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Peter Bottomley (Worthing, West) (Con):
How many of the 33,000 applicants have been judged “eligible”? Mr. Speaker, the House is grateful to you and to my
hon. Friend the Member for South Cambridgeshire (Mr. Lansley) for ensuring that the question was asked today, and to the Secretary of State for giving some answers, but the matter goes deeper than that; she and her colleagues are responsible for making the best of the situation that we are now in.
When the Prime Minister returns, will he and the Secretary of State get together with Dr. Richard Marks, the London anaesthetist who thinks that a changeover for everybody on 1 August is not sensible, and Dr. Gordon Caldwell of Worthing, who since the autumn has been offering suggestions on how to make things better? Will she discuss with that group—and perhaps even with the Liberal and Tory spokesmen, too—whether it is sensible for the run-through grades to start on 1 August, given the current unfairness and lack of equality of opportunity?
Will the Secretary of State also discuss the problem in the present system—I do not mean the computer system—which means that a PhD, the result of three years of relevant work, is judged to be no more important than a 150-word essay on leadership on the application forms?
Ms Hewitt: As I have previously told the House, there are 34,415 applicants UK-wide in the MTAS system, and 32,649 of them are eligible. Of that total, about 30,000 are already working in the NHS, whether in training posts or in non-training posts. That is why, as I stressed to the hon. Gentleman and the House on previous occasions, the NHS will continue to need those jobs and those doctors, even though not all, by definition, will be able to be in training posts.
On the issue of 1 August, I have already referred to Dame Carol Black, the work of the review group and the reasons why it has been generally agreed through the review group’s leadership that we need to fill as many posts as we properly can for 1 August. That is what will happen through round one, although not all the jobs will be filled.
The hon. Gentleman referred specifically to two doctors who had particular proposals to make in relation to 1 August. If he could pass those proposals or the doctors’ details to me, we could follow up directly with them and seek their advice on it. I will ensure that it is brought to the attention of my colleagues and the review group.
Jeremy Corbyn (Islington, North) (Lab): The Secretary of State will be aware of the tremendous stress caused by the process to young doctors, who have been through a long period of training at great public expense and want to contribute to the health care of the entire community. I have met groups in my constituency who are very stressed by it and worried about the future. Can she offer any assurance as to how many of those junior doctors, who have completed a long period of training and worked very hard, will be unemployed at the end of the process? To me, the idea of unemployed doctors, when there is such enormous health need, is unthinkable.
Ms Hewitt:
My hon. Friend is right to speak about the stress that has been caused to junior doctors and their families. I have talked to and corresponded with a large number of them, so I have seen that directly,
although it is worth bearing it in mind that the old system which Modernising Medical Careers is replacing was thoroughly unsatisfactory, hugely stressful to junior doctors, and on top of that required them to go through multiple applications in different formats, with no national principles guidance and no consistency or transparency at all. We need to bear in mind the enormous problems that led people to believe that we needed a completely different approach to medical training. Of course the stress exists. That is why we are doing everything possible to ensure that round one is successfully completed and that further training opportunities are then made available and people recruited to those jobs, but supported through the recruitment process.
My hon. Friend mentioned unemployment. I come back to the point that of the 32,000 or so eligible applicants across the UK, over 30,000 are already working in the NHS in training places or, in around 8,000 or so cases, non-training jobs. All those jobs will continue to be needed. What we have to do and are doing is ensuring that applicants and other doctors are matched to the available training posts and the other jobs in a way that is fair to all those applicants, but also right for patients.
Mike Penning (Hemel Hempstead) (Con): Many of us in the House as Members of Parliament and as members of the Health Committee, on which I have the honour of serving, have been contacted by doctors who are desperate for progression in their training programme. Although the Secretary of State says that the previous system was not perfect, it was not a disaster and a crisis like the one that she has brought on the NHS. I reiterate what 99.9 per cent. of those who contacted us said—actually, I have not found a single doctor who has not said—resign, resign now, take responsibility for the disaster and go.
