I wish to share time with Senator O'Toole.
Third Level Education: Statements (Resumed).
Is that agreed? Agreed.
I welcome the Fottrell report, an analysis of medical education in Ireland. This is the first time an inclusive review of this nature has been undertaken and it has been a worthwhile exercise. It provides a platform from which we can take stock and from which we can provide for differently structured access to a professional education that equips young professionals and disposes them towards continuous professional development when they enter employment.
Given the needs of society and ever-changing patterns evident in other professions, it is clear that a fresh approach to medical education is needed. Similar change is required in medical research and an extending knowledge base will call for ongoing reform in syllabi and curricula. It will call for other things too. It will call for a more diverse range of skills and understanding and it will call for a different sense of mission.
Health issues are complex. The health service is struggling; costs are spiralling. However, we should not lose sight of the care of individual patients — something that should be at the centre of our thinking on health services. Good medical education and quality health care are inextricably linked and perhaps we have not always recognised this in the past. We must change the structure of medical education. The concurrent model for undergraduates has served a purpose and may do so in the future, though in a more limited way. A consecutive graduate/postgraduate model must be introduced immediately to multiply access routes to the profession. Multiple access routes will widen the perspectives and approach of medical practitioners. Different perspectives shared will deepen professional conviction and foster diversity.
Alternative access to the medical profession is, ironically, a health issue because it is not healthy for 16 year olds to be deciding on careers in medicine while pressure to score maximum CAO points to secure a place in medicine is deeply unhealthy for even the most well adjusted school leavers. In addition, the single route for entry to medicine is not a healthy prospect for the patients who the emerging doctors will ultimately treat.
Difficulty of access to and, indeed, exit from the medical profession does not make for a healthy professional community. It is time to set aside all orthodoxies and think more creatively about medical education. Medical education should not be the preserve of universities or the establishment. The professionalisation of nursing is a case in point. Nurse education departments have been established at both universities and institutes of technology around the country. In my constituency of Waterford, the nurse education programme at Waterford Institute of Technology attracts students of outstanding quality and commitment from across Ireland and overseas. The facilities provided in the learning environment there are particularly advanced and impressive.
On the wider issue of funding in higher education, there are two strands, namely, how much we spend as a country and how we spend it. Recent attempts to play catch-up in terms of the amounts we spend are welcome but what is often forgotten is that investment in higher education is investment in the future and a vote of confidence in our young people. Inadequate funding is a problem but so too are inadequate distribution mechanisms. State funding for organisations should not be a given. It must be competed for by higher education institutions, especially those seeking financial support beyond minimum and core requirements.
Greater coherence with regard to objectives and measuring outcomes and purpose is also needed. We must differentiate the scales of funding for various initiatives so they better match strategic goals at regional and national level. I would like to see an extension of the specialised funding programmes already in place. Advancing national objectives and goals and building a better society should be key bases on which we judge funding bids from the institutions. We must ensure that medical education and, more widely, the entire higher education community is steering a true course in specific directions while not neglecting other imperatives.
Reference was made by Senator Ormonde during the debate to the question of a university for the south east. I lend my support to that quest. There are fewer graduates in the south east than in any other region of the country. A comprehensive submission has been made by Waterford Institute of Technology for its upgrading to university status. I fully support that submission, as do all politicians and the electorate in the south east, which is the only region without a university.
I welcome the Minister of State, Deputy Brian Lenihan, to the House. I am glad to have the opportunity to speak in the debate. The Minister of State will be getting the point in stereo, so to speak, as I intend to reiterate the points made by my colleague from Waterford, Senator Cummins. In contributing, I will concentrate on the issue of funding, particularly with regard to how Waterford has been discriminated against. However, at the outset I will refer to the Fottrell report.
I agree with the thrust of the Fottrell report with regard to increasing the number of medical students, particularly Irish students. The system contains a high proportion of non-EU medical students. These students are very welcome and no-one has a problem with them. We are delighted to see them come to Ireland and hope they will continue to do so. However, we need more Irish students in the system because medical professionals, particularly those who go on to become consultants, tend to travel the world to gain experience before eventually settling down. It is more likely they will settle down in their country of origin than anywhere else. For that reason, it is important that we have more Irish medical students, who will hopefully enter our medical system, which would be a major help to our hospitals. More and more funding is being pumped into the health services but, unfortunately, difficulties remain. This is one step which will help to resolve the problems.
