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We heard that position clearly enunciated by the right hon. Member for Richmond, Yorks and repeated by the hon. Member for Altrincham and Sale, West (Mr. Brady). The Conservatives want a wholesale change in the treaty. That is a perfectly proper political ambition—or at least, it would be if even one other party in the European Union agreed with them. However, they are totally isolated and playing a game of fantasy Europe. They invent policies because they cannot deal with the reality of what is happening in the European Union today. They are trying to pretend that somehow, there is a way through without facing reality. Unless and until they face up to the genuine issues and problems, no one can take their views seriously.
The right hon. Member for Richmond, Yorks gave an entertaining, characteristically witty speech. However, at the end of it no one was any the wiser about what the Conservative party pretends to believe. We must all deal with Europe as it is, not how we might like it to be.
Mr. Vara: The Minister questions Conservative policies. Will he enlighten the House on his party’s policy on the constitution? Why have there been so many U-turns, with the Prime Minister wanting a referendum and then not wanting one?
Mr. Hoon: As I have already said, the difference between the Labour party and the Conservative party is that we are dealing, day in, day out, with the realities of what is happening in the European Union. The hon. Gentleman was not here at the time of the Maastricht treaty debates, which occupied the House for months on end. At that stage, the Conservative Government were grappling with the detail and having to confront the realities of constitutional change in the European Union. It was a painful process for the Conservative party, because the hon. Member for Stone and his sidekicks caused enormous trouble for the then Government. Nevertheless, that treaty was ratified in the end. It was agreed by the House on behalf of this country. That is the difference between the Conservative party then, when it was seriously engaged in European issues, and its current pathetic attempt to pretend that it is discussing those matters.
Mr. Brady: Is the right hon. Gentleman really saying that there is an unstoppable momentum towards further integration with the EU? That would be a huge cause for concern. We, and the hon. Member for Birmingham, Edgbaston (Ms Stuart), say that it should be possible to bring powers back, but is the right hon. Gentleman saying that there is no point in the British people or the British Parliament saying that, because we simply have to roll over and do what we are told by Brussels?
Mr. Hoon:
Is that really the hon. Gentleman’s position? Does he really think that that is what happens, and that Brussels makes sure that everything it wants to achieve happens, while the British Government simply go along with it? He knows that that is not the case. The illustrations that he gave earlier included the working time directive. One of the reasons why the working time directive has not been implemented is that the Government have preserved
our opt-out, to ensure that we do not jeopardise this country’s huge economic success by implementing legislation that we do not judge to be appropriate at this stage. That is the way in which we deal with real issues, unlike those on the Conservative Front Bench.
Mr. Stewart Jackson (Peterborough) (Con): I am touched by the right hon. Gentleman’s obsession with the internal politics of the Conservative party rather than with the politics of the Labour party and the Government. If he and his colleagues have made such a positive case for the European Union over the past nine years, why is it so incredibly unpopular in polls up and down this country, and across the whole of Europe?
Mr. Hoon: The European Union is not incredibly unpopular. I suggest that the hon. Gentleman go and look at the various soundings that are taken on this issue. Neither is it popular, however, as I made clear in my speech this morning to the Centre for European Reform. My hon. Friend the Member for Rhondda mentioned mobile phone costs earlier, and we need to set out the way in which Europe makes a huge difference to people’s lives. Another practical illustration of that is the number of cheap flights that all our constituents take advantage of these days. Anyone who comes to my local airport, East Midlands airport, will see planes full of our constituents travelling regularly on cheap flights across Europe— [ Interruption.] I am being heckled about this. I have to say that I too am on those flights, so I speak from experience. Those changes were achieved in this country only as a result of legislation in the European Union.
David Taylor: I am grateful to my regional neighbour for giving way. Does he acknowledge that the growth in cheap flights has almost nothing to do with our membership of the European Union, and everything to do with aviation being a tax-free zone in Europe, as in other parts of the world?
Mr. Hoon: I am sorry that my hon. Friend made that point, because he is completely wrong. If he looks at the history of the development of European transport he will see that the only reason why those cheap flights are possible is that, through the European Union, we brought an end to the restrictive practices under which a limited number of national carriers were protected by their Governments and prevented from flying from airports such as East Midlands and many other regional airports around the country to regional airports in other parts of the European Union.
