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Editorial Friday 14 October 2011: Professor Malcolm Grant nominated to chair NHS Commissioning Board

Andrew Lansley (saviour, liberator) has nominated Click here for details of 'NCB chair to give Comrade Sir David a run for his roubles - few Lords a-leaping as the meek shall inherit the Bill', the new issue of subscription-based Health Policy Intelligence.


Professor Grant's full list of public service appointments is one of the founding members of UCL Partners, about which Sir Robert Naylor, CE of co-founder UCLH, spoke to us last year.

So, we know Professor Grant is a lawyer with an interest in environmental science. That ought to mean that he's got a forensic approach, and is good with evidence. So far, so good.

He is currently provost and chancellor of University College London, which has shot up the international ranking of universities. He was chair of Russell Group of elite UK universities 2006-9.

He's also a New Zealander by birth, so he would originally have pronounced the word chips "chups".

He hasn't worked in the NHS, which with Comrade Sir David's ne plus ultra status as the NHS insider's insider, is probably a good thing.

Here's a good thing about him: he's a free speech man.

Some footage is here of his speech celebrating the 5th birthday of the London Centre for Nanotechnology - which he starts with a decent joke.

Change in the NHS
He speaks about the NHS, saying "we are going through, yet again, reform of the NHS in this country - we have one of the best health services in the world, but it's nowhere near good enough, and we know that there will be a revolution in the nest few years as we try to ensure that improvements in diagnostics and pharmacogenetics and self-care and self-treatment are brought home to patients, giving them the capacity to control their own medication and their own choices".

That bit gives me a fair bit of cause for optimism.

Professor Grant goes on to discuss "the extraordinary importance of what is sometimes overlooked ... what I would call the political and social science environment, in which discovery and new technology is brought into what is sometimes an unreceptive public domain.

"I had the responsibility some years ago of chairing the Government's commission on GM crops, so I know well through scars all over my back where the problems lie. Overnight, a whole generation of plant scientists developed a clear-spoken expertise on economics and monopoly power and pricing in global markets for seeds. And equally, an entire generation of organic farmers pronounced with great authority on gene flow and upon the incidents that would flow from the uncontrolled growing of GM crops in the open.

"These were two communities whose voices never overlapped; who never engaged in trying to work out what were the differences that lay between them in the introduction of important technology across the world. The consequence is that Europe still lags behind the rest of the world in the cultivation of GM crops, and there is huge opposition to them" .

He refers also to "nanotechnology always gives proof to the vice chancellor's dictum of the relationship between the size of what is being studied and its cost: it is inverse in the case of nanotechnology": a good joke that his audience appreciated. It's interesting to think how he will approach the NHS: an organisation where the relationship is essentially linear.

But he then gets really interesting, referring to the funding of innovation in science "a few years ago, when every regional development agency was asked about their vision for the future, and they replied as one, 'nanotechnology'. It can't work like that. Investment for the future has to be highly focused".

Economic approach
Economically, he's a dry, but not ludicrously so. Having said that government should consider raising the £3,000 cap on university tuition fees in 2009, Grant added that he did not support doing so and suggested that people discussing £20,000 annual university fees were "barking mad".

There is footage here of his debating tuition fees with junior NHS doctor Julia Prague.

He wrote a fine blog on the subject of funding, which is here.

UCL now plans to raise the annual fees to the maximum £9,000 permitted by the Coalition Government.

Professor Grant refused to commit to the million-pound annual cost of paying UCL staff the London 'living wage'.

In 2009, he called for tuition fees to be replaced by a graduate tax.

Professor Grant earned a package worth over £400,000 in 2010.

Protecting elites and ranking complexities
What is going to be very relevant for the NHS and reconfiguration is Professor Grant's conviction that with regards to universities, elite institutions should be funded and lower-quality institutions should be cut.

Professor Grant also comprehends the complexities of ranking, as The Guardian in 2009 shows. He talks about it here, using UCL founder member Jeremy Bentham's line about "nonsense on stilts".