Hansard

I am pleased to speak in the debate as convener of the Health and Sport Committee as we consider the bill at stage 1. As we have heard, this is a fairly straightforward single-purpose bill and our report, which supports its general principles, was agreed to without division.

I thank all those who assisted the committee with our scrutiny, those who responded to our call for views and those who gave oral evidence. We were particularly pleased to hear directly the views of students on the Scottish graduate entry medicine, or ScotGEM, course, whose impending graduation next year prompted the introduction of the bill at this time.

As we have heard, the bill seeks to remove a legislative prohibition that prevents the University of St Andrews from holding qualifying examinations or awarding degrees in medicine or dentistry. The ScotGEM course that prompted the introduction of the bill provides for Scotland’s first graduate entry medicine degree, which is completed over four years and results in a primary medical qualification as a bachelor of medicine and bachelor of surgery or MBChB. It is aimed at graduates who are interested in a career in general practice and provides a focus on rural medicine and healthcare improvement—areas where there is an acknowledged shortfall in meeting future needs.

As we have heard, the course is jointly provided by the University of St Andrews and the University of Dundee, in collaboration with the University of the Highlands and Islands, and the first cohort of students is set to graduate in 2022.

We heard from their representatives that ScotGEM students enrolled on their programme of study with the clear expectation that their degree would be jointly awarded by the University of St Andrews and the University of Dundee. We heard that, for a number of students, that joint award was an important factor in their decision to apply. If the bill were not to be passed, the ScotGEM students’ degree would be awarded by the University of Dundee only.

It was striking that some of the greatest reservations about the bill were expressed by the principal of the University of Dundee. While ScotGEM is a promising example of collaboration between Dundee and St Andrews, the roots of the ban on St Andrews awarding primary medical qualifications lie in the complex and long-standing relationship between the two neighbouring seats of learning—at times as partners and at times as competitors.

That complex relationship will no doubt continue to evolve after the passage of the bill, but the committee was encouraged that the ScotGEM initiative would produce positive outcomes next year and beyond. Under the initiative, students can receive a bursary of £5,000 a year for up to four years, as long as they commit to working an equivalent number of years for the NHS in Scotland. It would be interesting to know how many years of service have been committed to by the current cohort of students in exchange for that financial support.

Beyond ScotGEM, the bill’s policy memorandum highlights—as the cabinet secretary has just done—that the University of St Andrews and seven other institutions have submitted bids to

“develop proposals for a new medical school”

as part of a process that has been put on hold as a result of the Covid pandemic.

The question of where any new medical school should be located was clearly not one for us to consider in the context of the bill, although it will no doubt be of great interest to future health committees. While the bill is necessary for St Andrews to be considered in that context, it does not automatically enable the university to award primary medical qualifications beyond the current ScotGEM programme. As we have heard, doing that would also require both regulatory approval and financial support, as is the case for existing medical and dentistry schools.

The cabinet secretary told the committee that she would expect future consideration of proposals for a new medical school to look at undergraduate numbers, anticipated flow for associated clinical placements, issues of access and skills retention and workforce demands.

The committee heard concerns about the potential impact that a new medical school at St Andrews might have on the viability of existing schools, especially regarding clinical placements for students. Although such a process does not arise directly from the bill, we have recommended that any future consideration of proposals for a new medical school should take into account the wider evidence that we heard on NHS recruitment and retention and on widening access to medicine.

The committee unanimously supports the general principles of the bill and looks forward to seeing it progress to stage 2.