Ann Ormonde (Fianna Fail)

I welcome the Minister to the House and I commend her on introducing the new funding arrangement. Although the thinking on that started back in 1997, the Minister grasped the nettle by introducing a strategic innovation fund with the sole objective of promoting change and transformation in third level education.

Today's debate is about both third level education funding and the reform of our medical schools. The first issue needs a full debate for itself so I think it a pity that the two issues were combined for today's debate. It is important that we are able to make points about where we go from here with funding, but we also need to discuss the reform of our medical schools so the Minister must forgive me if I do not say too much about the funding issue. We will no doubt return to that at another time when the Higher Education Authority makes proposals on the criteria for how funding should be allocated to third level and fourth level education and on how we should allocate the huge amounts of investment being made in research and grant schemes. Returning to a pet subject of mine, I think we will also need to consider promoting some of our institutes into universities. We certainly need a university in the south east to tackle what went wrong with the distribution of universities in the past. Waterford should not be penalised because of that situation and we now have an opportunity to deal with that. We will return to this when there is more time to debate the subject seriously.

Today, I prefer to discuss the Fottrell report. The report is well put together. Unfortunately, I only have time to deal with the recommendations but I intend to return to this report and discuss it in greater detail. The recommendations relate to how we reform our medical schools and examine the gaps that have existed for the past number of years. In 1978 a cap was put on the intake of students into medical school and it has not changed since then. Medical education was financed by increasing the number of non-EU students. Something had to give when the gap between supply and demand became huge. There was great demand for doctors and consultants but most of our doctors left the country when they qualified. They distinguished themselves well because of the quality of our medical education.

How can we lure these people back and open up the system? I congratulate the Minister on opening the discussion on the recommendations in the Fottrell report. The recommendations relate to student intake, curriculum reform, funding and the assessment of students who enter by different paths. It is great that the numbers will be increased from 305 to 725 over a four-year period in steps of 70, 40, 35 and 35. It is nice to see such clarity about the increase in numbers.

The points will also be reduced to 450. That will remove the stress from the second level sector. Of late, some second level schools have tended to become grind schools, particularly at senior cycle, whose purpose is to maximise the achievement of points. That has had a significant impact on the education of young people. That is not how education should be but the points system and the CAO process have dictated it. I am glad the Minister intends to move forward from that. How to devise a system that will work will be a major problem. I do not know if we will get it right.

There is also the issue of curriculum reform. If we increase the intake of students, it will be necessary to increase the number of academic clinicians and the number of teaching hospitals. At mid-stream the students' medical education moves into the hospitals. This was always on an ad hoc basis but it must be tightened up and structured. This is also true of the funding. Until now, I understood that most of the money was allocated from the Department of Education and Science and that a certain amount came from the Department of Health and Children. The same amount of money should come from both Departments given that half of the education takes place in the medical school while the other half is conducted in the hospitals. The funding has not been tidied up over the years so perhaps the Minister will examine this issue.

My pet subject is the assessment of applicants. I often think of the students who wanted to do medicine and who repeated the leaving certificate time and again. Maybe they got between 490 and 520 points and found, for the third time, that they were unable to get through. It was awful, to say the least. I am glad there is an effort to tackle it but the jury is out on how to do so. What methods should be used?

Aptitude tests were mentioned during the debate. They can be the fairest way of making a determination; there is no influence. However, aptitude tests are like crosswords in that if one practises them enough, one will become good at them. I have administered aptitude tests and one often finds there are 5% who never get them right but who are very good students. How to evaluate suitability for entry into any course is a big issue and I do not know if we can get it right in this case.

Senator Henry mentioned that 570 points are required for veterinary medicine. Prospective radiography students must secure 510 points. They must be the cream of the country to do radiography. I do not deny that it is a good course but it does not warrant those points, no more than veterinary medicine or medicine warrants 570 points. In the past, some members of my family studied medicine. They were just about able to get into college but became very good general practitioners. Now, some general practitioners are bored with their lives because they are too bright for what they are doing and would prefer to be doing something else. This is a serious issue that must be addressed.

What is wrong with an interview? I see nothing wrong with it. Of course, it must be fair and transparent. If one comes from a medical background, knows what is involved from a young age, is not terribly bright but would be a very good doctor, why not accept such applicants? We should not rule out the option of an interview. The same is true of any other profession. Take, for example, politicians who come from a political background. They have to be good when they get into politics but they know what they are facing when they enter politics. Other professionals whose children are anxious to get into the same profession can also find it difficult. However, I hope there would not be another type of elitist discrimination whereby somebody who comes from a medical background must get into medicine. That is not the way it should be considered.

I could discuss this subject for a long time but I cannot. Funding is an important issue with regard to the entry of graduates. It is a great move forward but how can we fund them if they have already gone through a third level primary degree course? How can they get through the system? The stakeholders must become involved and the roles and responsibilities of stakeholders such as the Department of Education and Science, the Department of Health and Children, the Higher Education Authority, the Health Service Executive and the expert group must be defined in detail. There must also be an outline of how the part-time graduates will get through the course.

There is a great deal of work to be done. The Minister should not fast-track it but take it slowly. We have lived with the points system for the past 20 years. Now is the time for a change. If we get one aspect of it right, it must be the entry issue. I must conclude but I could talk for another half hour on this subject.