I agree with the new methods of medical training. The necessity to achieve 600 points in the leaving certificate in order to study medicine leads to a rat race. It is now proposed that there should be different means of entry. We all know people who would not be able to achieve such high leaving certificate results but would probably make great doctors. I welcome the new methods and hope they will be put in place at an early date.
I recently considered the statistics with regard to third level funding in the various cities. Of the five cities, I will exclude Dublin because it is so much bigger than Cork, Galway, Limerick and Waterford that it should not be included in any comparison. In 2005 recurrent expenditure was €154.6 million in Cork, €114.9 million in Galway, €86.2 million in Limerick and €33.5 million in Waterford. That funding goes into the local economies and it is easy to see that Waterford city lags behind in this regard as, of the four gateway cities, just 8.6% of expenditure goes to it.
In the same year, capital expenditure was €34 million in Cork, €13.8 million in Galway, €11.4 million in Limerick and €1.7 million in Waterford. Therefore, just 2.8% of capital expenditure went to Waterford, which is not good enough. I realise that capital expenditure can vary from year to year because projects may be at their peak one year and taper the next. However, if one examines the figures for any past year, the other three cities were always ahead of Waterford in terms of expenditure.
The most important figure is recurrent expenditure because it relates to the amount going into the economy of those cities every year. Waterford lags badly behind because it does not have a university of the south east and, as a result, the city and the region suffer.
Most people believe the south east to be a prosperous region. That is not the case. The latest data from the Central Statistics Office suggest that the per capita income in the south east is 88% of the national average. The only region with a lower percentage is the Border region.
Waterford Chamber of Commerce recently commissioned a study by Goodbody Economic Consultants which tried to establish the current economic performance of the south east and identify where action is needed, set out the role of third level institutions in enhancing national and regional economic performance, review the international literature to illustrate the direct and indirect impact of universities on the regions, estimate the current and future impact of a university on the region given a number of scenarios and illustrate the direct and indirect impact that a university could have on the region. Considering the starting point and the economic data, the performance is poor. For example, the number of admissions to university from Waterford people is 25% fewer than from the west. Some 22% of Waterford people continue with higher education compared with a national average of 30%.
Such statistics must tell somebody something. We need a university and we will not attract private funding until such time as we have one. The Minister for Education and Science, Deputy Hanafin, has in the past trotted out the argument "What's in a name?", and pointed to the position of the London School of Economics and the Massachusetts Institute of Technology. That is a totally different scenario. Those institutes are able to attract huge research grants from the public sector and more particularly the private sector. As we do not have a university, we are not able to do that. People from the south east make up 11% of the country's population. We attract 0.69% of higher education grants. It is no wonder we tend to fall behind other cities.
Another measure of what is available in an area relates to the types of jobs there. Managers and professionals in the workforce account for 40% of the total in Dublin, while in Waterford they account for 28%. Only 5% of all graduates find employment in the south east. Some of the conclusions from the report I have been referring to include that the south-east region has underperformed, as I have proved, relative to other regions through the 1990s. This is particularly so with regard to the west, yet we always hear the cry from the west about how it is suffering, and it is still an Objective One region.
Significant additional investment is required if the south east is to participate fully in national economic growth. Underinvestment is reflected in comparatively low income levels, low levels of employment in the high tech sector and in business services. It is also reflected in relatively low educational qualifications among the region's population.
One of the key remaining areas of weakness is the low level of investment in higher education within the region. This weakness is particularly significant in the context of the knowledge economy that Ireland is striving to become. The attainment of a knowledge economy is now a key policy goal at EU, national and regional levels. The development of a university within the south east is a key policy objective for the region. The role and resources that a university would bring to the region would lead to the creation of over 700 jobs over the next five years. They would generate an additional €32 million within the local and regional economy. The region would have a substantial new driver of economic development.
Many countries throughout the world have initiated substantial regional development as a result of creating a university. Examples include Denmark, Sweden, Austria, Poland and Finland. Higher education participation, attainment and accessibility would increase with the provision of a university, and this would translate into the south east being a more attractive region for inward investment. The resourcing of research and development would attract substantial funding from national and international sources and provide a flow of new technologies and innovation into the region. Commercialisation of these activities would result in new knowledge industries emerging in the south east.
