Alternative providers and alternative medicine

Jo Johnson thinks that the market in Higher Education is unfair. There are currently stringent procedures in place for any institution that wants to award degrees and call itself a University. One facet of this is the requirement that any new provider must initially have its degrees validated by an established University; The University of Suffolk, which gained University title this month, provides an example of how this can work, but many of those seeking to enter the market are unhappy with current arrangements.  Roxanne Stockwell, Principal of Pearson College, complained: “Until an institution has its own degree-awarding powers, it cannot offer degrees without being validated by an existing university. Under the current system, a new partner has to find a willing validating partner, and it is locked out if it cannot.”

Jo Johnson, in his role as Minister for Universities and Science last year, criticised this arrangement. He memorably said: “I know some validation relationships work well, but the requirement for new providers to seek out a suitable validating body from amongst the pool of incumbents is quite frankly anti-competitive. It’s akin to Byron Burger having to ask permission of McDonald’s to open up a new restaurant. .....I can announce that we will shortly be lifting the moratorium that has been in place for applications for new Degree Awarding Powers and for University Title. Once again, we are opening the doors to new entrants and challenger institutions, all in the interest of increasing the choices available to students.”

So how wide should the door be opened? This raises deep questions about what constitutes a University. Currently, British Universities have a strong international reputation. Historically, they have been subject to strict scrutiny in return for receiving government funding. They combine research and teaching to push forward the boundaries of knowledge, and have trained students to value knowledge for its own sake, not just as a means to an end.

Not everyone wants that kind of education: some students do not enjoy formal academic study and may prefer vocational courses or apprenticeships. It is important that our higher education system caters for them. The question confronting us now is how far we should extend the definition of a University. It is interesting to consider the Word Cloud I made of ‘alternative providers’, shown in Figure 1.

Figure 1: Alternative providers from http://www.hefce.ac.uk/reg/register/getthedata/. Key: Blue have University Title; Brown have Degree-Awarding Powers; Pink offer designated courses; Violet deliver HE as a franchise only. Taken from http://cdbu.org.uk/speedy-entrances-and-sharp-exits-letting-in-more-alternative-providers/.

Among those listed are six institutions providing training in various forms of complementary and alternative medicine. Two of these had progressed to the point of having degree-awarding powers, which is one step below having University Title.

Let us be clear: the subject matter that these institutions teach is not endorsed by serious scientists.  David Colquhoun highlighted a worrying trend for UK Universities to give degrees in ‘anti-science’ back in 2007. In Australia, where chiropractic has been taught within the regular University system, it has come under increasing attack by scientists, who note that by awarding degrees in these subjects, one gives credibility to procedures that are placebos at best and dangerous at worst.

Are these concerns just a sign of anti-competitiveness and elitism? Are scientists trying to squeeze out the alternative providers because they think they’ll poach students from them, just as McDonalds might try to ensure that Byron Burgers are denied space for development? I’d argue not, and furthermore that Jo Johnson’s analogy shows a startling lack of understanding of what a University is all about. Medicine has had many false leads and it would be the height of arrogance to assume that what we know now is the only truth. But the difference between medicine and alternative medicine is not just that there is evidence for effectiveness for medicine; it’s also that in medicine there is a continuous movement to develop and improve theory and practice, rigorously testing and debating ideas and using scientific methods to evaluate them. It’s difficult to do this well and it often goes wrong, but there is broad agreement about the importance of evidence.

Well, you might say, what about religion, another topic that features heavily among alternative providers? Should theology be banned from Universities because it is not evidence-based? The answer is no, and for similar reasons to those given above: the difference between our traditional Universities and the new providers is that Universities teaching theology consider a range of perspectives and teach students critical thinking. You do not need to be a believer in any God to study theology. In contrast, new providers are often narrow in their focus: many of those with religious affiliations look as if they train students in one religious viewpoint and one only.

Defining the difference between what is suitable and not suitable for inclusion in a University degree course is itself an interesting intellectual exercise. We should not assume that something is good just because it already exists, and is bad if it is new.  But if we just ignore this distinction and have a free-for-all whereby anything can be regarded as higher education provided that there are students willing to pay for it, we will end up with a system in which the terms University and Degree will count for very little, and where the survival of a higher education institution has more to do with its marketing skills than its academic standing. In the past, there were few institutions clamouring to become Universities because it was not easy to make a profit from Higher Education. That has all changed now that higher education providers can get their hands on money from the Student Loans Company. Experience to date suggests we need to have more, rather than less, scrutiny of alternative providers in the current financial climate.