That is an example of European Union legislation directly benefiting our constituents and our citizens. It illustrates the challenge that we face, which, as I made clear in my speech this morning, is to ensure that we can
demonstrate the benefits that flow from an increasingly integrated single market. Who was the Prime Minister who regularly extended qualified majority voting in order to ensure that we had a successful functioning single market? It was Baroness Thatcher. When I was a member of the Legal Committee of the European Parliament dealing with single market issues, she was responsible on 12 occasions for changing the basis of qualified majority voting to ensure that the development of the single market benefited the people of the United Kingdom and of the European Union. We must ensure that that process continues.
We must go on completing the single market, because it provides benefit for British business and enormous opportunities, in an enlarged European Union, to sell to a single market of 460 million consumers. That has been an enormous advantage for the United Kingdom, and when the Conservatives were thinking seriously about European issues, they recognised that. We now have no idea where they stand on those issues. They are supposed to be sympathetic to the interests of British business, but their policies would challenge the basis on which many businesses in the United Kingdom operate, which is selling into a large single market.
If the Conservative party had its way, according to what limited knowledge we have of its position, the businesses that provide employment opportunities for people in the United Kingdom would necessarily fail. Without that single market, they would not be in a position to sell their products or employ their people. That is the challenge for the Conservative party. I accept that it is also a challenge for Government, and this Government have accepted that challenge.
It being Seven o’clock, the motion for the Adjournment of the House lapsed, without Question put.
Petition
Telecommunications Masts
7 pm
Mr. Mark Lancaster (North-East Milton Keynes) (Con): It is my pleasure to present the petition of Mrs. Anne-Marie Jones of the Bluebridge residents association, signed by 317 others.
The Petition of the residents of Milton Keynes,
Declares that the proposed erection of a 24m Lattice Tower telecommunications mast at Fingle Drive, Stonebridge, Milton Keynes will have an adverse visual impact on the local community.
The Petitioners therefore request that the House of Commons urge the Government to work with Milton Keynes Council to prevent the erection of this mast.
And the Petitioners remain, etc.
Commonwealth Doctors and Dentists
Motion made, and Question proposed, That this House do now adjourn. —[Mr. Alan Campbell.]
7 pm
Mr. Austin Mitchell (Great Grimsby) (Lab): I regret that a Home Office Minister has drawn the short straw in having to reply to this debate. I shall not cast any aspersions on the Home Office; I shall leave that entirely to the Home Secretary. I want to raise the effects of ending work permit-free entry for international medical graduates who complete their training by working in the national health service, which will affect several thousand doctors—I have heard estimates of between 10,000 and 17,000.
The regulations were suddenly brought in on 10 March, without consultation and without discussion in the Commons. They came into effect on 3 April, and the immediate reaction was fear among international medical graduates working in the health service about their futures. Would they be allowed to stay? Would they have to have a work permit? What would happen to them? The matter was brought to my attention by Pakistani doctors in Grimsby, where more than 100 international medical graduates work in our local hospital trust. The more I found out about what is being done, the more disgraceful the situation looked. There was a working-training relationship whereby graduates from Pakistan, India—which over-produces doctors by a considerable amount—Bangladesh, Malaysia, Sri Lanka and other Commonwealth countries came here to complete their training by working in the health service and did not need work permits to do so. That relationship benefits us, the health service that employs them and the home country, because those doctors return better skilled and better trained.
The NHS has always incorporated international medical graduates, whose initial qualifications were obtained outside the UK, under the permit-free training system. We therefore had a commitment to help train international medical graduates from the Commonwealth, who work as house officers, senior house officers and in other capacities in the health service. Some of them stay on to higher grade posts, some obtain qualifications from the royal colleges and improve their skills when they get back home, and some stay and work as GPs, often in the most difficult and deprived areas of the country, where we need them. Some, of course, go home. The system has served us well. It has served the origin countries well, too, as the training that they get is of a high standard.
Suddenly, under the new regulations, preference must be given to graduates of British universities. Nobody quibbles with that; everybody accepts it. We must have a preference for doctors produced in our own country. The second preference, however, is for doctors from the European economic area. That means that Commonwealth doctors who previously came in without work permits will now be disadvantaged. There are doubts about the linguistic abilities and relevance of the training received by doctors in the European economic area compared with the skills and linguistic abilities of international medical graduates who must take the Professional and Linguistic Assessment Board test to work in this country. The PLAB will not be required for European economic area doctors.
First consideration being given to British and EEA doctors means that many international medical graduates will not even get an interview. Applications will therefore become very uncertain, because hospitals and other institutions will have to prove that no British or European doctors are available.
