The politics of health policy knowledge transfer: the evolution of the role of British health economics academic units

Eleanor Mackillop,Sally Sheard

doi:10.1332/174426418x15378681544353

Eleanor Mackillop, Sally Sheard

Open Access

https://doi.org/10.1332/174426418x15378681544353

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Journal: Evidence & Policy	Publication Date: Nov 1, 2019
Citations: 3	License type: CC BY 4.0

Affiliation: Cardiff University, University of Liverpool

Abstract

Economics is now central to health policy decision making, within government departments and the National Health Service. We examine how and why a health economics academic unit – the Centre for Health Economics (CHE) at the University of York, England – was created in 1983, funded and commissioned to provide research evidence to the British government, specifically the Department of Health and Social Security (DHSS) and its successors. Building on the knowledge transfer literature, we document the origins of this relationship and the different strategies deployed by successive governments and researchers. This paper demonstrates the value of historical methodologies such as oral history and textual analysis that highlight the limitations of existing knowledge transfer theories, by foregrounding the role of politics via the construction of individual relationships between academics and policy-makers.

Highlights

Since its emergence in the 1960s in the United Kingdom (UK), health economics – or economics as applied to health – has sought to influence health policy-making, especially through mobilising ideas of scarce resources, supply-demand and cost-Eleanor MacKillop and Sally Sheard effectiveness
The political ‘substantiation’ that health economics provided can be seen in the development of Quality-Adjusted Life-Years (QALYs), which became politically acceptable in the 1980s at a time of increasing health demands and pressure to reduce health spending (MacKillop and Sheard, 2018).The 1970s oil shocks and public expenditure crises, followed by the post-1979 context of spending limitations and the growth of New Public Management (NPM), played a key role in securing the position ofYork academics within the community of health policy-makers: their concepts of scarce resources, cost-effectiveness, and resource allocation formulae chimed with current political values and culture
This paper has explored knowledge transfer (KT) between academia and government by illustrating Department of Health and Social Security (DHSS) civil servants and York economists’ roles, relationships, strategies and tools in health policy-making

Summary

Introduction

Since its emergence in the 1960s in the United Kingdom (UK), health economics – or economics as applied to health – has sought to influence health policy-making, especially through mobilising ideas of scarce resources, supply-demand and cost-. Not dealing with research units Ettelt et al’s (2013) paper on the setting-up of a DH-funded rapid-response unit to provide international healthcare comparisons is interesting for its discussion of the barriers to policy-research linkage.They explain that structures are required to facilitate KT and increase research-government interactions They argue that such structures can help build trust and grow the credibility of researchers, risks may include increased demands on time and resources, mismatch of timelines and incentives, and a lack of institutional support and organisational culture to sustain the exchange.This structure was seen as a one-way transfer from research to DH, where policy-makers would ‘tap into’ the researchers’ knowledge and network as and when needed for quick policy responses.

Methods

Conclusion