Barbara Millar's article (Failing the acid test, pages 24-27, 26 March, and Letters, 9 April) on the NHS research and development programme is wide of the mark.
As a result of the R&D declaration exercise after the Culyer report, there was a huge shift of the resources to underpin R&D in the NHS, on 1 April 1997. Around£75m of R&D money transferred from London, and about the same was gained by trusts outside London. This total shift of£150m (which compares with a total R&D budget for trusts of£330m) is attributable to the robustness of the process. It is not surprising relatively smaller adjustments were appropriate on 1 April 1998.
Innovation underpins advances in healthcare. Medical practice relies on the R&D of past decades: advances from penicillin to PET scanning have come as a result of inspired R&D. We owe it to the new NHS that it should benefit from UK commitments to R&D which ensures up-to-date and evidence-based delivery of healthcare.
Malcolm Green, Vice-principal for postgraduate medicine, Imperial College, London W2.