House of Commons - Science and Technology

Select Committee on Science and Technology First Report

III STRUCTURES

National Cancer Research Institute

PROPOSALS FOR A NATIONAL CANCER RESEARCH INSTITUTE

19. Our predecessor Committee recommended the creation of an overarching National Cancer Research Institute (NCRI) in the UK, with responsibility for planning and co-ordinating most aspects of UK cancer research.[39] It explained the role it thought the NCRI should play, and recommended that it should operate "at arm's length from Government under the authority of its own Royal Charter".[40] The Cancer Plan announced that the DoH Director of Research, Analysis and Information and the National Cancer Director were to work together to create proposals for the NCRI. Most of those who contributed to the Committee's original inquiry, including the two largest charities, were against a large institution when so many centres of excellence were already established. The Government agreed and decided to form a 'virtual' NCRI, administered by a small staff and housed within the Medical Research Council. It built on the existing Cancer Research Funders' Forum.

CANCER RESEARCH FUNDERS' FORUM

20. The Cancer Research Funders' Forum (CRFF) first met in Autumn 1999, during the Committee's initial inquiry. Set up following the Prime Minister's Cancer Care 'Summit' in May 1999 to improve collaboration in cancer research, it consisted of representatives from the DoH, the Medical Research Council (MRC), the Cancer Research Campaign (CRC), the Imperial Cancer Research Fund (ICRF), the Leukaemia Research Fund, the Ludwig Institute and Marie Curie Cancer Care. It was chaired by the MRC. The CRFF was involved in developing and implementing many of the policies contained in the Cancer Plan, including the National Cancer Research Networks (NCRNs), the National Translational Cancer Research Network (NTRAC) and the NCRI. It was criticised by many for not including the pharmaceutical industry. In May 2000, Professor Sir Paul Nurse, Director General of the Imperial Cancer Research Fund, told the Committee "I think it would be a good idea to have [industry] not only represented in the Forum, but, in addition to that, look at ways in which we can promote research and break down the barriers between the different organisations".[41]

NCRI

21. The NCRI was established on 1 April 2001. It is staffed and housed by the MRC, and Professor Sir George Radda, Chairman of the MRC, was appointed Chairman. There are three full-time staff, including the Administrative Director, Dr Liam O'Toole, and two seconded part-time staff. The funding for this secretariat is shared equally between the public and private sectors. It has in effect replaced the CRFF, and broadened that body's membership. The NCRI, unlike the CRFF, includes the pharmaceutical industry, and the Association of British Pharmaceutical Industries (ABPI) has established a UK Cancer Group to provide input to the NCRI. Other Research Councils are also likely to join. Full details of the NCRI's membership and organisation are provided in the NCRI's memorandum.[42]

22. We have found that some confusion exists about the NCRI. Many of our respondents were unaware that it had developed from the CRFF, and thought both bodies still existed.[43] Others had not even heard of the NCRI.[44] The cancer charities did not consider this a major problem for the work of the organisation. Professor Nurse told us " by setting it up as a virtual institute, it never will have a very high profile, but that does not mean it does not make a difference".[45] The Minister told us that the NCRI "is still very early on in its life and I think it would probably be surprising if it had a huge national profile at this stage. The more that it does in practice the higher its profile will become, but it may be something that the various members of the Institute will want to consider at some point as it develops".[46] We welcome the establishment of a National Cancer Research Institute and are pleased to hear of strengthening links between Government, charities and industry, although it is too soon to judge the effectiveness of its projects. We believe that the Institute could benefit from a higher profile amongst those not directly involved in its work.

National Cancer Research Network

REGIONAL NETWORKS

23. The NCRI is responsible for overseeing the National Cancer Research Network (NCRN). The NCRN, which is funded entirely by the DoH, consists of 34 regional networks across England, informally known as NCRNs. In 1995, an Expert Advisory Group recommended the creation of cancer networks, to be based around cancer centres, in order to deliver better clinical cancer services to patients. These service networks, known as Calman-Hine networks, were established over the next few years.[47] The 34 NCRNs match these existing cancer service networks. The first nine NCRNs were rolled out in April 2001, and by December 2001 31 of these networks were operational in England.[48] Independent networks operate in Scotland and Wales. We asked the Department of Health for a map of the networks. Apparently none exists. A list of the networks was sent to us. It would be helpful to researchers, clinicians and patients if a map of the regional Cancer Networks was available and we recommend that such a map be published in the next NHS Cancer Plan progress report.

24. The Government Reply stated "the NCRN will: integrate research and cancer care; improve the quality, speed and co-ordination of cancer research; and increase the number of NHS organisations, health care professionals and patients participating in cancer research studies".[49] The work of the regional NCRNs is to co-ordinate research work, including that supported by both charities and the NHS, and improve liaison with cancer services. The initial aim of the Network is to double the number of patients in clinical trials within three years. The first set of figures on patients enrolled in clinical trials since the establishment of the NCRNs will be available in summer 2002.[50]

25. Those submitting memoranda to us who had a regional NCRN operational in their area were broadly positive about them. The NHS Cancer Plan promised extra funding of £20 million per year by 2003 to support the NCRN infrastructure. However, there was concern that funding was not at the level promised by the Government. Breakthrough Breast Cancer states that "there is evidence that in some cases hypothecated funding for cancer is not reaching the intended recipients (i.e. Cancer Networks)".[51] We heard of uncertainty regarding the function and funding of NCRNs in areas which did not yet have a functioning network.[52]

26. We welcome the Government's move to establish a network structure for research funding and collaboration across the regions. It might be asked why, if the purpose of the NCRN is to integrate research and cancer care, the Government established a separate research network, rather than introducing a research element into the existing service networks. The relationship between the two networks is not entirely clear. Professor Richards told us that the same hospitals were involved in both networks although different staff work within them.[53] He also said "the approach is to have every cancer network across the country become a research network".[54] We can only hope that the workings of the separate research and service networks are clearer to those working in, and treated within them, than they are to us.

