Faced with an ageing but ailing population and a lack of GPs in Scotland to care for them, the Scottish Government has resolved to give more places at Scottish medical schools to those from Scotland and the EU, while reducing those available to students from the rest of the UK.
Initiatives to retain doctors
The Scottish Government has recently trialled a number of initiatives with a view to retaining doctors. Examples include the Scottish Targeted Enhanced Recruitment Scheme which offers grants to those who train in remote locations, and bursaries available under the ScotGEM graduate entry programme for those who go on to work for NHS Scotland.
The new proposal forms the next step in the SNP’s plan to plug the gaps in healthcare provision, especially in rural and remote areas where jobs have proved harder to fill. It follows a £23 million investment to increase the number of medical places available at Scottish universities.
The justification for “indirectly disadvantaging” students from the rest of the UK lies in the hope that the plans will allow 36 more doctors to enter general practice in Scotland every year. Currently, retention rates of those who come to Scotland to study have been lower than those who welcomed the recent investments in medical schools would have liked.
Equality Impact Assessment
According to the Government’s Equality Impact Assessment, 80% of Scottish students stay on for specialist training in Scotland. The figure for those from the “Rest of the UK” is only 44%. The report argues that the measure is not unduly discriminatory, given that it pursues the legitimate aim of retaining more doctors. This outcome could not be achieved through less harmful means.
In assessing the impact of its proposal on the characteristics protected under the Equality Act 2010, such as race and religion, the Scottish Government noted its potentially indirectly discriminatory effects. Under the Act, such effects are not prohibited as long as there is a legitimate aim and the least discriminatory measures to meet that aim are pursued.
The result for universities on both sides of the border is a further bout of much unwelcome uncertainty. At present, students from England, Wales and Northern Ireland make up 29% of the medical student population in Scotland. While demand for places in this highly competitive field is unlikely to falter in Scotland, the plans could mean fewer applications from outside the country. With the highly contrasting policies on tuition fees in place either side of Hadrian’s Wall, Scottish medical education providers stand to lose part of their income from non-Scottish UK students, whose quota may be reduced under the proposal being mooted.
Problems for the healthcare sector in Scotland
With recent trends such as junior doctors fighting back against working conditions and hours, trainees following more protracted career paths or taking more breaks during their training, as well an increasing trend in those turning away from the NHS towards the private sector or providing locum services on a self-employed basis, it is clear that many problems face the healthcare sector in Scotland.
It is not yet clear how the plans will affect higher education institutions’ entry processes or what the impact will be post-Brexit when universities in Scotland may no longer be under an obligation to admit EU-students free of charge. It is evident that just as in so many other areas, universities in Scotland are likely to see some changes to their student populations.
The Scottish Government’s Equality Impact Assessment can be found here.