The view of the dean of the faculty of medicine, who speaks with the full authority of the other medical professors in the university of Edinburgh and has had contact with those in Glasgow and elsewhere, was that he regarded
the establishment of a National Joint Council for Medicine and Dentistry as being particularly important. There are obvious reasons why these subjects need to be distinguished in this way … there is a statutory limit to the number of medical and dental students, unlike the free market situation that is developing for the numbers of other students. Hence the University cannot augment its income in relation to medicine or dentistry by increasing the student intake. This of course means that medicine and dentistry will become increasingly expensive when expressed in terms of income per full time equivalent number of staff. Without national recognition and protection our medical schools will suffer savage staff losses. That is, of course, happening here in Edinburgh where we are being asked to lose 83 posts despite being at exactly the average cost for United Kingdom medical schools.
The dean asks the House to appreciate
the key relationship of the medical and dental professions with the National Health Service.
That is vitually a monopoly employer and hence there has to be a relationship between the number of doctors employed in the NHS and the output of the medical schools. Again this is best done on a UK basis rather than a Scottish one.
That is one reason for the amendment.
According to Edinburgh university, we should not be training doctors and dentists just for Scotland. The dean states:
To do so would not only mean a drastic reduction in output but would destroy our role as one of the major medical schools in the UK.
He also argues that we must consider how to maintain national standards. The General Medical Council plays the key role, as does the General Dental Council—[Interruption.] The hon. Member for Southampton, Test (Mr. Hill) has a distinguished medical school within his constituency, at Southampton university. I would have hoped that he would support us.
The letter continues:
Currently the Education Committee of the GMC is suggesting major changes in the curriculum. The GMC has recently carried out a national review of the final professional examination. All these endeavours are designed to maintain the UK's role as a centre of excellence for medical education and to allow confidence in the uniformity of qualification standards. In this context it makes considerable sense that there should be a National Joint Council for Medicine and Dentistry which could then act as a bridge between the Scottish Higher Education Funding Council and one for England and Wales. It would then be complementary to UK-wide organisations such as the GMC.
That is the considered view of the dean. Because of the importance of the subject, I thought that it was only sensible to bring it to the attention of the Scottish Office.
I have just received a letter from the Minister; for the sake of coherence, I should like to outline it to the House, because I wish to reply to it in the hope that the Government will make a further response. The Minister acknowledges the letter from Professor Christopher Edwards. Following a conversation which took place at the House, he says that he has had a chance to study amendment No. 87 in the light of the concern which I expressed in Committee about maintaining United Kingdom links. He says:
Unfortunately, I think amendment No. 87 would be a step in the wrong direction, as it simply requires the Scottish Higher Education Funding Council to set up a Scottish Medical Committee. What we want is a joint, UK medical committee, and I shall be glad to give you an assurance in the House that the Government will require the three funding councils to take action and set one up.
Fortuitously, the Secretary of State for Education and Science is present. I hope that he will spring to his feet and agree to that. He was referred to in Committee at length in terms of his D. H. Lawrence attitude. Here is his chance to contribute to Scottish proceedings.
There is real concern about medical standards. It is probably a United Kingdom rather than a Scottish matter, as the Minister's letter suggests, but it is important that, in the English Bill or from the Secretary of State for Education and Science tonight, we get an undertaking. I cannot think of any other reason why the right hon. and learned Gentleman should so courteously have come to the House to take part in our debates. [Interruption.] Sotto voce the Secretary of State says something. If he had spoken a little louder, we would have heard what he said.
I had better complete the picture. The Minister says in his letter that the procedure was adopted with the Universities Funding Council in 1988 and he sees no reason why it should not produce the desired effect now. He hopes that that meets my concern, but it does not completely meet my concern. I should like to know in concrete terms what the Department has in mind to insert in legislation.
In Committee, among the many letters which I offered to my colleagues was one from Lord Wilberforce. The Appeal Court judge of many years reminded us that what Ministers or any of the rest of us said in Standing Committee or on the Floor of the House mattered not at all when it came to the courts interpreting legislation. That is why it is so important and why I asked for a concrete undertaking about what will be introduced in legislation on the subject. I leave it at that.
I am grateful to the hon. Member for Linlithgow (Mr. Dalyell) for reading out my letter, which I gave him this afternoon. That obviates the necessity for me to repeat the points in it. The hon. Gentleman is right to emphasise the importance of a co-ordinated approach and of the three funding councils operating with a joint medical committee. I do not know what I can say to the hon. Gentleman to persuade him that it is not necessary to put this on the face of the Bill to ensure that it is delivered, but I can give him an undertaking—in concrete, stone or any material of his choosing—that the Government will ensure that the funding councils take note of the views expressed in this House, and will ensure that there is co-ordination between the three funding councils in the form of a joint medical committee.
This will meet the reasonable expectations of those who have argued in favour of the importance of this idea. I do not underestimate it: I simply take issue with what the hon. Member for Linlithgow said at the end of his speech—that this matter must be written into the legislation, and that it is a matter for the courts. It is not. It relates to the relationship between the Secretaries of State in the territorial areas and their respective funding councils.
I hope that the hon. Gentleman will feel able to withdraw the amendment and will take comfort from having secured a far stronger undertaking than he was given in Committee. His persistence in advancing this view has scored something of a victory.