinical academic medicine and the Royal College of Physicians on behalf of the Academy of Medical Sciences, and accepting everything that the Minister has said about the increasing numbers of medical students, is it not time that the Government looked at the effect that the research assessment exercise may be having on those in junior careers in clinical academic medicine? Could not the Government also look at whether there could be some recognition of both teaching and research in the performance measures for foundation and NHS trusts?

§ Lord Warner
My Lords, I repeat what I said to the noble Earl, Lord Howe: we are working with Dr Mark Walport who is working with many of the people mentioned by the noble Baroness on improving the career pathways for young academic doctors. That is the way forward in this area. I am certainly happy to consider what the noble Baroness said in relation to foundation and other trusts, but I must draw her attention to the fact that the Healthcare Commission is looking at the criteria for assessing performance in the NHS through its consultation on assessment for improvement. I shall draw the points made by the noble Baroness to its attention.

§ Baroness Masham of Ilton
My Lords, does the Minister agree that some young academic doctors do not have enough time to carry out their clinical research? This was the case with a cousin of mine who is now working as a microbiologist in Perth, Australia.

§ Lord Warner
My Lords, clearly many of these young people are very creative and talented. They will, to some extent, move around the world and the country into different jobs during their careers. I repeat what I said: we acknowledge that there is a need to improve the career pathways for young academic doctors. That is why we commissioned Dr Mark Walport to lead this work, with many of his colleagues and interests in the medical academic fraternity, so that we can have a better career pathway in future.

§ Lord Skelmersdale
My Lords, it was reported in the past few days that a doctor was planning to set up a medical school outside the NHS. What is the Minister's reaction to that?

§ Lord Warner
My Lords, he will have to convince the General Medical Council that the arrangements are satisfactory for the training and qualification of doctors.

§ Lord Chan
My Lords, while accepting that the Minister has encouraged NHS consultants to teach and has given them contracts, is he aware that some of them take teaching as the last resort in their responsibilities? Therefore, should not this be monitored to see how effective these contracts are?

§ Lord Warner
My Lords, it is not for government to monitor that particular work. Universities and medical schools take responsibility for the quality of the people they use in teaching. To repeat the point that I made in my reply to the noble Earl, Lord Howe, there has been a 30 per cent increase in NHS consultants with honorary contracts undertaking teaching and research. We value the contribution that they are making to the training of the doctors of the future.

The Lord Bishop of St Albans
My Lords, the Minister will be aware that, on a daily basis, medical staff in our hospitals face the most complex ethical issues. Is he able to assure the House that, in any review of academic training of medical staff, adequate training is given to those staff in their consideration of major ethical issues?

§ Lord Warner
My Lords, I certainly have not heard of any concerns that that training is inadequate. I know that doctors, both in training and when they are in practice, take these ethical issues extremely seriously.