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

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)

Table 2.

Table 3