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We have also heard a tremendous amount about the funding budgets of medical education and training. Let me make it clear that the Government’s view is that we should be as transparent as possible in ensuring that all money allocated for medical education and training is serving its purposes. Whether ring-fencing or other arrangements are the best way to ensure clarity and robustness in spending and funding is an issue that I will look into. Currently, we have service-level agreements with the strategic health authorities that ensure funding is available for training. I add that there has been an increase of at least 139 per cent in funding for medical education between 1997 and 2008.

The noble Baroness, Lady Finlay, raised the role of the doctor. It is absolutely crucial that we have a clear understanding of the part that healthcare professionals play if we are to meet the needs of the NHS in the future. This is why we have accepted Sir John’s recommendations on this principle, and why consideration of how the roles of clinicians need to develop will be a key part of the workforce in education and training board that is being set up in the NHS Next Stage Review, where Sir John himself is an adviser.

The noble Lord, Lord Turnberg, raised the issue of the number and location of posts, and information for applicants. We have published, at a national level, much more detailed information about the number of different posts, their location and, crucially, the relevant competition ratios, which we hope will allow trainees to make a decision. The noble Lord, Lord Turnberg, and the noble Baroness, Lady Finlay, also raised the issue of the CRO and the CMO’s role as the accountable

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officer. We have acknowledged the importance of the role of the CRO by ensuring that it is filled by a clinician who is dedicated wholly to the role. As a former dean, who has had direct experience of medical education, the noble Baroness will know that the CRO reports to the departmental board through the director-general of workforce and the CMO. The subgroup also reports to the departmental board, which comprises the CMO, the director-general of workforce and the recently appointed medical director.

The noble Lord, Lord Patel, referred to the creation of an exam at the end of medical education. This is an interesting idea and I know that the medical school committees have previously considered this. However, we also believe that it is a good thing that the curriculum varies across medical schools, and that variation should not have an impact on the exam or test that is being referred to. The noble Baroness, Lady Emerton, referred to nurse preceptorship. I understand the point of the noble Baroness about introducing preceptorship here. It is a debate that I have heard a great deal about and it is certainly part of the Next Stage Review debate.

I have heard a very interesting debate about this. I have captured a lot in relation to the Next Stage Review and I reassure the House that we will see a lot of the recommendations currently in the Tooke report, and, more importantly, further creative recommendations to address some of the challenges we have faced in the past and set the scene for the future.

Lord Patel: My Lords, I thank the Minister for his very considered response, and I am bound to say—

Baroness Royall of Blaisdon: My Lords, I regret that the noble Lord has no right of reply in a Question for Short Debate.

Lord Patel: My Lords, I am sorry.


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