Hansard

I agree that we need to increase the number of medical graduates and, in turn, doctors. That is why our manifesto committed to increasing the number of medical graduates, which is what we are doing. We promised to increase that number by 100 per annum.

Let me turn to some of the reasons why I think that there would be unintended consequences. As I said, we have seen an increase in undergraduate numbers since 2016 in response to a UK-wide undersupply of graduates. Between 2015-16 and 2020-21, the controlled intake for medicine grew by 22 per cent. It further increased to 1,117 in 2021-22. Our modelling shows that we need to increase that number, as Liz Smith said, which is why the 2021 programme for government commits to increasing undergraduate numbers by 100 each year during the current parliamentary session. That will allow us to increase numbers to ensure that we have sufficient supply with a degree of headroom, but in a planned fashion.

If we were to go down the route that Dr Gulhane and the Conservatives suggest, my concern would be that we would have no idea of how many students to expect until they matriculated each year, and we could find that we did not have the clinical capacity to train them. Even if we were able to train them, we might find that there was no job for them as a qualified doctor at the end of the day. That would lead to a real danger of creating medical unemployment.

Secondly, our planned increases have allowed us to focus undergraduate education on areas of known NHS patient need. For example, we know that, in the future, we will need more doctors working in community settings to care for our ageing population. That is why we commissioned Scotland’s first graduate medical entry programme, with its focus on producing GPs and on remote and rural placements, and GP track courses at the University of Glasgow and the University of Aberdeen. If we had no control over places, that would limit our ability to commission our medical schools to adopt new and innovative approaches to respond to the long-term policy drivers.

My third point is one that I wanted to make in my attempted intervention on Dr Gulhane. Our planned expansion has allowed us to focus on opportunities for Scottish students from all sectors of society. The 50 ring-fenced widening access places that were introduced in 2016, and which have been maintained annually thereafter, were increased to 60 in 2021. This year, all those places have been filled by students from some of the most deprived backgrounds in Scotland. We probably all welcome that.

We have also set up two pre-medicine entry courses at Glasgow and Aberdeen universities, which are aimed at potential applicants from less socially advantaged backgrounds who might have narrowly missed the grades that are required in order to study medicine.

We have also widened access to medicine in the widest possible sense. The University of Edinburgh course for graduate health professionals is a unique route for experienced healthcare professionals to use to study to become a doctor. That HCP-med programme is specifically designed for healthcare professionals who live and work in Scotland. If we were to have no control at all over numbers, widening access students would be the first to lose out. If we were to have a free-for-all, those who have traditionally been furthest away from gaining entry to medical school would be the ones who would lose out.

I understand that I am probably fairly short of time, Presiding Officer. It is important to have a mixed economy of medicine graduates for many other reasons. We are delighted to have people from across the UK and international students who want to study to become doctors here, too.

For all the reasons that I have highlighted, including—crucially—my point that if we remove the cap, we will remove the ring-fenced places that are designed to widen access, as well as the fact that all UK nations set controlled intakes for medical undergraduate places, I ask Parliament to reject the motion and to support our current process of planned expansion to meet the future medical workforce needs of the NHS in Scotland.

I move amendment S6M-02139.2, to leave out from “calls” to end and insert:

“welcomes the sustained increases in medical undergraduate places at Scottish universities; notes that the level of new domestic training places for medicine is proportionately higher in Scotland than anywhere else in the UK; further notes that, this year, the Scottish Government fully funded all places for Scottish domiciled students holding an offer from a Scottish medical school, where they met the terms of their conditional offer; recognises that the Programme for Government sets out steps to substantially increase training places further; believes that widening access to medicine is essential, and supports doubling the number of widening access places to help create a more diverse medical workforce.”