---

Lord Glentoran: My Lords, what plans do Her Majesty's Government have for reforming or restructuring the funding mechanisms for national sports bodies, in line with the independent sports review "Raising the Bar" produced by my noble friend Lord Moynihan and Kate Hoey MP?

Lord Davies of Oldham: My Lords, that important report is being studied carefully. The noble Lord will recognise that we have been concerned about administration in sport, and he is right to raise that issue. It has not always been the case that the quality of administration has matched either the necessary resources or the rightful expectations of potential recipients. I can report one obvious area of progress: Sport England has reduced its central staffing from 120 administrators to 90, which indicates the pressure being applied by the department and reflects the fact that sporting bodies need to get their house in order—in terms of the quality of administration—to justify the resources that they distribute.

Baroness O'Cathain: My Lords, would it not be good if the Minister could say that he would consider
 
26 Apr 2006 : Column 148
 
the suggestion made by the noble Lord, Lord Addington? Things change. The fact that something was put together in a department 10 or 20 years ago does not necessarily mean that it should stay like that for ever. There is now a big emphasis on sport which was not there at that stage—it applies in particular, on the very points that the Minister made, to the spin-off for health, for obesity and for other issues.

Lord Davies of Oldham: My Lords, that is right, but the noble Baroness will have recognised from my initial figures that sport is still a small percentage of the department's allocation. The changes to the amounts spent on culture—on heritage generally, in museums or on art—are marginal. I hear what she says, and all suggestions on how we could organise government more effectively are to be taken into account. There is no doubt that sport, as I have indicated, has increased in importance to the nation. However, there is no case for reconstructing government on the basis of improvements to allocations to sport.

Baroness Tonge: My Lords, how much money has been made out of the sale of school playing fields over the past 10 years? Does the Minister think that that was in the interests of promoting sport in this country?

Lord Davies of Oldham: My Lords, the noble Baroness will not be surprised if I cannot quote the figure from the sale of school playing fields, but I assure her that their sale happens now only when other sporting facilities take their place and the proceeds are allocated to them. In fact, we are not prepared to see a reduction in sporting opportunities for our young people in schools. The resources from all sales go to improve playing facilities, which often means that a field that has more limited use—being used only for certain sports—can be translated into sports halls that can be used all year round and for a wider range of sports.

NHS: Overseas Doctors

3.29 pm

Baroness Barker asked Her Majesty's Government:

What consultation took place prior to the recent implementation of visa restrictions for overseas doctors.

The Minister of State, Department of Health (Lord Warner): My Lords, in July 2005, the immigration rules affecting postgraduate medical education were clarified. Throughout the summer of 2005, the Home Office consulted on changes to the immigration system, one effect of which was to require work permits for postgraduate medical training posts occupied by overseas doctors from outside the EU. In March, we announced that, in future, those doctors would require work permits. A wide range of medical and NHS interests have been consulted at each stage.

Baroness Barker: My Lords, I thank the Minister for his reply. What will happen to doctors appointed after
 
26 Apr 2006 : Column 149
 
7 March, whose permit-free status will not last for the duration of their post? Will they be given a period of grace? Looking to the longer term, does he agree with the BMA and the royal colleges that there should be an annual international application process that would stop the cycle of feast and famine in doctors, which is damaging to the NHS and to the healthcare systems in the countries of origin of those doctors?

Lord Warner: My Lords, there are some complex arrangements, and I shall give the noble Baroness a fuller reply about the transition to the new arrangements. I can say that employers of doctors and dentists who are in post or were offered before 7 March a post that starts before 4 August for which they do not have sufficient leave to complete can apply for work permits without needing to satisfy the resident labour market test. I shall give her further more detailed particulars.

On the latter issue, we will of course consider any proposals put to us to improve the administration of the arrangements. It is worth telling the House that the changes were introduced because we were becoming very successful in expanding our medical schools, and we must ensure that postgraduate training places are available to UK medical graduates.

Lord Walton of Detchant: My Lords, does the Minister accept that, ever since the National Health Service was introduced in 1948, it has been hugely dependent on services given by overseas doctors, many of them coming from the Indian subcontinent? With the expansion of the UK medical school intake and with many doctors coming from within the EU, it is clearly important that their employment opportunities should be protected, but is it not invidious that many overseas doctors from outside the EU at present in post and in training positions find it impossible to obtain work permits to complete their training, having been assured when they came to the UK that they could complete that training without any difficulty?

Lord Warner: My Lords, we have not in any way changed the rules for work permits for doctors outside training posts. We have ensured that, as UK medical students graduate and need to move into postgraduate specialist medical training posts, there is an ample supply of those posts to be filled. Otherwise, we would be wasting the investment in the expansion of our medical schools. We are also concerned to become more self-sufficient, so that we do not drain doctors from overseas into this country. I share the concerns of the noble Lord; we recognise and pay tribute to the huge contribution that international medical graduates have made to the NHS and patients in this country.

Earl Howe: My Lords, will the Minister take on board my concern and that of the BMA that the very least that is required is clear guidance to trusts, deaneries and, for that matter, the general public about what are highly complex rules—not least,
 
26 Apr 2006 : Column 150
 
guidance about which particular categories of overseas doctor can work without a work permit? There is a considerable lack of clarity in that area.

Lord Warner: My Lords, the noble Earl is absolutely right: it is a complex area that has changed in many ways. The immigration system now has a different set of arrangements for its points rule. There is a very good website on UK work permits with a full explanation. We are working with NHS employers to ensure that their website is up to date and are in constant touch with the BMA about the issues.

Baroness Finlay of Llandaff: My Lords, can the Minister please clarify the position for overseas undergraduate medical students, of whom there are approximately 2,500 in this country, who came over to this country paying full fees at the very high rate that overseas students pay and believing that they could train at an undergraduate level and receive postgraduate training before returning to their own country? They now face enormous debts as a result of those fees.

Lord Warner: My Lords, there has been change for some time in this area, as I said in my original Answer. The General Medical Council has been working hard to stop young doctors coming here on spec to secure training. In the past year, there has been a 40 per cent drop in the number of overseas doctors taking the GMC's PLAB tests.

Baroness McIntosh of Hudnall: My Lords, will my noble friend confirm that there is still a considerable shortfall in mental health professionals in the National Health Service? Can he say whether the arrangements for overseas doctors are likely to have an adverse impact on our ability to fill the gap in that area, which presumably will persist until the intake of students that we have been able to get as a result of the expansion of medical schools throws out professionals at the end of their training?

Lord Warner: My Lords, there are now 27,000 more doctors in the NHS than there were in 1997. We continue to expand medical schools. The needs of mental health services are being addressed considerably by the large expansion in the number of mental health staff, who are non-medical staff in many cases, an expansion that is needed to make those services more effective.

---