Ms Hewitt: The substantive points have all been discussed at length in the House on this and other occasions.
Ms Hewitt: On responsibility, when something like this goes wrong and when there are real problems in the implementation of an agreed policy, I think there are two things that a Minister should do: apologise and take responsibility for sorting it out, and I am doing both.
David Taylor (North-West Leicestershire) (Lab/Co-op): It is to be hoped that the MTAS affair will cool the passionate relationship that has existed between the Department of Health and the private sector IT industry. Can the Secretary of State respond to a point that is being made by the Opposition? They say that a substantial number of doctors will disappear overseas. What proportion of the 33,000 eligible applicants are of overseas origin?
Ms Hewitt:
A significant number of the applicants are of overseas origin, many from the Indian sub-continent, including many in my own city, Leicester. Many of them have been working in the NHS for many, many years in non-training posts. What the new system has provided is an opportunity for those who
wish to do so to apply for training posts where they will be considered, like every other applicant, on their merit. We should recognise that because the NHS in the past never trained enough doctors to meet the need of the service and of patients, something for which Conservative Members might care to take responsibility, the NHS has always depended on large numbers of doctors, nurses and other professionals from overseas to help care for patients. We should pay tribute to their dedication, along with the dedication of all the other junior doctors and professionals in the NHS.
Sir Nicholas Winterton (Macclesfield) (Con): I am sure the Secretary of State is aware that there have been more statements and urgent questions on this subject than virtually anything else in recent times. That indicates the seriousness with which the House views the subject, as do many of our constituents, many of whom are junior doctors and are writing to us expressing their concern about their future and their families, and whether they can make a positive contribution to the national health service. I am not after resignations and I do not seek to make vast political points across the House. Can the Secretary of State tell us today that the difficulties that have been encountered by junior doctors in respect of their future career have now been overcome and that the problem is solved?
Ms Hewitt: We are solving the problems, but precisely because this is a matter of great concern to junior doctors and many other people, I have undertaken to keep the House up to date. That is the right thing to do and I do not think the hon. Gentleman is complaining about the number of statements that that requires. The matter has to be sorted out step by step, and the first priority was to sort out round one and ensure that every applicant gets at least one interview and is fairly considered for a post. That is drawing towards completion as the job offers start to be made, probably next week. Then we will move into further recruitment opportunities, as I explained, with proper support for junior doctors through that. Stage by stage the problems are being solved and the system will, I believe, allow junior doctors, who have made such an enormous contribution already and done so much work, to continue making that positive contribution to the NHS that they want and we want.
Rosie Cooper (West Lancashire) (Lab): As the ex-chair of a hospital under both a Tory and a Labour Administration, I can honestly say that the time of junior doctor rotation is always difficult and, yes, this year it is more difficult than ever. Will my right hon. Friend please comment on the BMA’s view that to abandon the process now would be disastrous for everybody concerned? Will she also say what role the BMA and the royal colleges will play in the resolution of the problem? The hon. Member for Macclesfield (Sir Nicholas Winterton) said that he wants resolution, not resignation. Most people out there want to know that junior doctors will be treated properly, that the professionals are involved and are backing the process, that we are dealing with it and that patients’ care is paramount. With that assurance, they want resolution, and that would be the end of it for most people.
Ms Hewitt: I entirely agree with my hon. Friend. She makes an important point. The BMA and its junior doctors committee have said that the BMA does not support the judicial review that has been brought by Remedy UK, and that writing off all the tens of thousands of interviews that have already taken place would be disastrous for doctors, for patients and for the NHS. The care and safety of patients, as well as the need to ensure that junior doctors are treated fairly, must be paramount in the process. My hon. Friend also referred to the professional leadership, particularly the leadership that is being shown by the medical royal colleges and by the BMA. They must and will be closely involved in the independent review that will be led by Sir John Tooke, which will enable us to learn lessons, to review Modernising Medical Careers, and to ensure that the principles of MMC, for which there remains widespread support, are properly implemented in future, so that junior doctors and patients are looked after.
