Health on frontline

THERE may be another explanation for the disappointing quality of university-based health service research reported in "Clinical ratings queried" (THES, March 7).

If community-based clinical subjects did badly it may confirm the remoteness of ivory tower researchers from the delivery of community care.

John Swales's predecessor as research chief at the National Health Service and his regional officers threw millions of pounds at the university medical schools whose track record of expertise and responsiveness in relation to practitioners in community settings was generally abysmal.

Fortunately, Professor Swales is introducing a new funding system to underpin research in the health service. The emphasis is on research to support effective clinical practice. Let us seize the moment to enhance the research capacity within primary and community services themselves.

The people in that front line who will make breakthroughs in the entrenched problems of services may be employed by NHS, health authorities, charities, universities (with and without medical schools) or a combination of these employers, but we need them to "keep watch" with us based right on the frontiers of practice.

Woody Caan

Head of research and development Lifespan Healthcare Trust Cambridge