A university would instil a sense of pride in the region and provide a renewed source of cultural identity and development. The downward trend in economic and social performance would be redressed, and by increasing the attractiveness of the region for inward investment, the area could contribute more substantially to the national economy. The university would have greater flexibility in dealing with the needs of the region. It would attract new partnerships and a new range of investments, and it would create a potential for private funding and a critical mass impact. The university could rely more on private funding and reduce the dependency on the Exchequer, thus contributing at national level while creating a more autonomous learning region. What is good for the south east will be good for the State.
I wish to share time with Senator Norris.
Is that agreed? Agreed.
I welcome the Minister of State, Deputy Brian Lenihan, to the House. One of the reasons I wish to speak today is to apologise to the Minister for Education and Science, Deputy Hanafin, for a mistake I made in a debate on primary education last week. I misread the amendment to a motion and did not realise the amount of funding that the Department was giving to the particular tasks I was discussing. This was related to English language teaching for immigrants. After I had spoken, I realised that a large amount had been allocated to it. I was incorrect and I apologise. I ask Deputy Brian Lenihan to pass my apologies to the Minister.
I wish to discuss one particular topic, namely, the funding of third level education. Senator Norris will discuss the Fottrell report. I appreciate and welcome the new funding which has been allocated to third level education. This is a change to what has been done in the past. I do not wish to be accused of looking a gift horse in the mouth, but there are a number of caveats to the issue.
The funding is at the level where it should have been to begin with, but the new approach should be sustained. Education is not an area where a tap can be turned on from year to year and turned off at other times, according to the circumstances of the economy. A stop-go scenario is all wrong. The reason I mention this is because we have had a recent example of stop-go in action. I hope it is a lesson from which we can learn.
In the retrenchment made by the Government after the 2002 election, third level funding suffered severe cuts. The vitally important programme for research in third level institutions, a long-term project, was starved of funds for more than a year. That pause in research funding had a devastating impact on our reputation in the wider academic world. Having attracted worldwide attention by our decision to generously fund research, we then squandered the advantage by pulling in our horns almost before the projects had got off the ground.
A second caveat is that this new level of funding is still not all which is required. It is only large in comparison with what has gone before. With regard to the size of the challenge facing us, it is not nearly enough. I hope the same courage which led the Government to make the recent decision will carry it forward to when it emerges that a world-class third level system will require funding in excess of what is envisaged at this stage.
A third caveat is that funding should not be restricted to the necessary science-based disciplines. I yield to nobody in my enthusiasm for investing in science-based research. However, I would like to go back to the old thinking in what is the traditional concept of a university, back to the ideas of Cardinal Newman relating to an ollscoil. In this place, by definition, everything is taught and knowledge is pursued not just for the economic benefits that it can bring, but for its own sake. That concept is necessary to produce future generations of rounded people. This is the type of education written about by Newman 150 years ago in Ireland. This would produce roundly educated people, not just technicians who know of nothing outside their own specialisation.
Above all we should remember that our third level institutions are and must remain more than just glorified technical schools. While we make sure we are strong in the technical disciplines that will determine our economic future, we must not forget there is a wider picture, which defines us as a civilised society.
I have one last point as I know Senator Norris wishes to speak. At the debate on primary education last week, two figures caught my attention. One was the pupil-teacher ratio, which is now 17:1. I thought this was wonderful. However, it was later revealed that class sizes had been reduced to 25. I did not understand the discrepancy until I realised that approximately a third of a teacher's time at primary level, and probably elsewhere, is not directed at teaching alone. We should be aware that in third level education, research is required into science and into issues that will enable universities to produce rounded citizens. I welcome the funding that has been allocated.
I thank my colleague, Senator Quinn, for giving me a few minutes of his time. I agree with his statements, which related principally to the general question of third level funding. He invoked the name of the late Cardinal Newman and his idea of a university. I will consider a more specific point, namely, the impact of the Fottrell report.
I am glad the Minister has seen fit to implement most of the proposals contained in the Fottrell report. I heard Professor Fottrell on the radio not long ago welcoming this himself. My colleague Senator Henry and I, on advice from constituents in the University of Dublin, have raised a serious question. It is absurd that we are training in our schools more medical students from abroad than Irish medical students. In fact we were allowing foreign students to enter medical schools with lower points, which meant that Irish students who ought to have qualified for places were disadvantaged at a time when there was an insufficient supply of doctors to service the needs of the community. That was an absurd situation and I am glad the Minister has started to address it.
