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Doctor Recruitment

7. Mr. Jim Cunningham (Coventry, South): What recent progress has been made in the recruitment of doctors in the NHS. [19661]

The Minister of State, Department of Health (Mr. John Hutton): The Government are committed to delivering an additional 10,000 doctors by September 2005, over a September 2000 baseline. Good progress is being made towards meeting that target. Almost 7,000 more doctors are working in the NHS now than in 1997.

Mr. Cunningham: I thank my right hon. Friend for that answer. However, has he read recent reports in the Coventry Evening Telegraph that the Walsgrave university hospital trust has had difficulties in recruiting doctors and trainee doctors? Will he look into the matter and report back to the House on the outcome?

Mr. Hutton: I shall certainly look into the matter on behalf of my hon. Friend. I am sure that he will welcome the fact that the Coventry and Walsgrave trust was very recently able to announce the go-ahead for the new medical school to be built on the site of the Coventry and Walsgrave hospital. I hope that, like me, he will regard that as a very positive investment in the future, to ensure that the NHS has the doctors and surgeons that it needs for the new century.

Dr. Evan Harris (Oxford, West and Abingdon): As the previous question indicated, it is no good just recruiting doctors if we cannot retain them. In addition to the demoralisation that is caused by the naming and shaming of doctors as a result of star ratings that are based on no meaningful outcomes, will the Minister look into the issue of female junior doctors who, because of the new pay deal, when seeking to train flexibly, are paid less than those who are in full-time work? Will he also look into the issue of black and Asian doctors who are still not allowed to become consultants although they have the skills to do so? The majority of them are to be found languishing in non-regular trust-grade posts, the terms and conditions of which are often poorer than those for the mainly white junior doctors whose posts they are mirroring.

Mr. Hutton: I agree strongly with the hon. Gentleman that we need to improve the recruitment and retention of doctors, which is what we are doing. We recently announced measures that will add appreciably to our endeavours, such as the new flexible career scheme for hospital doctors, and we have a similar package in place for general practice. Golden hellos are being introduced for people entering general practice. We are making good progress in all those areas.

The hon. Gentleman raised a number of very fair points. He will be aware of some of the measures that we have proposed that will help move those issues forward. I simply ask him to reflect on this fact. We are committed to the growth of the national health service and to recruiting more doctors, and we have the resources in

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place to do so properly and effectively. The choice, as always in these matters, is between a Labour Government committed to the growth of the NHS and a Tory Government that would cut the national health service.

Mr. David Hinchliffe (Wakefield): What progress are the Government making in persuading NHS consultants who work part time in the private sector to work full time in the NHS instead? We were given figures last week indicating that under the concordat with the private sector, some 70,000 patients have been treated in the private sector by these doctors. How many more patients would have been treated instead in the NHS if those doctors had been working full time in the health service?

Mr. Hutton: It makes no sense to have spare capacity in the private sector which can be used by NHS patients if it is being denied to them. If, as a result, NHS patients have to wait longer for their care and treatment under the NHS, that needs a solution, and the Government have provided a way forward. My right hon. Friend the Secretary of State for Health made an announcement last week about expanded choice and a greater use of the private sector, and we will be treating NHS patients in that context. The money will ensure that that happens. That is a sensible result, and a good result for the NHS.

Mr. Nicholas Winterton (Macclesfield): I am sure that the Minister accepts that all hon. Members want to see more doctors in the national health service, whether in hospital or in general practice. Does he agree that if he can achieve the Government's target, it will mean that doctors will be able to spend more time with their patients, that those in general practice will be able to make more home visits—which I believe to be essential—and that, as a result of more time being spent by doctors with their patients in hospital and in general practice, there could be better outcomes which could produce a better health service and better health?

Mr. Hutton: I am able to agree with everything that the hon. Gentleman says. I do not want to embarrass him, but that is usually the case in Health questions. He is absolutely right. We will secure those results by recruiting more doctors in general practice, and more nurses and therapists as well. In that way, primary care—which is, after all, where 90 per cent. of all patient journeys begin and end—can provide a more flexible service and the health care professionals who work in primary care can spend more time with their patients. That is what the doctors and nurses want, and it is what the Government want.

Mr. Jon Owen Jones (Cardiff, Central): Does the Minister recognise that a significant number of refugees in the United Kingdom are fully qualified and experienced doctors, but are unable to practice because they lack sufficient skills in English? Will he undertake to look at the possibility of setting up a cost-effective scheme to help these doctors improve their language skills so that they can contribute to the work of the national health service?

Mr. Hutton: I agree strongly with my hon. Friend. That is precisely what we are doing: we have asked the Royal College of General Practitioners to lead a specific project dealing with the recruitment into the NHS of more

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refugee and asylum-seeking doctors. That makes sense for the NHS and will help towards meeting the wider targets that we set for improving the service.

