Health education to meet the needs of the people and their Universities

 

Written by Professor David Green CBE

Universities educating the next generation of medical and healthcare professionals to work in the NHS should receive additional funding this September in order to help the Country going forward.

The way to do this is to back a ‘Health Education led’ plan.

This proposed plan is an alternative to the £2 billion bail-out plan advanced by the Board of Universities UK just before Easter, which has not ‘landed’ well with the country’s decision makers:

https://www.universitiesuk.ac.uk/news/Pages/Package-of-measures-proposed-to-enable-universities-to-play-a-critical-role-in-rebuilding-the-nation-.aspx

Universities UK proposed the Government increases the Quality-Related Research grants to universities to make up for the loss of income from international students and summer conferences due to the Covid-19 crisis. This UUK plan would concentrate £2 billion of public funding on a small number of universities, leaving the majority of universities who educate health professionals with multi-million pound deficits, which are none of their own making.

The central issue with the UUK package is that the headline proposal – increasing Quality Related (QR) research funding for next year by 100% - fails to stabilise most universities’ finances – while a handful would benefit from a ‘bail out’. Furthermore the package would increase regional inequality, while doing little or nothing to expand the education of health professionals – particularly in the Midlands and the North of England. The net result was a proposal which missed the target and failed to capture the public mood.

This article advocates that a ‘Health Education’ led approach is adopted as the main measure of the much-needed financial rescue package for the country’s Universities.  

Instead of doubling QR research funding, which is so very unequally distributed between institutions, regions and cities, the headline policy measure should be directly related to the number of students being educated by each university to become health professionals.

A one-off ‘Rebuilding Britain’ grant based on the contribution of Universities to health education should be paid to universities in September 2020.

This should be granted at the rate of £5,000 for every student at each university who was classified by the Higher Education Statistics Agency (HESA) as studying in Group 1 (Medicine and Dentistry) or Group 2 (Subjects Allied to Medicine) in 2018-19, which is the latest year for which we have complete data. During this year 323,700 students were classified as studying subjects in these two groups. Heath students in these 2 groups were educated at 110 of the 140 institutions in England.

The effects of these ‘Rebuilding Britain’ grants to Universities would be transformational for the good.

First and foremost they would enable the Universities who educate health professionals across the country to maintain and expand their invaluable work in health education next year.

‘Become a Health Professional’ ‘Serve and Protect the NHS’ and ‘Save Lives’ are proposals that, as the response to the pandemic has demonstrated, the people of the UK as a whole truly support.   

The alternative to a grant of this kind is that a majority of the Universities who educate health professionals – particularly those who educate nurses so successfully – will have a financial heart attack just as the nation and the health trusts need their local Universities to rebuild and develop the health workforce post-pandemic. Adopting these proposals will help Universities and their local Health Trust partners, particularly those serving ‘left behind Britain’ to:

  • Develop skills and new health professionals across the board
  • Develop Knowledge and Research in the health sector
  • Drive Regeneration
  • Drive Social Mobility and Innovation
  • Provide Civic Leadership in Towns and Cities

This Health Education-based measure would cost £1.618 billion across the UK compared to £2 billion for the ‘QR method’. Thus nearly £400m would be left to serve as a ‘Rebuilding Britain stabilisation fund’ to assist, on a discretionary basis, the small and specialist Arts, Music and Agricultural institutions which were hard hit by the pandemic, along with that small minority of remaining  universities whose financial model may have been broken by the impact of the pandemic.

As Education is a devolved responsibility and is funded and regulated very differently across the four nations, this article concentrates on England – but the same logic and argument can be applied in Scotland, Wales and Northern Ireland.

The impact of this proposal on institutions in England is shown in Table 1. (see below).

As well as making economic and financial sense this proposal makes political sense. It meets the mood of the moment, which the UUK package did not. Secondly, this proposal will distribute substantial financial aid to help the NHS, cities and towns right across the Country, which the UUK package would not. It is a levelling up package, which meets the country’s priorities.

In Table 2 (see below), 25 towns and cities are identified that will each benefit significantly from this ‘Health Education’ package, in contrast to the QR based package proposed by Universities UK.

The differences are profound – especially in Bradford, Chester, Derby, Middlesbrough, Newcastle-under-Lyme, Norwich, Ormskirk, Plymouth, Preston, Wolverhampton and Worcester as well as in their nearby towns and villages.

This broad, fair distribution of funding will mean that universities across the Country will be well placed to contribute towards much needed regeneration, educating local people to become highly skilled health workers, promoting social mobility, whilst contributing to civic leadership and social innovation. Well-led, socially responsible universities can do so much for public benefit.

