My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In so doing, I declare an interest as someone who has to rely on specialist medical care at times.

The Question was as follows:

To ask Her Majesty’s Government how they plan to deliver their assurance of continued employment for junior doctors after 1 August while the doctors progress through the second round of recruitment to speciality medical and training posts.

My Lords, the delivery of the Secretary of State’s employment commitment will be managed by strategic health authorities, which have been asked to produce plans for its delivery. These plans will be performance-managed by the MMC programme team. The employment commitment will help trusts to manage any service gaps which might otherwise have existed. The employment commitment covers eligible MTAS applicants who are in substantive employment on 31 July. This includes all doctors in deanery-approved training posts or with a substantive contract. It does not cover locum doctors or doctors on short-term contracts.

My Lords, I thank the Minister for that reply but I am not sure whether it is a very satisfactory one. Is she aware that on 1 August about 10,000 junior doctors will be without posts? How many patients will be put at risk?

My Lords, there are two elements to that question. First, the number of doctors in training who do not have posts is not entirely clear yet. Of course, a second round of applications is beginning now and will end on 31 October. At the end of that process, some doctors will not have training posts. However, that was always the case. The vast majority of those doctors will still have jobs; it is merely that they will not be in training. As to the way in which patients will be treated after 1 August, junior doctors have changed in hospitals at the beginning of every August. We are confident that there will be proper continuity of care and safety for patients.

My Lords, in the light of the experience gained so far of running MTAS, what are the perceived benefits of the system? If there are none, should it not be scrapped?

My Lords, as the noble Lord will know, there have been many difficulties with MTAS. It is not properly in use at the moment and whether it will be used for 2008 is under consideration. I hear what he is saying and I am sure that if it should be scrapped, it will be.

My Lords, how many deaneries have reneged on the assurances given by the Government by offering jobs wrongly in round 1, by using the discredited application forms in round 2 that failed in round 1, and by putting the closing date for round 2 before the completion of round 1? I declare an interest as the person organising a meeting this Saturday on “Living with MTAS 2007” for junior doctors.

My Lords, I regret that I do not have that information to hand. I will ensure that the noble Baroness has it before her meeting on Saturday. However, I should say that the Government understand the terrible stress and anxiety that has been caused to junior doctors. We hope that from now onwards the situation will be much better for them and their families.

My Lords, the Minister said that the effect of the failure of this system upon the morale of junior doctors, upon whom the future of our National Health Service depends, has been utterly devastating. Can she confirm, first, that if any system is to be devised to be introduced in 2008, the application form which did not allow those involved in shortlisting to identify doctors of the highest quality will be totally rejigged? Secondly, can she give any information about the progress of the inquiry being undertaken by Sir John Tooke into the future of this process?

My Lords, the Government well understand that there was great unhappiness with the application form and this issue is being considered carefully by the department. As to the Tooke review, the recommendations will be brought forward in September 2007. It is on the basis of that review that we will take decisions relating to 2008 and beyond.

My Lords, the Minister has just told us that the Government are going to take forward their thinking about MTAS in the light of the Tooke review, to be published in September. Will the Government accept the recommendations of the review, whatever they might be, and—given the level of interest in this House in the MTAS business and since we will be in recess—how will she make sure that Members of the House know what is happening and whether there will be a chance for a debate as soon as we come back?

My Lords, the Government will examine the recommendations of the Tooke review carefully and will act accordingly. However, I point to the fact that the Government acted on every recommendation brought forward in the Douglas review, so that bodes well for the future. The House will not be sitting when the Tooke review reports but I will ask the department to write to every noble Lord who is interested in the subject, to ensure that they are properly informed of the review’s outcome. The third point, in relation to a debate, will be a matter for the usual channels.

My Lords, how can the noble Baroness say that those 10,000 doctors who will not get training posts will still have jobs, bearing in mind that the training posts that they are already in will have been filled and that the National Health Service is trying to reduce its costs?

My Lords, the National Health Service is, quite properly, trying to get its budgets into balance, but that does not mean that there has been a huge reduction in the number of doctors employed. I am confident that the vast majority—not each and every one—of those doctors will find employment or some other form of education; many things can be done, and I will certainly inform the noble Lord in writing.