Researchers condemn changes to NHS

A GOVERNMENT task force has provided the first hard evidence of the disruptive impact of health service changes on research and development in the NHS.

The task force, which heard evidence from more than 200 sources at every level in the NHS and research community, found that 'almost every respondent had serious concerns' over the threat posed to R & D by the changes and other government healthcare policies, including the reorganisation of London's healthcare and GP fund-holding.

The findings confirm the growing anecdotal evidence collected by doctors and research bodies. Nine leading doctors and scientists last month revealed they were leaving London because of fears for the future of medical research and teaching in the capital in the new internal market. Five of them are world-renowned geneticists.

Several teaching hospitals are also losing key figures, and the UK Co-ordinating Committee on Cancer Research has said clinical trials are in jeopardy.

The report of the task force, published yesterday, concluded that an emphasis on priority setting and cost-effectiveness had 'exposed deficiencies in the mechanism for setting overall R&D priorities and for directing NHS funds towards them'.

Virginia Bottomley, Secretary of State for Health, welcomed the report's recommendations to safeguard the long-term future of NHS R & D but refused to accept that the internal market had damaged existing work. She also dismissed claims that an NHS 'brain drain' was under way as 'ludicrous doom-mongering' and cited several examples of top foreign scientists moving here to take up NHS research posts.

Professor Anthony Culyer and his team heard that competition in the internal market was 'inimical' to R & D which accounts for 1 per cent of the NHS budget of pounds 36bn. Health care purchasers and providers were unwilling to invest in it because they did not own the results.

There was evidence, respondents claimed, that '. . . short-term cost pressures were also driving out R & D- related investment . . . The clinical science base was being eroded'.

Others said that 'increasing reliance was being placed on special trustees and industrial sponsors to fund the continuation of programmes'.

Professor Culyer admitted yesterday that the objectives of the internal market were at odds with that of R & D programmes. 'What is being highlighted is a tension (between the two).'

The report, which makes more than 20 recommendations, also addresses long-established problems of ad hoc funding and lack of accountability. No one knows exactly how much is spent each year on R & D or what on. It proposes that a single source of funding should replace the current 'diverse' mechanism from 1995-96.

It also recommends a central forum to exchange information between research bodies which sponsor or support NHS R & D to better target projects to clinical need.

Supporting Research and Development in the NHS; HMSO; pounds 5.95.

David Blunkett, Labour's spokesman on health, yesterday said a survey commissioned by John Major showed the NHS could be a weapon for Labour at the next election. The survey identified the NHS as one of the four key issues which had alienated voters from the Tories.