One final point: the alternative providers I have discussed here could do very well on the Teaching Excellence Framework (TEF), which will rate higher education institutions according to three main criteria: student satisfaction, drop-out rates and employability. Indeed, if they recruit their students from among disadvantaged social groups, they might well achieve higher TEF scores than more selective institutions, because benchmarking is used to adjust the outcomes. So under Jo Johnson’s oversight, we could end up with a situation where the quality of teaching at the Anglo-European College of Chiropractic is deemed superior to that at the Universities of Oxford and Cambridge. An interesting thought.

The Green Paper’s level playing field risks becoming a morass

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The Green Paper Fulfilling our Potential: Teaching Excellence, Social Mobility and Student Choice is a consultation document by the Department of Business, Innovation and Skills (BIS) that sets out plans for a radical shake-up of English universities. One of its many goals is to encourage ‘alternative providers’, aka private higher education institutions (HEIs), into the system.

The rationale behind this move has four elements:

Widening access: The need to widen access to higher education is a central plank of the Green Paper. New providers are seen as part of this: they “can offer programmes that are attractive to hard-to-reach communities and to groups of people that are not currently well-served.”

Equipping students for the world of work:  As I have argued elsewhere, the Green Paper is rather disingenuous in creating the impression that businesses are unhappy with the quality of university graduates.  Nevertheless, there is a shortage of STEM graduates and there is scope for different approaches, one of which is the ‘Degree Apprenticeship’, announced by BIS in March 2015, where the student “will be employed throughout and so have the opportunity to develop employability skills that employers value.” One can see that these apprenticeships would be appealing to those on a low income (and to many others as well!) as the cost of course fees is shared between government and employers.

Competition: For a conservative government, competition is a key driver for improving the world. We are told that: “Widening the range of high quality higher education providers stimulates competition and innovation, increases choice for students, and can help to deliver better value for money.”

Fairness:  Since students are now paying full fees, it seems unfair to allow traditional universities to have a monopoly on the higher education market. According to the Green Paper:  “More providers entered the sector in the last five years than at any time since the last major expansion in 1992, but it’s still too difficult to set up a new institution. We want to see a level playing field for all providers and a faster route to becoming a university.”  

I knew very little about the “alternative providers” that BIS is so keen to encourage, so I had a dig around on the internet. I found a HEFCE Register of Providers but this contained only 12 institutions with degree-awarding powers, and it did not have historical data. I also wondered about accuracy, as the register did not include the New College of the Humanities*. It did include an assortment of religious institutions (e.g., Assemblies of God Incorporated, Elim Foursquare Gospel Alliance, Salvation Army) and those offering training in various therapies (British School of Osteopathy, the College of Integrated Chinese Medicine), but of these only the British School of Osteopathy was a recognised HEI with degree-awarding powers. An email to HEFCE confirmed that the register was set up only in 2014. They gave me a contact for the department of Business, Innovation and Skills (BIS), but an email to them requesting a source for the claim “More providers entered the sector in the last five years than at any time since the last major expansion in 1992” has so far not elicited a response.

Further digging around established that in January 2015, plans were announced to form an Independent Universities Group (IUG) representing private institutions with degree-awarding powers or university title. The goal was to establish a kind of “Russell Group” of independent providers, who could be clearly distinguished from what the Times Higher Education called “dodgy for-profit colleges”. However, discussions between these institutions seem to have been derailed by the election and the IUG has not so far been formed.

I looked at the courses on offer at this “high-quality” end of the sector, to see how far they meet the four goals outlined above.

