THE leader of the Isle of Man Medical Society has written to all members of Tynwald just before they vote on the proposal to make all students pay towards their tuition fees.
Dr Christopher Clague’s letter appears after a {http://www.iomtoday.co.im/news/education/doctors-say-that-student-fees-will-affect-patients-1-5268263|letter appeared in the Isle of Man Examiner from the Isle of Man Medical Society opposing the proposal}
Tynwald votes on the proposal today (Tuesday).
The letter appears in full below:
Dear Member of Tynwald,
Re Proposals to introduce means testing of university tuition fees for students embarking upon higher education courses from the Isle of Man
This matter was discussed at the most recent executive committee meeting of the Isle of Man Medical Society. At that time it was resolved that the Ssciety’s principal officers should communicate to Members of Tynwald the strongly held views of the medical profession concerning plans to introduce means testing of tuition fees for aspiring Manx students in higher education after autumn 2013.
I write because this regressive move will have two serious effects, both of which we would invite you to reflect on exceedingly carefully, well in advance of Tynwald making any final decision on this matter by way of a vote. Firstly, the profession has grave concerns that such a move will have a seriously negative effect on recruitment of Manx students into the medical profession from Manx schools. Secondly, the profession is concerned that such a move will have profoundly negative effects on the retention and recruitment of high quality specialists and general practitioners into posts within the Manx NHS, leading directly to serious future gaps in the local medical service.
Embarking on a career in medicine is already an extremely costly undertaking, both for intending medical students and their families. To attain even a basic medical degree, aspiring medical students must embark upon what is essentially a full time course of study that lasts for either five or six years.
They do not have the same holidays afforded to their peers during which they can take part-time jobs, to help offset the costs of their studies, and their families must already support them at medical school for up to 48 weeks each year.
Students must frequently be maintained in London or other major cities, since most UK medical schools are situated in major population centres. Furthermore, they must frequently travel to other hospitals within the region for some weeks at a time, continuing with their ongoing rent obligations, as they undertake attachments elsewhere. Even basic rents in London can easily exceed £750.00 per month, to which must be added the costs of utility bills, food, books, daily travel to and from their teaching hospital and the not insignificant costs of travel between university and the Isle of Man. Such maintenance costs alone can thus easily fall into the range of £1000 -£1500 per month.
To this, aspiring students now face the added additional costs of tuition fees, at a time when financially challenged UK universities are already revisiting their tuition fees for students originating from non-EU jurisdictions. Our students face the prospect of taking on enormous loans, to be accumulated over a period of many years, to be advanced at rates and repayment terms far less advantageous than those available to their British counterparts. They face the prospect of having enormous debt loads for years or decades after graduation, seriously impacting on their ability to take on a mortgage or other necessary loans at the start of their careers, since junior hospital doctors in the UK receive only comparatively modest levels of remuneration.
There is now a serious danger that for intending medical students from Manx families, the pathway into medicine will be cut off to all but those from wealthy and privileged backgrounds. Which of your constituents will embark on an uncertain future that demands they or their parents indebt themselves to the hilt to take on obligations that are frequently larger than their parents’ mortgages? This will be doubly tragic for those very bright and industrious individuals who may have worked for many years to secure an academic path that may previously have been denied to other members of their families, and will particularly impact on those individuals who may have been offered places at Oxford or Cambridge, or other prestigious universities, where the fees may be considerably higher than the norm.
Medicine will be all the poorer if all the Island has to offer from its schools are those who are accidentally born into wealth.
Much has been of the supposition that students funded by the Island’s taxpayers may never return to productive work on the Island, and the Island should therefore spend its money elsewhere. The Medical Society wishes to underscore to members of Tynwald that of the many specialists and family doctors in practice on the island, the number of medical graduates initially originating from the Isle of Man, whose medical education was funded by the Manx taxpayer, includes at least three consultants (excluding myself) as well as a much larger number of general practitioners.
