My Lords, the National Institute for Health Research awards funding transparently and competitively for research of high scientific quality that has relevance to the NHS and represents value for money. We therefore expect that the maximum is spent on research rather than on administrative overheads. Trusts with teaching hospitals received a total of £500 million from the NIHR in 2011-12.
I appreciate that funds go directly to the researchers from the body that the Minister mentioned and from the Medical Research Council. What I am concerned about is that I am told by those working, and possibly doing research, in these teaching hospitals that the bulk of the money is paid to the person doing the governance of research and development, and not a penny of that money is actually going to the researchers, who are funded in the way that the Minister has said. Ever since 2006, when that was set up, there has been a great growth of these people doing nothing but checking on the work of the real researchers.
My Lords, every NHS trust or foundation trust has to oversee the governance of the research taking place within it. That is an inescapable part of the process. I do not think there is any confusion in anyone’s mind between support for research governance and the actual research itself, which is done by academics and clinicians working in academic and clinical departments. It is up to each trust to determine how its budget for research is allocated, but I can reassure my noble friend that the money is getting to where it needs to go.
My Lords, would the Minister agree that since Sally Davies took charge of how research is done within trusts, there has been a significant improvement in insuring that more of this money actually goes to serious translational research, which is an area that the health service really needs to concentrate on? I hope that the Minister will agree that that job has been done rather effectively.
I do agree with the noble Lord. Before the creation of the NIHR, research allocations to NHS hospitals were made essentially on a historical basis, with no assessment of quality or value and no ability for the funding to move in response to competition. The NIHR undoubtedly changed all that. The NHS funding for research is now awarded transparently and competitively and robust systems are in place to ensure that it is used only to support research rather than being diverted for other purposes.
I agree with the noble Lord. The Government are providing a record £800 million over five years for NIHR biomedical research centres and units as from April of this year. The centres are based within the most outstanding NHS and university partnerships in the country; they are leaders in scientific translation; and they will play an integral part in the life sciences strategy which the Government published last year.
My Lords, may I declare an interest as a surgeon and say that surgical research attracts less than 2% of the total funding that goes into research? There may be those in this House who feel that surgeons just cut and do not actually do an awful lot of laboratory work, but the truth is that research is an integral part of surgery. We are there to bring translational research from the lab to the patient and to produce results, particularly in the field of cancer. I would therefore be grateful if my noble friend could assure me that there will be much greater emphasis on providing support for surgery?
I agree with my noble friend about the importance of surgical research. The NIHR funds extensive research in surgery across a wide range of funding streams. The most recent estimate of its spend on directly funded research relating to surgery was £7.3 million, but that is a rather historic figure which goes back to 2009-10. In February this year, the NIHR issued a call for research on the evaluation of technology-driven implanted or implantable medical devices and decisions will be made on that next March. Twenty million pounds has been invested in the NIHR Surgical Reconstruction and Microbiology Research Centre, which is an initiative between my department, the Ministry of Defence, the University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham. I hope that my noble friend will agree that that is a positive development.
My Lords, the Minister said very clearly in his Answer to the first Question that it was a matter of “value for money”. Is there not a danger that the Government will cost the exercise at the expense of the care that should be had by patients in this country?
No, my Lords. The very point that I made to the noble Lord, Lord Winston, was that by the creation of the National Institute for Health Research, we were avoiding the very thing which used to happen in the past. Now, we can be quite certain that research money from the NIHR will be used to support research and not be diverted into other places.
My Lords, we welcome the greater emphasis that the Government are giving to NHS research and the commitment to the National Institute for Health Research. However, there is an acute shortage of clinical academics who are both medics and front-line researchers. What steps are the Government taking to rectify this situation so that we can get better links between research and patient outcomes?
I share the concern of my noble friend, although he will be pleased, I am sure, to know that through its integrated academic training programme, the NIHR has taken a lead in reversing the decline that we have seen in recent years in clinical academic careers. Around 250 NIHR academic clinical fellowships and 100 NIHR clinical lectureships are now available annually for medics, which is good news. I also think that intercalated degrees play a very important part in developing the next generation of clinical academics, as does the INSPIRE programme from the Academy of Medical Sciences.