This compilation of previous publications from the 1980s and 1990s, together with some new chapters written for this book, focuses on the peer review system of grant funding by the Medical Research Council (MRC), since replaced by the Canadian Institutes of Health Research (CIHR).

Forsdyke raises critically important issues that go to the heart of peer review and I agree with the importance which he attributes to this subject. He argues that the peer review system is seriously flawed. He does not reject peer review per se but offers a "bicameral" system of peer review, in which the emphasis is on past performance rather than proposed research.

In this system, one would be judged primarily on the basis of what had been achieved with available funds. Specialist financial officers would determine if the proposed budget for the new research were realistic and limited funds would be provided on a sliding basis, not only to a top per cent of those receiving a passing grade.

I agree with much of his critique of the existing system but we part ways in his recommended solution. His proposed system does not meet the criticisms which he himself lodges against the existing system.

I should note first that I am not a biomedical researcher; I am a sociologist and a social gerontologist. I have, however, sat as a member and/or chair of numerous peer review grant committees at universities, provincially, at the National Health Research and Development Program and MRC (in the 1990s after they began to broaden their definition of health). I was a member of the MRC task force in the early 1990s charged with recommending how the council should implement its decision to broaden beyond biomedical research to health research.

I subsequently sat on MRC's standing committee on education, standing committee on research and evaluation (and as such was an observer of both biomedical and 'health' review committees) as well as on the executive of the task force the federal health minister requested the president of the MRC to form on what became the CIHR and on the executive of the interim governing council of the CIHR. I am currently a member of the institute advisory board of CIHR's Institute of Healthy Aging.

Forsdyke's criticisms of peer review are numerous: excellent researchers may not always be excellent communicators and therefore may not be able to write for science peers on committees, there is a skill required in grant writing; we need as much excellence in the design of our peer review system as we need excellence in science.

He also notes: the existing system is error-prone and our recognition both of scientists and of scientific discoveries is also error-prone; good scientists often go unrecognized and similarly good ideas go unrecognized. Often, the more creative the thinking, the less communicable it becomes; and "The dynamics of peer-resistance of novel ideas in the Victorian era may be similar to those of the present era." (p. 54)

The current system encourages safe, popular areas likely to produce publishable results in a short time, and forces them away from interfaces between the disciplines. It tends towards destructive comments rather than constructive comments; it will not fund contemplative or theoretical work, and, whether a particular proposal is funded or not depends on who reviews it.

Because we have become so specialized, we will seldom receive true "peer" review. And, partnerships with drug companies direct dollars to particular research questions, meaning there is less money available for other questions. Finally, the shift to applied research means there is less money for basic research.

All of these are good points and will get little argument from me.

It is appropriate to point out that recognition of some of these failings of peer review have been major factors in the creation of CIHR. CIHR legislation, for example, states that health research for the public good shall take precedence over private interests; the background papers written by the interim governing council note explicitly the bias of current peer review against both innovative ideas and against multidisciplinarity and argue that both must be corrected within the CIHR.

Multidisciplinarity was a criterion for some of the transitional funding as MRC was transforming into CIHR (such as the Community Alliance in Health Research and Interdisciplinary Health Research Teams competitions). Both innovation and multidisciplinarity are being considered at CIHR at the present time. Although the peer review committees have yet to be transformed, a subcommittee of the governing council is examining the issue.

Furthermore, I fail to see how Forsdyke's bicameral peer review system will address his concerns and indeed would suggest it would be even less optimal than the system we have today. The bicameral system has a major focus on "performance" rather than "promise." But, for established investigators, the current system does put a major emphasis on their past research record (this is true of both CIHR and SSHRC), and it is incorrect to suggest otherwise.

How an almost exclusive emphasis on past record could assist innovation is not clear. Indeed, the author says major diversions from what the individual has done in the past would go to a review similar to what we have today. This bicameral emphasis on past record suggests we would have even more of the same rather than more innovation. How does a de-emphasis on the proposed idea ensure more innovation?

There would also be specialist financial officers to review the budget for the proposed research -- yet elsewhere the author points out that much of the budget justification we receive today is unnecessary -- even generalist peers know more or less what lab assistants, research assistants, etc. cost and what they do. The author does not present an argument that currently submitted budgets are difficult to assess so it is unclear as to why we need such specialist financial officers.

Review committees at the present time assess the budget and, if found wanting, either as too low to conduct the research, they have recommended higher budgets (this happens seldom but it does happen) or as too high, in which case they cut the budget and recommend approval with a lower budget than requested (this is common). In order to fund more projects, councils have for many years, imposed additional across-the-board cuts on all projects.

How does the sliding scale proposed by Forsdyke improve the current system? He argues even a small amount of money is better than none and that researchers will find others to make up the shortfall. But, earlier he bemoaned the shift to applied research.

While I do not support the bicameral system proposed in this book, the concerns raised are real and require redress. Without arguing that remedies are known or will be implemented, the granting councils (including CIHR) are aware of the problems and are searching for solutions. These are difficult and complex problems.

For example, multidisciplinarity is a major catch word of the day, but how many of us are asked to put our names on proposals for a show of multidisciplinarity and then are provided segregated funds to do our disciplinary research or worse, are not involved once the project is funded?

Co-investigator status means little in these situations. How do you find true peers when trying to assess multidisciplinary proposals? One strategy that has sometimes been used to ensure "true" peer review is to link in an expert by conference call for that proposal only. How do we predict today, what will be important in the future? One current direction of funding agencies is an emphasis on relevance -- and then they are criticized for shortsightedness.

The danger, of course, is that basic investigator-initiated research receives short shrift. Many, including Forsdyke, criticize this direction. In sum, the issues raised in this book are important, indeed critical. Unfortunately, the author, like others, has not found the solution to them.

Neena L. Chappell is professor of sociology and director of the Centre on Aging at the University of Victoria.