Alistair Jarvis, the chief executive of Universities UK (The Guardian, April 10) was right to say:

“Universities will also have a central role to play in the recovery of the economy, revitalising communities and helping people rebuild their lives. We can develop skills, knowledge and research, drive regeneration, social mobility and innovation, and provide civic leadership in towns and cities.”

Unfortunately, the Universities UK ’100% increase in QR’ package would not deliver this – but the ‘Health Education led’ package proposed here will.

This is clearly illustrated in Table 3 which compares the effects of the two packages on the 10 universities in England which best reflect society and the 10 which least reflect society.  The two groups, are identified from research published by Professor Iain Martin in a Higher Education Policy Institute Briefing Note in 2018:

https://www.hepi.ac.uk/2018/04/05/benchmarking-widening-participation-measure-report-progress/

Taken together both groups educate very similar numbers of health professionals.

Last year 34,283 studied at the ‘best reflect society’ group, while 34,950 studied at the ‘worst reflect society’ group. While 20,000 more UK students studied at the ‘best reflect society’ group the Health Education led package produces an equitable result.

The exact opposite is the case for the ’100% increase in QR’ method. The UUK package would give just £194 per UK student educated by the ‘best reflect society’ group while giving £5,002 per UK student to the ‘worst reflect society group’, whatever subject they studied.

This would lead to a massive increase in inequality – funded entirely by the UK taxpayer!

There are always very good arguments for funding research. But is there really a good argument, as a response to the Covid-19 pandemic, for conferring an extra grant of £19.4m in public money next year on the London School of Economics, who do not educate a single health student, while granting The University of Salford who educate 5,550 health students £4.2m – less than a quarter of the proposed additional grant to the LSE?

By way of contrast, Kings College London, the biggest Health University in the country and one of our great research-intensive Universities gains £57.5 million from the ‘Health Education’ package and there is still serious money to support all the excellent health education and ‘widening participation’ work undertaken by so many Universities around the country.

The benefits arising from the ‘Health Education’ method are far greater than those arising from the ‘QR method’. Unlike the UUK package the ‘Health Education’ led method meets the defined goals of Universities UK as spelt out by its chief executive Alistair Jarvis.

The ‘Health Education led’ approach will meet the needs of society and individuals across the country. It will stabilise the finances of universities. It is politically compelling and will be widely supported. It is time for universities to contribute our all to the national programme to rebuild Britain. This is the plan that our Universities should advance. This is the plan our nation needs.

 

Table 1. (Data Source: HESA)

