ABSTRACT
The evidence that can certainly be delivered by researchers is that which is consonant with the political imperatives of the government that happens to be in power, or which shows that there is an alternative way of doing things that is both better and cheaper than the traditional way. We were able to produce an evaluation that met both of these criteria when we demonstrated that psychiatric care in a district general hospital was superior to care in a mental hospital, and was also cheaper (Goldberg 1979; Jones et al. 1979). Schmiedebach, in Chapter 2 of this volume, argues that there are three types of evidence, and political evidence is presumably an example of his first type, i.e. evidence based upon social, religious and cultural contents, and on personal convictions. The health-services researcher offers Schmiedebach's third type of evidence, i.e. evidence from scientific research that shows that having the treatment is effective. Here the concept of ‘treatment’ is extended well beyond the effectiveness of a new drug, and extends to the effectiveness of a way of organising clinical services. The situation is not quite as clear as Schmiedebach describes because research aimed at understanding the causes of mental illness is not really as dead as he suggests, and is in fact still funded in most developed countries both by governments through their research councils and by charitable bodies. However, Schmiedebach is quite right in asserting that his third type of evidence has assumed progressively greater importance in the last half of the twentieth century.
