Evidence based policy: proceed with care

The emergence of evidence based medicine in the early 1990s led to some clinicians challenging managers and policymakers to be equally evidence based in their policymaking. This demand was shared by some health policy analysts: “At a time when ministers are arguing that medicine should be evidence-based, is it not reasonable to suggest that this should also apply to health policy? If doctors are expected to base their decisions on the findings of research surely politicians should do the same … the case for evidence-based policymaking is difficult to refute.”1

The need to be seen to be making evidence based decisions has permeated all areas of British public policy. The government has proclaimed the need for evidence based policing, and the 1998 strategic defence review introduced evidence based defence.2 In the health sector, the concept of evidence based policy has gained ground, and a journal has been launched devoted to this challenge (Journal of Evidence Based Health Policy and Management).

Despite some groups using evidence based policy as a fig leaf, it seems difficult to argue with the idea that scientific research should drive policy. However, before accepting the argument we need to understand the implied model of policymaking.