Academic year 2018/19

HE provider

Medicine and dentistry

Subjects allied to medicine

Total health students

Total grant at £5,000 per health student educated

AECC University College

0

585

585

2,925,000

Anglia Ruskin University

100

6,995

7095

35,475,000

Aston University

70

1,925

1995

9,975,000

Bath Spa University

0

115

115

575,000

The University of Bath

50

1,240

1290

6,450,000

University of Bedfordshire

0

1,505

1505

7,525,000

Birkbeck College

0

315

315

1,575,000

Birmingham City University

0

6,305

6305

31,525,000

The University of Birmingham

3,000

2,090

5090

25,450,000

University College Birmingham

0

65

65

325,000

Bishop Grosseteste University

0

40

40

200,000

The University of Bolton

0

2,060

2060

10,300,000

The Arts University Bournemouth

0

0

0

0

Bournemouth University

0

3,360

3360

16,800,000

The University of Bradford

0

4,135

4135

20,675,000

The University of Brighton

535

4,130

4665

23,325,000

The University College of Osteopathy

0

490

490

2,450,000

The University of Bristol

1,995

1,205

3200

16,000,000

Brunel University London

0

795

795

3,975,000

Buckinghamshire New University

0

3,170

3170

15,850,000

The University of Buckingham

410

0

410

2,050,000

The University of Cambridge

1,615

1,125

2740

13,700,000

The Institute of Cancer Research

265

0

265

1,325,000

Canterbury Christ Church University

0

3,070

3070

15,350,000

The University of Central Lancashire

1,095

5,080

6175

30,875,000

University of Chester

0

3,485

3485

17,425,000

The University of Chichester

0

140

140

700,000

City, University of London

0

3,770

3770

18,850,000

Conservatoire for Dance and Drama

0

0

0

0

Courtauld Institute of Art

0

0

0

0

Coventry University

0

4,900

4900

24,500,000

Cranfield University

0

0

0

0

University for the Creative Arts

0

0

0

0

University of Cumbria

0

2,865

2865

14,325,000

De Montfort University

0

4,545

4545

22,725,000

University of Derby

0

3,810

3810

19,050,000

University of Durham

0

135

135

675,000

The University of East Anglia

955

2,895

3850

19,250,000

The University of East London

0

1,370

1370

6,850,000

Edge Hill University

140

3,985

4125

20,625,000

The University of Essex

10

1,880

1890

9,450,000

The University of Exeter

800

955

1755

8,775,000

Falmouth University

0

0

0

0

The National Film and Television School

0

0

0

0

University of Gloucestershire

0

325

325

1,625,000

Goldsmiths College

0

85

85

425,000

The University of Greenwich

0

4,080

4080

20,400,000

Guildhall School of Music and Drama

0

0

0

0

Harper Adams University

0

25

25

125,000

Hartpury University

0

15

15

75,000

University of Hertfordshire

5

6,105

6110

30,550,000

The University of Huddersfield

0

2,855

2855

14,275,000

The University of Hull

495

2,750

3245

16,225,000

Imperial College of Science, Technology and Medicine

4,250

5

4255

21,275,000

Keele University

790

3,170

3960

19,800,000

The University of Kent

0

950

950

4,750,000

King's College London

4,590

6,910

11500

57,500,000

Kingston University

0

2,425

2425

12,125,000

The University of Lancaster

330

270

600

3,000,000

Leeds Arts University

0

0

0

0

Leeds Beckett University

0

2,380

2380

11,900,000

Leeds College of Music

0

0

0

0

The University of Leeds

2,275

3,115

5390

26,950,000

Leeds Trinity University

0

35

35

175,000

The University of Leicester

1,360

735

2095

10,475,000

The University of Lincoln

0

1,940

1940

9,700,000

Liverpool Hope University

0

60

60

300,000

Liverpool John Moores University

0

4,110

4110

20,550,000

The Liverpool Institute for Performing Arts

0

0

0

0

The University of Liverpool

2,290

1,675

3965

19,825,000

Liverpool School of Tropical Medicine

325

100

425

2,125,000

University of the Arts, London

0

0

0

0

London Business School

0

0

0

0

University of London (Institutes and activities)

0

0

0

0

London Metropolitan University

0

630

630

3,150,000

London South Bank University

0

6,355

6355

31,775,000

London School of Economics and Political Science

0

0

0

0

London School of Hygiene and Tropical Medicine

1,170

0

1170

5,850,000

Loughborough University

0

120

120

600,000

The Manchester Metropolitan University

20

2,475

2495

12,475,000

The University of Manchester

3,455

4,505

7960

39,800,000

Middlesex University

0

3,635

3635

18,175,000

Newcastle University

2,905

2,045

4950

24,750,000

Newman University

0

240

240

1,200,000

The University of Northampton

0

2,175

2175

10,875,000

University of Northumbria at Newcastle

0

4,395

4395

21,975,000

Norwich University of the Arts

0

0

0

0

University of Nottingham

2,195

3,975

6170

30,850,000

The Nottingham Trent University

0

155

155

775,000

The Open University

0

3,320

3320

16,600,000

Oxford Brookes University

0

2,645

2645

13,225,000

The University of Oxford

1,485

1,025

2510

12,550,000

Plymouth College of Art

0

0

0

0

University of Plymouth

960

4,990

5950

29,750,000

The University of Portsmouth

0

2,065

2065

10,325,000

Queen Mary University of London

3,255

415

3670

18,350,000

Ravensbourne University London

0

0

0

0

The University of Reading

0

1,590

1590

7,950,000

Roehampton University

0

440

440

2,200,000

Rose Bruford College of Theatre and Performance

0

0

0

0

Royal Academy of Music

0

0

0

0

Royal Agricultural University

0

0

0

0

Royal College of Art

0

0

0

0

Royal College of Music

0

0

0

0

The Royal Central School of Speech and Drama

0

0

0

0

Royal Holloway and Bedford New College

0

0

0

0

Royal Northern College of Music

0

0

0

0

The Royal Veterinary College

0

0

0

0

St George's, University of London

1,390

3,105

4495

22,475,000

St Mary's University, Twickenham

0

500

500

2,500,000

The University of Salford

0

5,550

5550

27,750,000

SOAS University of London

0

0

0

0

Sheffield Hallam University

0

5,650

5650

28,250,000

The University of Sheffield

2,045

2,795

4840

24,200,000

Solent University

0

270

270

1,350,000

The University of Southampton

1,605

2,135

3740

18,700,000

Staffordshire University

0

2,530

2530

12,650,000

University of St Mark and St John

0

185

185

925,000

University of Suffolk

0

1,425

1425

7,125,000

The University of Sunderland

0

2,395

2395

11,975,000

The University of Surrey

0

2,745

2745

13,725,000

The University of Sussex

535

415

950

4,750,000

Teesside University

90

4,725

4815

24,075,000

Trinity Laban Conservatoire of Music and Dance

0

0

0

0

University College London

4,270

3,295

7565

37,825,000

The University of Warwick

1,020

980

2000

10,000,000

University of the West of England, Bristol

0

7,590

7590

37,950,000

The University of West London

0

3,030

3030

15,150,000

The University of Westminster

0

605

605

3,025,000

The University of Winchester

0

60

60

300,000

The University of Wolverhampton

80

3,895

3975

19,875,000

University of Worcester

0

2,705

2705

13,525,000

Writtle University College

0

0

0

0

York St John University

0

550

550

2,750,000

The University of York

385

1,005

1390

6,950,000

Total

54,625

234,005

288630

1,443,150,000

 

Table 2.

