“It ain’t broke, but let’s fix it anyway.” Although this is not a sentence you will find anywhere in the text of David Cooksey’s 2006 report on the funding of medical research in Britain,1 this coarse description does capture the thinking that underpins it. Generous praise for the achievements of UK health and medical research—then a “but.” It’s rather like a school report: doing pretty well, but could do still better. And this teacher is having his way: the report’s central recommendations are being implemented. So what is happening—and should researchers be nervous?

It was Gordon Brown who set the ball rolling a couple of years ago with his announcement that Medical Research Council and National Health Service research and development funds were to be combined in one ring fenced pot to be held jointly by the secretaries of state for health and (as was) trade and industry. Brown was responding to the widely held view that too many of the products of British biomedical research have been left for others to exploit commercially. He had been persuaded that a single research fund, strategically deployed and with economic benefits in mind, could improve matters. The plan had three objectives (box). The man chosen to devise a means of meeting them, David Cooksey, has experience not only in business but in the oversight of medical research, including a governorship of the Wellcome Trust.