Doctor Training

George Howarth Excerpts

Tuesday 17th January 2023 Westminster Hall

[Several hon. Members rose—]

[Sir George Howarth (in the Chair)]

I remind hon. Members that they should bob if they wish to be called in the debate. I call Jim Shannon.

[Jim Shannon (Strangford) (DUP)]

It is a pleasure, Sir George, to speak in this debate, which I thank the hon. Member for South Cambridgeshire (Anthony Browne) for leading. I am happy to support the thrust of it and am pleased to be the Opposition Member speaking for it—that does not take away from others who probably wished to be here.

There is no doubt that we have faced years of NHS turmoil, and one of the main issues is a lack of sufficient staffing across all aspects of the NHS—nursing and doctors being the most prominent. There are countless reasons why we should train more doctors, but there are domestic issues hindering us from doing so. The hon. Gentleman referred to them, and I will address them from a Northern Ireland perspective. I am my party’s health spokesperson, so I am happy to speak on these issues.

I first want to put on the record—others will undoubtedly do the same—my thanks to the doctors of the NHS for all they do for our health in the United Kingdom of Great Britain and Northern Ireland. We are fortunate to have two fabulous universities in Northern Ireland: Queen’s University Belfast and Ulster University. I have spoken to many students who say there seem to be some issues with the number of places available for those who want to become doctors. Northern Ireland prides itself on the opportunities we offer to international students. We have an amazing scheme, but Queen’s can offer only about 100 places a year for medicine, and there is therefore a shortfall. If that could be increased, it would benefit us in Northern Ireland and people across the United Kingdom. The Minister is always responsive to our requests, so will he outline whether he has had any discussions with the Northern Ireland Assembly and the Department back home?

The hon. Gentleman referred to levelling up, and obviously I want Northern Ireland to be part of the levelling-up process. I welcome that the Government are committed to that, but sometimes we need to see the small print, so I ask the Minister to share some thoughts on that.

I understand that more than 10% of the 100 medicine placements at Queen’s are awarded to international students. I stated earlier that there is still a fantastic opportunity for international students, but once they have completed their degrees, a large proportion do not stay in Northern Ireland and go back home to their own countries. That means there is a gap between the number of students who are trained here, and the number who enter professions and become, for example, junior doctors.

Let me give an example from back home. Two constituents I spoke to excelled in their GCSEs, AS-levels and A-levels—the hon. Gentleman referred to qualifications and the success of education. They were both A* students whose ambition was to stay at home, train and work in Northern Ireland. Unfortunately, they were not successful in obtaining a placement in Northern Ireland, and are now in Edinburgh and Wales, given that they had no other options. Those are not the options they wanted; they wanted to be at home. That is why I asked the Minister about the discussions back home.

Our junior doctors recently voted to strike. More than 173,000 members have agreed to a three-day walk-out due to staff pay, excessive rota hours and a lack of support from superiors. Those issues have to be addressed; they cannot be ignored. I have met some of those junior doctors, nurses and consultants to discuss the issues, and I must say that the excessive hours and shifts they are being asked to work are overwhelming. There is a burden on our junior doctors and those who wish to become junior doctors at a very early stage. Sometimes they work 12-hour shifts for four to five days. Just over the weekend, I heard about the pressures that an accident and emergency unit is under. Our junior doctors are tired and feel underappreciated. Again, the importance of addressing that is clear.

Hiring additional doctors seems like an easy answer to a complex problem. It is never as simple as that, of course. People say, “Well, just hire more. The country is crying out for junior doctors.” We know that, but how do we make it happen? Although that is true, the reality is that the NHS and its staff have been underfunded for years. We do not have the money to fund our junior doctor sector and ultimately hire more. The 100 university places at Northern Ireland’s largest university are simply not enough to meet the demand. It is therefore really important that we address the issue. We must encourage our students to stay and work here, but why should they do that when they feel defeated because they are not getting placements where they want—in our case, back in Northern Ireland?

The Health and Social Care Committee stated that stakeholders have recommended increasing the number of places by 5,000 a year—the hon. Gentleman referred to that—and others have suggested that the figure should be as high as 15,000 a year. As part of the levelling-up process, we need to see the benefits of levelling up for all the regions of this great nation.

