University of St Andrews (Postgraduate Medical Degrees) Bill: Stage 2
We will now consider stage 2 of the University of St Andrews (Postgraduate Medical Degrees) Bill in a Committee of the Whole Parliament. Members should have a copy of the bill—SP bill 51—and the marshalled list, which contains only one amendment. No separate groupings have been prepared. If there is a division on the amendment, the electronic voting system will be used and I will allow a voting period of two minutes.
Section 1—Power to grant postgraduate research degrees in medicine
As I said, amendment 1 is in a group of its own.
Section 1(2) of the bill sets out the people to whom the bill applies—in essence, those people who can study for the qualifications allowed by section 1(1).
When evidence was taken by the Enterprise and Lifelong Learning Committee at stage 1, I indicated that section 1(2) of the bill might have been drafted too narrowly, as it might inadvertently exclude people working as doctors—those registered under section 19 of the Medical Act 1983—from sitting the postgraduate examinations. At the meeting, I signalled my intention to lodge an amendment at stage 2 to correct the matter. I am pleased to say that the proposed amendment was endorsed in the committee's stage 1 report.
The first part of the amendment would change the words
"are entitled to be registered under section 3 of the Medical Act 1983"
in subsection (2) to
"are registered, or are entitled to be registered, under section 3 of the Medical Act 1983".
That part of the amendment makes it clear that people who hold registration under section 3 of the Medical Act 1983 and people who are entitled to hold registration under that section can apply to study for qualifications under the bill.
Section 3 of the 1983 act relates to the full registration of United Kingdom persons who hold a primary UK qualification, who have passed a qualifying examination and who satisfy the requirements in relation to experience in the 1983 act. Section 3 also provides for the full registration of European Union candidates who hold primary European qualifications. The bill requires people only to be entitled to registration as a medical practitioner under section 3 of the 1983 act; they do not actually have to be registered. For example, candidates might take a postgraduate course to further scientific research and might not intend to practise clinical medicine—there would be no benefit to them in being registered. The amendment would allow both types of people to study for the postgraduate qualifications.
The second part of the amendment would insert proposed section 1(2)(b), which provides that people who hold registration under section 19 of the 1983 act—or people who, in the opinion of the University of St Andrews, would be directed to be registered by the General Medical Council under that section—can study for the qualifications that are allowed by the bill. Section 19 of the 1983 act provides that people who hold one or more recognised overseas qualifications—from Australia or Malaysia, for example—who have the necessary knowledge of English, who are of good character and who satisfy the requirements in relation to experience of section 20 of the 1983 act can be fully registered as medical practitioners if the GMC sees fit.
The majority of candidates who apply to study for the postgraduate qualifications in medicine that are allowed by the bill will already be registered as medical practitioners. If they intend to work with patients as part of their course, but are not already registered, they will apply to the GMC for registration to allow them to study for the qualifications. They will have to prove their registration in their application to the University of St Andrews to study for the postgraduate research degree in medicine.
Not all candidates will require to be registered. People who choose to study a laboratory-based course will have no contact with patients. An additional reason for not registering is the cost. If registration brings no benefit and is not required for the qualification, the candidates need not pay. It costs £290 for UK and EU people to apply for full registration and £390 for non-EU people to apply, with an annual retention fee of £290.
If a candidate is not fully registered under section 3 or section 19 of the 1983 act, it is up to them to prove to the university that the GMC would direct them to be registered as medical practitioners. The university advises me that, in practice, applicants will be able to write to the GMC for confirmation that they would be entitled to full registration.
I will say a little about why the references to sections 3 and 19 of the 1983 act in proposed sections 1(2)(a) and 1(2)(b) are slightly differently framed. To reflect the different requirements of sections 3 and 19 of the 1983 act, proposed section 1(2)(b) refers specifically to the opinion of the University of St Andrews. Under section 3 of the 1983 act, anyone who meets the specified criteria is entitled to be registered.
Under section 19 of the 1983 act, a person must satisfy the registrar that he or she holds one or more recognised overseas qualification, that they have the necessary knowledge of English and that they are of good character. However, satisfying the registrar on those three things does not entitle a person to be registered. The person must also satisfy section 20 of the 1983 act in relation to their experience and only then—if the GMC thinks fit so to direct—will that person be entitled to full registration as a medical practitioner under section 19. It would not be appropriate for proposed section 1(2)(b) to state, "are entitled to be registered under section 19" as is done in proposed section 1(2)(a). Even if the candidate meets all the criteria in section 19, the final decision still rests with the GMC. The amendment is drafted to reflect that difference.
The third part of the amendment would add proposed section 1(2)(c), which provides that people who hold limited registration under section 22 of the 1983 act can study for the postgraduate qualifications that are allowed by the bill. When the amendment was considered, it became apparent that people who hold limited registration under section 22 of the 1983 act should also be entitled to study for the qualifications. Section 22 provides for the limited registration of people who have gained their primary qualification from an overseas institution that is not listed as recognised for full registration, which includes some medical schools in the United States of America. Such institutions must, however, be recognised by the World Health Organisation and be listed in the "World Directory of Medical Schools".
In order to gain limited registration, the candidate must pass a two-stage test of medical competence—the PLAB test parts 1 and 2. The test is called the PLAB test because it is set by the Professional and Linguistic Assessments Board. The candidate must also hold an English language certificate and pay the appropriate fees, which currently total about £1,000. The PLAB tests are set at the level expected of a senior house officer in the UK—a doctor who has completed at least his or her provisional registration year.
The requirements of limited registration are stringent. A few doctors are exempted from the PLAB tests, but those rare exemptions exist to make provision for relatively senior overseas doctors who wish to visit the UK for highly specialised training or experience.
The amendment would allow the bill to provide that people who hold limited registration—those who have passed all the tests and are working in the UK—can undertake the postgraduate qualifications allowed by the bill.
I apologise to members for the lengthy explanation of the amendment. As the subject matter is technical in nature, I felt it best to explain fully the background to the changes and to illustrate how they would work in practice.
I move amendment 1.
No member has asked to speak, so we go straight to the Deputy Minister for Health and Community Care. We are very tight for time, by the way.
I am aware of the concerns that Iain Smith has expressed that the bill as introduced would not allow the university to grant postgraduate medical research degrees to doctors who had gained their primary qualification overseas.
We would not want to deny overseas doctors who are eligible for registration under section 19 of the Medical Act 1983 access to the new medical research degrees. We would also not wish to deny access to doctors who are eligible for limited registration. The proposed degrees would not affect their eligibility for registration.
Some candidates for the proposed degrees may wish to pursue a career in medical research, rather than practise as doctors. In addition, overseas doctors may wish simply to gain experience of research in St Andrews before returning to their own countries to a medical research career or to practise medicine.
We therefore agree that it is appropriate for the university to admit to the degrees candidates who are fully registered or eligible for full registration under section 3 of the 1983 Act; overseas doctors who are fully registered or, in the view of the university, eligible to be fully registered under section 19; and holders of limited registration under section 22. We believe that amendment 1 would achieve the intended purpose and so we support it.
Amendment 1 agreed to.
Section 1, as amended, agreed to.
Section 2 agreed to.
Long title agreed to.
Meeting closed at 15:18.