My Lords, investment in education and training will not be ring-fenced in the 2007-08 financial year. There will be a service-level agreement between the Department of Health and strategic health authorities that will hold strategic health authorities to account. The key aim of the agreement will be to ensure that the funding of training and the commissioning of training places are based on long-term workforce needs.
My Lords, I thank the Minister for that Answer. However, will he reconcile a statement made by the Secretary of State, the right honourable Patricia Hewitt, in an interview this month with the editor of the British Journal of Healthcare Management with regard to the transfer of multi-professional education and training budgets to meet the deficits last year? She said,
“now this is fixed I would not expect the NHS to have to take similar action”,
this year. However, four strategic health authorities have already stated their intent to reserve between 3.7 and 11.8 per cent of their budgets for NHS reserves. How will the strategic health authorities be monitored? How will corrective action be taken to ensure that the right level of places are reserved for students, and that deficits from last year are made good in the light of the right amount of students qualifying in 2010-11?
My Lords, last year was exceptional. The NHS faced a deficit. We required the NHS to turn the situation around. It did that. We expect the final outcome for 2006-07 will be that the health service is not in deficit. That has led to hard decisions having to be made, including on education and training. I assure the noble Baroness that education and training remains a priority. The Government have seen a huge increase in the number of training places. Through the service-level agreement, we will ensure that strategic health authorities acknowledge their part in ensuring that a national strategy for workforce planning is furthered and encouraged. But the SHAs have to make their own decisions, balancing workforce needs and the needs of training places, and we will certainly ensure that that happens.
My Lords, does the Minister accept that some years ago it was agreed that the training and education budget in the NHS should be ring-fenced, and indeed that last year it was agreed that the joint funding for Medical Research Council and NHS research and development would also be ring-fenced? However, the budget for education and training in the NHS was raided by the primary care trusts because they were running out of money and, despite the assurances, £93 million was taken off the research budget last year. What action are the Government taking in the light of the agreements, to which the Minister referred, to make certain that these raids, which have had a devastating effect on training, teaching and research, will not be repeated in the future?
My Lords, as I have indicated to the House, last year was an exceptional year. It was absolutely essential that the NHS got out of deficit. It looks as though it has done so, but that led to some very difficult decisions having to be taken. I well take the noble Lord’s argument that we need to ensure long-term sustainable provision, both in R&D and in education and training. I am sure that he will acknowledge that there have been big increases in this Government’s overall support for research and development. As I have said, we have seen considerable increases in the number of training places.
On the question of removing ring-fencing, it must surely make sense for strategic health authorities, which know the needs of the service in a region, and which can work and are working closely with the providers of student places, to have the flexibility to take decisions according to their priorities, with the department maintaining an overview and ensuring that we also have a national strategy in place.
My Lords, there are no such plans, but I have met representatives of the universities, and I have encouraged close liaison between the universities and the strategic health authorities to ensure that there is close co-operation and partnership.
My Lords, these are, of course, matters for the NHS Appointments Commission. To my certain knowledge, a number of strategic health authorities have close connections with universities. However, the main thing is not so much who is a non-executive director but that universities and strategic health authorities work together. I believe, in the light of what happened last year, that there is a determination to ensure that they work closely together.
My Lords, I declare an interest as vice-president of the Royal College of Nursing. Is the Minister aware of the devastating effects on some of the universities and their provision of nursing education of a sudden reduction in funding by some of the SHAs? Between 2000 and 2005, these universities have been working with their NHS partners to expand nursing education to meet the NHS national plan. Now they are being forced to make drastic reductions in academic staff and intakes of students. There is, for example, a proposed reduction of 19 staff at the University of East Anglia. Can the Minister say how universities will be able to meet the need for continuity in nursing education in the future—a need that is bound to expand, given the lack of retention—and what reassurances can he give the NHS about the continuity of provision of new qualified nurses?
My Lords, I have already explained that last year was a very difficult year. We are determined that universities and the health service will work together in the future. Of course the NHS can provide further certainty for universities. Equally, universities can be more flexible in the training that they provide for people who will work in the NHS.