If we are to stand any chance of getting tomorrow's cures today, then your money, given either through taxation or directly to some disease-related agency, must go to the “right” researchers. If you have stayed with me this far you should know that there are at least two ways of evaluating researchers, conventional peer review, and a modification of the latter which I call bicameral review. My prescription for reform of the health research system is to replace conventional peer review with bicameral review (see Chapter Ten).
But I am a researcher, not a salesman. One of the points I have been making (Chapter Nine), is that the skills required for successful marketing are often at variance with those required for successful research (successful research, not successful research fund raising). As a good researcher (I hope), I instinctively adopt the non-dogmatic, diffident approach. Thus, I am forced to state somewhere in this book that it is entirely possible that if my reform plan were implemented there could be a disastrous slowing of the rate of progress towards better treatments and cures. I do not believe this, but there seems to be no way of proving it. An experiment could be designed to compare conventional peer review with bicameral review, but it is most unlikely that it could be uncontroversially implemented. As in so many matters affecting our complex society, it would be very difficult to agree on satisfactory end-points which would be used to quantitate success or failure.
So the debate on whether to move to bicameral review will have to be fought out in the political arena. Hence this book. It is for you,