The intake of students is to more than double from 305 to 725, which is welcome. The increase received a strong welcome from distinguished medical correspondents, including Dr. Muiris Houston of The Irish Times, who had previously asked how the €200 million would be spent to address the medical manpower needs in our society. The Fottrell report estimated that we needed between 700 and 740 students. The Minister has set a target in the middle of that range so she is doing exactly what was suggested.
The starkness of the situation is illustrated by the chairman of the Irish College of General Practitioners, to whom I always listen because the public generally encounters the medical profession at GP level, which is the bedrock of the medical service. He estimates that we need to produce at least one GP every fortnight, which is a large number. He also points out that approximately one third of current GPs will retire in the next 15 years so we will need to produce at least 150 family doctors each year. It was an urgent situation but has been largely addressed and I look forward to seeing the implementation of this report.
Before I proceed to the significant question of postgraduate work in medicine, I will deal with the proposal to introduce aptitude tests within the next two years. I would like more information but I am attracted to the idea because the personality of a doctor is very important. It is not quite as important for a surgeon because patients have usually been knocked out by the time they get to that stage but if a person is sick, depressed, distressed or abashed, a good manner is very important.
This has been addressed in various ways. In the old days being a doctor was almost a family profession, passed on from one generation to the next, and there were good arguments for that because a child will pick up the bones of a trade from parents. The Minister of State is nodding and smiling and he should know what I mean because his family has made a fine contribution to politics and continues to do so.
Universities usually noted family connections and maybe required an interview. We are such a small society and given to gombeenery, if I may use a word that caused such distress in the House earlier, which means that there is often a problem if people are perceived as gaining an advantage from their family connections but that is wrong. To create a rigid, arithmetical meritocracy would also be wrong. In principle, I am attracted to the idea of an aptitude test but such tests can be risky. I have undertaken two intelligence tests. In the first I "out-Einsteined" Einstein but in the second I should have been closeted in a padded cell.
The Senator has one minute left.
I thought the Leas-Chathaoirleach was about to call for my removal.
Graduate students are an important element of university life but they need funding because many who wish to proceed to postgraduate research in medicine after their first degree leave Ireland for more exciting research prospects and better funding overseas. To retain their talent we need to focus on funding.
I will also raise the Buttimer report, which is important because it deals with consultants. It states that we need to shift from a consultant-led system to a consultant-providing system and I agree with that point. That must be considered but it would need to feed into the system at least 1,000 extra consultants and that will take money. Thank God we have the money to adequately fund this important area of our life.
I welcome the Minister of State. I am immediately reminded of the important contribution his father made when Minister for Education in the late 1960s, not merely in implementing free second level education as announced by Donogh O'Malley but also in setting up the institutes of technology and the NIHEs. A very important factor in our economic success has been the expansion of both second and third level education, particularly since the late 1980s, which was initiated by another relative of the Minister of State when she was Minister for Education. The large-scale expansion served economic as well as social purposes.
As the heads of universities are apt to remind us at regular intervals there are considerable financial constraints, despite the fact that third level institutions benefited from an enormous amount of capital investment, particularly over the past ten years. I am glad to say that investment continues, some of it from private sources and some from public. There is clearly deep dissatisfaction with the decision of the rainbow coalition to abolish fees. It was not a very bright decision but it is a political reality and is not reversible, no matter what arguments are put forward. It is like the arguments made in the 1980s that all objective reasoning demanded the reintroduction of domestic rates. The abstract arguments may have been very cogent but it was and remains utterly impossible to do so politically.
In the competition for resources it is not always obvious that third level education has a higher priority than, for example, first level, even though the per capita spending at third level is already much more than at first level. Financial constraints cause incredible insecurity among those interested in pursuing a university or lecturing career and I have sympathy with such people, some of whom are members of my wider family.
Relatively speaking, the income and status of university staff have fallen, possibly as a result of expansion. It is not surprising that a situation has developed throughout western Europe over the past 30 or 40 years, whereby the best academics at a certain stage in their careers cannot resist the better funding opportunities on the other side of the Atlantic. Not only Ireland but the entirety of Europe is at a disadvantage in this matter, although various countries have tried to address the problem in different ways. For example, across the water, problems are arising with third level unions over the issue of top-up fees.
