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Evidence based policymaking

BMJ 1995; 310 doi: (Published 14 January 1995) Cite this as: BMJ 1995;310:71
  1. Chris Ham,
  2. David J Hunter,
  3. Ray Robinson
  1. Director Health Services Management Centre, University of Birmingham, Birmingham B15 2RT
  2. Director Nuffield Institute of Health, University of Leeds, Leeds LS2 9PL
  3. Director Institute for Health Policy Studies, University of Southampton, Southampton SO17 1BJ

    Research must inform health policy as well as medical care

    That politics is driven more by values than facts is not open to dispute. But at a time when ministers are arguing that medicine should be evidence based,1 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. Although individual patients may be at less risk from uninformed policymaking than from medicine that ignores available evidence, the dangers for the community as a whole are substantially higher. The impact of policies that are poorly designed and untested may be disastrous—witness the recent failures in mental health services. As such the case for evidence based policymaking is difficult to refute.

    This argument applies to politicians of all parties, not simply to those who currently hold office. Certainly, the failure of the government to evaluate the effects of its health care reforms properly at the outset will go down in the history of the NHS as an omission of the highest order, but the record of the Labour party when in government is not entirely creditable either. Rather than dwell on past mistakes, it may be more constructive to consider how future politicians may be better informed by evidence. There is a role here for both the government and independent agencies.

    Let us begin with the government. The establishment of the NHS research and development programme has at last focused attention on the importance of evaluation. The programme is also …

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