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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![element of dental SIFTR, except that it is considerably less than the 25 per cent attributed to medical SIFTR”. 33. Scotland, Wales and Northern Ireland all have equivalents of SIFTR, called respectively ACT (Additional Cost of Teaching), SIFTR and STAR (Supplement for Teaching and Research). ACTR in 1994-95 totalled £94m (Q1100); STAR in 1993-94 came to £24.7m. The Scottish Office has never endorsed 75:25 or any other figure for the split of ACT between teaching and research, “because we did not have an empirical basis for making such a decision” (Q1102). The teaching Health Boards recently commissioned Price Waterhouse to analyse ACT; they endorsed the 75:25 split, but according to the Scottish Office (Q1103) their study was flawed. Dr R Kendell, the Scottish Chief Medical Officer, considers that a 50:50 split would be “not implausible” (Q1126). 34. The amount of SIFTR or equivalent paid out per undergraduate medical student is not the same around the UK. The amounts for 1994-95 are as follows: England £37,744 London £41,141 Wales £37,744 Scotland £42,362 Northern Ireland £37,744 35. SIFTR is payable only to hospitals, not to the primary sector (GPs) and only in respect of medical and dental students, not student nurses. See Appendix 10. 36. Now that it has been decided to ascribe 25 per cent of SIFTR, in the first instance, to the new NHS R&D budget, an Advisory Group has been set up to consider how to allocate the remaining 75 per cent, the teaching element (p370). Dr Graham Winyard, the Group’s chairman, described this to us as “the last piece of the jigsaw” (Q583). The CDMS put it to us (p462), “There is an urgent need for liaison between the NHS R&D funding stream and the SIFT funding stream, with University representation on both, to ensure that infrastructure support of the main research base teaching hospitals is maintained”. “Non-SIFTR” 37. “Non-SIFTR” provides limited support - too limited, according to the MRC (p48) - for the infrastructure and service costs of research in non-teaching hospitals. “The non-SIFTR awards are awarded centrally by the Department [of Health]. It is available only to hospitals which are not SHAs or eligible for SIFTR because they do no undergraduate teaching. To qualify in any one year, units have to attract external research grants which equal or exceed £100,000 and one per cent of their overall budgets. Five NHS Trust hospitals successfully applied for non-SIFTR awards in 1994- 95”, to a total of £2m (DH pp5, 198, Q§8). Special Health Authorities 38. In London there are eight hospitals associated with postgraduate medical institutes. Until 1994, these hospitals were run by SHAs, and funded centrally by the Department of Health outside the NHS internal market. However most of the SHAs have now become Trusts and entered the market, following recommendations of the Report of the Inquiry into London’s health service, medical education and research (the Tomlinson report) of October 1992. For 1994-95 they continued to receive a central subvention of £253m: £201m as “central support for clinical services necessary to sustain approved R&D programmes”, allocated by reference to the Review of the R&D taking place in London postgraduate SHAs (the Thompson review) of June 1993, and £52m as central support for patient care unrelated to research (“CASPE”). The former is intended to be subsumed into the new NHS R&D budget, returning to the SHAs in the form of excess service cost funding or facilities funding. The latter will be reduced to zero by 1997-98; there will be a compensatory increase in market funding distributed to purchasers (DH Q604, pp5, 364).](https://iiif.wellcomecollection.org/image/b32219337_0001_0060.jp2/full/800%2C/0/default.jpg)
