Cam Donaldson

Professor Cam Donaldson
Cam Donaldson, July 2014
Born	(1960-11-30) 30 November 1960 Glasgow, Scotland
Nationality	British/Canadian

Cameron Richard (Cam) Donaldson PhD (born 30 November 1960) is one of the world's foremost health economists;^[1] and current holder of the Yunus Chair in Social Business and Health at Glasgow Caledonian University.

He is renowned in the academic community for his research on measuring and valuing the benefits of health care, using economics in health care priority setting and economic evaluation. He has published over 200 refereed journal articles and seven co-authored/edited books, including the recent Credit Crunch Health Care: how economics can save our publicly-funded health services,^[2] from Policy Press in 2011. In almost 30 years in health economics research, Cam has won over £25m in competitive funding awards, over £10m of this as principal investigator.

Early life and education

Donaldson was born in Glasgow.^[3] His father was a trade union activist, working as a stereotyper at the Scottish Daily Express. His mother was a comptometer operator. He has two sisters and a brother.

In the early 1970s, Express Newspapers moved his father's job to Manchester. Not having supported a football team in Scotland, and due to the famous Scottish footballer, Denis Law, finishing his career there, Donaldson picked Manchester City, and has remained a lifelong fan of the club. Having been educated at Bishopbriggs High School and Cheadle Moseley School for Boys, Donaldson went to study Economics at Nottingham University (1979–1982), immediately followed by a Masters degree in Health Economics at the University of York. The interest in health came from wanting to apply economics to the public sector, and health, at the time, was a new and interesting area of exploration.

Career

Immediately after his Masters, Donaldson worked as a Research Fellow during the first year of the Centre for Health Economics (CHE) at the University of York. Here he met two of the three main collegial influences on his career – Stephen Birch (now at McMaster University) and Alan Maynard (the first director of CHE, and still at York).

From York, Donaldson jumped into multidisciplinary environments in the (then) Health Care Research Unit at Newcastle University (1984–1988) and the Department of Public Health at the University of Sydney (his first Lectureship; 1989–1990). He then returned to Scotland to spend most of the 1990s as Deputy Director of the Health Economics Research Unit at the University of Aberdeen (1991–98). Initially, he deputised to part-time Director, Professor Gavin Mooney, one of the 'founding fathers' of health economics,^[4] who persuaded Donaldson to undertake a PhD under his supervision. He became a Professor at Aberdeen in 1996 and, for five years of his tenure at Aberdeen, served as national organiser of the Health Economists' Study Group (HESG), the UK body for health economics researchers. This was the first time that the organisation of the HESG had moved outside of the University of York.^[5]

From 1998 to 2002, Donaldson worked as the Svare Chair in Health Economics at the University of Calgary. Here, he built a group of health economics researchers, holding an appointment there until 2011, visiting frequently. Whilst in Calgary he established the Health Economics Methods Group of the Cochrane Collaboration with Luke Vale (of the University of Aberdeen, now at Newcastle) and Miranda Mugford (University of East Anglia) and acted as co-convenor from 1998 to 2008.

In 2001, the Health Foundation (a major charitable funder in the UK) announced a national competition for a Chair in Health Economics. Any university applying had to team up with a named candidate. Donaldson's colleagues (particularly Professors John and Senga Bond) at Newcastle invited him to be their candidate, and together they won the funding of £3m. What made Donaldson equally proud, however, was that three of the candidates who made it through to the final five were PhD students of Mooney.

At Newcastle, as well as building another significant group of health economists, Donaldson became the inaugural Director of the Institute of Health and Society (from 2006 to 2010). There he worked closely with Professor Michael Jones-Lee and Rachel Baker, now Professor of Health Economics at Glasgow Caledonian University, in translating Jones-Lee's work on valuing human life and safety into the health arena, an endeavour that led to £1.5m of competitive research work for the Department of Health in England and the European Commission, again led by Donaldson.

In late 2009, Donaldson was approached about becoming the inaugural Yunus Chair in Social Business and Health at Glasgow Caledonian University (GCU) and the Director of the new Yunus Centre for Social Business and Health. He was intrigued by the mission (for the 'Common Weal') of this post-1992 university, and increasingly concerned that, despite world class research at top universities and world class health care provision in the National Health Service, health inequalities were not only persisting, but growing. The idea of thinking differently about health creation for the most deprived groups through more community-based initiatives, such as social enterprise and fair credit, and working with Nobel Peace Laureate Muhammad Yunus on such issues, drew him back to Scotland. The Yunus Centre has attracted over £3m of research funding since its inception, most notably from the UK's Medical Research Council.

