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Does health services research improve health services?

Walter Holland, an early pioneer of health services research (HSR) in the UK National Health Service (NHS), has written an unusual and highly personal account of his life as a researcher and research leader. For what can often be a rather arid, uninspiring subject, he has brought many aspects of it to life in an engagingmanner, making effective use of anecdotes and insider knowledge. At the same time, while making the occasional reference to current health policy issues and their largely evidence free character, it is a curiously dated book and one that is hard to categorise. Whatever else it purports to be, the book is neither a complete history nor a systematic review of HSR’s evolution in England. The most thoroughly documented period is from the 1970s up to the 1990s, and then the sequence of events tails off and becomes much more selective. There is, for instance, no mention of the Cooksey review in 2006 of UK health research funding (Cooksey, 2006) and no mention of the Department of Health strategy published earlier that same year, Best Research for Best Health: A New National Health Research Strategy (Department of Health, 2006). More surprising, perhaps, is the complete absence of any mention of the National Institute for Health Research (NIHR), the sprawling empire so successfully created in 2006 and built up over subsequent years by Sally Davies who, since 2010, has been Chief Medical Officer for England. Possibly more than any other advocate for research, she has firmly established HSR’s place in England, if not the United Kingdom, and ensured that its funding has remained remarkably intact during a period of severe public spending cuts. Without doubt, the NIHR has increased the volume of applied