Dáil Éireann Debate, Thursday - 19 October 2023
80. Deputy Mairéad Farrell asked the Minister for Further and Higher Education, Research, Innovation and Science if he will provide an update on his efforts to increase the number of graduate entry medicine places; the reason he has not tried to reduce fees as a means to attract more applicants; and if he will make a statement on the matter. [45694/23]
View answerI would be interested to hear an update on the efforts to increase the number of graduate entry medicine places. Maybe it is my age but more people I know are going into graduate entry medicine than before. What are the efforts to increase the number of such places and the reasons for not reducing the fees to attract more applicants and from more diverse backgrounds?
There are two main factors driving my approach to addressing issues with medical education: ensuring we produce enough doctors to meet the requirements of our healthcare system and our society and providing more places for students in a context where the level of demand has consistently exceeded the number of places available.
It was encouraging this year that, for the first time in a long number of years, when the CAO offers came out for undergraduate medicine, we saw a fall in the points required.
Last year, the Minister for Health and I announced an agreement with Irish medical schools to increase the number of places available for EU students by 200 over the next five years. This began with an additional 16 students in September 22, climbing to 122 in September 2023 and to 200 by 2026. This agreement included additional graduate entry medicine places. To date, an additional ten graduate entry places, with five in 2022 and another five in 2023, have been created, while the other 110 places were on direct entry programmes. The Deputy will also be aware of the work we are doing on an all-island basis. From next September, we are enabling access to medical education on an all-island basis through the work we have done with the University of Ulster in Derry and Queen's University in Belfast.
As the Deputy knows, the free fees initiative pays the tuition fees of eligible students undertaking their first full-time undergraduate programme. The free fees initiative does not meet fees in respect of students who are completing a second undergraduate degree. For better or worse, that is currently how the graduate entry medicine programme is classified. However, unlike for other second undergraduate degree programmes, the State provides a subsidy to institutions towards the cost of provision. The tuition fees payable by students are determined by the higher education institutions, taking the availability of this subsidy into account. In the academic year 2022-23, the State contribution was €12,100 per students, the balance of fees being payable by the student. This State subsidy is now being increased incrementally. The State contribution for graduate entry medicine places this year is €14,500.
Regarding funding for graduate entry medicine, Department is also working with the Department of Health on these matters. I am sympathetic and supportive of the case being put forward by graduate entry medical students. We need to find a way that works and does not have unintended knock-on consequences because the policy direction has always been that we have the free fees initiative for one undergraduate degree programme. We need to tease our way through that. I have given a commitment to meet graduate entry medicine students in the coming weeks.
I thank the Minister. I am not harassing the poor souls who write responses to parliamentary questions but I am a little bit confused. I submitted a parliamentary question on this issue because I am confused about the current approach.
The response to a parliamentary question I received from the Department stated: "The State contribution was €11,950 per student with the balance of fees payable by the student." Different colleges have different fees. In UCD, for example, students pay fees of just under €17,000. Taking what the Minister has told me and what was stated in the parliamentary question to which I refer, surely the balance should be €5,000. That is clearly not how the system works because that is not what is happening. When it was first introduced, the purpose of graduate entry medicine was to open up the discipline to those people who would not traditionally have had the ability to study medicine. We also need more doctors to be trained.
On that, we have to be honest. The graduate medical entry programme was introduced to try to diversify the medical profession. We also have to be truthful that in recent years we have seen points for undergraduate medicine places skyrocket to the point that accessing those courses became prohibitive for many. People could achieve the best points possible in the leaving certificate and still only go into a random selection lottery for a place. We have tried to break that cycle via a very significant increase in undergraduate medicine places. The all-island approach coming next year will help further, with additional places in this jurisdiction. That has seen the points for undergraduate medicine places fall.
The Deputy is right to be slightly confused because it is a little bit confusing. The answer to the parliamentary question is entirely correct. Universities set the fees, as they do for any second undergraduate degree or postgraduate programme. The State makes a contribution towards the cost. We have increased the subsidy we are providing. Universities have not reduced their part of the fee. That is a matter for them. The fact is that the State subsidised these courses by €11,950 between 2021 and 2022 and the figure is now €15,500 for new graduate entry medicine places from this year.
That confuses me in a different kind of way. I am not suggesting that the Minister is not outlining the facts but if the money coming from Government for fees is increasing, surely there should be some kind of conditionality that the fees charged to students decrease. It is my understanding that the fees will increase again next year. That is what students have told me.
The reality is that the cost of these fees has a corrosive effect on diversity in the medical vocation. The cost of fees continues to make medicine and the studying of medicine a privilege. It is, of course, a privilege but it should not be something that is almost an elitist privilege rather than something that should be available to everybody. There are more people studying medicine now but older people are trying to study medicine and find it-----
Does Deputy Durkan want to come in?
No, I am happy so far.
With my questioning. I thank the Deputy.
I hope he is happy with my answers. I agree with the Deputy's point that we do not want people who want to access the medical profession to reach barriers and blocks that mean we cannot diversify the profession. I know, as a former Minister for Health, how important diversification in medicine is.
When we talk those most in need, as recently as last year we extended the 1916 bursary to general entry medicine students. For the first time, the most financially disadvantaged students can use the 1916 bursary for graduate entry medicine. That was an indication of how we wanted to make progress in diversification.
In defence of the institutions, if that is the right phrase, we have examined how to properly and sustainably fund medical education in Ireland. Everyone would think that the model had been too tilted in favour of international students rather than providing opportunities for Irish and EU students. That was probably because of financial holes in funding over many years in universities. We have seen a conversion of many international places and we are increasing the funding provided. As part of that, we are increasing the subsidy. I want to do more to help our graduate entry medicine students. I will meet them in the coming week. We will tease through some of the issues and see what practical steps we can take to help them.
