Organisation and Policy for Research and Development: the Health Department for England and Wales 1961 to 1986

This thesis is a history of the research and development (R&D) programme of the health department for England and Wales, 1961 to 1986. It is a study of the development of the British ‘health research state’, showing how the department’s programme was shaped not just by health policy but also by science policy; non-government actors; and the requirement for co-existence with the Medical Research Council (MRC). A longitudinal analysis shows that the departmental R&D budget underwent rapid growth from a near zero-base in 1961, rising to a real-terms peak in 1976. Growth rates during this initial period outstripped those for total civil R&D. After 1976, the departmental R&D budget began to decline when adjusted for inflation, with a step decrease in 1981. This pattern of meteoric rise followed by decline can be attributed in part to the ‘Rothschild reforms’ in national science policy and their subsequent reversal - an occurrence unique to the health domain. These events, which related to biomedical research only, were overlain onto a longer-term rise and reversal in health and personal social services research (HPSSR), which had separate, earlier origins and differing drivers. The nature of the different streams of research and their governing dynamics are elucidated. Evidence is drawn from interviews, archives, official publications and secondary sources. An analytical framework draws on political, institutional and social epistemology theory to consider power and interest in the health research state, organisational responses, and governing assumptions about research utilisation. For biomedical research, structural interests and the power of the medical profession are shown to be central to the course of events. HPSSR was caught up in the resulting turbulence, but not to the extent of complete derailment and the Department became an important patron of HPSSR during this period.