City/Town

£5,000 per health student educated

100% increase in QR

Gain from supporting health student education

 

Birmingham

68,475,000

51,598,800

16,876,200

(Aston, Birmingham, Birmingham City, UCB, Newman)

Bradford

20,675,000

3,916,448

16,758,552

 

Brighton

28,075,000

20,902,555

7,172,445

(Brighton, Sussex)

Canterbury

20,100,000

17,504,088

2,595,912

(Canterbury Christchurch, Kent)

Chester

17,425,000

1,540,053

15,884,947

 

Carlisle

14,325,000

275,905

14,049,095

(Cumbria)

Derby

19,050,000

1,080,997

17,969,003

 

Greater Manchester

90,335,000

86,586,453

3,748,547

(Bolton, Manchester, Manchester Met, Salford)

Huddersfield

14,275,000

5,854,126

8,420,874

 

Hull

16,225,000

7,997,854

8,227,146

 

Ipswich

7,125,000

8,169

7,116,831

(University College Suffolk)

Leicester

33,200,000

23,868,830

9,331,170

(Leicester, De Montfort)

Lincoln

9,900,000

3,912,228

5,987,772

(Bishop Grossteste, Lincoln)

Middlesbrough

24,075,000

1,645,976

22,429,024

(Teeside)

Newcastle

46,725,000

43,209,636

3,515,364

(Newcastle, Northumbria)

Newcastle-under Lyme

19,800,000

7,339,301

12,460,699

(Keele)

Norwich

19,250,000

17,287,407

1,962,593

(UEA, Norwich University of the Arts)

Ormskirk

20,625,000

1,452,574

19,172,426

(Edge Hill)

Preston

30,875,000

4,181,368

26,693,632

(Central Lancashire)

Plymouth

30,675,000

8,835,242

21,839,758

(Plymouth, University of St Mark and St. John)

Sheffield

52,450,000

50,108,723

2,341,277

(Sheffield, Sheffield Hallam)

Stoke on Trent

12,650,000

936,907

11,713,093

(Staffordshire)

Sunderland

11,975,000

1,423,344

10,551,656

 

Wolverhampton

19,875,000

2,048,169

17,826,831

 

Worcester

13,525,000

1,012,294

12,512,706

 

 

Table 3

English Universities that Best Reflect Society

       

Name of University

Number of UK domicile students

Number of health students

£s grant to university under current QR proposal

£s per UK domicile student under current QR proposal

Total £s grant to university if £5,000 given per health student

Hull

13,855

3,245

7,997,854

577

16,225,000

Derby

17,380

3,810

1,080,997

62

19,050,000

Edge Hill

13,485

4,125

1,452,574

108

20,625,000

Chester

13,585

3,485

1,540,043

113

17,425,000

York St John

6,265

550

556,683

89

2,750,000

Leeds Beckett

21,890

2,380

2,563,937

117

11,900,000

Worcester

9,435

2,705

1,012,294

107

13,525,000

Anglia Ruskin

20,950

7,093

2,503,403

119

35,465,000

Northumbria

22,350

4,395

7,163,590

321

21,975,000

Manchester Metropolitan

30,450

2,495

7,082,146

233

12,475,000

Total

169,645

34,283

32,953,521

£194 average per student

171,415,000

 

English Universities that Least Reflect Society

       

Name of University

Number of UK domicile students

Number of health students

£s grant to university under current QR proposal

£s per UK domicile student under current QR proposal

Total £s grant to university if £5,000 given per health student

Cambridge

13,545

2,740

131,618,517

9,717

13,700,000

Bristol

19,450

3,200

49,505,717

2,545

16,000,000

Oxford

16,890

2,510

151,832,913

8,990

12,550,000

UCL

21,540

7,565

150,211,313

6,974

37,825,000

Durham

13,270

135

26,285,252

1,981

675,000

LSE

3,855

0

19,393,014

5,031

0

Imperial

9,040

4,255

98,333,623

10,878

21,275,000

Bath

12,495

1,290

18,681,044

1,495

6,450,000

Exeter

18,680

1,755

26,263,054

1,406

8,775,000

Kings

20,510

11,500

74,535,595

3,634

57,500,000

Total

149,275

34,950

746,660,042

£5,002 average per student

174,750,000