My first question is why was this measure rushed in, given that it is so far-reaching, and will impact on many doctors and other people working in the health service, and on many relationships with Commonwealth countries? I can see no reason, apart from to allow the Prime Minister to announce a new immigration system for this country, into which doctors suddenly had to be crammed at the last minute. The intention behind the old work permit-free system was to give a preference to Commonwealth doctors, but the organisations concerned were not consulted about the new measure, which was simply rushed in during March.
My second question is, why was there no consultation? I made a mistake in the early-day motion that I tabled on this issue. I said that the British Medical Association was hardly consulted, but it corrected that; it was not consulted at all. It informed me that there was a meeting in January at which the intention of introducing a new scheme was vaguely announced, but no time or other specifics were given; the scheme was announced, rather than discussed. Suddenly, a couple of months later—in March—the scheme was rushed in. So there has been no consultation with the BMA.
Lord Warner, at the Department of Health, continues to tell correspondents that there have been consultations, but there have not. Indeed, I have in front of me a long list of organisations complaining about that issue. For example, I have communicated with the Indian, Pakistani, Bangladeshi and Malaysian high commissions, none of which were consulted. All those countries and their doctors are affected by this scheme. The Overseas Doctors Association, moreover, was not consulted.
I want to read some extracts from statements that were issued to the Home Office, the Department of Health or publicly. The Royal College of Psychiatrists found that
“many trusts have put Senior House Officers on short-term contracts. Many of these contracts will expire this summer.”
In response to this new initiative, work permits will be required. The RCP says that its people, who have come through their training and
“provided a service to the National Health Service...are now at risk of having to go back home.”
It adds that psychiatry, which has always had a high proportion of applicants who are international medical graduates, and which has become dependent on them,
“is likely to encounter the loss of a substantial number of trainees under the New Rules, probably...more than other specialities.”
The Association of Anaesthetists of Great Britain and Ireland says that the regulations have been introduced in a manner that shows little
“proper consideration for those who are already working in the NHS”,
and will make it difficult for foreign graduates to come here and get postgraduate experience.
The Royal College of Paediatrics and Child Health says:
“In many areas of the UK paediatric services have depended on these doctors and we have a duty to be fair to them.”
I’ll say we have a duty to be fair to them! It continues:
“Many face uncertain futures at short notice. Some long-standing training schemes are also threatened.”
Not only does the health service depend greatly on the work of these international medical graduates; training schemes that have been developed will have to be wound up, and at short notice.
The trainees committee spokesman of the Royal College of Physicians says:
“I am particularly concerned about care of patients, especially in departments where colleagues from outside the European Community have provided the bulk of care for a long time.”
“the implementation of these rules started less than a month later on 3( )April 2006. It is our view that the almost immediate implementation of these rules is unfair and potentially deleterious to patient care.”
We have rushed into new regulations that will have a disastrous effect on the health service.
The Forum of International Medical Associations Chairpersons wrote to the Prime Minister saying:
“Not only will it make it impossible for any new doctor from overseas to obtain training in the UK, but doctors already under training will find their career path suddenly blocked.”
The Royal College of Obstetricians and Gynaecologists states that it has
“serious anxieties about this new ruling and the impact it will have on both the short and long term future of the specialty of obstetrics and gynaecology.”
There is a shortage of British recruits in that area, so we are even more reliant on doctors recruited from overseas in the traditional fashion. The president of the college has written:
“We are particularly concerned about the effects on our own specialty where there are at present insufficient UK graduates entering training to develop the workforce to sustain services. The consequences for Women’s Health and for Obstetrics and Gynaecology in the short and medium term look bleak to say the least.”
I have also seen correspondence from various departments of obstetrics and gynaecology. For example, the department in Sheffield thinks that it will be very difficult for it to recruit gynaecologists and obstetricians because it depends on overseas graduates. The East Lancashire Hospitals NHS Trust states:
“Currently, 72 per cent. of our trainee doctors are from outside the EU”.
How will they be replaced? The trust also says:
“The process to obtain work permits is both costly and time consuming (minimum of 3 months in our experience)”.
The hospital will have to put in the administrative work and pay the costs of £145 per work permit—another charge on the health service.
The Royal College of Surgeons, like many of the other royal colleges, has developed sponsorship schemes in co-operation with other nations, in which
“overseas Surgeons come to the UK for short periods to complement their local training. These doctors then return to their home country”.
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