Mr. John Redwood (Wokingham) (Con): Out of the 13,000-plus applicants who will not get training posts, how many will carry on in NHS doctor jobs, and therefore, by deduction, how many will either go abroad, be unemployed or have to seek other kinds of work? That is the figure that people are interested in if they do not want to see that talent wasted for the NHS.
Ms Hewitt: As I have said before, over 30,000—the overwhelming majority—of eligible applicants are already working within the NHS, some in training posts, some in non-training posts. All of those jobs will continue to be needed. Therefore, there is no reason at all why junior doctors need to abandon the NHS and their hopes and aspirations within it, because the jobs are there and the doctors are needed. Over the last 12 months the NHS has employed 3,500 more doctors than it was doing even 12 months ago, and there are about 35,000 more than we inherited from the right hon. Gentleman’s Government. So there are more doctors and there is better care for patients, and as we work through the process and the problems we will match the doctors and the trainees to the posts and the needs of the service and the patients.
Anne Milton (Guildford) (Con):
The Secretary of State has said that she is keen to take responsibility for sorting out the fiasco, and I know that the junior doctors in my constituency will be relieved to hear that because without a doubt they want resolution, but they
and my constituents want to know who was responsible for it. If it was not the Secretary of State, who was it?
Ms Hewitt: We have talked on previous occasions about the many years of consultation and engagement that led up to the introduction of Modernising Medical Careers, the successful introduction of the foundation programme starting in 2005, to which the hon. Lady did not refer, and the real problems of implementation in what was always going to be a difficult transition year. We need to learn the lessons from that and we will do so through the Sir John Tooke review. In the meantime, I take full responsibility for sorting out the problem, and that is what we are doing.
Mr. Crispin Blunt (Reigate) (Con): On the issue of the availability of care in hospitals on 1, 2 and 3 August when the junior doctors begin their induction training, the right hon. Lady during a previous urgent question said that she had commissioned advice in response to questions from me. Has she had that advice, and if so, will she place it in the Library of the House?
However, I have to say to the right hon. Lady and to the Minister of State, her right hon. Friend the Member for Doncaster, Central (Ms Winterton), that there are no excuses here. If I as a constituency Member of Parliament was being invited into my local hospital by the junior doctors to hear a presentation by the doctor on the BMA’s junior doctors committee about the state of this matter in October, and I then tabled parliamentary questions that were answered by Ministers in October and November, Ministers have nowhere to hide from the responsibility for this utter fiasco. Why will they not take the honourable option?
Ms Hewitt: On the issue of 1 August, which we have discussed before, not all doctors in training will change jobs on the same date at the beginning of August. Therefore, arrangements for this year will to a great extent reflect current practice. As has already been said, hospitals are very used to the fact that a number of doctors do change their rotation in early August and they make appropriate arrangements to ensure that patient care, and above all patient safety, are not jeopardised as a result.
Let me say yet again, if I need to, that I take responsibility for this. I have apologised because that is the least that junior doctors deserve given the distress that they have been subjected to, and we are all now focusing on sorting out the problems and ensuring that junior doctors are treated fairly and that patients continue to receive excellent care.
Points of Order
1.14 pm
Mr. David Winnick (Walsall, North) (Lab): On a point of order, Mr. Speaker. I accept entirely that it is up to Members to mobilise support for or against a private Member’s Bill. That has been the long tradition in the House. But as you, like your predecessors, are the defender of Back Benchers, I want to bring to your attention the fact that it becomes very difficult to oppose, as I do, the Freedom of Information (Amendment) Bill, which will come before the House on Friday and which will exempt Parliament from the Freedom of Information Act 2000, when we find that the usual channels—to use a phrase—are mobilising support for that measure. I do not for one moment suggest that that in itself is unparliamentary, but it means that all the machinery of the Government and to some extent the Opposition is being mobilised in favour of a private Member’s Bill, which places those of us who are opposed to it at a grave disadvantage. I understand, for example, that Parliamentary Private Secretaries are almost on a three-line Whip, although some have opposed coming in—
Mr. Speaker: Order. The hon. Gentleman has been here a long time. In fact, he used to help me and give me advice on matters. I can only say that he is right to say that I am here to defend Back Benchers, and on Friday everyone will get a voice in this Chamber. I cannot get involved in what is happening behind the scenes.