The society’s president, who has engaged in specialist practice on the Island for over fourteen years, had his undergraduate medical training and subsequent specialist training funded in its entirety by a Yorkshire LEA, the Royal Navy, and the Ministry of Health of the Government of Ontario, and without the assistance of those bodies would not have been able to have afforded either to complete his medical training or to be in practice on the Isle of Man today. However, he thinks it unlikely that the Isle of Man Government would be kindly disposed to respond favourably to any of those bodies, should they write demanding repayment of a ‘debt’ incurred by the Manx taxpayer. Jurisdictions in the western world do not impose restrictions on the free movement of graduates. The Isle of Man has doubtless been the beneficial recipient of many individuals from the other professions who have both contributed significantly to the economic development of the Isle of Man and have also contributed to a major part of its tax base.
So far as retention and recruitment of medical staff is concerned, the tuition fee funding arrangements that have hitherto been a part of life for all Manx taxpayers have frequently been a clincher when enticing much needed medical staff to take up offers of employment on the Island. Contrary to commonly held views, the Isle of Man is often viewed as a parochial professional backwater and we constantly struggle to attract high quality individuals to our shores. Such enticements have now evaporated. Regrettably the knowledge that Manx doctors are now going to be fully responsible for both maintenance and tuition fee funding for their children of university age, the latter at rates that are likely to be significantly higher than domestic student rates in the UK, whether in Medicine or other subjects, is likely to have an even more negative effect, driving those who are already here away. Each doctor now knows that the cost of providing tuition fee support for each child in higher education will now be a minimum of £9,000 each year, rising to more than double or triple that amount at some institutions. They also know that since the Isle of Man Department of Education has never managed to negotiate the same tuition fees at UK institutions for Manx students as are offered to UK domestic students, their children will always be classed as ‘overseas’, ‘international’ or ‘island’ applicants, a cash cow to be milked when times in the UK get tough.
The society is already aware of key specialists, with children more than three years away from university entry, who are already evaluating the continued viability of remaining in practice on the Island, knowing full well that the costs of maintaining each child at university are now likely to rise to at least £20 - 25,000 each year, to be paid out of already taxed income. (You will recall that parental educational deeds of covenant, which might formerly be taken out in favour of dependent children in higher education, have now been abolished by the Manx Treasury.) For some doctors who will have three children overlapping at university, such costs may reach £75,000 in a single year, if they are unwilling to burden their children with massive debts. While a return to the UK may not make much economic sense, jurisdictions such as Australia are hungry to recruit experienced specialists and generalists at no cost to themselves, and there is no doubt that Australia’s gain may be the Isle of Man’s undoubted loss, with profound effects on the ability of a small Island medical service to deliver appropriate standards of care to your constituents. In the recent past, it has proven exceedingly difficult to attract staff of similar calibre to the Island, when experienced staff depart.
Members of the society were very pleased to read in a Financial Times supplement, ‘Doing Business in the Isle of Man’ (November 15, 2012) that the financial position here in the Isle of Man is presently exceedingly favourable when compared to other neighbouring jurisdictions. ‘ With growth running at 3.4 per cent in 2010 - 2011 and estimated at the same rate this year, the Isle of Man is one of the few areas in the developed world to have escaped recession…GDP stood at £3.5bn in 2010 and the Island has no debt. Inflation has begun to fall sharply after increases in VAT, food and energy prices are filtered out . . . Eddie Teare, Treasury Minister and a retired senior banker, says: We are still growing…’ The same FT supplement also carries a word of caution from Garth Kimber, Chief Executive of Xela Holdings, an online gaming company, who states: ‘It is an island and note everyone wants to live on an island. If we want to bring quality employees over, they have got to see the benefits.’
Surely such favourable economic news as that reported in the Financial Times should make such draconian measures as those that are proposed quite unnecessary?
For the sake of the future health of the Isle of Man, and for the continued well being of our young men and women, who must continue to be afforded educational opportunities that may have been denied to their parents, we would urge you to reject any move to abolish the universality of tuition fee funding. The future well being of a society lies in assuring equality of educational opportunities for all, and in educating its future workforce and voters to the highest possible standard. The Isle of Man must surely expect its political representatives to ensure each Manx student achieves their ultimate potential and that our young people are equipped to compete on an equal footing, anywhere in the world.
Dr Christopher Clague
President, Isle of Man Medical Society