The future of the Service Increment for Teaching (SIFT) budget
A letter from Dr Hamish Meldrum, Chairman of Council to Mr Alan Johnson, Secretary of State for Health
February 2008
Dear Secretary of State
I am writing to state our deep concern that the ability of teaching hospitals to deliver medical education will be put at risk if the Service Increment for Teaching (SIFT) budget is diverted away from medical education as is being mooted by the Next Stage Review Education Commissioning and Funding group.
We do not believe that taking money away from medical education can be justified given the direct correlation between the proper funding of high quality undergraduate medical education and the acquisition of skills, knowledge and experience of newly qualified doctors. Further, removing funds from medical education would have serious consequences for the financial viability of teaching hospitals and medical schools, and adversely impact on the quality of NHS education that medical students receive.
Rather than divert money away from existing funding streams for medical education, the NHS must adopt a stronger culture of valuing medical education. The SIFT levy should be ring-fenced to protect it from being diverted to subsidise the service as occurred in 2006-2007 when Strategic Health Authorities used the Multi-professional Education and Training budget to offset financial deficits elsewhere in the NHS [1] . Second, given the striking lack of accountability of SIFT funding, there is an urgent need to introduce an audit trail to ensure that the existing annual allocation is hypothecated toward medical education.
There have been enough pressures on delivering medical education in the past ten years – from the significant expansion of medical student numbers to the 27% decline in the clinical academic workforce. Any move to reallocate SIFT away from medical education would take money away from direct and indirect staff costs, clinical and non-clinical teaching facilities and individually arranged consultant sessions to teach medical students – thereby putting an already stressed system under further strain.
Properly funded, long-term investment in medical education is crucial to producing high-quality doctors who in turn deliver high-quality patient care. Reducing medical SIFT is not justifiable because it would disproportionately and unjustifiably affect medicine, threaten the viability of some medical schools and risk significant financial destabilisation across Strategic Health Authorities. It is therefore vital that the existing SIFT budget is not misappropriated away from medical education.
I look forward to hearing from you.
Yours sincerely
Dr Hamish Meldrum
Chairman of Council
[1] NHS Financial performance– Quarter 1 2006-07, DH