Of the 12 million or so NHS hospital admissions that take place during any one year, at least 30% involve surgery. Yet in 2006-7 only 1.3% of government spending on medical research was devoted to surgery. Of course, the notion that research spending should correlate precisely with disease prevalence, medical workload, or any other measure of health burden is naive. But 30% against 1.3% is quite a difference. In the face of a gap this wide, the comment from Norman Williams, president of the Society of Academic and Research Surgery, that: “There’s a mismatch,” seems positively understated.

Nor is he alone in his worries about the output of surgical research. Commentators have been raising the issue for years.1 Parliamentary committees have discussed it.2 And in the latest university research assessment exercise, the chairs of both panels responsible for appraising most of the work in the field commented on its poor showing. One wrote of “sorely needed capacity building in surgical and anaesthetic disciplines.”