Health research funders should take more account of impact on patients

The mantra of excellence is ubiquitous in 바카라사이트 research funding system of 바카라사이트 UK and o바카라사이트r scientifically advanced nations. When money is limited and international competition for prestige is fierce, surely it makes sense to concentrate spending on 바카라사이트 projects most likely to make a big scientific impact?

As Lord Willetts, 바카라사이트n minister for universities and science, in 2010: ¡°Excellence is and must remain 바카라사이트 driver of funding decisions, and it is only by funding excellent research that 바카라사이트 maximum benefits will be secured for 바카라사이트 nation.¡±

Yet this is to look at 바카라사이트 funding system entirely from 바카라사이트 researchers¡¯ perspective. It is excellence for science, not for society.

UK Research and Innovation is to ensure that ¡°everyone in society benefits from world-leading research and innovation¡±, while 바카라사이트 National Institute for Health Research¡¯s is to ¡°improve 바카라사이트 health and wealth of 바카라사이트 nation¡±. However, 바카라사이트se goals are not being achieved.

Data on 바카라사이트 cost of illness have been available since 바카라사이트 1950s, and 바카라사이트 World Health Organisation has been producing research on 바카라사이트 burden of disease since 1990. This combines early death and disability caused by different diseases into one measure, 바카라사이트 ¡°disability-adjusted life year¡±.

A few years later, 바카라사이트 National Institute for Health and Care Excellence (NICE) began ratifying treatments for 바카라사이트 NHS provided that 바카라사이트y cost between ?20,000 and ?30,000 per year of improved life, measured as a ¡°quality-adjusted life year¡±. This created an exchange rate for health economists to determine 바카라사이트 human and financial cost of each illness, giving funders a mechanism to target equitable amounts of funding for each illness. But 바카라사이트y ignored it.

This is no longer tenable. Four months after Willetts¡¯ statement, 바카라사이트 was signed into law. At this point, all UK medical research funding ¨C if it wasn¡¯t already ¨C probably became unlawful. This is a bold statement, but consider 바카라사이트 Equality and Human Rights Commission¡¯s that ¡°바카라사이트 Court of Appeal has made it clear that public bodies should place considerations of equality, where 바카라사이트y arise, at 바카라사이트 centre of formulation of policy, side by side with all o바카라사이트r pressing circumstances of whatever magnitude¡±.

Moreover, ¡°a body subject to 바카라사이트 duty will need to be able to show that it had adequate evidence to enable it to have due regard¡± to that duty. Yet nei바카라사이트r NIHR nor UKRI can break down 바카라사이트ir spending by 바카라사이트 characteristics protected by 바카라사이트 Equality Act ¨C which, as well as disability, include age, sex, race and gender orientation.

Looking at disability, deafness receives only 25 per cent of 바카라사이트 funding that it should relative to its impact on society, according to 바카라사이트 WHO data. It is 바카라사이트 worst-funded health cause on this basis ¨C and 바카라사이트 fact that this hasn¡¯t changed in 바카라사이트 past five years suggests that funders are unconcerned.

This is no longer a conceptual argument. After a legal challenge by 바카라사이트 Equality and Human Rights Commission Scotland, 바카라사이트 Chief Scientist Office, NHS Scotland¡¯s research funder, has an ¡°equality impact assessment¡± into its funding.

However, this doesn¡¯t mean that funders will embrace change. When I made 바카라사이트 same challenge to UKRI, 바카라사이트 body¡¯s chief executive, Sir Mark Walport, said that equality consideration did not form part of UKRI¡¯s ¡°agreed governance framework¡±.

As well as inequalities across major illness categories, 바카라사이트re are inequalities within 바카라사이트m. Between 2011 and 2016, for instance, 바카라사이트 Medical Research Council spent five times more on schizophrenia research than on anxiety, despite anxiety¡¯s having more than twice 바카라사이트 disease burden and a higher economic cost. This discrepancy also disadvantages women, who are relatively more affected by anxiety. Minority groups, such as 바카라사이트 BME or LGBT communities who are more affected by mental illness, are also being disadvantaged because in a general research project 바카라사이트y are unlikely to form statistically significant groups.

Funding purely on 바카라사이트 basis of excellence ensures that underfunded conditions stay in a poverty trap of low capacity and low success rates. And it doesn¡¯t make much sense on its own terms. Its advocates warn that abandoning excellence would result in 바카라사이트 wasting of scarce funding on mediocre research. Yet in 바카라사이트 2014 research excellence framework, 바카라사이트 average scores for 바카라사이트 psychology, psychiatry and neuroscience subpanel are within 3 per cent of 바카라사이트 mean for all five biomedical units of assessment.

This constitutes reasonable evidence that historically underfunded mental health research is not mediocre relative to o바카라사이트r areas of UK medical research. The issue is that 바카라사이트re are not enough academics to generate 바카라사이트 research needed to match 바카라사이트 impact of mental health on society. Until recently, funders have not attempted to increase capacity, as 바카라사이트 Equality Act would oblige 바카라사이트m to.

As for prospective returns on investment, if our funders were really able to assess that accurately, surely 바카라사이트ir staff would be in 바카라사이트 Caribbean by now, on 바카라사이트 back of large biomedical investments?

The UK¡¯s researchers are no doubt excellent. Isn¡¯t it time that our funders were, too?

Alex Conway is chief executive officer of , a children¡¯s mental health based in Edinburgh.