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House of Lords

Monday, 6th March 2000.

The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.

Prayers--Read by the Lord Bishop of Wakefield.

Academic Medicine: Vacant Chairs

Lord Peyton of Yeovil asked Her Majesty's Government:

    How many chairs of academic medicine are now vacant, and what action they propose to take to encourage suitable candidates to come forward.

The Minister of State, Department for Education and Employment (Baroness Blackstone): My Lords, these data are not collected centrally. However, I am aware that concerns are being expressed about filling some of the posts. Work is in hand by the universities to establish the size of the problem. We shall consider whether further action is needed at the national level once we have received the results of that work.

Lord Peyton of Yeovil: My Lords, that is a very interesting Answer. However, will the noble Baroness agree that the problem is caused at least in part by people who should be engaged in research and training being pushed into clinical duties? Does she agree that that gives Ministers, particularly in the other place, the opportunity to give well dressed up answers to show that they have fulfilled their pledges, which they probably have not, and that they are doing better than their predecessors, which they should be doing but are not?

Baroness Blackstone: My Lords, I am not sure about well dressed up answers being produced in the other place. I assure the noble Lord, Lord Peyton, that there can be no question of academic clinical staff being pushed into NHS work simply in order to bolster the statistics of the numbers of doctors working in the NHS. Academic clinical staff are, of course, a very small proportion of the total numbers in the medical profession. However, I am aware that there are many time pressures on that particular category of staff. They are required to carry out good research and there are great pressures on them to achieve in the research assessment exercise (RAE). They have considerable teaching responsibilities but many of them carry out clinical work, too. Some work must be done to ensure that the balance is right and that the jobs do not become unsustainable and unattractive because too much is expected of that particular category.

Lord Walton of Detchant: My Lords, I can answer the noble Baroness's query. At present there are 74 vacant clinical chairs in the United Kingdom. Does she agree that the noble Lord, Lord Peyton, is right in that, to some extent, the pressures of clinical

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work to the detriment of teaching and research have affected recruitment in clinical academic medicine? Further, does she agree that with the Government's commitment to introducing an additional 1,000 medical students, it is crucial that this sector of clinical academic medicine should be improved? Will she take account of the Savill report of the Academy of Medical Sciences, published today, which makes a number of important and innovative suggestions about how to improve recruitment in clinical academic medicine?

Baroness Blackstone: My Lords, yes. I shall be delighted to take into account the work of the Savill report. Of course, that will be a matter also for my right honourable friend the Secretary of State for Health, who is responsible for the NHS side of this issue. However, perhaps I may address the question of the 74 vacancies. That figure derives from a BMA survey, not from centrally collected statistics. The survey was not of the complete population of all medical schools. Moreover, one-third of those surveyed did not reply. Therefore, I believe that we must take the figures with a little pinch of salt. Perhaps I may say also that, of the 74 vacancies quoted in the unpublished BMA survey, 26 were in the process of being filled.

I am trying to provide the background to this matter in order to assist your Lordships. However, I do not in any way want to intimate that there are not considerable pressures on the people who occupy those posts. More work needs to be done in considering how to alleviate the pressures in order to ensure that the posts are filled. There will, of course, be another 1,000 medical students and that means that we shall need to recruit more staff in this category.

Lord Clement-Jones: My Lords, does the Minister agree that, in fact, recruitment in academic medicine is presently at an all time low and that that may account partly for the failure to fill many of those chairs, rather than it being a matter purely of the recruitment process? Can she confirm what her department and the Department of Health are doing to improve recruitment into academic medicine? The noble Lord, Lord Walton of Detchant, referred to the report of the Academy of Medical Sciences. I wonder whether the Minister has looked particularly at the tenure track proposals made both by that academy and by the Royal College of Physicians?

Baroness Blackstone: My Lords, yes, I am aware of both those reports. However, the recruitment of academic staff is, of course, a matter for the universities; it is not carried out by central government, as the noble Lord is fully aware. The universities are looking at all those issues. Further work is being done. The group which is taking it forward is expected to report in May or June. When the Government receive that report, they will consider whether anything needs to be done centrally. However, I would not be quite as gloomy as is the

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noble Lord about general overall recruitment in academic medicine. I have received reports that there is still a large number of young doctors who are very attracted by this type of work.

Lord Naseby: My Lords, since the noble Baroness has confessed that she does not know the size of the problem, should we not perhaps have a tsar to look at academic medicine? If such an appointment is made, perhaps he or she should look at not only the number of medical students but also at the percentage of those medical students who go into full-time work, whether it be of an academic nature or as clinicians?

Baroness Blackstone: My Lords, I do not know that we need either a tsar or a tsarina for that particular purpose. It is important that young medical students who are about to qualify are given information about all the options available to them. But substantial numbers of them are interested in research and go into research. That is one reason why the UK is ahead of many other countries in terms of both the quantity and quality of its medical research.

On the noble Lord's more general question, the vast majority of young people or, indeed, slightly older people--because more mature students are coming into medicine--who qualify go into careers in medicine.

Lord McColl of Dulwich: My Lords, if, as the Minister said, the review was incomplete and medical schools did not reply, that means that there is a minimum of 74 vacant chairs. That must be so if the questionnaires were not completed. In view of the fact that there is not the slightest doubt that morale is very low in the world of academic medicine, will she consider revising the answer which she gave a few moments ago when she said that she would consider whether further action is necessary? Such action is desperately needed now.

Baroness Blackstone: My Lords, that is really a matter for universities. The Government do not directly recruit people into universities. They are not the employer in that case. Nor do the Government set the pay of academic staff. Again, that is a matter for the universities, as are the conditions under which people work. So it would be quite wrong for the Government to set down in stone today what should be done. More work needs to be done to consider the extent of the problem. I do not know whether there are more than 74 such vacancies. I suspect that there are not because I suspect that those medical schools which did not reply are more likely to be those that do not have a particular problem. I do not know. But we need to have all the data in front of us before we decide whether further action is needed.

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Death Penalty: Worldwide Abolition

2.44 p.m.

Lord Faulkner of Worcester asked Her Majesty's Government:

    What efforts they have made to secure the worldwide abolition of the death penalty.

The Parliamentary Under-Secretary of State, Foreign and Commonwealth Office (Baroness Scotland of Asthal): My Lords, the Government oppose the death penalty in all circumstances. EU guidelines on death penalty demarches in third countries were agreed under our presidency, allowing us to raise both individual cases and capital punishment more generally. We have established a panel of indepen- dent experts to advise on practical steps to promote abolition. And we have led the EU efforts for a successful death penalty resolution at the UN Commission on Human Rights.

Lord Faulkner of Worcester: My Lords, I thank the Minister for that encouraging reply. In the light of her welcome commitment to support the European Union policy towards third countries which states that the death penalty,

    "has no legitimate place in the penal system of modern civilised societies",

will the Government intensify their efforts to secure its abolition throughout the Commonwealth? Is my noble friend aware that up to last Thursday no fewer than 19 people have been put to death in the United States this year--three of them juvenile offenders and one of them a 62 year-old great grandmother who had suffered a lifetime of sexual, physical and emotional abuse and whose other misfortune was to live in the state of Texas where the governor is a candidate for the presidency of the United States?

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