Barbara Millar reveals her lack of historical knowledge of R&D in the NHS in her spirited critique.

The NHS has always spent a considerable amount on R&D. Or rather, doctors spent it without any accountability to their colleagues, managers, politicians or the public.

What has changed is that R&D funds are now transparent, potentially available to all staff, and spent on subjects felt to be of importance to a wide range of stakeholders.

Nick Black, Professor of health services research, London School of Hygiene and Tropical Medicine.