Epidemiology of indications.

Having just completed the writing of a history of the first 50 years of the Nuffield Provincial Hospitals Trust, I was interested in Dr Stephen Frankel's stimulating editorial in your December issue, especially so since it also has some relevance to the recent correspondence in the J7ournal of Public Health Medicine about health service research. My interest is because until the advent of the Health and Social Services Department on the scene, an event which was specially noted by Sir George Godber and Dr Richard Cohen in the publication commisioned by the Trust, Portfolio for health,' the Trust perhaps financed more of what has come to be known as "health services research", which included support for epidemiologists, than any other body. During that period and indeed since, I have been struck by the record unearthed by my explorations for the History, which has been sobering to the extent that so much ofthe research sponsored and the findings published has gone unheeded. The current obsession with the "reforms" obscures a wealth of "indications" of how to improve the public health. It is not my intention to comment in detail on Dr Frankel's observations even if (schooled by the 1 Frankel S. The epidemiology of indications. Editorial. J Epidemiol Community Health 1991; 45: 257-9. 2 McLachlan G. Portfoliofor health: the role andprogramme of the DHSS in health services research. London: Nuffield Provincial Hopitals Trust and the Oxford University Press, 1971. 3 Morrell DC. Role of research in development oforganisation and structure of general practice. BMJt 1991; 302: 1313-6. 4 Ashley-Miller M, KayAW. Initiating and supporting public health research-United Kingdom. In: Holland W, Knox G, Detels R, eds The Oxford textbook of public health (1 st edn). Oxford: Oxford University 1985. pp. 402-8.