APPENDIX 38
Memorandum submitted by Professor Emeritus
James Spencer Malpas, University of London
INTRODUCTION
1. During my career as a medical oncologist I
served on numerous committees concerned with cancer research and
the provision of services for the care of patients with cancer
in adults and children. Among the most frustrating were those
concerned with medical or scientific manpower. The present shortage
of cancer clinicians and academics was entirely predictable. I
hope in this short memorandum to suggest how this could be remedied
as this shortage is the single most important factor affecting
cancer research at this time.
2. It is undeniable that there is presently
a shortage of medically trained academics with 20 per cent of
established chairs vacant. Careers in academic medicine are perceived
as unattractive because of the shortfall in earnings at every
stage. It is no help for doyens of the profession to say that
the work is sufficient reward—it does not pay the mortgage.
A second factor is the removal of tenure which has affected the
security of many senior academic positions and which compares
unfavourably with that enjoyed by colleagues in whole time clinical
practice.
3. There is going to be a shortage of doctors
in the United Kingdom for at least the next 10 years. The key
to improving research on cancer and its treatment is to attract
the best trainees in sufficiently large numbers to provide a critical
mass of expertise.
4. This can be achieved by:
1. Making financial earnings compatible at
each stage of an academic career with their non-academic counterpart.
2. The introduction of a tenure track system
in which suitable young physicians are given an appropriate length
of scientific training leading, if everything is satisfactory,
to a tenured post. The duration of this tenured position is arguable
but for someone in their early 30s it should not be less than
15 years thereby covering the most productive period of their
careers.
3. The introduction of a distinction award
system for medical scientists. There has been some criticism of
the distinction award system but as Churchill said of democratic
government it's the worst form except for all the others!
4. Encouraging young post-doctorates, either
from a clinical or scientific background to join research teams
in Universities or Hospitals. It is important to avoid the temptation
of setting up a monolithic cancer institute. These institutes
only serve to denude other good centres of expertise and result
in an unacceptable concentration of cancer patients. The United
Kingdom has an insufficient reserve of cancer orientated medical
manpower to enable this to work.
SUMMARY
The attraction of the best medical and scientific
personnel into cancer research is impeded by lack of financial
reward and security. This is the fundamental cause of the unsatisfactory
state of affairs in this country. All other considerations are
of secondary importance.
A proposal is made to address this problem and
to avoid damaging existing centres.
March 2000
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