26 June 2007

Medical Royal Colleges – “Are they fit for purpose?”

• “The Royal Colleges of medicine and surgery have grown with little regard to purpose and value for money.” Their merger might make them more cost-effective
• Greater transparency of their activities is needed – particularly where public funds are involved
• Their advice to Government should be more “evidence-based” rather than consisting of “evidence-free views”

Writing in the July issue of the Journal of the Royal Society of Medicine, one of the UK’s leading health economists has attacked the medical Royal Colleges for providing questionable value for money.

Professor Alan Maynard of the Department of Health Sciences, University of York, and his co-author Yezenash Ayalew, also from the University of York, ask whether there are too many Colleges for them to be cost-effective, and whether their merger would not only reduce costs but also bring about “improved management of their functions”. They suggest that one organisation, with national standards of training and examination, might be better at producing and maintaining practitioners. “We need,” says Professor Maynard, “to be sure that the Royal Colleges provide excellence in training and career performance management of practitioners so as to ensure that there is consumer protection for all patients.”

As registered charities, the Colleges benefit from tax subsidies. This, the authors argue, makes their activities a matter of private and public interest.  According to Maynard and Ayalew, the Colleges are further subsidised by the NHS, which loses eminent practitioners for weeks each year when they act as College examiners and advisers. This imposes “a high opportunity cost on hospitals” because, while the examiners are paid College fees, the hospitals are not compensated for the loss of their services. Furthermore, the Colleges have “a remarkable influence” on public policy making that is “not always clearly evidence–based.” College officials may be eminent practitioners in their particular field, yet “their expertise in terms of NHS policy advice may be quite limited.” Maynard and Ayalew believe that the Colleges' lack of a coherent and collective response may have enabled the Government to push through untested and radical health policies.

[ends]

Performance management and the Royal Colleges of medicine and surgery [PDF 55k]

Notes

‘Performance management and the Royal Colleges of medicine and surgery’ by Professor Alan Maynard and Yezenash Ayalew, will be published in the July 2007 issue of the Journal of the Royal Society of Medicine.

JRSM is the flagship journal of the Royal Society of Medicine. It has been published continuously since 1809. Its Editor is Dr Kamran Abbasi.