The NHS lacks the knowledge it needs to deliver better services to the public because of biases in the research economy, says a book published by the King's Fund today.
Public Interest, Private Decisions, by Anthony Harrison and Bill New, says that although Britain spends over £4 billion every year on health-related research, the majority of it is driven by commercial imperatives rather than the public interest.
Public Interest, Private Decisions shows that the health research economy is dominated by pharmaceutical and biotechnology companies. This means that research into conventional medicines, with a view to obtaining new patents, is by far the biggest activity. Areas such as complementary therapies, health improvement and health service management, where profit-making opportunities are limited, receive fewer resources.
Even in a field like cancer, where private, charitable and public agencies are all heavily involved, gaps remain. Some cancers attract little attention and relatively few resources have been dedicated to determining the best ways of organising cancer care.
Anthony Harrison said:
'It is now 14 years since a House of Lords committee first drew attention to the distortion of research priorities in health. Many of those distortions remain today despite more than a decade of efforts by the government to counter them. Health-related research is not sufficiently diverse to meet the public's needs because decisions about what is funded are dominated by the most powerful professional and commercial interests.
'In addition, concerns over BSE and MMR have dented public confidence in science, such that trust in Western medicine can no longer be taken for granted. It is now in the interests of the research community to get back in step with public priorities and perceptions of risk to avoid more incidences of people shunning its work in future.'
Public Interest, Private Decisions calls for decisive action from the government and the research establishment to redress the imbalances in today's research economy, especially to promote more research into how the NHS can work better for patients. It recommends:
- The government should set up a new body to ensure public funds for research are targeted towards areas of neglect, and to promote more diversity in the research economy
- A task-force should be set up to consider how the incentives facing commercial organisations could be modified to bring public and private interests into closer alignment.
Notes to editors
For more information, or a review copy of the book, please contact Daniel Reynolds on 020 7307 2581.