Volume 1
Medical research and the NHS reforms / House of Lords, Select Committee on Science and Technology.
- Great Britain. Parliament. House of Lords. Science and Technology Committee.
- Date:
- 1995
Licence: Open Government Licence
Credit: Medical research and the NHS reforms / House of Lords, Select Committee on Science and Technology. Source: Wellcome Collection.
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![4.29 The Department of Health considers that the Ten Key Principles are still in force (p365), though they admit the possibility that they might require revision (p367). With regard to NHS capital schemes which might require university accommodation to be relocated, the Department of Health agreed with the Department for Education in 1993 that the NHS must keep the university informed from an early stage, and must include costs and benefits for education and research in the formal appraisal of the proposed investment; and that “any costs falling upon the university should ordinarily be proportionate to the education and research benefits which will accrue” (p366). On this basis, the Department believes that any situation can be resolved amicably; but they know of no case where the NHS has in fact explicitly paid for new university accommodation. “As a recognition of the continued anxiety from the university sector, the Department [of Health] is working with the Department for Education, the Higher Education Funding Council for England (HEFCE) and the CVCP to clarify the position and draw up explicit guidance”. 4.30 The anxiety of the university sector is apparent from the HEFCs’ account of the same story (p395, Q1350). The agreement in 1993 failed to solve the problem, because the requirement to keep universities informed was in some cases disregarded, and because of the difficulty of assessing “education and research benefits”. In March, new guidance was “in the final stages of agreement”. In the mean time, the HEFCs will not make capital provision for moves driven by the NHS (CDMS pp75, 78; MRC p46; CVCP p87, QQ173-6; Dr Green p213). 4.31 This is adepressing story of Whitehall at its worst, and of the failure of two Departments to act together for the common good. The argument is not over whether urban hospital services require rationalisation, nor over what are the consequences for the medical schools, but merely over which Department should take responsibility for those consequences. The agreement of the Ten Key Principles was an important step, but the Principles have not been converted into practice. In some of the cases referred to above the situation has been saved by far-sighted managementat local level; in other cases such management appears to have been lacking, and the cost and other consequences have been left to lie where they fell, on the universities and medical schools, and therefore on the future of medicine in the UK. 4.32 We welcome the news that fresh guidance is being drawn up. It is already too late for some medical schools, which have lost key staff as a result of uncertainty and funding difficulties. The new guidance must enforce joint planning procedures; in the absence of RHAs, a strategic role might fall to the RDRD, the Postgraduate Deans and/or the new Regional Education and Development Groups. The guidance must make it clear that, in some cases of hospital rationalisation, moving the medical school will not produce “education and research benefits” beyond the mere restoration of the status quo ante, and that in those cases the NHS will either foot the bill or change the plan. Even where education and research benefits are identified, resources must still be identified to pay for them; if neither the university nor the HEFC is able or willing to find such resources straight away, then either the NHS must foot the bill or the project must be delayed or shelved. It must be explicitly recognised that for the university to be forced by the NHS to bear capital costs which are none of its making from recurrent or external income is not an acceptable outcome. 4.33 It might be argued that the failure of the statutory university representatives on the RHAs concerned to prevent these situations from arising justifies the Government’s decision not to preserve their position vis-a-vis the new regional offices. We hold the contrary view: abolishing this tier of representation will make such situations more likely to occur in future. We recommend that a formal mechanism be devised to enable university representatives to be involved in planning and decision-making at regional level where research and teaching interests are at stake. This could be best achieved by establishing Policy and Strategy Planning Committees in each Region, chaired by Regional Chairmen, including within their membership the Postgraduate Dean, the RDRD, the Regional Director of Public Health, and nominees of relevant universities. We welcome the Minister’s assurance on Report stage of the Health Authorities Bill (Lords Hansard 24th April 1995 col. 751) that “There is nothing to stop regional chairmen within their regions building any mechanisms they wish in order to strengthen those links [with universities]”’.](https://iiif.wellcomecollection.org/image/b32219337_0001_0041.jp2/full/800%2C/0/default.jpg)
