Sunday, 12 February 2012

The Art [Deco] of Figure Skating in Morecambe, the NHS and Beyond

Last week was dominated by finance, numbers and the exploration of consequences. Following some considerable preparation work, I found myself once more on the way to the seaside town of Morecambe for this year’s University Financial Planning Conference. However, getting to the venue was a trial on its own. Early morning rain falling on frozen roads created sheet ice and led to hazardous roads and pavements. Cumbria and Lancashire police forces reported more than 100 road accidents between the hours of 05.00 and 09.00 am, in and around the M6.

The venue for the conference was the Midland Hotel, a renovated Art Deco style hotel, well past its once glorious heritage. I didn’t like it last year when we went there, and my desire for being there again hadn’t grown over the intervening 12 months. My deep joy reached a new low when I got out of my car and slipped on the icy surface. But at least this year I was aware of the toilet hidden in the bedroom cupboard (I kid you not) and I got a double bed (complete with an explicable cuddly toy) and a view that was handy for keeping an eye, overnight, on my car in the car park.

However, my comfort, well being and sense of the atheistic were not the reason I was there. The Senior University Leadership Team were gathered together to address the severe economic and financial situation impacting upon our future as a University. This situation is caused by a number of interrelated issues. Overall, there has been a 2.5% reduction in the Higher Education Funding Council England (HEFCE) grant made available to universities which is down to some £6,507bn. A new fee system has been introduced, and students starting in September 2012 will be impacted by this, with fees for programmes rising to some £9000 per year in some Universities. Student applications are down by some 30% on this time last year, and changes brought in by the UK Boarder Agency for overseas students has dramatically reduced the number of overseas student coming to the UK.

In addition recurrent research funding has decreased by 1.1% and HEFCE have reduced the weighting given to the quality-related research funding away from activity rated 2* with only that research rated at 3* and 4* receiving any quality related payment. It is these payments that in part, allow for the development of high quality research, and research capability at a School and College level.

These overall funding reductions have resulted in a challenging situation for many Universities, and for many Universities, (Salford included) there is a growing need to find ways of increasing income and reducing costs to deal with this situation. Some Universities seem to have come up with imaginative approaches. The Guardian last week published the Top Ten Universities raising the most in library fines:

University of Leeds£1,869,340

University of Manchester£1,299,342

University of Wolverhampton£1,252,253

King's College London£1,197,715

University of Hertfordshire£1,147,238

University of Birmingham£1,114,863

University of Plymouth£1,058,777

University of Nottingham£1,025,560

Kingston University£1,020,753

University of Durham£1,005,426

Thankfully, our University does not feature in this ‘top ten’ list and our Financial Planning Conference took a different approach to what could be done at School, College and University level in addressing increasing income and reducing costs. In terms of increasing income, we discussed the development of new integrated interdisciplinary programmes focused on emerging markets, how to substantially shift the strategic focus and quality level of delivery for our CPD portfolio, and further leveraging the Media City advantage. These proposals are in the processes of being translated into financially relevant targets and commitments. Reduction in costs included continuing the work on reducing the non-staffing budgets, but also we considered the need to address the skill mix and size of the current workforce. Again these discussions are to be given a financial, temporal and spatial framework over the next few weeks.

As a School I believe we are well placed to maximize the opportunities that arise from changes in our operating environment. Last week the Department of Health announced the predicted funding for the NHS£65bn will be available for local doctors, nurses and other health professionals to to spend in the development and provision of local health services. In addition, around £5.2bn is to be spent on Public Health Services. Of this, at least £2.2bn will go direct to Local Authorities to help local communities stay as healthy as possible and to reduce health inequalities. These figures were developed by mapping PCT spending in 2010/11 on to the future structure, subject to the passage of the Health and Social Care Bill, and uplifting these to 2012/13 levels. And whilst it is not yet possible to find the funding allocation for Adult Social Services, (some £16.1bn was spent in 2009 – latest figures available), it is likely to be around £25bn.

The size of these investments in health and social care, alongside the re-organisation of service providers, new technologies and a changing workforce provide the School with enormous opportunities to change and further develop our educational, research and service development portfolio.

And it would be good to do so. In my own field this week, the launch of a National Survey of Investment in Mental Health Services in England was announced. This is the tenth national survey and aims to provide detailed analysis on spending for mental health services which will help the Department of Health and Local Authorities in formulating policy for the provision of mental health services.

This might also be a good thing, as last week it seemed that a lot more people might be at risk of being labelled mentally ill due to behaviour most people would consider normal. But not necessarily what American psychiatrists and psychologists might consider normal judging by what is proposed to be included in forthcoming Diagnostic and Statistical Manual (DSM-5). Thankfully powerful voices in mental health care in the UK are speaking out against the publishing of DSM-5, an updated version of the ‘psychiatrists bible’ that attempts to categorise every type of mental disorder, including some that are clearly difficult to accept as disorders. For example, among the anxieties to be labelled mental disorders in DSM-5 are shyness in children and uncertainty over gender. Loneliness could attract a diagnosis of chronic depressive disorder, and so could unhappiness following bereavement. A serial rapist could be classified as mentally ill, and given a diagnosis of paraphilic coercive disorder. Under the DSM-4, last revised 12 years ago, children who argue and refuse to obey parents can be classified as having oppositional defiant disorder.

Thankfully I didn’t get to the page that described the diagnosis of middle aged men who have an acute dislike of visiting art deco hotels, where toilets are hidden in cupboards; lunch largely consists of bowls of severely charred chicken pieces and to be asked do so during the cold British winter – but I bet the page is there.