Top medical academics are privately battling to dismantle a government strategy for health research, which they fear will pit universities against each other and drive some medical schools out of the research market.
Medical school heads warned this week that key London teaching hospitals - which have historically received a disproportionately large amount of the Department of Health’s £650 million research budget - might collapse if the department withdraws their cash as part of a shake-up of research funding.
They also slammed proposals for a premier league of five academic medical centres across the country as "divisive".
Gareth Williams, dean of the faculty of medicine and dentistry at Bristol University, said: "Immediately there would be difficulties in recruiting and retaining people [for the universities not chosen]. Then of course no matter how good it is, all of the research comes under threat."
The new National Health Research Strategy, which is open for consultation until next week, is the brainchild of Sally Davies, the DoH’s director of research. David Gordon, chair of the Council of Heads of Medical Schools, praised Professor Davies this week for trying to claw back her department’s R&D budget, long suspected of being swallowed up by the short-term demands of patient care in hospitals.
But medics in the capital are awaiting the consequences with trepidation. London research hospitals secured more than £281 million from the DoH’s research pot in 2002-03, compared with £26 million in the North West and £18 million in the South East.
Nick Wright, warden of Barts and the London, Queen Mary’s School of Medicine and Dentistry, said: "This money is given to trusts and used to keep clinical services open. It is not spent on research. If you remove it, it will raise the tariff and could well destabilise some of the London hospitals."
The strategy earmarks £100 million for academic centres at the "top five" research hospitals, sparking fears across the country that unsuccessful bidders will be pushed out of the research market as they struggle to attract funding.
Competition for the proposed centres will be fierce, with universities outside London battling to secure more funding than in the past. Manchester, Newcastle, Oxford, Cambridge, Birmingham and Southampton universities are seen as likely strong contenders.
One senior academic source said: "It is already proving divisive. People are trying to find out what the rules are and position themselves accordingly."
Mike Spyer, vice-provost for biomedicine at University College London, said that London medical schools would be on a "difficult footing" as the department tried to spread funding more liberally.
New medical schools that are still establishing their research base have warned that they may be left out in the cold. Sam Leinster, dean of the University of East Anglia’s new School of Medicine, Health Policy and Practice, said: "The General Medical Council is quite clear that a research-rich environment is essential for medical education. If you pull the research out of all the other institutions, where is this environment going to come from?"
One medical dean added: "This strategy has been put together too hastily. And Sally has blotted her copybook as she did not originally want to consult on it. She even kept the Medical Research Council in the dark."
But Professor Davies insisted that the department’s intention had always been to consult and that she would take on board the sector’s concerns. "I think they haven’t read the strategy as we are proposing it."
She said universities that fell outside the new top five would not be prevented from winning other funding: "It is key that the [R&D] money is transparently allocated to be spent on what it says it is spent on."
Extra fellowships initiative
The Department of Health aims to avert a recruitment crisis in academic medicine by introducing hundreds of new clinical fellowships and lectureships, writes Anna Fazackerley.
A survey of university medical and dental schools published in June showed that the number of medics and dentists choosing to go into academia was still falling.
The scheme will breathe new life into these disciplines, with the appointment of 250 new academic clinical fellowships for people in the early stages of their career and 100 clinical lectureships for middle-ranking people each year.
The DoH has yet to announce a firm budget for the initiative, but confirms it will fund over 1,000 new posts. This will be overseen by the new UK Clinical Research Collaboration.
The Higher Education Funding Council for England and the DoH will also invest £100 million over ten years to attract senior medics and dentists into "new blood" fellowships.