Research councils for sciences and humanities, which are our means of addressing this issue, have undoubtedly brought about improvements to the situation through requiring people to compete for projects and funding. We also have a reasonably healthy situation in that a substantial amount of private research funding is available to colleges and universities. Many institutions are well geared towards applying for EU grants and to foundations such as the Wellcome Trust for scientific research moneys.
However, the problem remains that, because their employees can easily move to other countries or earn more in the private sector, Irish universities have to compete. Science, in particular, is a universal field. A lot of thought is required on how we can become more competitive and the Minister for Education and Science is concerned that only one lrish university appears in the Financial Times’ top 100 list of third level institutions. People who have done well out of this economy — the commercial barons of the 20th and 21st centuries — should be encouraged, like medieval barons, to fund substantial facilities that will bear their names in perpetuity. However, the right to bear a name should not be sold too cheaply by colleges because only a limited number of such opportunities arise. This practice is ingrained in the United States, where companies and rich benefactors fund facilities all the time.
Medical education here has been more focussed on earning money for colleges than on training doctors to work and serve in Ireland. Hence, a large percentage of students in some of the royal colleges come from outside the country and will probably not remain here. It is a question of balance.
High points are not necessarily related to an aptitude for becoming a doctor. The system of selection has been very crude to date, so I welcome the proposals for change.
Any attempt to address the anomalies in the supply of professionally trained doctors or the restrictions at entry level, including the Fottrell report, has to be welcomed. In my first year of teaching at secondary level, I encountered a student who excelled in her first year with A grades in every subject. Already ahead of her peers at that stage, she continued to perform well throughout second and third years and received top grades in the junior certificate. From first year, the student's goal was to study medicine, an ambition she fulfilled after getting maximum points in the leaving certificate. However, after studying medicine in Trinity for a year, she realised it was not the course she wanted to do.
My story is an example of the carrot and stick faced by many people. Is the expectation of points a sufficient reason to apply for dentistry, veterinary or general medicine? Are we using the correct motivational tools for people entering particular disciplines? Students often choose these subjects, or are pushed to do so by their parents, simply because know they will get the requisite points. That is not a good enough tool in terms of getting people into appropriate specialties.
It is important, not only at university level but also at secondary level, that a greater emphasis be placed on progression. Career guidance teachers have a restrictive mandate and there may only be two of them in a school of 500 pupils, which is insufficient to give one-on-one supervision to students' progression in terms of finding out where their talents lie, what they want to do and where they want to go. More tools should be available at secondary level to help students decide their futures.
The number of undergraduate places for medical students will increase by 250 over the next four years and by 40 in this year alone. Will there be associated costs for these courses and, if so, will those costs be prohibitive for some students? Senator Mansergh hit the nail on the head with regard to the financial insecurities experienced by people who wish, for example, to pursue six year courses in medicine or dentistry. In terms of the announcement of €200 million, where is the costing for this figure? The figure of €200 million has been thrown out for these extra courses. Is there any breakdown of the proposed expenditure or a timeframe for it? The Government is good at making announcements and I recognise the ability of Fianna Fáil and the PDs to come up with fantastic spin. The Transport 21 plan was not costed and had no timeframe and this €200 million is the same. We do not know how the figure was calculated or how it will be spent. This Government will have a legacy of spin. We are not managing the money generated by the hard working taxpayer properly.
The cap on Irish students was addressed in the Fottrell report. We put 750 students through medical training every year but there is a cap of 300 on the number of Irish students. We facilitate 450 students of non-EU origin. I am not arguing against that, we should facilitate it because it generates income for universities. We should, however, raise the cap for Irish students and facilitate secondary students by reducing the number of points necessary for entry. That would allow good Irish students who are capable of being good doctors to come through. Universities face problems in funding, they are at a disadvantage and they get extra revenue from non-EU students so it is important they continue to be able to take such students in but the cap on the numbers of Irish students should be raised.
We do not need another task force on rolling this out, another aspirational plan from consultants. There are templates to facilitate this process, such as the computer package at the University of Limerick. We should not waste extra resources on consultants, reviews and task forces.
The document contains the target of 2,500 extra consultants in the next ten years. It would be great to see it but is it achievable? I hope the figure has not just been plucked from the sky.
I welcome this report. Elements of it are vague but that can be addressed. My colleague in the Dáil will table a series of parliamentary questions in the next few weeks to elicit more information. It is important that we review the holistic aspect of why students want to enter medicine, how they go about it and the processes involved. At present, entry is not based on merit. There are constraints for families who cannot afford the substantial expense involved in going to medical school.
