Academic Health Science Centres

Lord Willis of Knaresborough Excerpts

Tuesday 2nd July 2019 Grand Committee

[Lord Willis of Knaresborough (LD)]

I, too, thank the noble Lord, Lord Butler, for initiating this debate. Given the number of people who will no doubt speak on behalf of different academic health science centres, the Committee should take it as read that I believe that they are all doing excellent work, because I want to explore one or two other areas.

On the need for a 21st-century research-led healthcare system, there is no political discord whatever—I think that we all agree on that, full stop. When the noble Lord, Lord Patel, managed to get the words “research led” on to the statute book during the passage of the Health and Social Care Act 2012, it was remarkable because it created a journey to which I think we all aspired.

There were some excellent signs. The early establishment of some academic health science centres during the years of the Labour Government was positive. In 2014, it was good to see the re-designation of six of them, five of them being in the “golden triangle” and the other in Manchester. I believed that was exciting but hoped it would pave the way for more. Why is there excellent research only in the south-east rather than elsewhere in the country? So far, that expansion has not transpired. If we simply go ahead and re-designate those already there, what will happen to my area, Yorkshire and the Humber? Are we saying that there are no initiatives worthy of designation in Yorkshire and the Humber or the north-east? Surely not. I hope that the Minister will take that on board.

My first plea in any reaccreditation exercise is to include areas that have a strong track record of collaboration between academia and research. In so doing, please use the opportunity to simplify structures that Peter Drucker once described as,

“the most complex in human history”.

Drucker was interesting, but it cannot be right to have differing governance, finance, clinical and political structures in each of the organisations, most with scant involvement of the people they serve. I have a great deal of time for Drucker but he had not looked at the rest of the health research landscape when he made his comments. As Professor Ovseiko argued in 2014, in a superb article on improving accountability through alignment, unless our model of competing structures for research, education, patient care and funding is radically streamlined we will not realise the huge potential for improved patient care that lies within our grasp.

The current landscape defies logical examination. We now have academic health science networks in every region with a remarkably similar mission to the AHSCs, except that they have a budget. Some have close ties with their AHSC, if it exists—not so in Yorkshire and the Humber—some do not. They should surely be brought together within the AHSN using its organisational structures, which are already there and are being paid for by the taxpayer. What about the collaborations for leadership in applied health research and care—the CLAHRCs—of which I am currently chairman, which are soon to be replaced by another set of organisations, the applied research collaborations, for which I am a prospective chairman? Again, some have close ties with a regional AHSN, some do not. For good measure, how do we ensure that our remarkable research effort actually benefits all our citizens, not simply the regions where the organisations currently are?

Finally, money is essential in this. We have a host of small elements of money. We need this to be properly funded. The whole nation needs to be involved and to take this wonderful opportunity forward.