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Experience must inform the evidence

Posted: 10 August 2001 | Subscribe Online


Peter Beresford suggests that the reputation of research findings may be about to change for the better.

Research is often criticised for merely confirming at great expense what we already know. But this looks set to change this year. The two most contentious contemporary issues both hinge on research. The policy response to the foot and mouth disaster, mass and "contiguous" culling, was based on computer models developed by academics at Imperial College, London.

Critics say their evidence base was inadequate but these researchers look like playing a key part in restructuring British agriculture. This may not only mean fewer small farms, less cultivation and more agribusiness. Our whole understanding of the English and Welsh rural landscape may also need to be revised.

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The battle over public-private partnerships and private finance initiatives has dominated the domestic political agenda since the general election. Over the summer rival research findings have been used as the key weapons. Each side argues that policy must be based on "evidence" not "ideology". Each side attacks the other for failing to do this.

Meanwhile, research reports make front page news and think-tank authors crowd the TV news hospitality suites. So it is at our peril that we assume research is ineffectual.

That may be true of the grant chasers preoccupied with personal promotion and the next academic research assessment exercise. But big businesses like Serco, Nomura and Norwich Union are hardly supporting health research out of the kindness of their hearts. If they were, shareholders would fall on them like a ton of bricks.

Mental health service users highlight the bad effects research can have. The research priorities of drug companies, for example, reinforce the chemical response to people's distress and leaves many service users feeling damaged and unsupported.

Now the reprioritising of research has come home to social care, with the establishment of the Social Care Institute for Excellence. Its brief is to promote knowledge-based social care practice. The appointment of Scie's chairperson, the disability rights activist Jane Campbell, must represent one of the most significant single developments for user involvement in social care. Indeed it may come to be seen as a key departure for the government public policy agenda which embraces participation, empowerment and partnership.

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Jane Campbell's appointment offers a serious chance to address many of the new questions that are being raised about research and evidence. How do we insure an inclusive approach to knowledge formation? What constitutes evidence? How should we understand the relationship between direct experience and evidence?

Scie has much less money than its health equivalent, the National Institute for Clinical Excellence, so what impact on practice will it actually be able to make? As Jane Campbell says: "We are very used to making things happen with very little resources. Finance isn't the only criterion. We have the will."

Her approach looks set to herald a new kind of partnership and a new kind of research putting emphasis where it belongs - on the "public", as citizens and service users.

Yvonne Roberts in on holiday.



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