These are the challenges. We must look at the entire process, not just at the student who has just completed his or her leaving certificate, but at the child leaving national school. We should look at the help offered to students who want to be doctors. Students who do not get grade A results in first and second year in the junior certificate have already decided they are not capable of being a doctor. It should not be a race because it will turn into a race to the bottom if we do not look for the most capable people.
I welcome the Minister of State to the House and the opportunity to make a few points on third level education rather than the Fottrell report.
I agree with Senator McHugh about the points system. When I was doing my leaving certificate, points were very high for medicine. At that time, contemporaries of mine who achieved maximum points automatically entered medical school. It was not because they had a gift or were particularly suited to the profession, but because peer or family pressure and the points system dictated they do medicine. The net result was that those more suited to life in a library were studying to be surgeons while those working in a library should have been studying surgery.
There is an ongoing review of the senior cycle and the syllabi at leaving certificate level. That is necessary because it should place a greater focus on a child's strengths and work with the child to ensure he or she plays to them. It should not be about getting 100% in an exam.
Tip O'Neill said all politics is local and I will use this opportunity to speak about the institute of technology in Sligo and the ITs in general. It is some time since we have heard about the Bill to amend the Regional Technical Colleges (Amendment) Act that will place institutes of technology under the auspices of the Higher Education Authority. Why has the legislation not progressed? It would give the institutes of technology in Sligo and Letterkenny the greater autonomy they require if they are to perform to their potential, facilitate the development of institutions similar to the Massachusetts Institute of Technology, and allow the institutes of technology to respond to the many changing needs of business. I ask that the Bill's progress through the House be accelerated.
On funding for science and technology, Sligo is grateful for the investment it has been allocated to refurbish existing facilities. However, despite having bucked the national trend by increasing the number of science students, both school leavers and adults, the Sligo Institute of Technology has not received additional funding to accommodate the extra numbers. I appeal for further funding for this purpose.
On the Order of Business I called on the Minister for Enterprise, Trade and Employment, Deputy Martin, to develop a strategy for the north west. Traditional manufacturing in the region is in freefall, with a number of high profile closures in recent months and many more in recent years. While I do not wish to distract from the bad news in Ballivor, my focus is on the north west which has experienced many more job losses per capita in recent times than other areas.
Significant additional investment must be made through the core budgets of the institutes of technology in applied research and technology transfer. The Minister of State may be surprised to learn that the Sligo Institute of Technology received only 2% of Science Foundation Ireland funding this year and just 6% of funding allocated under the programme for research and third level investment, PRTLI. If we are serious about tackling problems in the traditional manufacturing sector, we will need to invest substantially more in applied research and technology transfer in the institutes of technology. With proper investment the Sligo and Letterkenny institutes of technology could be developed into centres of excellence in this field.
I welcome the Minister of State to the House and I am pleased to have an opportunity to speak on the Fottrell report. I discussed undergraduate medical education with Professor Fottrell, who has produced an excellent report, many years ago when he was president of University College Galway. We are all aware of the difficulties arising from the high points required to gain entry to medicine and the large number of foreign students studying medicine here. I am also aware of the economic implications of the latter.
For some time, the Government and universities have examined alternative approaches to undergraduate medical training. For example, graduate entry, which has been available in veterinary medicine for some years, was recently introduced for medicine. This is a worthwhile approach in that it also includes an aptitude test and interview.
Senators raised the shortage of medical practitioners, an issue also highlighted by the Irish Medical Organisation. The problem is particularly acute in rural areas and is likely to worsen as more general practitioners retire. A GP who chooses to live in a rural community makes an advance commitment to the community and, as such, should be provided with assistance, including additional resources to develop a practice.
Since the introduction of out-of-hours GP services, it has become clear that some of the catchment areas are too large. The reasons for this are a shortage of GPs and a lack of resources. The Westdoc region, as it is known, has a good structure in place, with drivers in vans and jeeps available to drive general practitioners to patient visits. Sometimes, however, doctors are required to travel excessive distances. People living in Galway, for example, should not have to depend on a service operating out of counties Mayo or Roscommon or vice versa. Will the Department consider introducing new centres to reduce the distances between patients and doctors? The co-operative system works well but catchment areas are too large and doctors must travel too far. Ten years ago, doctors worked on rota every third or fourth weekend. This has changed and they are now driven to patients. In the western region one can at least notify the Health Service Executive of problems with the out-of-hours GP service, whereas the service is privatised in some areas, which is the wrong approach.
