APPENDICES TO THE MINUTES OF EVIDENCE
APPENDIX 1
Memorandum submitted by the Academy of
Medical Sciences
The enclosed paper summarises the activities
and achievements of the Academy of Medical Sciences in its first
three years of operation. It owes its growing success and reputation
to the expertise and energy of its Fellowship, the dedication
of the Officers and Council Members, and the commitment and enthusiasm
of the administrative team. Despite limited resources, financial
and human, and a high degree of uncertainty about future funding,
the Academy is making its mark. Increasingly sought for its views
and comments on policy matters and on issues of medical science,
the Academy is leading the way in tackling key issues relating
to research infrastructure and careers, particularly the rejuvenation
of clinical academic medicine throughout the UK. A pre-publication
copy of the Academy's latest report, Clinical academic medicine
in jeopardy is enclosed.
The Academy is independent and, unlike the other
learned academies, as yet receives no contribution from the Science
Vote. It covers its core costs from a start-up grant from the
Wellcome Trust, which comes to an end in 2003; from the subscriptions
of its Fellows; from generous donations; and from income earned
from the provision of services to the medical science community.
The Fellowship is the Academy's most powerful asset: the Fellows'
enthusiasm and commitment to the work of the Academy (unpaid)
underpins the success of current activities. The Fellowship also
provides 25 per cent of current income. A fundraising campaign
is under way to raise funds to assist the expansion of the Academy's
programmes.
Looking to the future, the Academy is eager
to extend its services to Parliament, to Government Departments,
Industry and to other interested bodies; to undertake research
and policy projects that will address the key medical and health
issues of the day. Among our key objectives are (a) the implications
and assessment of new techniques (genomics, proteomics, metabolomics)
in both diagnosis of disease and selection of appropriate treatments,
(b) bringing together a wide range of disciplines from medicinal
chemistry to the law and social sciences to inform and address
the medical and ethical aspects of scientific advances in an aging
population, and (c) to enhance the collaboration between academics
involved in biological and clinical disciplines with scientists
in industry to promote the rapid translation of research into
practice and expand the national industrial base. To achieve all
of these objectives a grant of £1,000,000 per annum from
government sources would be needed.
April 2002
Annex
The Academy welcomes this opportunity to respond
to the Science and Technology Committee inquiry. This paper will
describe the background that led to the formation of the Academy
in 1998, detail the achievements of the first three years and
provide information about current levels of funding and resources,
and set out the Academy's programme for the immediate future.
INTRODUCTION
As this paper will demonstrate, the Academy
has a commitment to knowledge and policies that will improve health
for present and future generations. The remarkable progress being
made in the life and medical sciences bring the prospect of great
benefit to healthcare but they have also given rise to much public
anxiety. The Academy has a key role to play in the independent
assessment of new developments and in informing policy makers
and the public about the likely implications and any possible
hazards. In recent years much concern has resulted from the high
level of public exposure given by the media to maverick science.
AIDS, BSE, GM foods and the MMR vaccine are all important topics
where this has taken place. It has proved very difficult to persuade
the public to give due weight to the consensus of properly conducted,
peer reviewed science in these areas. The Academy, as an independent
expert body, has an important role to play in serious, informed
scientific debate on such contentious issues.
Discoveries in basic medical sciences have not
always been recognised promptly as having relevance to clinical
practice and it can take considerable time, years and even decades,
before some discoveries have been translated into benefits for
patients. One of the major objectives of the Academy is to promote
and facilitate the rapid application of research to the practice
of medicine and to the advancement of health and welfare.
In order to achieve these goals, is it is important
that institutional structures and organisational culture are reformed
in such a way as to facilitate and encourage a move towards conducting
research and teaching on an interdisciplinary basis. Success is
likely if there is the right mix of skills addressing medical
research.
BACKGROUND
Founded in 1998, the Academy of Medical Sciences
is still relatively new but has already established a strong position
within the UK's Academy group, alongside the Royal Society, Royal
Academy of Engineering and the British Academy.
