My Lords, I thank my noble friend Lord Turnberg for securing this debate and declare my interest as an engineer and chairman of the Warwick Manufacturing Group at the University of Warwick. I also run the Institute of Digital Healthcare jointly with the medical school.
Two years ago, I was treated for pneumonia at the Queen Elizabeth Hospital Birmingham, a fantastic new hospital led by an outstanding former nurse, Dame Julie Moore. The care I received was immaculate, and I understood then why the NHS is sometimes called our other national religion. However, I see it as our national science. After all, it is the subject of many experiments and is constantly being tested.
One current test is higher care standards, which requires more medical staff on wards. As a result, agency staff costs have soared. Monitor expects the bill to be over £4 billion this year, blaming a fundamental mismatch between supply and demand for medical staff. A lot of companies have made very good profit exploiting this, and it is rather ironic Ministers are now proposing a cap on rising bills as the answer. The truth is that, whether in energy or agencies, price caps are a short-term fix. The solution is to increase supply.
Several medical schools, including Warwick, offer four-year medical degrees for graduate entrants. Such graduates do very well both academically and in their career. Warwick graduates are currently second only to Cambridge medics in gaining specialty training places. Shorter courses also mean qualified students can contribute to the NHS earlier. Four-year graduate entry degrees broaden access, attract quality applicants and give faster returns on public spending. It would be ludicrous to close such programmes. Yet medical schools could be forced to do so, as EU legislation demands that medical qualification takes five years. Currently, the fifth year for graduate entrants is the first-year foundation programme. During this time, graduates are provisionally supervised under the GMC before full registration as an independent practitioner is granted.
However, after the Greenaway review, the Government proposed merging degree graduation and full registration. This would unintentionally make four-year courses impossible, as removing the year under provisional registration would leave graduate entry courses short of the EU demand for five years’ training. To resolve this, graduate entrants could continue to do their first foundation year under provisional registration, and I understand the GMC may favour such a solution. We must innovate to attract outstanding medical students then get them working as soon as we can. To achieve this, I urge the Government to pledge that future graduate entrants will retain the option of a four-year medical degree.