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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![Commissioned programmes 40. Professor John Swales chaired the CRDC Advisory Group on Cardiovascular Disease and Stroke. He acknowledges room for improvement (pp255, 261): getting medical researchers to attach importance to “value to the NHS” required “a learning experience”; and the endeavour to involve purchasers and consumers was not a great success, since “neither of these groups appeared familiar enough in scientific method to throw much fresh light on research needs...A more interactive process would have been extremely valuable”. However, overall, “It has been a very considerable success...the first fruits of that success will be evident within the next year or two” (p473), and “I was very impressed indeed by the expertise and care exerted by Michael Peckham’s staff in support of this programme” (p261). 41. Sir Christopher Paine, President of the Royal College of Radiologists, was a member of the CRDC Advisory Group on Cancer: “The idea, I think, was a good one and we learnt from it”, but he was not entirely happy with the outcome (Q872). Consultation was wide and time was short; as a result, “All sorts of good ideas were put forward and real deficits in knowledge were explored, but...we did not focus on the areas which we could really do something about. It turned out to be a list of things that were more theoretical than practical in some ways, I thought”. 42. Professor D Brock of Edinburgh University found a recent NHS call for research proposals in his field of heterozygote screening for cystic fibrosis “so appallingly and ignorantly misdirected that I could not respond to it...Those who have time to sit on committees of this nature will inevitably be distanced from the cutting edge of research and therefore prone to ask the wrong questions... The UK has one of the best records of any country in medical research, and has gained this by using scientists to propose projects and their peer groups to judge the suitability of the proposals. I cannot understand why we are now contemplating moving to a committee-led system” (p284). 43. The Leukaemia Research Fund (p451) expresses the same view in more measured terms. “The second parameter [for the success of a research programme, the first being the objectivity of peer- review] is the coming together of the right individuals, in the right place, at the right time... This can be more difficult to achieve than devising the research project and is often due to serendipity. It is difficult to see how endless policy papers, strategic reviews and commissioning teams can truly influence these basic tenets. Equally it will be interesting to see how rapidly this complex administrative infrastructure can respond to new directions and innovations in biomedical research”. They speculate as to the cost of maintaining the numerous committees at national and regional level; similarly the AUDGP refer (p428) to “the enormous amount of time taken in the preparation and peer review of bids for funding, particularly in the first four months of 1994”. . 44. The RCN commends the CRDC’s approach (p330), but reports “a tendency for subject areas to exclude the nursing and paramedical contribution, and to be medically led or focussing on clinical treatment. We would urge the CRDC to extend its notion of treatment to include the management of chronic illness, and the wider context of illness as it affects the quality of life, morbidity and longevity of the individual patient, carers and family”. Yet according to Professor Jane Robinson of Nottingham (p336), “The opportunities for nurse researchers to obtain funding in this area (whether alone or as members of interdisciplinary research groups) appear to have been far greater than they are, or ever were, from the Research Councils”. 45. Dr Peter Doyle (Q794), commenting on the need for an evaluative culture in which good practice is disseminated effectively and bad practice is stopped, said, “The establishment of the Standing Group on Health Technology under Professor Sir Miles Irving is a massive step forward in achieving that approach”. Professor Swales (p255, Q861) feels that the Group has cast its net too wide: “A more restricted pilot programme to assess the best approach in such an innovatory strategy would I feel have been more appropriate but clearly not acceptable when political pressure to obtain results was so intense”. 46. According to some witnesses, the time-horizon of the Strategy is short-term (MRC p44, IPSM p448, CSTI p438, ARC p412). Professor Peckham acknowledged in November that there is an element of truth in this (Q46), but only an element: “We have to deliver results in the short term, which is why we put so much emphasis into mobilising research results. At the same time there is a need to commission clinical trials and support longer term research”. In March (Q1279), he told us that the Secretary of State’s announcement in December concerning implementation of the Culyer report implied “a commitment to long-term support of research”.](https://iiif.wellcomecollection.org/image/b32219337_0001_0084.jp2/full/800%2C/0/default.jpg)