Translational Research

NATIONAL TRANSLATIONAL CANCER RESEARCH NETWORK (NTRAC)

27. Translational research is defined as research activities undertaken with the aim of assessing advances made in basic research and bringing about, or translating, their application to clinical practice where appropriate. It is research which is essential to connect the cancer research laboratory and the clinic. Ideally this is achieved by placing research and clinical facilities geographically together and ensuring adequate funding of both. The NRCN's aim of doubling the number of patients in clinical trials is one contribution towards improving the UK's traditionally poor record of translational research. The Department of Health has also created a network devoted to translational research, the National Translational Cancer Research Network (NTRAC), which is under the oversight of the NCRI. The Director is Professor David Kerr, Rhodes Professor of Therapeutic Sciences and Clinical Pharmacology at Oxford University. He told us "NTRAC aims to get more science into the clinic (e.g. increasing the number of novel diagnostic or therapeutic agents entering clinical trials)."[55]

NTRAC CENTRES

28. NTRAC will operate though a maximum of ten centres which will each receive NTRAC funding. These centres will be based in existing cancer institutions. NTRAC's aim is to increase co-operation between elite cancer units "sharing common aims, equipment, trials and ideas in order to realise patient benefit, and contribute towards the competitiveness of the UK's science base".[56] Applications to become NTRAC centres were received in October 2001, and the first eight centres were announced in January 2002.[57] The last two centres are still under consideration. Funding will begin in April 2002 and last for five years in the first instance, with a review after three years to be carried out by the Department of Health. Each centre will receive a likely maximum of £200,000 from NTRAC itself for direct costs and a further £50,000 for indirect costs per year. This funding is part of the announced £20 million per annum new Government cancer research expenditure, and not additional to it.[58] We asked Professor Mike Richards about the Department of Health funding, which we considered low. He told us "this is not the basic funding of those centres. Those centres are funded from a variety of different sources, including MRC funds but also including funds from the charitable sector".[59] Professor McVie confirmed that the centres had been promised support by both the Cancer Research Campaign and the Imperial Cancer Research Fund. He was enthusiastic about the future of the NTRAC centres and the NCRNs: "I cannot believe that these networks should not be the sort of paradigm for other kinds of trials in cardiac medicine and in Alzheimer's".[60] We welcome the introduction of a network specifically designed to further translational research. We recommend that the level of core funding for NTRAC centres is kept under review, to ensure they are able to operate effectively.

MRC CANCER CELL UNIT, ADDENBROOKE'S

29. There have also been developments in translational research outside NTRAC. In April 2001, a new Cancer Cell Unit opened at Addenbrooke's Hospital in Cambridge, housed in the new Hutchinson/MRC Centre. This is a joint venture between the MRC, the CRC and the University of Cambridge. The MRC contributed £5 million towards the cost of constructing the Research Centre and a further £15 million towards research in the unit. It is not clear if that sum is included in the Government's spending figures for either 1999-00 or 2000-01. Announcing the unit in April 2000, the Honorary Unit Director, Professor Ron Laskey, said "the unit has the potential to combine laboratory based research with direct access to cancer patients in a hospital base".[61] The Research Centre will also house university groups from the Department of Clinical Oncology, directed by Professor Bruce Ponder. The two directors will work together. This new centre has been welcomed warmly by cancer researchers. We urge the MRC to support further translational research activities along the lines of the new Addenbrooke's Cancer Cell Unit.

BEATSON INSTITUTE, GLASGOW

30. A major centre for translational research in Scotland is run in collaboration between the Beatson Institute for Cancer Research and the University of Glasgow. The Beatson is responsible for basic research and the University of Glasgow's Departments of Clinical and Radiation Oncology carry out translational research based on the Institute's findings. Activities are also linked to other Universities and clinical work in the Beatson Oncology Centre at the University of Glasgow School for Cancer Studies. The Beatson laboratories, which have been supported by CRC, have around twenty research groups working in them. This work has recently been threatened by a management crisis at the Oncology Centre. In November and December 2001, four consultant oncologists resigned from the Centre, citing a lack of funding, which was making their jobs impossible. One, Dr Habeshaw, explained in a letter to The Herald newspaper, "expectations have never been higher, but our ability to meet them seems never to have been lower".[62] The departures mean that there are now nine consultant oncologist vacancies at the Beatson. Professor McVie described the situation as "devastating" and told us "our entire investment in translational medicine in the West of Scotland, which is about six or seven million pounds a year, is at risk here". Healthcare in Scotland is a devolved issue. We recognise that the Scottish Executive has already taken prompt action - appointing a new Centre manager. However, we must express our concern at the situation at the Beatson as it has implications for cancer research across the UK. We have referred our concerns to our colleagues on the Health and Community Care Committee in the Scottish Parliament for them to take further as appropriate.

39 HC 332, para 156 Back

40 HC 332, para 156 Back

41 HC 332 - iv, Q 310 Back

42 Ev 52 Back

43 Ev 56, 59, 61 Back

44 Eg, Ev 53 Back

45 Q 127 Back

46 Q 176 Back