The Academy of Medical Sciences was established
following the report of the Atiyah working party to the Medical
Education and Research Coordinating Committee (MERCC). It was
formally inaugurated in November 1998 as a charitable company
limited by guarantee.
A founder fellowship of 351 fellows were nominated
by the Royal Society (90); the Royal Society of Edinburgh (20);
The Council of Heads of Medical Schools (90); the Academy of the
Medical Royal Colleges (120); and MERCC (31). The current number
of Fellows, following the elections of 9 April 2002, stands at
714.
REMIT
The Academy's prime purpose is to promote the
translation of medical science into clinical practice for patient
benefit. It is an independent, interdisciplinary body representing
the medical science community and those involved in the delivery
of health care: clinical academics, non-clinical scientists, veterinary
scientists, dentists, nurses, and the professions allied to medicine.
With such broad representation, the Academy
occupies a unique position within the research community, with
the potential to play a key advisory role to both the Office of
Science and Technology and the Department of Health. The Academy
currently enjoys excellent working relations with the R&D
Department of the DoH. It also maintains regular contact with
officials at the OST and is hoping to involve Senior Officers
more prominently in a new initiative to be launched later this
year. [See Next Steps].
In bringing together these many disciplines,
the Academy provides an intellectual focus for the medical sciences
and seeks to influence national, fiscal and regulatory policy.
Policy work is targeted at four key areas:
— research environment and infrastructure
requirements;
— recruitment and training;
CURRENT PROGRAMMES
AND ACTIVITIES
1. Scientific advice
A considerable amount of the Academy's effort
and resources is devoted to providing expert advice to Government
and policy makers. This takes many forms: printed reports, responses
to consultations, representation on Government panels and committees,
and evidence to parliamentary committees. The Academy has responded
to the following:
— Regulation of Biotechnology;
— Code of Practice for Scientific Advisory
Committees;
— R&D expenditure in Government
departments;
— openness and animal procedures;
— Phillips report: Academy paper on
issues of governance;
— livestock infections: written evidence
to the Royal Society inquiry;
— use and disclosure of medical data;
— revalidation: a response to the GMC;
— modernising the SHO grade: a response
to the Department of Health;
— Review of Appraisal, Disciplinary
and Reporting Arrangements for Senior NHS and University Staff
with clinical and academic duties: a response to the Follett report.
The Academy participated in the inquiries into
Complementary and Alternative Medicine and Stem Cells, providing
oral and written evidence.
In November 2001 the Academy was invited to
provide a briefing on medical issues for the Science & Technology
Committee of the House of Lords. Five key topics were chosen from
over 90 suggestions submitted by the Fellowship:
— new, emerging and re-emerging infections;
— vaccination—benefits, risks
and new potential;
— personal information, confidentiality
and medical research;
— organ and tissue retention for research
and teaching;
— stress—myths and realities.
As a result of this briefing, the Select Committee
will, in 2002, conduct an inquiry entitled "Fighting infection".
2. Working parties and reports
Academy investigations are carried out through
dedicated working groups. Topics for study are selected from suggestions
submitted by the Council and the wider Fellowship, drawing upon
their collective knowledge and experience. Examples are listed
below. For a complete list of publications see Annex B.
Zinc Cadmium Sulphide dispersion trials:
a report on these trials was prepared at the request of the Chief
Scientific Advisor at the Ministry of Defence. The report has
been published by the Ministry of Defence and a paper based on
the findings has appeared in the Journal of Occupational Medicine.
Career Structure And Prospects For Clinical
Scientists: a working party chaired by Professor John Savill.
[See section on Research Support.]
Academic Medical Bacteriology: a working
party chaired by Professor Brian Spratt. A group has been established
under the chairmanship of Sir Richard Sykes to oversee and implement
the report's recommendations and the Academy will be working closely
with all the stakeholders, including the Department of Health.
Non-Clinical Scientists on Short Term Contracts
in Medical Research: the report of a working group jointly
chaired by Professor Pat Jacobs and Professor Jim Smith.
