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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![to build a knowledge-based service has run up against the tendency of the market mechanism to force every relationship onto a contractual basis. 4.41 In this case, the form of contract chosen is clearly inappropriate, and contrary to the interests of the health service. We recommend that the Department of Health should impose no restriction on the right to publish, other than notification of the intention to publish two weeks before submission of the paper for publication. No restrictive provisions must be included in contracts for NHS service support for work funded by other bodies. 4.42 TheConference of Medical Royal Colleges (CMRC) has drawn our attention to a related issue: conflict between academic openness, and a tendency for Trusts to seek quasi-commercial confidentiality (QQ907-910). They offered two examples: one concerned audit protocols, and the other the outcomes of cardio-thoracic surgery. Both situations were resolved, but only after disagreement and delay. Careers in clinical research 4.43 Recruitment and retention in clinical academic medicine are a general problem, which goes wider than the NHS R&D Strategy and beyond the terms of reference of the Culyer report (CDMS pp72, 74, 79, QQ144-7; CVCP p87, QQ170-171; BMA p406). The scale of the problem varies between disciplines; the worst effects are being felt in surgery, anaesthesia, paediatrics, geriatrics, obstetrics, orthopaedics and pathology. In these areas, recruits to academic posts are few in number and sometimes - often, according to the Royal Society of Edinburgh (p315) - of less than the highest quality. There seem to be two main reasons for the problem: disparity of reward between academic and non-academic medicine (see Appendix 5); and uncertainty and insecurity in academic medicine engendered by the impact of NHS-driven reforms (including the rationalisation of urban hospitals - see above). 4.44 Professor Swales sees this problem from two angles, as a medical Dean and from his work for the British Heart Foundation. He reports (Q838) that, while many enthusiastic young people want to enter academic medicine, not enough of the best of them stay on the academic track. “Anecdotally, senior lecturer posts are particularly difficult to fill, even in the more attractive fields of medical research”. The BHF has funds to appoint two or three new professors of cardiology per year; they appointed one in 1993 and another in 1994, and in February 1995 had had only one application. 4.45 Sir Leslie Turnberg (Q886) makes a distinction between the medical disciplines, and other disciplines such as anaesthetics, orthopaedics, psychiatry and radiology. In the former, there is a shortage of career-grade academic posts (senior lecturer and above). In the latter, “there is a failure of people to go into these academic disciplines because of the attractions of rapidly going through the system into a consultant’s post and perhaps undue accentuation of the need to pass exams at the end of it all; so the training programmes will, in some instances, provide disincentives to those who might go into academic careers’. For the former, he suggests that the MRC and the major charities might help by funding more career-grade posts (Q888); for the latter, he suggests “reducing the rigidity of the programmes to encourage people to enter the academic ladder”. 4.46 Forthose doctors who still choose an academic career, the demands of service provision, administration and teaching are rising, taking more and more time from research itself (HEFCs Q1358). Professor Alberti tells us (Q1290) that, in respect of full-time academic staff, “trying to maintain six sessions a week only [of NHS service] is proving most difficult”. According to the Royal Society of Edinburgh (pp285, 315, Q1070), “The volume of paperwork and administration which is being required of senior academics creates an image of clinical academic activity which is not desirable”. AYMS (p319) calls for senior academics to have protected research time, and for this to be monitored locally to prevent undue pressure for more clinical service. The HEFCs offer Job’s comfort by observing (Q1370) that the Deans of medical schools are no more over-burdened with administration than other heads of departments.](https://iiif.wellcomecollection.org/image/b32219337_0001_0043.jp2/full/800%2C/0/default.jpg)
