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3 NIH and the Health Policy Environment
Pages 24-29

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From page 24...
... It is now time, the committee believes, to formalize certain aspects of this process. In particular, the process must respond to changes in recent years concerning the scope of health research and governmental patterns and practices, which together have increased external pressures for organizational change within the Public Health Service.
From page 25...
... Because of the complexity of the individual cases, it was not possible for the committee to decide whether the nation'a needs would be best served by expanding the NIH mandate to include particular areas, by having them addressed by other agencies, or by devising improved methods of coordinating functions that inevitably cut across organizational lines. The committee believes that such boundary issues and the challenges of improved coordination and priority setting are crucial both for NIH and the integrity of the federal health structure, and that there must be a mechanism to assist the Assistant Secretary for Health to investigate these matters systematically and to propose workable solutions.
From page 26...
... The Health Science Board To address there changes in the NIH policy environment, and to deal with the increased pressures for organizational change documented in the previous chapter, the committee recommence: 1. A Health Science Board should be established in the Department or nealtn and Human Services to oversee the health research organization, missions, priorit ies, ~ement of the several elemen ~ e National Institutes of Health; the Ce~;~; ~ Drug Abuse and ~ _~8 Administration; the Nationa ~— the National Center for Health Services Research.
From page 27...
... In particular, the board would be concerned with the boundaries of the research missions of NIH and the rest of the agencies of the Public Health Service, and with proposals for major organizational changes in those agencies. The board's role is, in many respects, like that of the trustees or regents of a public institution.
From page 28...
... In such cases, the board must have the authority ant resources to establish appropriate study groups or pane 18 e To deal with the full range of health research, the Health Science Board must be located in the Public Health Service of the Department of Health and Human Service a. Many agencies ant departments of the federal government have a health research mission, but much of this research -- almose 80 percent in 1982 -- is concentrated in the Public Health Service.30 As the fiat of the Public Health Service units indicates, the range of issues covered and approaches used is quite broad.
From page 29...
... No advisory board or other entity in any of the Public Health Service agencies would have the necessary perspective or the credibility to deal with such issues. At a level higher than the Assistant Secretary, health research is only one of many important issues, and the board's advice would not get full attention.

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