Health: Academic Health Partnerships

Baroness Thornton Excerpts

Monday 29th November 2010 Lords Chamber

[Baroness Thornton]

My Lords, I join other noble Lords in congratulating the noble Baroness, Lady Finlay, on drawing this important matter to the attention of the House. As has so often happened in the past, the noble Earl and I are usually, or probably, the least qualified people to answer this debate, given the quality of the contributions that have been made this evening. I particularly thank my noble friend Baroness Donaghy for her thoughtful contribution.

Evidence from around the world demonstrates the profound role played by world-class research and teaching in driving innovation in healthcare. Academic health science centres are designed to maximise clinical and academic synergies by ensuring that clinical research and teaching staff work in concert to unified plans that transcend the separate structures of their respective clinical and academic institutions. In 2007 a review of healthcare in London led my noble friend Lord Darzi in a framework for action to recommend the creation of a number of academic health partnerships. In October 2007 Imperial College Healthcare became the first to be established in the UK when Imperial College London’s faculty of medicine merged with the Hammersmith Hospital and St Mary’s Hospital NHS trusts. I know that several more—mentioned by other noble Lords—have subsequently been established, notably Cambridge University Health Partners, King’s Health Partners, Manchester Academic Health Science Centre, UCL Partners, Barts and The London NHS Trust.

We can be proud of the achievements of these innovative partnerships and the benefits that they have brought in their own areas to the cities that they are in and across the world. The engines of clinical innovation— for example, at Barts and The London—will be 70 new clinical academic units, clusters of closely related specialties or sub-specialities working to a single plan for clinical care research and teaching. For example, guests from all over the world flew to London the week before last for the opening of a new cardiovascular biomedical research unit at the Royal Brompton Hospital. The BRU is a joint initiative between the Royal Brompton and Harefield NHS Foundation Trust and Imperial College London and puts the partnership at the forefront of international research into the most challenging heart conditions. It is funded by the National Institute for Health Research.

There appear to be three legs to the AHSC stool. For it to work properly it needs excellent education, excellent healthcare and excellent research. It also needs time. This is not a five-year project; this is a 15 to 20-year shift in the development of excellence and innovation in these areas. My understanding is that the funding of the academic health science centres is a mixture of MRC, DBIS and NIHR. Under the current structure, SHAs and PCTs have delegated responsibility to administer research funding. In addition to his powers to conduct or assist research, the Secretary of State has a duty under Section 258 of the 2006 Act to ensure that facilities are made available for universities with medical or dentist schools in connection with clinical teaching and the research connected with clinical medicine or clinical dentistry. This duty is delegated to the strategic health authorities and PCTs under the regulations.

Therefore, my first question to the Minister—echoed around the House—is unsurprisingly: how will this particular aspect be delivered and funding allocated under the new NHS structure? Who will undertake these duties with the demise of the strategic health authorities and PCTs? Linked to that, we need to ask about workforce planning. As many noble Lords have mentioned, clinical academics need to be fed through to these bodies. How will that happen?

The British Medical Association has recommended consideration of the roles of networks, health innovation and education clusters and the National Institute for Health Research and how these will fit into the Government’s overall plans. Can the noble Earl assure the House that the funding for the National Institute for Health Research is, indeed, safe?

On the necessity for ensuring excellence in education, we also need to look at the implications of the Browne review of university funding because we need to know how the leg that concerns teaching and universities will be affected. Presumably the cutbacks in the funding of higher education will have an impact on AHSCs in relationships with universities as they collaborate with them. There is the potential for a double whammy here, both in costs to individual students and, indeed, in the cutbacks that universities are to suffer as a result of the CSR settlement. Like other noble Lords, I welcome the fact that research has been protected under the CSR, but it seems to me that at least two legs of this stool are looking a bit dodgy. I invite the Minister to tell the House how the Government intend to support the future of these partnerships in the long term.