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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 May 19; 334(7602): 1036.
PMCID: PMC1871808
Body Politic

Spend, spend, spend—hide, hide, hide

Nigel Hawkes, health editor, the Times

A suppressed report on the now defunct NHS University speaks volumes about government waste

Anyone who doubts the Department of Health's ability to consume cash like a forest fire should take a look at the freedom of information section of the DH website. There, after a long and ultimately successful battle by Rod Ward, senior lecturer at the University of the West of England, is published the report written in 2004 by Sir William Wells into the NHS University. It's a tale to make the blood run cold.

I can claim a walk-on part. In May 2001 I was summoned, along with the political editor of the Times, to a briefing by the political adviser to Alan Milburn, then secretary of state for health. It was the middle of the election campaign, and to spice up the Labour manifesto somebody had invented the idea of launching an NHS University. McDonalds already had one, the Hamburger University, to train its staff in the finer points of fast food delivery: so did Disney, and 2000 other US corporations.

Mr Milburn's man skilfully dished us up a scoop, fast-food style. Cooks, porters, and other low-paid staff, he told us, would be promised £300 a year to start individual “learning accounts” and at any time 100 000 NHS staff would be taking courses, from cleaners to consultants. This was the “big idea” of Labour's campaign, intended to echo the success of the Open University, also a Labour idea. The NHS University would be a “model of excellence” and would cost £30-50m (€44-74m; $60-100m) a year.

The story duly appeared on page one of the next day's Times, and the NHS University was formally launched the same day by prime minister Tony Blair at the Royal Marsden Hospital in London. Did I wonder, even momentarily, if I might have been sold a pup? Possibly, but it wouldn't have been the first time.

Troubles began almost before Mr Blair had closed his mouth. The university title is jealously guarded, and those that hold it are quite prepared to defend it. Becoming a university requires Privy Council approval, and 55% of students must be taking degree courses, a level that the NHS University could not achieve for many years, if ever. Allowing it to become established would also threaten the future of existing universities, which formed a stockade to repel the encircling Indians. They won without breaking sweat. The NHS University was forced to rename itself the NHSU, in which the U stood for nothing at all. Honestly, nothing.

That was a big psychological setback that more prudent planning might have avoided. It upset the chief executive of NHSU, Professor Bob Fryer, who had taken to calling himself vice-chancellor designate, and insisted that the university title mattered. But NHSU went ahead, recruiting staff without ever quite defining what it was about. “We have been struck, in the course of our review, by the absence of simple, clear descriptions of NHSU's purpose and the parameters of its role,” Sir William Wells commented dryly in his now published review.

Its ambitions were huge. “Step by step NHSU is expected to assume an umbrella responsibility for all learning in health and social care,” Professor Fryer said. But its powers were limited. It could not force anybody to take its courses, alternative versions of which already existed at established universities. It made few efforts to find out what its customers actually wanted. When it did, said Sir William, it was “too little, too late.”

Cash demands began to rise. The NHSU spent £28m in 2003-4, £44m in 2004-5, and put in a bid for £73m in 2005-6. It planned a “virtual campus”—a fancy website, I think this means—that was going to cost £20-50m over five years, but that was abandoned after a similar scheme, the online electronic university, crashed after spending £9.9m of public money on a learning platform that didn't work.

At this point health secretary John Reid, bless him, pulled the plug. Armed with Sir William's report he was able to stop the NHSU in its tracks and merge it with the NHS Modernisation Agency and the NHS Leadership Centre into something called the NHS Institute for Innovation and Improvement. Professor Fryer was found another job. In 18 months of existence the NHSU had absorbed £72m, and trained 30 000 people, mostly in fairly basic skills.

Sir William concluded: “NHSU's expenditure of £72m in 2003-5 can only be justified as large-scale investment which will reap major dividends in the future. This creates a potential for embarrassment if questions are asked about the value for money of NHSU . . . very rapid steps will need to be taken if the threat of embarrassment is not to be prolonged well into the future.”

Where public money is concerned, this government is pretty close to unembarrassable. But just to make sure, it suppressed Sir William's report and denied Mr Ward's request for it to be published, while simultaneously claiming it would be published “shortly.” When the Freedom of Information Act came into force at the beginning of 2005 he repeated the request, was turned down, and appealed to the information commissioner, who upheld his appeal. The DH then appealed to the next tier of authority, the Information Tribunal, backing down just days before that appeal was due to be heard. These are the same ministers who accuse journalists of being cynical.

Let's leave the last word to Rod Ward, who deserves it. He said: “We need to learn some of the lessons—we spent £72m of taxpayers' money and the management was diabolical.”

Where public money is concerned, this government is pretty close to unembarrassable

Articles from The BMJ are provided here courtesy of BMJ Publishing Group