Welcoming the Culyer reportBMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6957.751 (Published 24 September 1994) Cite this as: BMJ 1994;309:751
- K Peters,
- R Himsworth
The first comprehensive strategy for funding research within the NHS
The publication of Supporting Research and Development in the NHS is of great importance to the medical research community and the health service alike - for the first time a comprehensive strategy is set out for the funding of research within the NHS.1,2 This strategy seeks to integrate and support constructively all interests within the context of the NHS research and development programme and the new NHS administrative arrangments.
The task force responsible for the report consulted widely. Although the NHS research and development strategy receives praise for its systematic approach to priorities and for its emphasis on getting research into practice, many policies in the NHS adversely affect the environment for research. These include pressures to keep costs down in the internal market, efficiency indices, shorter length of stay, and the reduction in junior doctors' hours. Medical schools are concerned that the infrastructural support for research in their associated hospitals is endangered by short term considerations against which they are only partially protected by additional funding - for example, the service increment for teaching and research.
Other hospitals have limited or no access to such additional funding. The inadequacy of the support for research in the community is emphasised. A major deficiency in the present system is the lack of secure arrangements for the excess service costs of research involving patients in any situation - additional clinic visits, extra investigations, extended hospital stay - costs which in the past have been absorbed but not accounted for under the longstanding “knock for knock” (mutual uncosted benefit) arrangements. Clinical research suffers from the lack of coordination between the NHS and the major funders such as the Medical Research Council, medical charities, higher education funding councils, and industry. Two thirds of the NHS's current spending supports work sponsored …