Volume 1
Medical research and the NHS reforms / House of Lords, Select Committee on Science and Technology.
- Great Britain. Parliament. House of Lords. Science and Technology Committee.
- Date:
- 1995
Licence: Open Government Licence
Credit: Medical research and the NHS reforms / House of Lords, Select Committee on Science and Technology. Source: Wellcome Collection.
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![strengthened. It is a core function of regional offices, in which the RDRD is a member of the senior executive team. RDRDs therefore have the authority and resources to develop and sustain a long- term view as well as to deliver on short-term issues”. 14. “Individual Regions vary a lot, depending often on who their R&D Director is” (RCGP Q398).The CVCP (Q172) argued for the autonomy of the RDRDs to be constrained by principles applied nationwide, particularly in the context of infrastructure funding. The AUDGP report (p428) that the level of commitment to primary care research varies with “the preoccupation of individual RDRDs”. Dr Pam Enderby says the same of their relations with the therapy professions (Q1304), though Dr Jean Potts (Q1319) gave examples of good practice from Northern and Yorkshire Region. The RCN reports with satisfaction that most Regional R&D Committees have at least one nurse member (p329). The Deans of Dental Schools and the British Dental Association are dissatisfied with the dental input to the Strategy at Regional and indeed national level (Q324, p107, p433). 15. Dr Green (p211), noting that the creation of a single funding stream for NHS R&D following the Culyer report will increase the power of the RDRDs, concludes that the incumbents should be people of the highest quality, with experience of research and research strategy; that the universities, the MRC and the charities should be involved in appointing them; and that the CRDC and the Forum will have a role as “checks and balances”. He suggests “formalised mechanisms by which one or other or both of these can express its views to Ministers directly if necessary, as a fail- safe mechanism”. 16. From Scotland, where there are no equivalents to the Regional Directors, the Royal Society of Edinburgh expresses envy (p314): “An early impression of the new situation in England and Wales is that this is advantageous to the biomedical community and to the facilitating of research projects. Many of those working in Scotland would like to see consideration given to more local activity and the appointment of regional director equivalents for R&D”. Responsive funding 17. The Strategy is to some extent directed from above, by the national priorities set by the CRDC and the regional plans drawn up by the Regional Directors of R&D; but every RHA offers responsive project funding through some form of successor to the LORS, which ceased to be the subject of guidance from the centre in 1991. “Traditionally, many Regional locally-organised research schemes provided funding for biomedical research, often propelling newcomers to the research field into a lifetime of productive research activity” (RAEng, p459). The balance of commissioned health services research to responsive funding is typically 3-4:1; Trent is exceptional, in deliberately setting equal budgets for the two modes. Trent has put more money into LORS, whereas West Midlands is putting substantially less; the trend in other Regions is not apparent from the plans which we have seen. The criteria for funding are not uniform: some Regions appear to have regard to scientific quality alone, but West Midlands intends to relate responsive funding to its priority areas; North West and South Thames, without being prescriptive, will respect criteria of relevance; and North Thames will fund only “applied health services research”, to the exclusion of biomedical projects with no clear application to the NHS. See Appendix 8. 18. The AMRC, the RSE (p286) and SHERT (p286) express concern that the Culyer report will give even greater weight to the CRDC’s priorities. The Conference of Medical Royal Colleges (p272, Q884) urges that “a LORS function [ie responsive funding at regional level] is maintained within the R&D structure, perhaps as a Sub-Committee, for the assessment and award of grants to support good ideas coming to it from the NHS”. The AUDGP feels (p428) that the approach has been too top-down, and “has concerns about the balance between central control and peripheral ownership, with obvious implications, for commitment to the strategy”. The Royal Society of Edinburgh points to the “vital importance” of research which is “not goal-directed, but curiosity- driven” (p286). The Association of British HealthCare Industries (ABHI) (p414) express similar concern, that over-direction will “stop small but highly productive research projects from starting, and could make other useful programmes too large and academically rigorous”, thereby reducing motivation, diversity and the capacity to innovate. 19. Sir Leslie Turnberg and Sir Christopher Paine (QQ900, 905), speaking for the Conference of Medical Royal Colleges, call for balance: “There was nothing at the top before, and perhaps it is just as well there is something there, but on the other hand there is a risk...we set out with a good intent and ensnare ourselves in a bureaucracy”...““There has to be a route to the RDRDs and to the](https://iiif.wellcomecollection.org/image/b32219337_0001_0079.jp2/full/800%2C/0/default.jpg)
