The committee warns of a future shortage of staff in Scotland

It follows a year-long inquiry into the health service and the "drivers for change" which are likely to affect it.

The report said the NHS would have to recruit 400 hospital doctors to be able to implement the European directive on working hours.

Committee convener Roseanna Cunningham said the public needed to debate the future of the NHS.

The NHS should embrace change which would include the European Working Time Directive, new contracts for NHS staff, population change and a shift in the jobs market, the committee concluded.

Specialisation fears

It calls for an extra 100 undergraduate medical students every year and more effort to recruit doctors and nurses from abroad.

Ms Cunningham said: "Some of these 'drivers for change' are acknowledged by the committee as being outwith the direct control of the Scottish Executive.

"However, the enormous public reaction to the series of proposed changes to the NHS in Scotland has shown the strong desire for a public debate on this issue.

"It is essential that the public has the opportunity to debate the changes and influence the future of their NHS."

The report also says the medical profession's assumption that increasing specialisation is the way forward needs to be questioned, as the protests over hospital closures has shown.

Medical school

The British Medical Association in Scotland welcomed the committee's findings and said more workers were needed to cope with the growing demands on the NHS.

BMA Scotland's Dr Bill O'Neill said: "Increasing medical school places would certainly provide the basis for increased numbers of doctors in the long-term.

"The report highlights some areas of good practice and it's important that this is shared across the NHS so that it can develop and improve services.

"We accept that the public debate on balance between local, central, specialist and generalist care should be better informed."

The Scottish Conservatives said the committee's findings proved the executive's health policies were not working.

Tory health spokesman David Davidson said: "I like many others, am deeply concerned about the future of the NHS in Scotland.

"Adequate provisions have not been made and there is a real and urgent concern that we will reach a staffing crisis."