Roland Levinsky: The NHS University is bad for our health

Tony Blair, in his 2001 election manifesto, promised to create Britain's first corporate university, the NHS University. In blending two contentious issues, education and health, he believed that he had a definite electoral winner to secure his second term. Indeed, the letters "NHSU", when "Googled" recently into my computer, revealed around 2,730 web pages. Does this reflect the importance of this topic to the educational debate, or the controversy that the concept has engendered? And are we now seeing a public-relations exercise to forestall criticism prior to the official launch this autumn?

There is no doubt that the ambition to develop the skills of the people who work in the NHS, and to provide opportunities for lifelong learning is laudable. But is there a need to create yet another expensive bureaucratic organisation when much of the NHS's educational aims could be achieved by universities, further-education colleges, and the Open University?

The NHSU (U is a sleight-of-hand attribution of university status), says that it will not compete with traditional universities in pre-registration undergraduate programmes. This removes from the potential curriculum BA-level degrees in medicine, dentistry, nursing, pharmacy, and other professions allied to medicine, so it is difficult to see how it will meet current criteria for the university title, the stated aim, by 2005. Under current legislation, more than 55 per cent of courses must be at full degree level, and until the recent higher-education White Paper, a university was where research and teaching are pursued to mutual interdependence and benefit.

The NHSU is being developed with support from Learndirect (formerly the University for Industry), the Open University, and the UK's e-Universities initiative, and will deliver distributed education by distance learning and traditional face-to-face teaching. How this will work in every NHS Trust nationwide by 2005 is yet to be determined. In the document put out to consultation, the NHSU claims that it will have more than a million students of all kinds, from cleaners to consultants. It will offer courses ranging from literacy, numeracy and spoken English, to postgraduate specialisms. These are yet to be defined, but medicine and nursing are well provided for by the universities and royal colleges.

The rhetoric speaks enthusiastically of a "skills escalator", via which one can ascend, by a series of structured courses, from porter to consultant. As these opportunities exist in further and higher education, and examples of such achievement are known, the hyperbole fails to impress. Moreover, it is questionable why the initial series of courses - induction to the NHS, cleaning and infection control, communication skills for working with cancer patients, management skills, and first contact (triage) - have been chosen to launch a university.

In reality, the only "escalator" is financial; the budget is £30m this year; £50m next year; and £80m in 2005, the approximate teaching budget of two medium-sized universities. The NHSU, as described, is nothing more than an expensive franchise operation where the kite-mark is that of the NHSU rather than of the organisation developing and selling the course. The danger is that the aspiration to real university status can only be achieved if it takes over undergraduate and postgraduate qualifications of traditional universities. That would be disastrous, turning the clock back many decades. It would destroy the quality of medical education across the UK.

To achieve its educational aims, the NHSU should become a small, streamlined umbrella organisation, and, wherever possible, draw on the educational programmes and expertise of existing universities and further-education colleges. It should enrol its staff to these institutions, only making its own local provision for skills training when necessary. Since the NHS wishes its treatments of patients to be based upon objective evidence, it must not isolate its students from proper science, evidence-based education, scholarship and research.

One of the 2,730 web pages described the NHSU as an idea from the back of a taxi. I am reminded of the tale of the emperor's new clothes. I hope I am proved wrong.

The author is vice-chancellor of Plymouth University. He worked in the NHS for over 30 years, for 20 as a consultant paediatrician. The views expressed are personal

education@independent.co.uk