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The Minister of State, Department of Health (Mr. John Denham): In July 1998, the Government announced that intake of medical students in the UK would be increased by about 1,000 places per annum, or 20 per cent. The responsibility for the allocation of places to individual medical schools in England lies with the Higher Education Funding Council for England--HEFCE. Last summer, the HEFCE announced the
Mrs. Gilroy: I thank my hon. Friend for that reply. He will be aware that the team submitting the peninsula medical school bid is working hard to ensure that its bid is of the highest quality so that it can be among the successful next round of bids. Is he also aware that in the south-west peninsula young people are only half as likely as their counterparts elsewhere to enter medical training? Is he further aware that people in the south-west peninsula are 15 per cent. less likely to have access to some of the more complex tertiary medical treatments? Does he agree that Plymouth Derriford's becoming a teaching hospital will help us to address some regional equity issues?
Mr. Denham: I acknowledge the strong representations that my hon. Friend has made on behalf of the peninsula medical school and I had the opportunity to meet her recently to discuss the proposals. Of course I acknowledge the case that has been made to improve health provision and access to care in the south-west, but it is important to say for the record that the responsibility for the decision on the allocation of places lies with the Higher Education Funding Council for England.
Mr. Stephen Dorrell (Charnwood): I welcome the fact that the Government are continuing the policy of their predecessor of increasing the investment in medical training. However, does the Minister recognise that it does not make much sense to increase the number of recruits coming into the medical profession if that number is offset by increasing numbers of people leaving the profession because they are dissatisfied by the terms and the way in which their skills are used in the NHS?
What steps will the Government take to address the problems of medical morale, which have been identified by the British Medical Association, to reduce the number of people leaving the profession, bearing in mind that that is the cheapest way of increasing the total resource available from the medical profession?
Mr. Denham: The rate of retention of trained doctors in the health system in this country is extremely good, and we are pleased about that. The right hon. Gentleman has a bit of a nerve to raise that question but I shall answer it head on. What will maintain the high motivation that we have seen since this Government were elected, and will ensure high morale among medical staff, is continued investment in the NHS at the record rates that the Government have achieved. The best news for everyone working in the NHS is the average of 6.8 per cent. cash increase in funding that we have announced today, because that means that the professional staff working in our health service know that we are keeping our promise year on year to make the resources available to them to deliver the high-quality health services that they want to deliver.
Ms Joan Walley (Stoke-on-Trent, North): May I say how pleased I am that the long-awaited undergraduate medical school has been established at Keele university in north Staffordshire? However, will my hon. Friend look carefully at the projected numbers of GPs who are set to
Mr. Denham: I, too, am pleased that the HEFCE took the decision to make the allocation of medical student places to Keele university. One of the factors taken into account in the decisions over Keele and Birmingham concerned the proposed links with the development of general practice.
The good news is that over the past two years there has been a sharp increase in the number of medical students wanting to train to go into general practice. That will help us to address some of the localised shortages in general practice in some parts of the country. It will also ensure that we will be in a good position to meet the undoubted bulge in the number of GPs approaching retirement age over the next 10 to 15 years. It is therefore very important that medical school training, while remaining properly balanced, should include encouragement for medical students to consider entering general practice. I think that we are witnessing that happening.
Dr. Evan Harris (Oxford, West and Abingdon): Will today's medical students be expected to work excessive hours when they become doctors in training? The Minister will be aware that recent figures from the British Medical Association show that the number of doctors in training working in excess of the new deal has risen sharply. I hope that he will accept from me that that is due to the proper validation of previous figures--doctors are not working longer hours but the old figures were flawed. Has the Minister noticed that figures for the Oxford region, which were done properly, show very little rise? Will he examine that region to work out what has been done well there? I can tell him that if he does, he will find that the reasons for the good figures are planned consultant expansion, proper funding and the effective use of sanctions against trusts and consultants reluctant to change working practices.
Mr. Denham: The hon. Gentleman is absolutely right. The system has to be made tougher in certain parts of the country if we are to reduce the excessive hours worked by some junior doctors. That is why we have made it clear in the past seven days that we will invest an extra £5 million both this year and next to tackle the problem. That money will be made available through the regional task forces.
In addition, we are establishing a much tougher regime to monitor the performance of trusts on their delivery of cuts in the long hours worked by junior doctors. I have also made it clear that we are serious about our readiness to publish details of those trusts that fail to make proper progress on cutting junior doctors' excessive hours.
The Minister of State, Department of Health (Mr. John Denham): Walk-in centres are a key part of our plans to modernise and to improve the access to, and the convenience of, NHS services. The first 36 walk-in
Mr. Cunningham: I welcome the announcement about the walk-in centre for Coventry. I also welcome the additional, above-average cash allocation for Coventry, which contrasts with the record of the previous Conservative Government's treatment of Coventry's health service. Is not this a major step in the right direction--the modernisation of Coventry's health services?
Mr. Denham: My hon. Friend is absolutely right. The walk-in centre at the Coventry hospital site in the centre of the city is just one example of the Government's commitment to modernising the national health service in my hon. Friend's area.
In addition, a 7.2 per cent. cash increase in resources for the health authority has been announced for the coming year. The Government have also confirmed that we are determined to go ahead with a brand new hospital and medical school for Coventry.
Mr. Peter Bottomley (Worthing, West): Will the Minister accept a welcome for the development of walk-in centres? With regard to the normal walk-in centres--GPs' surgeries--will he consider whether special attention should be given to the needs of practices with significant numbers of people over the age of 85 rather than 75? In some areas where the numbers in that age group are at levels which the rest of the country will match in 20 years there are significant delays.
If we are supposed to acknowledge the cash increase at the beginning or end of our questions, I should like to do so for West Sussex. I note, however, that the increase is below the national average. Had there not been an increase, it would have been one of the very few years since the health service was created that one had not been made.
Mr. Denham: The cash increase is running at nearly twice the rate that it did in the last two years of the previous Government's term in office. The scale of the increase is as important as its provision.
The hon. Gentleman raises an important point about care of the elderly. General practice has an important role to play in providing proper health care for the elderly. Many of the primary care groups and some of the first primary care trusts have identified care of the elderly and the linking of the role of GPs, social services and secondary care as their top priority for the improvement of local services. Over and above that, a number of options are available to local GPs, funded within the health system, to improve health care for the elderly. For example, a number of GPs have made use of personal medical services pilot schemes, and some standard local development schemes are in place. So, there are a number of tools for improving care of the elderly at local level. The issue can be addressed by the local primary care group together with the local health authority.