Doctor Training

Kevin Foster Excerpts

Tuesday 17th January 2023 Westminster Hall

[Kevin Foster (Torbay) (Con)]

It is a pleasure to serve under your chairmanship, Sir George. I congratulate my hon. Friend the Member for South Cambridgeshire (Anthony Browne) on securing the debate.

At the core of the debate lies the increasing demand for healthcare and how we meet it. As our population ages and new treatments emerge, the demand for doctors will grow, not just in the UK but overseas. I note that in 2018 the Government increased the number of medical school places in England from 6,000 to 7,500 a year and opened five new medical schools. Yet is that cap the right one for the future? Does it reflect the demand-based decision making that we should have, or does it reflect funding-based or supply-side decision making, particularly from the Treasury? As has been mentioned, the cap is not down to a lack of demand among domestic students to be a doctor. In 2022, the Health and Social Care Committee found that record numbers of students are applying to medical school, but around three times more people are applying than there are spaces available. There are vacancies, but there is still strong demand to be given the chance to train for a career as a doctor.

Before I briefly turn to how domestic training levels should change, I must turn to what has inherently been the fall-back option when the domestic supply of doctors has not met domestic demand: recruiting abroad. I helped to create the health and care visa and supported the setting up of the Talent Beyond Boundaries pilot scheme, which assists refugee doctors in taking up jobs in our NHS, so I am delighted to see the many amazing medics who make the UK their home. They are the backbone of many local NHS and social care services and they help to sustain and improve them. I therefore thank them, particularly those who work in Torbay’s NHS, who literally make our bay better.

We must not assume, however, that international recruitment is always guaranteed. During my time as Immigration Minister, I often found that for some employers it became an article of faith that immigration would always provide access to an unlimited pool of skilled labour, and that therefore any vacancies must be solely down to there not being a good enough visa for the role—rather than to a lack of training or planning for the future needs of the industry concerned. With doctors, as in many other cases, there is a shortage of that skill across the whole world, which means that access to global labour markets via visa policy can make only a contribution: it is not a guaranteed long-term solution.

We need therefore to fix and ensure a sustainable supply of doctors to meet future demand here in the UK. Last year, the Health and Social Care Committee concluded that,

“the number of medical school places in the UK should be increased by 5,000 from around 9,500 per year to 14,500”,

and that

“the cap on the number of medical school places offered to international students should be lifted”.

The then Chair of the Committee is now the Chancellor of the Exchequer, which makes this an opportune moment to raise the issue.

I am conscious that the Minister with us today would not want to pre-empt the publication of the longer-term strategy that is now due, but it would be interesting to hear his thoughts on, for example, how the Government will seek to future-proof such a plan given the advance of new technology in creating new treatments. How will the decision making on future training places be determined? Will it be demand-led, or will it be funding-led? It has often been funding-led: we argue about what we should spend on medical training, and then a few weeks later have a meeting to talk about what future demand will be. In particular, how will the Government work to expand geographical locations for training? There are some exciting projects, such as the building a brighter future project at Torbay Hospital, which will expand regional health services. Is there an opportunity to expand training as well?

The debate is not just about the future of our NHS services. As has been so well argued, it is about ensuring that youngsters have the chance to follow their ambition to join those they feel inspired by: the people they see working across the community to save lives and provide care.