The Royal College of Radiologists has been in touch with me to say that employing additional junior doctors could assist with the oncology backlogs, which we all know is a priority for many. It has stated that there is a shortfall of 17%, or 163 clinical oncology consultants, which is forecast to increase to 26% or 317 consultants by 2026 without action to tackle the workforce crisis. What we are doing today will avert a crisis down the line, which is what we are trying to achieve. That is just one example of how our lack of junior doctors ultimately has a knock-on impact on our ability to provide priority treatment.

I will conclude, because I am conscious that eight people want to speak and I want to give each and every one of them the same time, but there is much more I could say about this matter. It is important that workers in our healthcare sector know that they are valued and that we very much appreciate their endless efforts, which can go unnoticed by some. This issue arises from an enormous variety of sources, but we have consistently heard comments about how there simply are not enough university places for the students who are willing to help. Everyone in this room knows that underfunding is also a crucial factor, so let us get the job done to make sure our NHS staff have the protections they need, are not under extreme pressures and do not feel undervalued. Today’s debate gives us the opportunity to ask for that, and the hon. Member for South Cambridgeshire has done this nation proud in his introduction. I believe the other speakers will support him in his ask of the Minister.

[Sir George Howarth (in the Chair)]

For the information of Members present, I do not intend initially to put a formal limit on speeches, but an advisory recommendation is that if everybody sticks to five minutes, we should be able to call everybody.

--- Later in debate ---

[Andrew Selous (South West Bedfordshire) (Con)]

It is upsetting for young British students who have the grades and desperately want to be doctors in a country that desperately needs them to be turned down. I nearly went through that as a parent; I have an interest because my eldest daughter is a junior doctor, and the agonies that she went through, and that we went through as parents, wondering whether she would get the grades and get a place, were awful. Many British families go through that, and it is simply not right when, as my hon. Friend the Member for South Cambridgeshire (Anthony Browne) has said, we have 30,000 doctors from India and 3,000 from Iraq. We should be able to train more.

I am encouraged that the Chancellor of the Exchequer has at last said that the Government will introduce a plan to ensure that the NHS has the workforce it requires to meet future need. The plan will be for the next five, 10 and 15 years, taking into account improvements in retention. That is absolutely right and, frankly, we should have backed it when he was Chair of the Health and Social Care Committee and made the same point. But better late than never—a sinner who repents and all that.

I want to talk mainly about general practice, but we have to get the training right for our doctors everywhere—in hospitals and in general practice. They work incredibly hard under huge stress. I will be delighted to visit the junior doctors’ mess at the Luton and Dunstable Hospital, as I had an invitation recently. I will listen very carefully to what is said there. Today I want to talk about general practice, and in particular about ensuring we have somewhere to train those young GPs as they go through their career. I was very upset to learn last Wednesday that my integrated care board—Bedfordshire, Luton and Milton Keynes—had to turn away eight trainee GPs, because there is nowhere for them go. That is an appalling situation.

Some 14,000 new homes are being built in my constituency. The NHS uses the measure of 2.4 people per home, which means 33,600 new residents, and we are really struggling to expand general practice. Last Wednesday, my integrated care board scrapped 30 of the 53 proposed expansions in primary care across its area—where we could have trained young GPs—for the lack of £2.95 million out of a £1.7 billion budget.

I think about those eight trainee GPs that Bedfordshire, Luton and Milton Keynes had to turn away. My constituents are particularly angry because to the east of Leighton Buzzard is a big new development called Clipstone Park. I have with me a copy of what Barratt Homes, Taylor Wimpey and David Wilson Homes say in the planning application, which states that the development will see the delivery of a doctor’s surgery. No ifs, no buts, no caveats; it will happen. People bought those homes on the basis that there would be a surgery where we could train the young doctors we are talking about. It is not happening, so is it surprising that there is a breakdown in trust among our constituents? It is simply not good enough. Two health hubs that desperately believe in integrated health and care have also not been given the go-ahead. Furthermore, I have discovered that of the £7 billion of section 106 money to fund facilities, including healthcare facilities to train doctors, less than £187 million went into health. That is simply not good enough.

We either take health seriously or we do not. We need to get waiting times down in hospitals. However, we also need to get down the time that many of our constituents spend waiting at 8 o’clock every morning, day after day, trying to see a young doctor, so many more of whom we need to train.

[Sir George Howarth (in the Chair)]

I remind Members that I will be calling speakers from the Front Benches at 10.30 am. To get everybody in, I will now impose a formal four-minute limit on speeches.