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.
94/132 page 92
![The United Kingdom 51. The AMRC told us of difficulties faced by charities in interfacing with four different systems of higher education funding. The MRC point (p66) to the additional difficulties which would arise if each part of the UK adopted a different method of assigning health service support to clinical research. The SHHD acknowledge this (Q1141); they intend “to end up with a system which is compatible with other parts of the UK”. The Welsh Office envisages adopting “a good number of the main recommendations” (p480); the DHSS (NI) regards the “general recommendations” as equally applicable to Northern Ireland (Q744); but in each case the context for implementation is rather different. ; National Forum and Central Research and Development Committee 52. Sir Leslie Turnberg has two worries about the new CRDC (Q876). First, it is very big. Secondly, “There is a danger that those who have to direct the research, and those who have research experience, will be dominated by the service need rather more than the balance I would like to see, which is in favour of those who have a direct interest and involvement in research”. The Chairman of NAHAT speaks for those responsible for “the service need” (Q923); he expects purchasers to have “a real and effective involvement in decisions about...[the levy’s] broad distribution between the R&D elements and, within those, the main areas to be covered”. The BMA, like Sir Leslie, comment on the size of the CRDC (p404): this means that “its role can only be advisory”. On the other hand Dr Pam Enderby, Chairman of the College of Speech and Language Therapists, considers that the CRDC still lacks “broad representation” (Q1304): as a result there have been cases of consultation being conducted on the basis of “ad-hoc-ism” and “somebody happening to know a speech and language therapist”, rather than through the proper channels. 53. The Royal Society of Edinburgh wants a seat in the Forum for the Scottish Chief Scientist (p284); Queen’s University wants a seat on the CRDC for somebody from Northern Ireland (p219). The CSTI call for representation at all levels for clinical scientists (p439); the ABPI expects seats for the pharmaceutical industry (p246); the Royal College of Midwives (p340) deplores the absence of representation of midwives, nurses and “user groups”. The Leukaemia Research Fund (p452) welcomes the creation of the Forum, especially since much research funding today is done in partnerships. However they warn, “The very different working practices and agendas of the NHS, the Research Councils and the biomedical charities will be difficult to reconcile within such a forum. The emphasis must be on co-operative partnerships, so that the whole is greater than the sum of the parts”. 54. The BMA is concerned that the Forum should not carry co-ordination too far. “There is aneed for a plurality of sources of funding for research and a plurality of views on priorities. Organisations that fund medical research should therefore retain their independence in terms of setting R&D priorities” (p405). Transaction costs 55. The transaction costs of NHS research assessment and “signing off” for service support have already been considered. The Culyer report itself expresses concern over the administrative and bureaucratic burdens which its proposals might impose; and this concern is widely shared. SCOPME (p471) is worried about the cost of accounting for “implicit” research, and the delay to research projects while their service support implications are costed. The RSE (p285) is concerned about the increasing workload involved in peer review. COSHEP are anxious that teaching hospitals should not have to instal “a new bureaucratic layer in order to get back this money” (Q971). 56. NAHAT (QQ934-6) reports that Trusts are appointing R&D Directors (“often a part-time but very high-calibre person” - Q1283) to manage the costing and charging which will follow the demise of knock-for-knock, and foresees that research facilities funds will have to be top-sliced to pay for their own management; “there is a concern about balancing the cost of acquiring such information as opposed to the ultimate benefit...We are unaware that research has been carried out, and we think it is appropriate to address that before devoting resources, which are very scarce, to such a process”. The HEFCs propose (Q1372) that the NHS should pay for contract managers, to assist the Dean of each medical school.](https://iiif.wellcomecollection.org/image/b32219337_0001_0094.jp2/full/800%2C/0/default.jpg)
