APPENDIX 33
Letter to the Clerk of the Committee from
Professor John S Smyth, Professor of Medical Oncology, University
of Edinburgh, and Director, Imperial Cancer Research Fund.
I would like to submit the following comments
as part of the evidence to be brought before the Committee's Inquiry
into the organisation of cancer research. I make these comments
as the Professor of Medical Oncology in the University of Edinburgh,
and as Director of one of the largest Imperial Cancer Research
Fund Units in the UK, working within an NHS Regional Cancer Centre.
I have been in this position for the past 20 years.
The terms of reference include comments on "barriers
to taking forward basic research into the clinic". You also
include "the suitability of NHS oncology centres for the
prosecution of clinical trials". These two points are linked,
and the Committee should be aware of the fact that in recent years
it has been increasingly difficult to progress basic research
or new early clinical trials into patient studies, given the additional
bureaucracy that followed the creation of Trust Boards. The right
to account for the use of NHS facilities is obvious, and the academic
community must have sympathy with the argument that research is
not always cost-effective in terms of patient throughput, the
use of out-patient facilities, day-care facilities and hospital
beds. Nevertheless, the Committee must appreciate that unless
steps are taken not only to tolerate but actually to promote clinical
research within the NHS, the UK will be seen as an unattractive
environment with which to progress new clinical treatments—this
particularly applies to the evaluation of new medicines in partnership
with the pharmaceutical industry.
Related to the above, the role of the pharmaceutical
industry is pivotal to the future development of anti-cancer drugs.
The United Kingdom used to be a particularly favoured environment
for this, but is increasingly failing to compete with colleagues
in continental Europe and even the USA. This is because of the
increased bureaucracy delaying the onset of clinical trials and
the need to recover costs plus profit for local Trusts.
The remit "suitability of NHS oncology
centres for the prosecution of clinical trials" relates to
both of the above points, but it should be positively acknowledged
that oncology centres that serve large populations are ideal settings
in which to prosecute clinical trials, if the costs and the facilities
are available.
The remit relating to "the status of research
amongst NHS clinical oncologists"—there is evidence
of clinical oncologists being so over-worked by routine NHS duties,
that it is increasingly difficult for those even in major teaching
centres whose contracts imply participation in research, to participate
in these activities. Job plans should be examined to allow and
encourage clinical oncologists to participate in ongoing clinical
research.
I myself do not see a need for a UK national
cancer institute. At present, there is excellent communication
between the major funding charity bodies and the UKCCCR has proved
effective in bringing relevant parties together in an awareness
of portfolios. Currently, it is not easy to staff the existing
major cancer research organisations, and some of the charities
would wish to expand if world-class scientists and clinical academics
were available. If a national cancer institute were established,
it is likely that this would be situated in London, which is increasingly
proving unattractive for recruitment to both senior and junior
posts. In my opinion, we do not generate enough clinical academics
and scientists to staff a new major initiative, and it is most
unlikely that the existing workforce would wish to relocate to
a single institution.
Professor John F. Smyth
Director
|