Hospital doctors work hard and would have a more structured life if they worked regular working hours. General practitioners who participate in the out-of-hours service must work long hours and be prepared to get out of bed in the middle of the night to care for patients.
We all agree that the points required to enter medical school are high but, as Senator Norris noted, the current system provides an objective assessment. It is possible other forms of assessment would be inferior. Nevertheless, the high number of points required demonstrates that the numbers of entrants to medicine and doctors in our hospitals are too low. I support the Fottrell report's recommendations in this regard.
I wish to share time with Senator Brian Hayes, Maurice Hayes and Daly. The points made by Senator MacSharry concerning his region and the job losses in County Meath are closely related to the point made in the most recent budget about developing co-operation between third level institutions. It is crucial for future competitiveness that this sector is able to develop research and development at doctoral level. The Fottrell report's proposals on third level education must be implemented. I ask the Minister of State to note this and ensure the institutes of technology are given a central role in this regard. I will develop my argument on this issue on another occasion.
On the medical issue, what is the position with regard to a solid proposal made by the University of Limerick to increase intake to the colleges next year? I hope university or third level politics are not the reason it appears to have been pooh-poohed.
The Ministers for Education and Science and Health and Children gave a commitment, when launching the Fottrell report, to make improvements in the area of oversight of medical education, intake and co-ordination. Ensuring improved governance and accountability by the joint delivery of medical education across both the education and health settings requires that an oversight body be established immediately. When deciding on the intake into medical schools we must recognise that a significant number of women doctors, in particular, practise for fewer than seven years. We should therefore allow a higher level of entry to compensate.
I thank Senator O'Toole for allowing me to share some of his time. I wish to make two points about the funding of third level education. The introduction of top-up fees in the UK will have a detrimental effect on the difference between Southern and Northern universities. It will not apply in Scotland owing to a decision of its local devolved Government. I understand that top-up fees will be reintroduced in Northern Ireland, which will give a significant financial windfall to colleges in the North in terms of research and educational opportunities. I flag the issue for the Government as one we will need to address at some stage. A comparative disadvantage in funding will exist between Northern and Southern institutes and colleges.
I now come to an old chestnut of mine. The total economic transfer that the Government gives to every 18 to 23 year old in full-time education is approximately €120,000, which is a significant sum. Someone going straight to work and bypassing the college route never gets a penny from anyone. I have always argued for an education credit that would be available to be drawn down at any time in a person's life. It is impossible for someone of 25 or 26 to go back to college because of the financial cost and the difficulty in getting time off work, which needs to be factored into our educational planning.
I am grateful to colleagues for allowing me to contribute. I also believe that at some stage we will need to revisit the issue of fees and funding. However, I wish to deal with the medical proposals. It is a pity that the very sensible proposal in the Fottrell report that people who have completed a primary degree should move on to medicine is immediately negated by regarding them as postgraduate degrees for which they must pay.
Hear, hear.
This problem could be overcome by giving them a bursary if they undertook to work as GPs or elsewhere in the public sector.
I too am concerned about the concentration on a high number of points. I welcome that the Minister has said that we will have some system for people with more than 450 points. We may as well have a lottery as any other system. No system can predict who will be a good doctor as there is such a range in the profession. I would favour establishing another medical school, perhaps in Limerick, which would concentrate on public health and preventive health among GPs and others in primary care. The other medical schools are all built on the curative model.
I ask the Minister of State to consider the issue of clinical placements for these people, which will be quite difficult. Private hospitals that ride on the back of the public sector in so many places should bear their cost of training through providing teaching places. I ask the Minister of State to consider medical students who get clinical practice across the Border — in both directions. Hospitals in Derry and Newry and others of which I am aware are very glad to take students, particularly from Galway, and it would be a pity if any changes we made were to inhibit that.
The report we are discussing sets out the foundations for medical training and research for the foreseeable future, which I welcome. In response to the point made by Senator Brian Hayes, the working party visited the United Kingdom and had discussions with the personnel involved in the area. It is important to be aware of what is happening in other areas. A delegation from Sweden also attended. The report is very detailed and informative and requires action. In her opening speech on the debate, the Minister indicated the Government was considering a new research plan to be established as soon as possible.
