Medical Students

Baroness Blackwood of North Oxford Excerpts

Tuesday 3rd May 2011 Westminster Hall

[Mr Andrew Smith (Oxford East) (Lab)]

It is a pleasure to have this debate under your chairmanship, Ms Dorries. I am very pleased to have the opportunity to raise some key issues about the funding of medical students. Aspects of the upheaval in higher education funding are, of course, important both for the recruitment of doctors and the availability of opportunities to study for the medical profession. They are of particular concern in my constituency, which is home to 1,000 undergraduates and 1,300 postgraduates in medical sciences. I am grateful for the briefing that I have received on the matter from the British Medical Association and the Oxford university medical sciences division, as well as for the concerns that constituents have raised with me on these issues.

At a time when higher education as a whole faces the challenges and dangers of the 80% cut in university teaching support and the trebling of fees, concerns about the costs of and access to medical education are all the greater. The length and intensity of medical courses both add to the cost to students and limit their opportunity to supplement their income through paid work.

The BMA estimates that, under the present system, medical students graduate with some £37,000 of student debt. With all universities charging or set to charge £9,000 for medical studies under the new regime, the BMA estimates that that figure will go up to around £70,000. That does not count overdrafts, credit cards, professional loans or family borrowing. We do not need to exaggerate the impact of prospective debt on students’ choices to be concerned that debts of £70,000 or more might be a barrier to able people from poor—or, indeed, middling—backgrounds who are considering entering the medical profession.

My concern is about the funding position facing all medical students. However, on the challenge facing us on widening participation, there is likely to be a triple impact on entry to medical studies. The A-level admission grades are understandably particularly demanding and poorer students from schools serving poorer areas are less likely to achieve them, which clearly demands further action within the school system. The requirement of medical work experience is also likely to be harder to fulfil for school students from financially hard-pressed families or, indeed, from families with no connections to the medical profession. At the same time, the prospective length and costs of study are considerably higher and it seems plausible that those are also having an impact on the relatively low rates of admission to medical studies from poorer socio-economic groups.

Statistics on admissions show that the wider challenge of opening up access to higher education is certainly compounded in the case of medical studies. The BMA equal opportunities committee report published in October 2009 includes a review of UCAS data. It states:

“The proportion of acceptances to medical school coming from socio-economic class I (31%) was almost twice that of acceptances to all other degrees from class I (16 %). Just 15% of students accepted into medical school came from the four poorer socio-economic classes (grades IV to VII) compared with 24% of students accepted to all degrees.”

The BMA has also said:

“The percentage of students from lower income families is slowly improving across the higher education sector but the rate remains stagnant in medicine.”



In the light of all that and the Government’s stated commitment to widen access to higher education, I would like to ask the Minister what the Government’s specific proposals are to widen the pool of talent entering medicine and whether the Government, in bringing forward the higher education White Paper, will look at the likely special factors at work in relation to medicine? I have listed some of those.

Will the Government also consider the advice and support given to able students in school, the necessity and operation of the work experience requirement and the £75 cost of the UK clinical aptitude test used as part of the selection process? That test gives an early signal to students from poor backgrounds that studying medicine is an expensive undertaking.

An important part of overall support for medical students is the provision of bursaries. As the Minister will be aware, the future shape of those has been uncertain for some time. The previous Government consulted on options for change in 2009, and last month the present Government set out new options for reforming the system.

[Nicola Blackwood (Oxford West and Abingdon) (Con)]

As I represent the other half of the Oxford university seat, the right hon. Gentleman will know that I share many of his concerns. In the light of his valid concerns about equal representation among medical students, does he agree that now is the crucial time to decide about the NHS bursary scheme, given that many students are deciding which courses to apply for?

[Mr Smith]

I am grateful to have the support of my colleague. I might describe her constituency as covering the other third of Oxford university. Her support on that point is very welcome. I was about to say that people are already asking what the situation will be, and obviously the sooner they can have certainty, the better.

The BMA has joined other bodies in consulting on the issue, and I understand there is some expectation that agreement will be reached. However, one big outstanding question is whether the new proposed bursary arrangements will cover tuition fees in the same way as they are covered now, with the Department of Health paying the fees for years 5 and 6 of an undergraduate course. If the bursary does not cover fees—it seems extraordinary that Ministers have not yet made the Government’s position on that clear—medical students would obviously face still higher costs and debt.

As my colleague and friend the hon. Member for Oxford West and Abingdon (Nicola Blackwood), whose constituency represents the other third of Oxford university, says, mounting urgency on that matter arises because would-be applicants worry about how the arrangements will work for 2012-13. I press the Minister to give an undertaking that tuition fees for medical students will be covered at least as well as they are now.