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NHS: Medical Training Initiative

Volume 718: debated on Thursday 11 March 2010


Asked By

To ask Her Majesty’s Government what assessment they have made of the effects of the scheme allowing medical trainees from sub-Saharan Africa to work in the National Health Service for a maximum of two years; and how many individuals have come to work in the United Kingdom under that scheme.

My Lords, the Department of Health operates the medical training initiative, which is designed to facilitate the entry of a number of non-EEA doctors into the UK, including some from sub-Saharan Africa, to benefit from training in the National Health Service. One hundred and ninety-one doctors have entered the UK since April 2009, including 12 from the sub-Saharan region.

My Lords, I thank the Minister for that Answer. Given that the lack of health workers is probably the greatest single issue affecting health in sub-Saharan Africa, given the tiny number that the Minister has just referred to of 12, and given the fact that the UK is one of the world’s leading educators, should the Government not be doing more on this—specifically, having a scheme designed to support the training of health workers from sub-Saharan Africa in this country, as well as giving extra support to their training in the region itself?

My Lords, the scheme has been developed since last year and is building up. We hope to build up to some 750 doctors. At the moment, it relates to low and middle-income countries. Recruitment for the scheme is quite informed—it is through the royal colleges, through word of mouth. Certainly, I think that the Department of Health will recognise the noble Lord’s contribution in this area and consider his comments. We are a big player in the international development of the health worker community, but we will look at whether sub-Saharan Africa should have some greater emphasis.

My Lords, does the Minister recognise not only that we can make a contribution in the way described by the noble Lord, but that this country has itself been enormously enriched by young doctors and scientists coming and working in our institutions and then continuing their relationship over a long period? Do the Government recognise that their understandable preoccupation with security and illegal immigrants has now tended to create a default attitude that guests are unwelcome until proved otherwise rather than the reverse, which is that the vast majority should be welcome? In practice and procedure, our border agency is creating a chill factor. Are the Government prepared to do something about it?

It was nice to absolutely agree with the first part of that question. We recognise that the exchange over the years has been enormously beneficial. The Government have an international health policy. World health is good for British health; we want to support it. I would not accept the claim that the immigration system makes this difficult. It is a very clear system. These are tier-5 people. The National Health Service has a central capability. It gets the appropriate approval from the royal colleges, et cetera. These people come in very clearly on a tier-5 visa for a finite period and then they are expected to go back to their own country. We are doing everything possible to make sure that their entry into this country is smooth.

My Lords, is there a parallel scheme to cover medical technicians and nurses and, if not, will my noble friend consider expanding the scheme? In the discussions in expanding the scheme, what steps will the Government take to make sure that the medical trainees return to the countries from which they have come, where they will be very welcome and valuable?

As far as I know there is no technician scheme. The Government will read this Question with care and consider whether the scheme should be grown in that area. As I understand it, we do not have any power to make sure that people go back to their own country. We have the power to make sure that everybody is absolutely clear that the visa to undertake this training is a tier-5 visa, which is finite in length, and that at the end of the training they must and will leave the country. I am sure that the good intentions of these individuals mean that they will go back to their own countries, taking their knowledge to help those nations.

My Lords, does the noble Lord agree that one of the best ways to ensure that such trainees stay in their own countries is encouraging British surgeons to train Africans in their own countries to do the various operations which are relevant to their people? For instance, Mercy Ships trains a lot of surgeons on-site in the relevant techniques that are so important for these countries.

My Lords, I entirely agree. What the NGOs do, and what the noble Lord himself does, in this area is extremely commendable and valid. This scheme is about bringing people to experience the British health system, the British health processes, ethics and so on. I have read some of the case studies. They get a valuable insight not exactly into a different method but into some different attitudes, processes and so on, which they take back. We should think of them as going in at the high end of their own health systems, enlivening them and helping them grow.

My Lords, some years ago a number of partnership agreements were entered into by UK medical schools with medical educational establishments in sub-Saharan Africa. Many of these agreements, which resulted in young doctors coming from Africa to train in the UK, fell by the wayside because of the political instability in some of the African countries involved. Is it not appropriate for the Government to now have discussions with the Council of Heads of Medical Schools to see whether some of these partnership agreements for the training of doctors from sub-Saharan Africa might be revived?

My Lords, that seems a perfectly sensible suggestion and I will make sure that the Department of Health considers it. We have got the technical sides of the scheme right, particularly the immigration things. We now want to build the scheme up—as I say, from about 200 to 750 a year—and that may well be an important way forward.

My Lords, in reply to my noble friend Lord Hughes, my noble friend Lord Tunnicliffe said that we did not have the power to make the African students go back to their countries of origin. We may not have the power, but do we know whether they do it? Do they go home?