§ 2.52 p.m.
§ Earl Howeasked Her Majesty's Government:
§ Bearing in mind the future needs of the National Health Service, what actions they are taking to attract new graduates into the medical profession.
§ Lord WarnerMy Lords. I think we are introducing a new institution of health Questions in this House.
Medicine continues to be a very popular choice, and English medical school intakes this autumn are planned to be more than 6,050—the highest figure ever. That will be more than 60 per cent higher than the 1997–98 intake. Since the extra places announced by this Government in 1999 came on stream, almost 8,200 more students have entered medical schools in England. These are the NHS doctors of the future.
In addition, some universities have introduced four-year fast-track graduate-entry medical degree courses. In October 2004, 691 students entered these courses in England against a planned figure of 590. NHS bursaries in the form of NHS-funded support in years two to four are also available to English-domiciled students undertaking the new four-year graduate-entry medical courses.
§ Earl HoweMy Lords, I thank the Minister for that helpful and positive reply. However, is he aware of the grave concern expressed this week by the BMA that, as a result of the financial cuts in prospect under the research assessment exercise, it will be impossible to increase the numbers of medical graduates that we need and that some long-serving academic doctors are now staring redundancy in the face? What comment does the Minister have on that?
§ Lord WarnerMy Lords, on the subject of medical academics, through the UK Clinical Research 1205 Collaboration I commissioned Mark Walport of the Wellcome Trust to undertake a review into this issue. His report has been received; we are considering it and hope to make an announcement shortly. It will improve the career pathways for doctors who are pursuing a route of academic medicine. I do not think that we accept the BMA's figures on all aspects.
§ Lord Walton of DetchantMy Lords, does the noble Lord accept that the decision by various UK medical schools to introduce the fast-track route towards a qualification in medicine for science graduates is most welcome? For some years, I was a trustee of the Foulkes Foundation, which gave grants to people with PhDs in science to enable them to study medicine in the hope—largely fulfilled—that they would subsequently become doctors working in academic medicine. Will the Government do all they can to increase the number of science graduates entering medical schools and the number of schools that offer these fast-track routes to qualification?
§ Lord WarnerMy Lords, we now have 14 medical schools offering four-year fast-track graduate entry. I pay tribute to the contribution that the noble Lord has made in this area. It has been a success, and the fact that, as I said in my Answer, the numbers are continuing to go up and that there were 100 more subscriptions than had been planned for in last October's intake gives testimony to the fact that this has been a great success.
§ The Earl of OnslowMy Lords, can the noble Lord help me as I am a genuine seeker after information? My daughter is a doctor and, when she did her houseman's training, there was no Working Time Directive. The directive has now cut the hours to a 44-hour week, if I am not mistaken. Before that, junior doctors were doing an awful lot more and gaining more training and more experience. How has the problem of what is, in effect, a reduction in productivity been overcome?
§ Lord WarnerMy Lords, it has been overcome with the usual adaptation and ingenuity of the NHS, to which I pay tribute.
§ Baroness McIntosh of HudnallMy Lords, I very much welcome the information that my noble friend has been able to give about the increase in the number of people entering the profession. However, can he say what the Government are doing to increase the interest that medical graduates are prepared to take in the rather less glamorous specialties? I have a particular interest in the current shortfall in specialists in psychiatric medicine. Can he say what efforts are being made to close the gap?
§ Lord WarnerMy Lords, specialty areas continue to seem to be less popular with people qualifying as doctors. We continue to work with all the interested parties to try to ensure that there is a good understanding of the opportunities in those areas. I do 1206 not have the precise figures in the specialty that my noble friend mentioned but I shall look into it and, if I can shed any more light, I shall write to her.
§ Lord Alton of LiverpoolMy Lords, can the Minister tell the House how many doctors and nurses now working in the United Kingdom are from Africa? Will he reflect on the criticisms made by the BMA yesterday that it is immoral to rely on thousands of people who are trained as doctors and nurses in Africa when we are not training enough graduates in this country to fill those needs?
§ Lord WarnerMy Lords, people have a right to come here to train. We have a long tradition of helping doctors from around the world both to become trained and qualified and to improve their postgraduate qualifications. The number of home graduates accepted to study medicine in the UK increased from 281 in the 1994 intake to 1,303 in 2003. Therefore, the increase in numbers in our medical training schools comes predominantly from people from within this country, and we have undertakings and understandings with different countries not to over-attract people to come to work in this country, thus denuding them of medical and nursing expertise.
§ Baroness BarkerMy Lords—
§ Lord McColl of DulwichMy Lords—
§ The Lord President of the Council (Baroness Amos)My Lords, the Liberal Democrats.
§ Baroness BarkerMy Lords, given that all 29 medical schools in this country have reported an over-subscription to their courses and that last year 120 people from the United Kingdom sought medical training in places as far afield as the Cayman Islands and Prague, can the Minister say what the Government are doing to ensure that there is a sufficient number of teachers of clinical medicine in this country?
§ Lord WarnerMy Lords, I tried to address that issue when I responded to the noble Earl, Lord Howe.
§ Lord McColl of DulwichMy Lords, what is the Government's attitude to the establishment of a private medical school, which will certainly increase the number of medical graduates?
§ Lord WarnerMy Lords, it is for the General Medical Council to decide and determine the suitability of particular places to carry out medical training. There are no plans, as I understand it, for a particular school to be endorsed, but no doubt if in the medium to long term there is an expansion of medical school places, consideration will be given by the GMC to any proposals coming out of the private sector.