The health department for England claims that its plans to transform the way clinical research is funded and structured will help make England “the best place in the world for health research, development, and innovation.”

The proposals, which are out for consultation until 12 October, promise a radical overhaul of existing arrangements, with a view to improving the information available so that patients and professionals can make better informed choices about health care and treatment. Although the precise details have not yet been set out formally, the proposals envisage a virtual Institute for Health Research directing and overseeing all NHS research; a streamlined funding system designed to reward research that is directly relevant to patient care; and 10 “academic medical centres” with £100m ($179m; €145m) a year to spend on innovative projects. Where these will be is not yet clear; neither are the clinical areas they will specialise in.

But if the ultimate aim is world leadership, the department faces a pretty daunting battle. The fact that applied research in the NHS is currently in something of a crisis is all too familiar (BMJ 2002;324: 446, BMJ 2003;327: 1041-3, BMJ 2005;330: 8). The …