Contributions

Using 'willingness to pay' to value the benefits of health care

The concept of willingness to pay (WTP) has existed in the literature since articulated by the Italian-born French engineer and economist, Jules Dupuit, in 1844. At its simplest, WTP implies that a natural measure of the extent of a person's preference for anything is the maximum amount that s/he would be willing to pay for it. Applied in areas of environment and safety since the early 1960s, Donaldson has pioneered this method in health. He has developed highly novel approaches to quantifying values of patients and the public with respect to treatment options, demonstrating that: WTP can ‘detect’ values of attributes of care beyond health gain (i.e. ‘process utility’ benefits),^[6] and; distributional concerns (i.e. that WTP is associated with ability to pay^[7]) can be accommodated in applying the results of WTP studies to publicly funded health care settings. Having produced (with Jan Abel Olsen) the first ever attempt to use WTP to establish relative priorities across health programmes,^[8] this led to the funding of an internationally renowned European Commission project ('EuroWill'), across six European countries, on which Cam was Principal Investigator (PI) (funded under BioMed2, 1996–99, PL 950832).^[9] His work on monetary valuation of health led the Department of Health and National Institute for Health and Care Excellence (NICE) to fund the 'Social Value of a QALY' (Quality Adjusted Life Year) project, on which Donaldson was PI. This conjunction of QALYs and WTP was subsequently explored in 10 countries through the European Commission funded project entitled 'European value of a QALY', on which Donaldson was also PI (Sixth Framework, 2007–2010, contract no: SP5A-CT-2007-044172).^[10][11]

Using economics in healthcare priority setting

Pushing forward the scientific boundaries of his discipline, Donaldson has led the development and use of an economic framework, known as programme budgeting and marginal analysis (PBMA), in local (geographically defined) health care settings where funders are charged with meeting the needs of local populations from limited funding envelopes. This has involved working directly with decision makers in several contexts at various levels of health care systems in the UK, Canada and New Zealand, working largely with Craig Mitton at the University of British Columbia in Vancouver. The main objective has been to adapt economics to complex management processes, so enhancing its uptake in decision-making. The main research innovation in this area has been extensive employment of qualitative methods to develop (and analyse progress in) use of such an economics-based framework. Such a combination of health economics and qualitative research remains uncommon. This framework has been used in well over 150 health organisations globally, was the basis of the first demonstration in the literature of a local health organisation scaling back services of minor effectiveness to fund something more beneficial,^[12] and continues to be disseminated internationally. Related to this work, Donaldson acted as Honorary Secretary to the International Society on Priorities in Healthcare^[13] from 2006 to 2011, hosting the records and accounts of the Society at Newcastle University.

Development and application of economic evaluation

Donaldson has acted as co-investigator on several economic evaluation projects over his career, and has made important contributions to methods development in this area. Each has involved collaboration with health care researchers and professionals in several clinical settings. These evaluations have all created new knowledge in their respective clinical fields and have had various degrees of impact (e.g. feeding into NICE technology assessments), notably in nephrology, care of frail older people, osteoporosis screening, general surgery, sexual health and stroke. He chaired the Family Planning Association's Expert Panel on the Economics of Sexual Health in England, which reported in August 2005. With respect to methods of economic evaluation, he has co-produced two important papers in health economics criticising the foundations of QALYs and demonstrating that, as with WTP, QALYs are influenced by socio-economic status.^[14][15]

Creating the first Centre for Social Business and Health

Donaldson has been able to build a multidisciplinary team, combining expertise in health economics, finance, sociology, social policy, political economy, history, public health and statistics. In 2013 Donaldson managed to secure a major programme grant worth £2 million over five years from the UK's Medical and Economic and Social Research Councils entitled 'Evidencing Social Enterprise as a Public Health Intervention'.^[16] The project commenced in January 2014.

Awards

Donaldson has won several competitive personal awards for his research, such as:

• Alberta Heritage Foundation for Medical Research, Senior Fellow (1998–2002);^[17]
• Canadian Institutes for Health Research Senior Investigator (2000–2002);^[18]
• Health Foundation Chair in Health Economics (2002–2010);^[19]
• Economic and Social Research Council, Advanced Institute for Management Research, Public Services Fellow (2003–2004)^[20]
• National Institute for Health Research, Inaugural Senior Investigator (2008–2012)^[21]

Service

Donaldson has served in the following capacities:

• Member of the Appraisal Committee of the National Institute for Health and Care Excellence (NICE)^[22]
• Member, Northumberland and Tyne & Wear Health Authority Modernisation Commission
• Member, Health Services and Public Health Research Board of the Medical Research Council
• Chair of Family Planning Association's Expert Panel on the Economics of Sexual Health in England
• Chair, joint Health Economics Post-doctoral Fellowships Panel of the Economic and Social Research Council, the Medical Research Council and the National Institute for Health Research
• Deputy Chair, Methodology Panel at the Medical Research Council^[23]
• Member, Research and Policy Advisory Committee for 'Relate’

Donaldson has been an assistant editor of 'Health Economics' and an advisory editor for 'Social Science and Medicine' and is currently on the editorial board of 'Health Policy' and is Associate Editor of a new journal, 'Social Business'.

Personal life

Donaldson lives in Glasgow with his wife and partner (since 1992), Diane, who is a successful university administrator. They have two children (Graham and Callum Imray) and a grandson (Dominic).

References