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House of Lords

Wednesday, 27th November 2002.

The House met at half-past two of the clock: The CHAIRMAN OF COMMITTEES on the Woolsack.

Prayers—Read by the Lord Bishop of Southwark.

NHS:Work Permits

Baroness Gardner of Parkes asked Her Majesty's Government:

    How many fast-track visas for skilled workers have been issued for people to work in the National Health Service and what National Health Service criteria are considered essential for such a visa.

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, during the past financial year, 24,272 work permits were issued to workers employed in the United Kingdom in a shortage healthcare occupation. Those workers will be employed in both the NHS and the independent sector. A panel of healthcare representatives has been created to advise Work Permits (UK) of the latest labour market and skills gap information.

Baroness Gardner of Parkes: My Lords, I thank the Minister for that Answer. Is the noble Lord aware that there is a problem in that some skills are simply not recognised? I have in mind an endodontist—that is, a person who carries out root canal therapies and treats the bottom end of teeth—who was admitted to this country some time ago under this visa system, but who suffered an additional eight weeks' delay because no one could find out what an endodontist does. Is the Minister considering producing a list in co-ordination with the immigration department so that people can more readily recognise the shortages of such specialist skills?

Lord Hunt of Kings Heath: My Lords, I am sorry to hear about that case. If the noble Baroness would care to furnish me with further details, I should be very happy to investigate the matter. In the list of occupations that are currently covered by the scheme, there is a definition section for "Additional Dental Specialties". Judging by what the noble Baroness has said, I believe that we need to look into the matter to ensure that it specifies all the specialties that need to be covered.

Lord Walton of Detchant: My Lords, no doubt the Minister is fully aware of the serious shortage of doctors in the NHS, not just in general practice but also in hospital specialties. Doctors who are nationals of member states of the European Union and who have qualified in those countries have the full right of entry into the United Kingdom. However, can the Minister assure us that the new arrangements for the

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registration of overseas doctors from other countries include the process of removing the bureaucratic rules that have prevented a number of them coming to this country? Further, have the Government had discussions with the General Medical Council in pursuance of that objective?

Lord Hunt of Kings Heath: My Lords, there is no doubt that the NHS requires many more doctors. We have made progress in that respect. There has been an increase in the number of consultants and GPs employed over the past four to five years. But, clearly, overseas doctors have always come to the UK. They have always provided great service, and we wish to encourage that process in the future. I can respond in the affirmative to the noble Lord's final question. He will know that the Government and the GMC are currently discussing these matters. We wish to see as streamlined a process as possible, and one that is commensurate with the public interest and public safety.

Baroness Noakes: My Lords, five years after Nelson Mandela made an appeal to stop the recruitment of nurses from South Africa and despite the Government's own code of conduct, can the Minister explain why the number of nurses recruited from that country last year rose five-fold to over 2,000?

Lord Hunt of Kings Heath: My Lords, the noble Baroness is right to raise the question of our policy towards developing countries. Indeed, we are firmly committed to ensuring that National Health Service employers do not target developing countries for recruitment, and that they work only with commercial recruitment agencies that adhere to our code of practice. In the year 2001–02, I believe that over 2,000 nurses from South Africa were registered by the nurses and midwives' council. But many of those will have applied for such positions as individuals, will have responded to advertisements, or will have been recruited by the private sector.

The noble Baroness may shake her head, but we have repeatedly told the NHS that we will not allow the service to undertake proactive campaigns in South Africa. We have a code of practice. If private recruitment firms are in breach of the code of practice, we shall remove them from it. Equally, if individuals from that country apply to work for the NHS, they have the right to do so.

Lord Patel: My Lords, can the Minister say how many overseas medical specialists have been recruited thus far? Further, can the noble Lord say whether the Government will be able to meet their targets?

Lord Hunt of Kings Heath: My Lords, we are very confident that the initiatives that we are taking will enable the NHS to meet the needs and increase the capacity of the service. In terms of staff increases, there has been a large increase in training places in this country. As regards the number of consultants, there has been an overall increase from 21,370 in 1997 to

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over 26,000 this year. As for international recruitment, current figures for entrants to the GMC register from the EEA and the non-EEA show encouraging signs of increase. A number of initiatives are bringing in more doctors; for example, we have seen 23 GPs from Spain in post, with nine arriving in the new year for induction. We have also received 6,198 expressions of interest as a result of the global recruitment campaign; 2,523 firm applications have been received, 904 of which have been sifted and are felt suitable for employment in the NHS, including 822 hospital doctors and 82 general practitioners.

Baroness Thomas of Walliswood: My Lords—

Lord Haskel: My Lords—

Noble Lords: This side!

The Lord Privy Seal (Lord Williams of Mostyn): My Lords, perhaps we should hear, first, from my noble friend Lord Haskel.

Lord Haskel: My Lords, can my noble friend say how many of these doctors and nurses who come from overseas work here for a time to develop their skills and expand their knowledge and then return to their country of origin as better doctors and better nurses?

Lord Hunt of Kings Heath: My Lords, I cannot say how many nurses and doctors have come to the UK and then returned to their own country to take up health practice; it would be very difficult indeed to quantify those figures. What is absolutely clear, however, is that it is in this country's best interest to continue to recruit and retrain people from overseas. There is a long tradition of doing so. The health connection between the NHS and countries abroad has been very effective in expanding British health goods and establishing international contacts. Long may that continue.

Baroness Thomas of Walliswood: My Lords, although one might welcome the recruitment of doctors from overseas so long as it is not a substitute for training our own doctors in this country, are there not also some dangers such as increasing competition—if that is the right word—from other advanced nations also seeking doctors in the same pool? What is the Minister's attitude to the proposed directive on mutual recognition of professional qualifications, which apparently will allow EU doctors to come to this country and practise for 16 weeks without registration?

Lord Hunt of Kings Heath: My Lords, we have some concerns on the latter point which we are discussing with other EU countries. More generally, it is true that a number of countries are seeking to recruit internationally. The NHS's success is ensuring that we have a very good recruitment campaign and that, when nurses, doctors and others come from overseas, they are treated well and supported well in the NHS.

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2.44 p.m.

Baroness Scott of Needham Market asked Her Majesty's Government:

    What action they propose to take in view of the fact that, outside London, bus passenger numbers have declined by 1.5 per cent for the last year for which figures are available, while the targets set in their 10-year plan predicted an increase.

Lord McIntosh of Haringey: My Lords, bus patronage is continuing to increase nationally, following decades of decline. At this early stage in the 10-year plan, most of the growth is in London; but some other areas are also achieving significant growth, especially where Quality Partnerships are providing imaginative solutions to the problems of congestion. Projected expenditure by local authorities on bus priorities should make a substantial contribution to bus patronage over the next few years. The Government are working with local authorities and the industry to identify how to reproduce the best results more widely.

Baroness Scott of Needham Market: My Lords, are the Government actively considering proposals from the bus industry for a pump-priming fund to develop new services outside town centres? Given current levels of traffic congestion, does the Minister not agree, in principle at least, that investment in measures to reduce reliance on the private car can only be a good thing?

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