Tony Baldry (Banbury) (Con):
On a point of order, Mr. Speaker. I have been fortunate to be in the House under three Speakers: Mr. Speaker Weatherill, whose passing we mourn, Madam Speaker Boothroyd and yourself, and it has been a role of all Speakers to protect the House, and that means protecting the House from being treated discourteously by Ministers.
For a number of weeks, I tabled a straightforward question to the Secretary of State for Communities and Local Government asking how many accredited domestic energy assessors and home inspectors there are in each local authority area, region and city in England and Wales. Every week I got the answer that it would be answered shortly. It was only following the intervention of the Leader of House after I raised the matter in business questions that I eventually got an answer that did not seek to disaggregate out home energy inspectors from domestic energy assessors, and clearly did not seek to distinguish between those who are still in training and those who had passed the necessary examinations, but concluded with the words:
“We do not expect assessors to work within local authority boundaries, as they will work largely by region—in some parts of the country, assessors will work across more than one region”.—[ Official Report, 8 May 2007; Vol. 460, c. 124W.]
So the Minister for Housing and Planning was seeking to suggest that she could not answer the question by way of local authority because domestic energy assessors were going to work by region.
I immediately tabled another named-day question for answer on Monday, pursuant to the answer of 8 May—
Mr. Speaker: Order. I cannot allow the hon. Gentleman to go through his diary in relation to the tabling of written questions. Courtesy is very important—
Tony Baldry: I was just coming to my main point.
Mr. Speaker: The hon. Gentleman knows that he has to come to the main point quickly, and he did not, so I have stopped him. Ministers are responsible for their replies and hon. Members are entitled to pursue the matter by way of further questions and Adjournment debates. It sounds to me as if the hon. Gentleman has a good case for an Adjournment debate. There is certainly no shortage of words. However, I have to stop the hon. Gentleman there. I have given him some good advice.
Members of Parliament (Employment Disqualification)
1.19 pm
Martin Salter (Reading, West) (Lab): I beg to move,
That leave be given to bring in a Bill to make provision for the regulation of remunerated employment of Members of Parliament; and for connected purposes.
My Bill seeks to regulate the remunerated employment that Members of Parliament may undertake. In short, it would bring to an end some of the more unacceptable aspects of moonlighting by right hon. and hon. Members, something which the public deplore and which serves only to bring Parliament into disrepute.
There has been much hand-wringing by political commentators and politicians about the declining esteem in which Parliament is held. We are right to be concerned about the rising cynicism and declining trust in our political institutions. Indeed, the House itself recognised many of those problems in the 2004 report from the Modernisation Committee entitled “Connecting Parliament with the Public”. The report noted:
“The legitimacy of the House of Commons, as the principal representative body in British democracy, rests upon the support and engagement of the electorate. The decline in political participation and engagement in recent years, as well as in levels of trust in politicians, political parties and the institutions of State should be of concern to every citizen. But it should be of particular concern to the House of Commons. Politicians have always scored low on levels of trust but even so there is a noticeable downward trend, with fewer and fewer people trusting politicians. Lower levels of trust are translating into a disconnection from the institutions of democracy. The fall in election turnout from a post-war high of 84 per cent. in 1950 to 59 per cent.”—
“in 2001 is the most obvious indicator of this decline. Turnout at elections in the UK is now lower than most other European countries.”
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