A detailed report was published in February
2002: it supports and extends the recommendations of the Concordat
on Contract Research Staff Career Management, and offers some
solutions.
The Academy of Medical Sciences has also collaborated
with The Royal Society and others on areas of common concern.
The Medical Uses of Cannabis: a report
produced by a joint working party with the Royal Society chaired
by Peter Lachmann and published in 1999.
Scientific Fraud and Misconduct: a NAPAG
(National Academies Policy Analysis Group) working party chaired
by Peter Lachmann. A paper was presented to NAPAG in January 2002.
Transmissable spongiform encephalopathies:
a statement by the Academy of Medical Sciences and the Royal Society.
Published May 2001.
The Academy has also published discussion documents
on Diet and Diseases: Facts and Fantasies; its response to the
House of Lords select committee on Complementary and Alternative
Medicine; and a position paper for the Chief Medical Officer on
"Vaccines: current status and future needs".
3. Research Support
The Academy's influential Savill report (published
April 2000) led directly to a Department of Health initiative
to support mid-career clinical scientists. The DH scheme is offering
eight awards a year for five years until a steady state of 40
fellowships has been reached. The Savill report estimated that,
when fully established, some 300 clinician scientists should be
supported in the UK. The importance of this initiative should
also be seen in the context of the rising numbers that will require
clinical training in the future to meet the anticipated need for
doctors. The Academy has also set up its own Clinician Scientist
programme and is currently seeking additional awards to expand
its research portfolio. Current partners in the Academy scheme
include the MRC, The PPP Foundation, Leukaemia Research Fund,
Arthritis Research Campaign, and the Primary Immunodeficiency
Association.
The Academy is a member of the National Clinician
Scientist Monitoring Committee (chaired by Sir John Pattison,
FMedSci) and provides a professional mentoring service to the
UK's Clinician Scientist Programme for which it receives a support
grant from the DoH.
4. Meetings and lectures
The Academy has developed a broad programme
of meetings. It holds events associated with the major corporate
events in the Academy's annual calendar (new Fellows' admission
day, the Annual General Meeting), meetings around the UK for the
Fellows and colleagues, and a programme of interdisciplinary single-topic
meetings.
Regional meetings are designed to provide a
forum in which local fellows can discuss the affairs of the Academy
with the Officers. This business meeting is then followed by a
programme of scientific talks and an open discussion on a controversial
topic. Meetings have taken place in Edinburgh (1999), Cambridge
(1999), Manchester (2000), London (2001), Newcastle (2001), and
Cardiff (2001). Further meetings are planned in Leicester, Southampton
and Birmingham.
There is an annual lecture in memory of Jean
Shanks, supported by the Jean Shanks Foundation. A full list of
meetings is attached at Annex A.
5. External relations
(a) In the UK
While the Academy of Medical Sciences is firmly
rooted in its expert fellowship, it also has a role to play in
the wider society in which it operates. For the Academy to achieve
its objectives, interactions with external agencies and with the
wider public are vitally important. At all times it seeks to complement
(not duplicate) the activities of other institutions.
Working relationships and alliances have been
established with the following organisations:
— Parliamentary Select Committees;
— Council of Heads of Medical Schools;
— Higher Education Funding Councils;
— Medical Research Council;
— Health Departments—and different
divisions within those departments;
— governing bodies of the professions
allied to medicine;
— British Medical Association and others;
— Private Sector: research charities
and trusts.
The Academy collaborates regularly with its
sister Academies, either through the National Academies Policy
Analysis Group (NAPAG), or through specific activities. For example:
the Academy is officially represented on the Royal Academy of
Engineering's Biomedical Engineering Focus Group. Examples of
collaboration with the Royal Society and The British Academy through
meetings and reports are listed elsewhere in this paper.
The Academy believes that much needs to be done
to improve the presentation of medical science, particularly in
the press and media. The Academy's working group on media relations
recommended that the Academy should develop a professional and
comprehensive communications strategy in order that it can make
its views available to the public. The Academy will be seeking
funds to support this strategy.
