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Nhs General Practitioners: Training And Employment

Volume 447: debated on Monday 6 February 1984

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2.39 p.m.

My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

The Question was as follows:

To ask Her Majesty's Government whether they are satisfied with the numbers of students in training for future employment as general practitioners within the National Health Service.

The Parliamentary Under-Secretary of State, Department of Health and Social Security
(Lord Glenarthur)

Yes, my Lords.

My Lords, I thank the Minister for that reply. Is he aware that there are very many young doctors who, when they finish their pre-registration course, are not able to get full employment as medical practitioners because of the shortage of posts? This is causing grave anxiety among the members of the BMA and, indeed, among many people who are interested in the National Health Service having enough doctors at all times. Is the Minister able to comment on that and give us an assurance that something will be done to prevent young British doctors being put on the dole by the activities of this Government?

My Lords, we are not aware of any significant unemployment among general practitioners. The evidence available to us is that unemployment among doctors in general is largely frictional and concentrated on junior doctors in the South-East, where competition for hospital jobs is most intense. As in other areas of medical employment, openings may not be readily available where the doctor may prefer to live, but that does not mean that openings are not available.

My Lords, as the Question refers to general practitioners and does not differentiate between general medical practitioners and general dental practitioners, can my noble friend explain why he answered only in respect of doctors? Is he aware of the great shortage of work for general dental practitioners at the moment which may eventually involve early retirement and which is certainly involving cut-hacks in training? There is an over-supply of general dental practitioners in training: is there also an over-supply of general medical practitioners?

My Lords, I am afraid that I cannot give my noble friend any facts so far as general dental practitioners are concerned. I think that in my answer to Lord Molloy's supplementary question I referred to unemployment among general practitioners, and not just doctors.

My Lord, would the noble Minister not agree that, on average, medical general practitioners have lists which are too large and that the trend should continue towards smaller, shorter lists in order that GPs may better fulfil their functions, particularly in large conurbations? Is he aware that, while there is a small but steady increase in the number of doctors undertaking the three-year vocational training course, as my noble friend Lord Molloy has said, there is now an increasing number who are failing to get into practice and who are unemployed? If the noble Lord does not have that information, perhaps he could get it from the Royal College of Medical Practitioners who would confirm it. Can the noble Lord's right honourable friend take some action, perhaps, to encourage general practitioners who are of a great age to retire earlier in order to give some of these young doctors an opportunity of getting into practice?

My Lords, when I answered my noble friend Lady Gardner I referred to the figures for dentists, which are, I think, slightly different. But the rate of growth in the number of family doctors in general practice has doubled in recent years and is now running at about 2 per cent. per annum, and the overall average patient list size continues to fall. At 1st October 1982 there were 22,786 what are technically called "unrestricted principals"—that is to say, family doctors—working in England, and the overall average patient list size was 2,155. The noble Lord also asked about early retirement. As regards that matter, my right honourable friend the Secretary of State is awaiting the outcome of some research which is being undertaken at present.

My Lords, on the question of pre-registration posts, is the noble Lord the Minister aware that last November grave anxiety was expressed on this by the Joint Consultants' Committee, and that the then chief medical officer gave an assurance that this situation would not happen again? Already this month—and there are not many days in it—the new chief medical officer has had to apologise and explain that nothing much has been done. If we ultimately have a situation in which even only 10 doctors cannot get jobs after they have qualified at a cost of £1 million to the nation, surely the Government must take this very seriously.

Of course, my Lords, the Government take seriously the employment of doctors; but, as I tried to indicate to the noble Lord, there is not the evidence to suggest that vast numbers of doctors are unemployed. It is a local matter, and is one that is generally considered to be frictional. I thought that the noble Lord, Lord Molloy, accepted that.

My Lords, can my noble friend assure me that, when the Secretary of State looks at the matter of early retirement for medical practitioners, he will also look at this same matter in relation to dental, optical, pharmaceutical, and all general practitioners who come under the General Practitioner Scheme?

My Lords, I shall certainly pass on my noble friend's views to my right honourable friend the Secretary of State.

My Lords, can the noble Lord say to what extent it is true that some areas of the country are far more attractive to medical practitioners than others, and that there is a problem in certain areas? Can he confirm that this is the case, and will he look at this as a matter of urgency?

Yes, my Lords. I think it is true to say that there are parts of the United Kingdom which do not attract doctors in the same way as other parts do. I believe that that touches on the point raised by the noble Lord, Lord Molloy.

My Lords, briefly, in so far as the Junior Doctors' Association of the British Medical Association and the Royal College are gravely apprehensive, it might be worth while if the Secretary of State—indeed, the noble Lord the Minister himself—would agree to meet them to talk about their grave apprehensions on this matter.

My Lords, I am sure that my right honourable friend will note what the noble Lord says.