Doctor Training

Anne Marie Morris Excerpts

Tuesday 17th January 2023 Westminster Hall

[Anne Marie Morris (Newton Abbot) (Con)]

I entirely agree that we need to train additional doctors; there is no question about that. The point has already been made that we need a diverse workforce and the creation of a number of new careers with shorter training periods. As my hon. Friend the Member for South Cambridgeshire (Anthony Browne) said, developing someone into a fully qualified GP, never mind a hospital consultant, is extremely time consuming. As my hon. Friend the Member for Bolsover (Mark Fletcher) said, we need to look at what we want our medically qualified practitioners to do and at how we can create the right career paths, some of which will be shorter and more specific to meet the needs that have been clearly demonstrated. There is no question but that various factors, including the growing population, covid and the ageing population, mean we face a real challenge.

I declare an interest because I represent a rural constituency in Devon and I have chaired the all-party parliamentary group for rural health and care. A couple of years ago, the APPG produced a report on the issue, looking at what needed to change. There are particular barriers in rural communities, compared to other areas. We have an increasingly ageing population with complex co-morbidities and a problem with attraction because, as has already been said, qualified doctors tend to want to stay where they were trained and not come to what they may see as a rural backwater. We also have a challenge finding accommodation for them, because our accommodation rates are very high compared to the level of income.

For me, one challenge is recognising the issues and then training and developing accordingly. We need more specifically oriented rural training opportunities and rural medical schools. There are one or two now, with the latest being in Lincoln, but the curriculum does not have adequate rural content or experience in all cases. It is abundantly clear, as demonstrated by the examples given by hon. Members, that that challenge will be met by recruiting people who live in rural areas. That may sound discriminatory but it would fill the national need for individuals to work in rural areas, and it has proved successful elsewhere.

Australia is well ahead of the game in terms of specific training programmes, but closer to home, in Scotland, there is a programme at the universities of Dundee and St Andrews where 50% of the course, in terms of content and practice, is focused on working in the highlands and other rural locations. Scotland and England may appear to be different, but some very rural parts of England face exactly the challenges as those in Scotland, so there is no reason why the same approach should not be applied. Scotland is also looking at conversion courses for nurses and pharmacists to become doctors—a point that was made earlier—but they are still awaiting approval.

The other key point is that many doctors will find themselves disproportionately in general practice and disproportionately dealing with geriatrician-type problems, so we need to ensure that general training goes through many more years of the curriculum because it often drops off once doctors get into F1, F2 and beyond. We also need to ensure that more doctors have a geriatric element in their training courses, rather than just leaving it to the specialisms, because every single doctor, whatever they land up doing, will find themselves dealing with older people with complex comorbidities. There is no question about that at all.

The real challenge is to focus on not just the need for more doctors, but to recognise what those doctors will be asked to do. That will impact not just on how and who we recruit, but on the nature and content of the training courses. It also ought to give us an insight into the big issue of retention, which is one of our biggest challenges. In the south-west, vacancy rates for doctors and nurses in 2018 was 7,743. In 2022, it was 10,755, so those are big issues that need to be addressed. I shall end on that note so that others can continue, hopefully in a similar vein.