• The website of Ashridge Business School takes you to Hult International Business School, a global organisation with campuses around the world. They offer one undergraduate degree, a Bachelor of Business Administration, for a tuition fee of £23,580 per annum.
• BPP University (owned by the US Apollo Group) offers undergraduate courses in Accountancy and Finance, Law, Business and Management, and Health. “Health” may be something of a misnomer, given that it includes an “Integrated Undergraduate Masters in Chiropractic (MChiro)” (see this article). Fees for undergraduate degrees are £6K per annum for a 3-year course and £9K per annum for a 2-year course.
• The University of Buckingham was founded in 1973 and is the private university in the UK operating under a Royal Charter. It runs a range of degrees in arts and humanities, and offer a more intensive 2-year degree curriculum, at a fee of just over £9K per annum. In 2015, they expanded to offer a medical degree at a cost of just over £35K per annum for a 4.5 year course.
• The College of Estate Management offers part-time online courses in areas such as building surveying and estate management, at a cost of around £5.5K per annum.
• The University of Law (owned by Montagu Private Equity), as its name suggests, offers a range of undergraduate and postgraduate law courses, and charges £9K per annum for a 2-year undergraduate LLB or £6K per annum for a 3-year degree.
• Regent’s University London offers undergraduate degrees in a wide range of subjects in arts and humanities, charging just under £16K per annum.
• RDI (a subsidiary of US firm Capella Education Company) partners with various UK Universities to offer distance learning courses. You can, for instance, take a Psychology degree at Anglia Ruskin University through RDI. The nature of the course gives flexibility in duration of study, with a total cost of just over £12K.
• Richmond, the American International University in London, offers a range of undergraduate courses, mostly in business and finance, with an annual fee of £9K.

My overall impression is that these institutions introduce some innovative practices that could help achieve the goal of widening access. In particular, we see places offering shorter, more intensive degrees, part-time degrees, and distance learning. Some of them are competing with public universities in terms of cost, because there is currently a lower ceiling on allowable fees, but many of them offer a restricted range of courses. There is little evidence that these alternative providers will do a better job than other HEIs in catering to the needs of employers. STEM subjects are expensive to teach and are barely represented in courses offered by alternative providers. The medical degree offered by the University of Buckingham is an exception, but it is priced out of the reach of all but the most wealthy. Only one of the private institutions described above, BPP University, features on a list of providers of Degree Apprenticeships: in general, it is HEFCE-funded institutions that have introduced these apprenticeships.  

Of course, it could be argued that a more diverse set of alternative providers would be seen if we could free them from the regulatory barriers that the Green Paper complains of. However, the regulation is there for good reason. The fact that the IUG group want to distance themselves from others in this sector should sound a note of caution about the potential downsides of the alternative provider market. It is noteworthy that most of the alternative providers from the IUG list offer courses that are eligible for loans from Student Finance England.  Only a year ago, Christopher Banks, Chairman of the Quality Assurance Agency was complaining that money was being squandered on loans to students attending dubious for-profit colleges.  Some institutions would encourage students to take out loans to cover their fees, but then offer inadequate courses associated with high drop-out rates.  Mr Banks was quoted as saying: “I would like to make sure we quickly respond and reinforce the need for consistent quality in higher education, because there is a danger, otherwise, that [the growth of private providers] will tarnish the reputation of the sector.”

We can also learn lessons from the USA, where the behaviour of some for-profit colleges in recruiting students to pay for worthless degrees is nothing short of a scandal. We should not forget that, only four years ago, the Apollo Group, who own BPP University, was investigated by the US Government for misleading students.

It is telling that the Green Paper recognises the potential problems of a marketised higher education sector, noting that students need protection from the consequences when their institutions fail. This has not previously been recognised as a risk, for the good reason that English universities have not failed. More recently, we have seen considerable hardship inflicted on overseas students when institutions have had their licences to sponsor overseas students revoked. In future, we may find students suffering, even after completing their course, if their degree comes from an institution that no longer exists. It is frankly surprising that anyone should be talking about reducing regulation of the private higher education sector and speeding up approvals when there is already evidence of unprecedented risks associated with the entrance of new providers.

There are many students who might benefit from having a wider range of options in higher education; I doubt that private HEIs are going to ‘drive up standards’ through competition, but they could potentially make a difference by complementing what is currently on offer. But if experience here, and in the USA, has taught us anything, it is that, in order to work well, alternative providers need to be carefully regulated and accredited only after establishing a solid track record.  

*Correction: 24th December 2015; David Sweeney of HEFCE pointed out that the New College of Humanities is on the directory and can be found via the web interface. On the .csv file that I downloaded it is included under an alternative name, i.e. Tertiary Education Services Ltd.
PS, 3rd January 2016: The relationship between Tertiary Education Service and New College of the Humanities is discussed further here.