(b) Overseas
The Academy was invited to the Inter-Academy
Panel in Tokyo in May 2002 and was a co-host with the Institute
of Medicine and the Japanese and Mexican Academies of Medicine
of the first meeting of the world's Academies of Medicine and
Medical Sciences that followed the IAP meeting. It has recently
been involved with the first global meeting of the Inter-Academy
Medical Panel in Paris 20-22 March 2002 which debated the topic
Confronting infections and antibiotic resistance around the world.
The Academy has joined the European Federation
of Academies of Medicine. Peter Lachmann was elected vice-president
for 2001-03 and will automatically become president for 2003-05.
The Academy has close relations with the Académie
des Sciences and the Académie de Medicine in Paris, co-operating
in a number of issues affecting the EU such as grace periods for
Patents, the Clinical Trials Directive, the Data Protection Directive,
and the Copyright Directive. There have been three joint meetings:
on TSEs, on Ageing and a meeting on stem cells.
NEXT STEPS
The Academy has an ambitious programme. Three
key areas are currently under development.
The Academy of Medical Sciences Forum
The healthcare sector is highly complex with
numerous interactions and partnerships, public and private. The
Academy recognises the need to work with all players and is currently
looking at mechanisms to increase the involvement of the industrial
sector in the Academy's activities. Later this year, the Academy
will launch the Forum. Its membership will be drawn from pharmaceutical,
biotechnology, medical engineering and medical IT companies and
will also embrace health products, the medico-legal and financial
sectors. Government departments, Research Councils and other sponsors
of research will be invited to join.
The key tasks of the Forum will be to deliver
the benefits of medical research more rapidly to patient care,
to foster the economic benefits of research, and to support the
medical research profession. It will be a unique facility for:
In the long term the project will be self-sustaining,
supported by the subscriptions of its members; in the short term,
however, funds are urgently being sought to pump-prime the project.
The Research Integrity Initiative
There has been widespread discussion over the
last few years on the problems of the management and treatment
of fraud and misconduct in research. This has focused largely,
but not exclusively, on scientific research and, within science,
particularly on the medical sciences. The Academy's proposal for
a Research Integrity Initiative has the support of the medical
profession and the Department of Health. A small working group
is currently being formed which will include representatives of
the major stakeholders, including Universities UK, and there are
early indications that the DoH will be willing to provide funds
to support the initiative.
Academy inquiry into "Impediments to medical
research"
Following the successful presentations to the
House of Lords Select Committee on Science and Technology in November
2002, the Council of the Academy has decided to conduct its own
inquiry into the impediments to medical research. The start-up
costs of the project will be met from sponsorship and additional
funding to cover the inquiry and publication costs is currently
being sought.
Summary
These three new projects represent a significant
step change in the Academy's developing programme and will go
far to meeting the aspirations and expectations of the medical
science community which provides such strong support for the organisation.
However, additional funding is urgently required and the Academy
will be looking to Government sources, amongst others, to support
this work.
GOVERNANCE
The Academy is a registered charity and a company
limited by guarantee. The work of the Academy is overseen by a
Council of 22 members elected from the Fellowship. This number
includes the four Officers of the Academy:
| President: | Professor Peter Lachmann
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| Vice president: | Lord Turnberg
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| Treasurer: | Sir Colin Dollery
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| Registrar: | Professor Mark Walport
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The head of the Administration is the Executive Director,
Mrs Mary Manning
FUNDING
The Academy's Fellows donate their time and expertise without
compensation. Its fixed cost is largely that of the professional
secretariat housed at 10 Carlton House Terrace (rent-free until
2003). The annual running costs of the Academy are currently around
£400,000 but will increase significantly when the rent-free
period expires next year.
A small team of five staff run the London office.
The Academy is supported by the subscriptions of its Fellows,
generous grants from Trusts, particularly the Wellcome Trust,
by income earned from services and by donations and sponsorship
for specific activities. However, any further expansion in the
scale and scope of the Academy's work (including the projects
mentioned above) will require considerable additional resources.
Mary Manning
April 2002
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