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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![Table 5: Special Health Authorities Former SHA hospital Hammersmith Hospital Royal Postgraduate Medical School Great Ormond Street and Institute of Child Health Hackney Hospitals for Children Moorfields Eye Hospital Institute of Ophthalmology Royal Marsden Hospital Institute of Cancer Research Eastman Dental Hospital Eastman Dental Institute Bethlem and Maudsley Hospitals National Hospital for Neurology and Neurosurgery Royal Brompton Hospital Institute of Psychiatry Institute of Neurology National Heart and Lung Institute Note: The Hospital for Tropical Diseases, associated with the London School of Hygiene and Tropical Medicine, is not an SHA, but part of UCL Hospitals NHS Trust (p363). 39. When we met Sir Colin Dollery, who as Dean of the Royal Postgraduate Medical School (RPMS) is deeply interested in the future of the Hammersmith Hospital, he was pessimistic. “The ex-SHA hospitals will have been taken from a situation of complete central funding into the internal market over a very short period of time, and without the local purchasers having funds, in many cases, to afford to buy...I foresee a very difficult future for the ex-SHA hospitals unless the policy is modified to a degree” (Q139). On the other hand, Dr Malcolm Green, Director of the BPMF which brings the other SHAs together, is content with the transitional arrangements (Q606): “The ex-SHAs have been...able to enter the internal market with a sufficient subvention for R&D to be able to take forward their aspirations”. 40. The Tomlinson report recommended that the postgraduate institutes should become part of one or other of the multi-faculty colleges of the University of London. Such arrangements are now being negotiated (p76, Q600). Local and “implicit” NHS research expenditure 41. An unknown amount of NHS resource finds its way into research at the level of local purchasers (DHAs, FHSAs and GP Fundholders) and providers (Trusts), whether explicitly or implicitly. Warwick University (p478) offers an instance of explicit funding by a provider: three joint appointments by the University and Walsgrave Hospital Trust, including a Professor of Medicine. Since the concept of “implicit” research is somewhat elusive, it is worth quoting in full what the Culyer report says about it: “2.24 Concern however was expressed [by witnesses to the Task Force] that neither commissioning nor responsive funding would support all the NHS R&D-related activity in the NHS. We found a widespread belief that the R&D currently funded explicitly by the NHS might be only a fraction of the total. Much of the “implicit” R&D-related activity was thought to fall outside the scope of R&D as presently defined in the NHS R&D Strategy, but was nevertheless considered to be of vital importance to the NHS. 2.25 Such implicit activity was often of high quality, undertaken by clinical scientists and by staff in routine laboratories, doctors, nurses, radiographers and others in clinical practice with training and experience in research, and directed towards providing new knowledge and techniques of general value to the NHS. It was the breeding ground for many new ideas. Often such work might lead on to an R&D project. Such activity was of great value to purchasers and providers of health care yet its value was often not recognised by them. There was concern that it would be squeezed out unless it was recognised and funded explicitly... R&D in NHS providers funded on their own account 3.34 We understand that NHS providers are currently funding a considerable amount of R&D and R&D-related activity on their own account out of their income for patient care...](https://iiif.wellcomecollection.org/image/b32219337_0001_0061.jp2/full/800%2C/0/default.jpg)
