The Scottish Institutional Ecology of Health and Clinical/Medical Research and Key Issues for Scottish Independence

This paper is driven by two key questions. First, what does a fully devolved healthcare system and partially devolved medical and clinical research system mean in practice, and what have been the social, economic and clinical challenges and opportunities engendered by devolution? Here, we want to identify and better understand the key institutional assets and unique selling points in Scotland that have been used to drive a particular health and wealth policy agenda. Second, what do different professionals and key stakeholders (academic researchers, NHS directors, research funders and commercial organisations) see as the potential benefits of full independence or further devolution, and what do they feel may be lost for clinical and medical research, society, economy and public health?A key message from our work in this area is that the Scottish healthcare system and the clinical and medical research systems are very much interdependent, and the complex institutional ecology that has evolved since devolution will have a significant impact on how the benefits and limitations of independence will be realised and distributed. So far the debate about independence has focused very much on health and social care, but the Scottish system and its quality depends hugely on its medical and clinical research base. This paper addresses this important part of the independence debate.This Working Paper is one in a series as part of Innogen’s work with the ESRC Future of the UK and Scotland programme.