Brian O'Shea
Question:6 Mr. O'Shea asked the Minister for Health and Children his views on the changes proposed by the Minister for Education and Science for entry to the medical sciences; and if he will make a statement on the matter. [22546/03]
Other Questions. - Medical Science Qualifications.
As the Deputy will be aware, the Minister for Education and Science requested the Higher Education Authority to commission a report into alternative methods of entry to high points health science courses at third level. The main drivers of this initiative were a perceived distortion of the points system and a fuelling of pressures on leaving certificate students because of the high points required for these courses. The report recommended that entry to a range of health sciences programmes should be on a postgraduate basis. It is proposed that the revised arrangements would be introduced initially in medicine, with other disciplines to follow.
These far-reaching proposals will require careful consideration and examination, especially in view of the impact that change would have on the supply of doctors and other health professionals to the health system. The need to produce health science graduates, including doctors, who are equipped with the broad range of professional skills and technical competencies which education currently provides is essential. There will be an ongoing requirement to meet the needs of the health system for staff in appropriate disciplines and numbers. It will also be important to ensure that all levels, including hospital, community and primary care, have the necessary capacity to provide the training opportunities required of undergraduate education.
With the Minister for Education and Science, I have established a working group on undergraduate medical education. The membership of this group includes the five deans of the medical schools, representatives from the major teaching hospitals, the Department of Education and Science, the Department of Health and Children, the Department of Finance, the national task force on medical staffing, the Medical Council, the Higher Education Authority, the nursing profession, the university sector and public interest representation. As part of its work, this group will consider the issues involved in the changes proposed in the report. It is expected that this group will report next year. At that stage a clearer indication of the implications of these proposals and the detailed implementation issues which need to be addressed will emerge.
Does the Minister agree there is a basic problem which is not being addressed in this regard? Universities and colleges have a vested interest in attracting foreign students to study medicine in Ireland. It is to their benefit to do so. Is the Minister aware, as indicated by the most recent figures available to me, that less than half the students currently studying medicine in this country are Irish? While nobody objects to foreigners being invited to study medicine in this country, does the Minister agree we have now reached a stage where we are not producing sufficient Irish medical graduates because of a distortion in the system? Universities and colleges find it more attractive, from their perspective, to bring in foreign students, because the money follows them. This matter is not being addressed in the arrangement which the Minister has set up.
Having regard to Deputy Twomey's comments in this context, does the Minister recognise there is a serious problem in GP areas, and in other areas also, in terms of shortage of doctors?
I believe we are taking the right approach. First, the deans of medicine came to my Department, not just on issues of capacity and numbers but also on broader issues of curriculum content, the future quality of graduates, international best practice and so on. The remit is necessarily broad and it is important to get it right. I accept the Deputy's point with regard to the incentives which universities have in terms of attracting overseas students who pay full fees. That structure has existed for a long time. The reality is that it has become an important revenue strand for universities and medical schools. However, the issue at this stage is not only in relation to doctors, it also relates to entry to the wider area of general medical science degrees before one proceeds to a particular specialty. For the first time in a long period, we are developing programmes within the ambit of the medical schools for the allied health care professionals, including speech and language therapists, physiotherapists and occupational therapists. Nursing also comes under that remit. It is important to get matters right. I believe the structures we have put in place will give us that result.
The Minister has diverted from the point of my question. Nobody objects to the development of this approach to medical education. Does he agree he has a responsibility to ensure there are sufficient places available to cater for own professionals? He is not dealing with that issue.
I wish to put three questions to the Minister. Does he agree there are downsides to his consensual, slow-motion style of decision making and that he could make decisions on the excellent report of the Higher Education Authority by simply calling all the interest groups which he listed to his office for a day and making decisions on the basis of what they have told him? He is losing months in the process of setting up a working group to look at a report which has already covered all the ground.
Taking my second and third points together, what are the Minister's views as to the impact on the supply of doctors as a result of acceptance of the proposed recommendations? Will he also elaborate on the capacity issue?
I did not catch the second part of the Deputy's question.
The Minister referred to an impact on the supply of doctors, about which he was worried in relation to accepting the Higher Education Authority recommendations. He also referred to a capacity problem with regard to training. Will he elaborate on each of those aspects, as well as answering my initial question?
On the Deputy's second point, if one develops a new system of entry to the medical profession, there is liable to be a transition period during which one must ensure there is not an interval of a year or two during which there are no graduates emerging.
As in the case of nurses.
The same could apply in this instance if we adopt a new method of entry. There could be a period without graduates. We need to ensure that does not happen or, alternatively, provide contingency plans to avoid the downside of such a situation. That potential currently exists in relation to the nursing profession and we are taking contingency steps in that regard. On the question of capacity, additional training places would be required in the universities.
Could the Minister not have dealt with all those issues in a day by calling in all the interests involved and then making decisions?
No. That is the approach which destroyed proper manpower planning in the health services.
That is nonsense.
(Interruptions).
An Leas-Cheann Comhairle
We must move on. I ask the Minister to reply to Question No. 7.
This is a very important point. In the early 1990s – I believe Deputy Bruton may have been in government at the time – the Government made a rushed decision to reduce the number of nursing students in training colleges. We are still experiencing the downside of that decision. Knee-jerk, rushed decisions do not work.
An Leas-Cheann Comhairle
The Chair has called the Minister to reply to Question No. 7.
The Minister has a report but is unable to act on it.
I have no report in terms of the broader issues of undergraduate medical education places.
The Minister is indecisive – that is the problem. He has a ten year plan which will take ten years to put into operation.
Basically, the Minister does not want to solve the problem because he wants to keep his job. He should try to work himself out of the problem.
(Interruptions).
An Leas-Cheann Comhairle
Order, please.
Recent controversies would not support Deputy Bruton's suggestion.
Does the Minister mean it all goes up in smoke?
I understand the person concerned also had a ten year plan.
Did the Minister discuss the health services during his recent visit to New York?