During the debate on the Disability Bill we highlighted the problems of getting speech therapists, occupational therapists and a range of personnel needed to help out with children's special needs. While this is late in the debate, during that debate a few months ago, indications were given about the situation in Limerick, as Senator O'Toole has stated. I support the Senator in this regard. We need to expedite the intake into Limerick University of speech therapists and language therapists. While it is possible to introduce plans, without the personnel it is impossible to implement them. I encourage the Minister of State to press ahead with that development.
I thank Senators for their very interesting contributions on the Fottrell report, which I will draw to the attention of the Minister. In response to a specific question by Senator McHugh, implementation of the Fottrell report up to 2013 is estimated to cost €200 million. Clearly the State is making a very substantial investment in this area and it is important for us to get a good return. I agree with the Senators who made many other suggestions as to how the quality and character of our medical education could be improved.
The investments and changes in medical education and training outlined by the Minister should result in an enhanced student opportunity, a more streamlined quality medical education and stronger oversight ultimately leading to improvements in patient care. However, whatever decisions we make in this area must reflect the changing face of general practitioner services. The introduction of the strategic innovation fund, seeking to address third level educational reform, should ensure that Ireland continues to develop as a knowledge economy in a very competitive global environment. The fund enables the higher educational system to achieve a new level of performance that will create a platform for effective return on the wider investments to be made until 2013, including investment under the ambitious forthcoming national research plan.
I was very interested in the contributions of Senators Brian Hayes and Maurice Hayes. In the important ongoing discussions between the rainbow parties, I hope that Senator Brian Hayes will raise his views about the famine of funds for third level education. Our third level institutions are unable to attract funds from abroad because of the fundamentally foolish decision taken by the rainbow Government to abolish third level fees.
Come on.
That comment is silly.
This is a hook on which we are caught and off which we will not be able to get ourselves.
Fianna Fáil did not object at the time.
This problem is recognised by the presidents of all colleges.
The Government could do something about it.
It is widely known and perhaps in this House these matters can be adverted to. However, I must confirm in the next breath that the Government has no proposals to change this position. Senator Maurice Hayes also raised the issue. It is of course widely accepted in third level education circles that this is the reality. It is very serious for the future of our higher education institutions. In the international league they are falling behind institutions that are in a position to attract private funding. No institution is in a position to attract private funding when investors are told that it is a free service for everyone. While we may face up to the issue in a decade's time, there is no immediate commitment to address it.
The infrastructure planned under the €900 million capital envelope forms another part of the Government's commitment to this sector, under which campus facilities will be improved. The Minister is anxious to make progress in higher education participation. Since the introduction of free second level education the average national participation at third level education among second level school-leavers has grown from 11% to approximately 54%. The gap between those who do not progress to higher education and those who do is diminishing with each generation. Recent surveys indicate significant improvements in participation rates from those in lower socio-economic groups. This progress has not occurred by chance and has been due to a number of key targeted programmes and interventions. Funding of access measures, including the student support schemes, has increased from €98 million in 1998 to €242 million in 2006. That was always the way to go in this area. Additional funding has been made available under various targeted initiatives by the Higher Education Authority. The rates of grant have increased in that period, with the highest maintenance rate increasing, with the introduction of a special rate of maintenance, from €2,098 in 1998 to €5,355 in 2005.
The institutes of technology were established some decades ago to respond to an economy link need that was not addressed at the time. They have done a first class job in that regard. Since becoming autonomous third level institutions in 1993, the institutes have undergone a number of dramatic changes in terms of the range of courses offered, the increase in staffing of up to 68%, the increase in full-time student numbers which are up 51% and part-time students which are up 45%.
Following on that period of growth, the institutes are now facing new challenges. As part of the approach to modernisation and reform of the sector, the Government has approved the drafting of legislation to transfer responsibility for the day-to-day management of the institutes of technology from the Department of Education and Science to the Higher Education Authority. It has long been an ambition of the institutes to be under the Higher Education Authority rather than the reputedly heavy hand of the Minister and her officials. Legislation is now being prepared to give effect to that and it is intended that that new legislation will facilitate the development of a strategic approach to higher education within a unified policy and budgetary framework. It will also enable a greater devolution to the institutes to take place in regard to academic and management autonomy.
I thank Senators for their contributions to what was a very useful debate. I am sure the Minister will have regard to the contributions of Senators.