Mr. Oliver Heald (North-East Hertfordshire): Today's Royal College of Surgeons report highlights the current alarming shortage of hundreds of key surgeons and the future shortage of thousands. A few days ago, Sir Peter Morris, president of the college, described surgeons as depressed and frustrated. The British Medical Association is today calling for swift action to unblock the training bottlenecks, and highlights the need to recruit overseas consultants. Does the Minister think that he has any chance of meeting his target for 2004, contrary to what the report says? If so, where will these surgeons come from?

Mr. Hutton: I am confident that we shall meet those targets. The hon. Gentleman referred to Sir Peter Morris's comments, and I am sure that he will be aware of what Sir Peter Morris had to say about the Conservatives; he is certainly talking about shortages. We are trying to address the shortages. As the hon. Gentleman knows, the NHS has been historically under-doctored for decades, and I am afraid that his party failed to address that. Sir Peter said:

That is absolutely right, because we should not lose sight of—

Mr. Speaker: Order. The Minister should not concern himself with the Conservatives. That is something for the Opposition to worry about.

Health Inequalities

8. Mr. Michael Clapham (Barnsley, West and Penistone): What progress has been made on tackling health inequalities. [19662]

The Secretary of State for Health (Mr. Alan Milburn): Good progress has been made, not least by targeting resources on the areas of greatest health need.

Mr. Clapham: I thank the Secretary of State for his reply, but may I draw his attention to the Government's chief medical officer's report this year, which states that, although progress has been made in health overall, there are growing gaps in health between socially disadvantaged groups and more affluent groups. When does he expect the primary care trusts to have completed their equity reports in relation to targeting inequalities? As he well knows, we in Barnsley have just one PCT, which has now been put together and is continuing its work. When the equity audit is complete, will we have more resources to deal with some of our inequalities?

Mr. Milburn: My hon. Friend raises an extremely important issue. For many decades, health inequalities in this country have been widening, rather than narrowing. Indeed, the chief medical officer's report, which was published yesterday, makes that glaringly obvious. There is a big commitment to deal with those problems. Obviously, they are not straightforward because we are

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dealing with some of the wider economic and social determinants of ill health, as well as ill health itself, but it is important to get the resources into the right place, as I said in an earlier answer. My hon. Friend will be aware from the announcement that I made last Thursday that, in the next financial year, we will invest about £150 million-worth of extra resources, specifically to recognise the greater demands that are made on health services in poorer parts of the country, such as his constituency, where we will invest, I think, an extra £2 million.

The primary care trusts will have an important role to play in that regard, and the fact that the resources and responsibilities are being devolved down to very local communities, with the PCTs in charge, will help to foster better partnerships between local government, the voluntary sector, the private sector and the NHS, not just to provide better health and social care services, but to deal with some of the root causes of ill health, of which my hon. Friend and other hon. Members are painfully aware.

Mr. John Redwood (Wokingham): Does the Secretary of State agree that one of the big inequalities is the fact that people in constituencies such as mine have to wait far too long for the routine operations that they need to get out of pain, unlike in some other parts of the country? What would he say to my constituent Mr. Levy, who read in the paper that the Government had lost a court case and that he could now go abroad and get his operation charged to the health service? He then read a couple of statements, purporting to come from the Secretary of State, saying that he is launching a policy to allow people to go abroad to get their operations done more quickly to get out of pain, only for me to receive from two junior Ministers in the Department of Health a strong no to my constituent, saying that there was no way that he was allowed to have his operation done elsewhere to get out of pain and that this was all a tissue of lies. What has the Secretary of State got to say about that?

Mr. Milburn: A tissue of lies it is not, but the right hon. Gentleman, or indeed any other right hon. or hon. Member, would not forgive us if we got the policy wrong with regard to offering patients the choice of being treated abroad. That has not been the case under Conservative or Labour Governments, but it is what we are advancing towards, and we will ensure that we get it right. There are obvious concerns about travel arrangements, clinical standards and ensuring that patients are fit to travel, but that is precisely what we are trying to do in three parts of the country, including the south-east—precisely the area about which the right hon. Gentleman expresses concern—and I hope that we can make progress before too long.

As the right hon. Gentleman rightly says, it is also important that, as we expand the NHS, we also extend choice to more patients. He will be aware that I was able to say last week that that is precisely what we want to do, starting with those patients who have the most severe clinical conditions. I cannot think of anyone who faces a greater dilemma than the heart patient who has the choice between paying for treatment or waiting for treatment. We want to solve that dilemma not by forcing people out of the NHS, as the Conservative party increasingly seeks to do, but by offering them choice in the NHS.

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