The Department for Health Insanity

We all know how profligate the government can be with our money but this item coming right after a mini-budget calling for spending cuts is not without irony. The Department for Health and Social Care has just announced it will finance £50M on research into health inequalities. £50M on doing something about them might be excusable but giving £50M to academics to find the answers we already have is just throwing our money away. For starters, the DHSC could look at Scambler (2011) and Thomson et al. (2006)

Don’t get me wrong. Many local councils are impoverished and bunging them the occasional £50M is no bad thing, especially as the DHSC does not seem to need it. But they should be sent the money to spend on what they are good at – social care for example – not something for which they have no relevant skills whatever. No less than 13 local authorities will get about £4M each to do their own things: there will no learning from each other. Instead “every collaboration will be set up in partnership between universities and local government, capitalising on the world-leading experience and skills of the academic community.” We do not know how the 13 were chosen but it seems unlikely that the 13 universities in question are all “world-leading” in this particular field.

Of course, when they have spent the £50M on research, there will be no money left to do anything about the findings. Another £50M on adult social care or persuading NHS doctors to remain in post would have been money really well spent.

The announcement is unclear whether the £50M comes from the National Institute for Health Research (NIHR) or the DHSC itself. The NIHR has not got around to publishing an annual report since their 2019/20 one. They spent over £1bn on a miscellany of UK research projects plus £120M overseas. In addition, the Medical Research Council spent £886M, including £19M overseas, in 2021/22.

I have no idea how much the UK, or England, should spend in total on medical academic research nor how they make their decisions nor what methodology for decision-making has been shown to be the most productive. I am pretty sure the NIHR and MRC do not know the answers either because, if they did, they would tell us.

I was once involved in an application to the MRC for research support. About a year later they turned us down on the basis that the research could not possibly work, i.e. it could not be done. Luckily, we had got the money from somewhere else and it had all worked out fine.

These two bodies should be merged and introduced to the real world.