My Lords, my noble friend Lord Turnberg has been so successful in recruiting speakers to this short debate that we have very limited time. As he recruited me only yesterday, my contribution will be more a series of snapshots than a deep analysis.
I agree with my noble friend that the Government have taken important steps, which he outlined, to reduce the shortfall. As well as that, they have promised an additional £100 million per annum by 2008 for NHS R&D. It would be interesting if the Minister were able to tell us how that funding will be allocated in relation to the problems outlined in the debate. However, most clinical academics will reserve judgment on those rather grand-sounding initiatives until results begin to come through. There is a long way to go.
It is surely unacceptable that clinical academic staffing levels nationally have been allowed to dwindle at the same time as student numbers have greatly increased. It is of course much easier and more politically visible to increase student numbers than create and fill new clinical academic posts. However, without that parallel increase, the end product will inevitably be of lower quality. As other noble Lords have said, it is the quality and quantity of research that is suffering most, as the clinical academic service demands on clinical academic staff are more pressing and urgent, especially when time and staff numbers are short. My information from the coal face comes from my son, who is a senior lecturer in oncology at Birmingham University and is involved in multi-centre chemotherapy drug tests. His unit is up to full strength, but other parts of the medical school are less lucky. Posts have not been filled as they have become vacant, with the results that I described.
Many clinical students have to travel some distance to peripheral hospitals to find sufficient numbers of patients with whom to gain all-round clinical experience. That practice is not new and has much to commend it; I felt that I gained a lot by those attachments to non-teaching hospitals. Teaching hospitals have a higher proportion of less common conditions, and students there have less hands-on experience. Although the National Health Service staff at peripheral hospitals who teach clinical students are good doctors and teachers, they mostly do not have protected time for teaching or research. In particular, they are often much too busy to attend academic seminars and other events at the university aimed at keeping teaching clinicians at the forefront of clinical knowledge. Those out-of-town clinicians are in fact keeping our medical schools going, especially now that student numbers have risen so much. They deserve better recognition, better academic status and facilities and, above all, dedicated paid teaching sessions. Although peripheral GP practices are perhaps treated better, many of the same factors apply there, too.
Another area pertinent to the debate is the joint funding of clinical trials and other research by the pharmaceutical industry and universities. The industry has to find not just 100 per cent of the universities' overheads, but now 110 per cent. In their present financial straits, universities naturally see this as a way of augmenting their income. After all, the company may make a large profit through application of the research. That actually means that less research is coming to the UK, despite its excellent reputation and research skills. Countries in Europe, especially the new members of the EU, are much cheaper and are rapidly increasing their skills. The Government should make it easier for the international pharmaceutical industry to continue to carry out research here.
It is vital that the Government's good intentions be translated speedily into action; otherwise, the danger is that this country's fine record in clinical research and teaching will be relegated to Division 2, instead of vying for the top place of Division 1.