The pursuit of ignorance

The economist John Maynard Keynes once observed, ‘There is nothing a government hates more than to be well-informed; for it makes the process of arriving at decisions much more complicated and difficult.’¹ Yet successive UK governments have committed to improving science-policy relations; efforts strongly supported in public health.² UK academics are now explicitly incentivised to demonstrate research impact beyond academia. It is therefore surprising that the UK Cabinet Office has introduced a clause that potentially limits the extent to which researchers can engage in policy debates.³

The new clause, to be inserted into all grant agreements, was announced by Cabinet Office minister, Matthew Hancock MP. It prohibits the use of government funds for ‘activity intended to influence or attempt to influence Parliament, government or political parties, or attempting to influence the awarding or renewal of contracts and grants, or attempting to influence legislative or regulatory action’.⁴ This seems to conflict with the pursuit of public health goals, which often require working to ensure policy actors are aware of research implications.

The tension may be inadvertent on the part of the government, but appears central to the agenda of the Institute of Economic Affairs (IEA), the free-market think tank cited in the announcement of the clause.⁴ Two IEA reports appear to underlie the clause,^{5 6} both presenting sustained critiques of public health advocates and researchers. The IEA’s position is that only money raised through sources other than taxation should be used to influence government spending; in effect privileging private sector views, some of which clearly run counter to public health (it is worth noting that the IEA has received significant funding from leading tobacco manufacturers,⁷ while Hancock was recently reported to have received donations from the IEA chairman⁸).

The seriousness of the threat posed by this new clause for policy-engaged health researchers depends on its interpretation but it seems likely to reinforce two key barriers to research use in policy identified in a systematic review: (1) poor research dissemination/accessibility; and (2) issues with the policy clarity/relevance.⁹ It is on the back of such evidence that UK Research Councils (RCUK) and the higher education funding councils have worked to encourage academics to become more outward-facing. A core example is the ESRC’s ‘impact accelerator’ awards. At the University of Edinburgh, such funding has been used to support researchers who mapped Scotland’s tobacco and alcohol retail outlets to make their results¹⁰ publicly available via an interactive website and, given the clear evidence of over-supply in deprived communities, to discuss policy implications with a view to informing policy decisions. The wording of the new clause suggests RCUK funders will no longer be able to support these impact-orientated grants.

The clause also appears to threaten the multi-funded UKCRC Public Health Research Centres of Excellence, established to encourage researchers to engage with policymakers and practitioners,¹¹ and the government-funded What Works centres, intended ‘to improve the way government and other organisations create, share and use […] high quality evidence for decision-making’,¹² a concept Hancock has previously praised.¹³

Leaving aside those who undertake research projects directly commissioned by RCUK or government departments, the wider threat seems greatest for those funded by, or working in research centres and units that are RCUK core-funded, such as the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. The picture is more complex for traditional university academics but even then, time not covered by direct grant income or teaching includes support from the government, via grants from the higher education councils. To take one example of work that could be prevented, researchers who found that NHS organisations with PFI contracts had higher capital costs than those without such contracts, ‘worked closely with several parliamentary committees, including the House of Commons Public Accounts and Treasury Committees, the House of Lords Economic Affairs Committee, and the Scottish Parliament's Finance Committee, to ensure that the research has informed legislative opinion and impacted on its decision-making’.¹⁴ The purpose was to reduce costs to the public purse and yet the new clause seems to rule out this kind of work unless academics are funded by sources other than the government.

The epidemiologist, Austin Bradford Hill, famous for his work with Richard Doll demonstrating the link between smoking and lung cancer, said he had initially believed that, as a researcher, he had ‘no part to play in telling the public about those results', lest such efforts come across as ‘propaganda’.¹⁵ Bradford Hill and Doll later radically revised this view; in public health, we rightly demand more of our researchers and (until now) so have UK governments. The need to improve the use of scientific evidence in policymaking is clear; this clause limits government-funded researchers’ ability to help achieve this, privileging those working to influence policy on behalf of commercial interests.