Lord Stevens of Birmingham (CB)

My Lords, I declare my interest as chair of King’s College London. I think that there is a welcome consensus that the UK should aim for self-sufficiency in the production of new doctors through medical school, specialty training and into the NHS. In fairness, the last Government deserve credit for having taken the decision to expand medical school undergraduate intake to put us on that path. It was also not unreasonable, as a temporary measure, to make use of selective international recruitment while those new doctors came through the system, not least as the independent Migration Advisory Committee reported at the time that, in respect of doctors, “there is sufficient and overwhelming evidence of a UK-wide shortage”. Given that it takes perhaps 15 years for new medical students to come into independent clinical practice, telling patients to hang on for 15 years while that intake fed through the system would not have been good, certainly for patients. However, the issue now is that, clearly, there needs to be better prioritisation during the transitional system. We spent a lot of time in Committee discussing the pros and cons of what that transitional prioritisation might look like, but one question that has not yet been completely resolved, which would aid the House in assessing the proposals that the noble Lord, Lord Patel, has put before us, is whether we could have a clear answer from the Minister as to what the increase in the pipeline and in the availability of specialty training places is going to be for the current year and over the next three years. As she pointed out to us in correspondence during recess last week, the NHS 10-year plan that the Government published last July talked about an additional 1,000 specialty training places over three years. However, the Secretary of State for Health and Social Care put on the table the proposition of not 1,000 but 4,000 additional specialty training places over three years, of which an additional 1,000 would become available in this coming year. That is what was put on the table in the discussion with the BMA on 10 December. Given that it is only a few months until these posts are filled, presumably the Minister must know the answer to the question: exactly how many additional specialty training places will we get for the year ahead so as to reduce the prioritisation problems with whichever criteria the Bill puts forth?