Pluralism in the organisation of health services research

The variety of methods used in health services research (HSR) embody categorically different epistemological assumptions. These are examined in an effort to contribute to a usable framework for the evaluation of HSR projects, and in the light of a need in the U.K. for adequate institutional arrangements for the promotion and funding of HSR. Research into organisation has revealed that if desired values are not explicitly built into the structure, other values may appear unbidden. The adequate institutional base is one which embodies, espouses and funds a meaningful and practical scientific pluralism. A possible classification is outlined and illustrated and its implications for competition amongst scientists and the social responsibility of scientists are briefly discussed.