Medical school expansion ruled out

April 26, 2002

There will be no new expansion of medical school places and no new medical schools despite government promises last week of 15,000 more GPs and consultants.

Officials at the Department of Health assured heads of medical schools this week that they did not face another round of expansion.

"We simply do not have the clinical academics to expand again," said Michael Powell, executive secretary of the Council of Heads of Medical Schools (CHMS).

The extra GPs and consultants are expected to come through a medical school expansion, which has already been announced, and better retention and recruitment.

However, the Department of Health is clear that the numbers of student nurses, midwives and other health professionals are set to expand yet again in 2003-04.

Universities UK warned that this expansion could take place only if extra money were provided. Janet Finch, vice-chancellor of Keele University and UUK's spokesperson on health issues, said: "UUK's submission to the spending review emphasised the need for adequate funding for universities so that they can educate the growing numbers of students in medicine and health professions."

The submission requested an increase of £60 million a year in recurrent funding. UUK said this week that even more would be required if the DoH's new targets were to be met.

In delivering the NHS plan, health secretary Alan Milburn said the extra investment in the National Health Service promised by the chancellor in his budget - a cash increase of £40 billion a year by 2007-08 - will pay for 35,000 more nurses, midwives and health visitors, and 30,000 more therapists and scientists as well as the 15,000 doctors by 2008. The report says: "Compared with 2001-02, by 2008 there will be over 8,000 more nurses each year leaving training - a 60 per cent increase. Similarly, there will be an extra 1,900 medical school graduates per year - a 54 per cent increase."

Many nursing courses in the Southeast have struggled to recruit since bursaries for overseas students were ended. The Council of Deans of Nurses estimates that overseas students accounted for a third of the intake last year in London and the Southeast.

A spokesman said: "If the government wants to expand student numbers, it has to put funding into facilities and provide for an expansion of health educators." He said that recruitment to nursing courses across the country had to be reassessed, as some areas have waiting lists whereas recruitment was particularly difficult in London and the Southeast.

The University of Hertfordshire takes two cohorts of 220 nursing students a year. It is between 25 and 40 places below target on the February cohort.

Ian Peate, principal lecturer in nursing, said: "It is not just the loss of the overseas bursary that has hit us. Bursaries for UK students are very low and in the Southeast living costs are high."

Mr Peate added: "There must be significant increases in nurses' and lecturers' pay. A policeman with 18 weeks' training can expect a starting salary of £23,840 whereas nurses with three years' education can expect between £16,000 and £17,600."

Lecturers' union Natfhe is campaigning for the estimated 8,000 nursing and other health educators in universities and colleges.

Andy Pike, Natfhe's national universities official, said: "We (want) an end to the long-hours culture, the same conditions of service for health educators as for other academic staff, fair academic grading and realistic rates of pay reflecting pay levels for comparable groups within the NHS, and time for travelling, clinical updating and clinical linking."

Heads of medical schools were relieved this week that no new expansion was planned. But the CHMS has called on the government to relax strict rules on recruiting overseas medical students. When the first expansion of medical places was announced in 1998, the government told medical schools to keep the number of their overseas students steady and to expand through UK students. "New medical schools have no overseas students," Mr Powell said.

Medical heads argue that this means not only a loss of overseas fees but also of future NHS staff.

Mr Milburn also announced a new Commission for Healthcare Audit and Inspection. It will take on the roles of the Audit Commission and the inspection powers of the Commission for Health Improvement and the National Care Standards Commission. It will assess the performance of every part of the NHS and report to Parliament.

The teaching of medical and health students in NHS hospitals is funded by the new multi-professional education and training levy. The commission is expected to look at how well it is spent and at NHS research funding.

Mr Milburn stressed the role of the NHS University, which will start work in 2003, in his document on delivering the NHS plan. However, the statement "there will be innovative common learning programmes across professions both pre and post-registration" has alarmed academics who had understood that the NHSU would not touch pre-registration education.

* Social service reforms are also likely to be hampered by a shortage of social workers. Some universities have struggled to attract applicants to social work courses, and Edinburgh University has just announced plans to close its undergraduate programme.

In Scotland last week, Cathy Jamieson, minister for education and young people, announced plans for a new social work honours degree.

In England, the government has already said that it plans to introduce a three-year degree as the new qualifying course for social workers in 2003, but questions remain over how students are to be funded and whether the masters route into social work will remain a viable option.

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