In the UK the formal evaluation of public services has a relatively brief history. Discovering what impact various social policies, programmes and projects have had on the intended beneficiaries makes political and economic sense. Why, one might ask, has evaluation had such a relatively limited pedigree?

Part of the explanation could perhaps lie in the response from several medical practitioners in the 1970s and 1980s who considered the movement towards evidence-based medicine as an unwarranted assault on their professional wisdom and integrity.

Laboratory experiments testing the effectiveness of drugs for treating a whole range of conditions had been carried out for decades. However, the origin and nature of the evidence have often stimulated controversy. A prime example of this was the resistance to acknowledging the well-founded evidence that smoking cigarettes caused lung cancer. It was not only the vested interests of the tobacco manufacturers and retailers that proved obstructive. Some in the medical profession – many of whom were themselves smokers – continued to advocate smoking as beneficial.

Research findings that challenge conventional wisdom and traditional practices often cause consternation among individuals and groups who see their customs and practice as potentially under threat. For some, change can be very uncomfortable.

Nevertheless, in spite of initial opposition from some quarters, evidence-based medicine, with its emphasis on the randomised controlled trial as the primary, if not the sole, method of producing cogent evidence, became widely accepted as the ‘gold standard’ on which to base professional practice.

While evidence-based medicine focused at the outset on the effectiveness of certain drugs and other clinical interventions, politicians and civil servants in countries where health services were funded wholly or substantially by the state began to take an interest in the comparative costs as well as the impact of treatments on people's health. Such a consideration also had relevance where access to health services depended on an individual's ability to pay, often through health insurance systems.

Although academic articles and books began appearing in some numbers in the USA during the 1960s, there was little academic or political interest in formal evaluation in the UK until two decades later. It would appear that in the UK, for example, the formulation of a policy, particularly when enshrined in legislation, was deemed sufficient to ensure its full implementation and once implemented to have the intended effect.