§ Mr. Pavittasked the Secretary of State for Social Services whether he will now make a statement about doctors from overseas and their service in the National Health Service.
§ Mr. CrossmanAs the Secretary of State for Scotland, the Secretary of State for Wales and I have said on a number of occasions, we recognise and are grateful for the valuable help we received from overseas doctors but we share the view of the Royal Commission on Medical Education that we should reduce our excessive reliance on this source.
The present output of our medical schools is about 2,000 a year, and this provides between 500 and 600 additional doctors each year towards meeting those needed for growth and development of the service. For the next two or three years we shall need further help from overseas doctors in numbers which we assess at about 700 a year, but the numbers required will diminish as increasing numbers of trained doctors emerge from British Medical Schools where places will rise—in accordance with the recommendation of the Royal Commission—by 1,000 to 3,700 by 1975. In the immediate future I estimate that our need can be met by limiting the number of doctors entering with employment vouchers to no more than last year's level 438W of about 1,000, and I have so informed my right hon. Friend the Secretary of State for Employment and Productivity.
In consequence, my right hon. Friend has made arrangements to limit the entry of doctors under Category "B" of the voucher scheme to about 1,000 in the current year. Vouchers can be used at any time within six months of their issue, and a considerable proportion are ultimately not taken up. It is therefore not possible to forecast the actual number of vouchers which will be issued. On the basis of past experience it is likely to be about 2,000.
Overseas doctors are mainly needed in the hospital service. This is where the main problem lies, rather than in general practice or other employment. I am convinced that it is essential for us greatly to improve and extend our methods of assessing both the level of clinical responsibility for which they are suited by training and experience and their ability to communicate in English—a factor to which I attach great importance. This kind of assessment can best be made by attaching doctors to a hospital under consultant supervision; the present scheme, on a voluntary basis, has been useful but it needs strengthening and expanding. I have therefore decided, after consultation with Commonwealth Governments, the profession and other interests concerned, to make assessment under the scheme compulsory before a doctor can enter hospital employment, subject to exemptions for certain groups of doctors for whom this requirement would be inappropriate. I expect it to be possible to bring these new arrangements into force on or about 31st October next.