Annex 5
Memorandum from the Medical Research Council
(MRC)
COMMENTS ON
SPECIFIC QUESTIONS
A: The impact of HEFCE's research funding
formulae, as applied to Research Assessment Exercise ratings,
on the financial viability of university science departments
1. The RAE is designed to build on strengths
which, as a general policy, is one that the MRC strongly supports.
However, from the biomedical sciences perspective, the process
leads to significant losers in certain key areas. While it is
of course open to Universities to allocate their QR funding as
they see fit, for example to build up disciplines or subjects
that have not been rated at the highest levels, this often does
not happen, no doubt for internal political and financial reasons.
The current RAE process disadvantages Departments whose research
is likely to have most direct impact on policy and practice, particularly
in the area of health: health services research (HSR) and the
professions allied to medicine (PAMs). Universities do not invest
in these areas as they know that it is unlikely to get them any
money via RAE, so they go for much "safer" things such
as genetics and stem cells. This has meant that in many medical
schools clinicians have been replaced by basic scientists in key
positions.
2. Such research is usually multidisciplinary,
which brings added disadvantages in the way the assessment is
applied. Also, the RAE goes against collaboration, as it places
greatest weight on the grants and publications of individuals
in a single institute. There is not only not a great deal of incentive
for people to work across universities in a spirit of collaboration,
there is actually a disincentive as the host universities regard
it as wasting time when they should be getting grants and papers
in for them, not other institutions. In addition, the relevant
departments are often newer ones, and/or in new medical schools,
and/or in the less research-intensive universities. If such departments
are rated at 4 or below in the RAE, it is difficult for them to
receive the funding they need to meet the country's knowledge
needs and to produce a research-informed workforce.
3. In relation to these, and possibly similar,
areas a major problem with the RAE is that it scores people and
departments on whether they are of international standing—which
usually means publishing in high impact international journals.
But of course lots of HSR should be judged not in terms of international
science, but of local relevance. Thus, for example, very useful
(for the NHS) research on referral patterns in British general
practice can never expect to get into the New England Journal
of Medicine but, at best, might appear in the British Journal
of General Practice which many (including RAE panels) would regard
as a "national" journal. Thus almost by definition,
much research in primary care in the UK cannot be international:
so universities simply close down these Departments (witness the
dire straits of primary care departments/research in London).
In part, this a problem of new departments with little critical
mass and research tradition (see above), but it is also partly
inherent in the work they do (and should be doing). Whilst the
Select Committee may be more interested in (say) chemistry than
HSR, we would like to use this opportunity to make the point that
the RAE has been harmful to much applied health research where
the target, mainly of necessity, has been a "local"
problem.
4. On a couple of more general points:
(i) The timeframe of the RAE makes it difficult
for Universities to plan long-term; it may take several years
for an activity to lead to outputs that would receive the highest
ratings—for example, establishment of tissue banks, data
archives, or population cohorts may take more than one RAE cycle
to start to deliver—and this will affect viability.
(ii) The RAE does not currently distinguish
between departments with upward trajectories (which should be
deserving of more support) and those with static or downward trajectories
(which may not). Again, while in theory this is in the hands of
individual universities to address, in practice they may not be
well placed to.
B: The desirability of increasing the concentration
of research in a small number of university departments, and the
consequences of such a trend
5. The MRC supports the concentration of
research in a small number of university departments. This becomes
increasingly important with the tightening of funding. In order
to deliver, departments must have a critical mass. Also, multi-disciplinary
research usually requires a concentration of expertise. Nevertheless,
not all research-intensive universities can be excellent at everything,
and it is important that the system allow for, and encourages,
pockets of expertise elsewhere.
C: The implications for university science
teaching of changes in the weightings given to science subjects
in the teaching funding formula
6. No comment.
D: The optimal balance between teaching and
research provision in universities, giving particular consideration
to the desirability and financial viability of teaching-only science
departments
7. It is difficult to define an "optimal
balance". As stated in the comments above, the MRC supports
the concentration of research in a small number of university
departments. This will mean that the balance in the research-intensive
universities will be (relatively) weighted in favour of research.
Nevertheless, we also believe that the conduct of research within
a department will improve the quality of the teaching. For example,
it will help to attract higher quality staff (though the best
researchers are not necessarily the best teachers) and will make
the teaching environment more research-aware and the teaching
itself more up to date with recent findings. Certainly research
students (Masters and beyond) need to be taught in a department
in which a substantial volume of research is conducted.
E: The importance of maintaining a regional
capacity in university science teaching and research
8. Regional capacity per se is generally
not a major concern to MRC. We will fund the best science wherever
it is. However, for knowledge transfer to SMEs, there is likely
to be benefit in close proximity between the SMEs and the researchers.
We see this mainly as an issue for individual universities and
the RDAs/DAs. Also, patients benefit if the hospital they attend
is a teaching hospital (ie with a medical school), which often
means they are also tertiary referral centres. Thus there is a
case for medical schools not to be too closely concentrated. Indeed
it has been Government policy for many years to match the location
of medical schools to patient populations, thereby helping to
reduce (geographical) inequalities in health.
F: The extent to which the Government should
intervene to ensure continuing provision of subjects of strategic
national or regional importance; and the mechanisms it should
use for this purpose
9. As a matter of principle, we support
the independence of the Funding Councils from Government Departments.
Government should be cautious in believing it might be better
able to judge this issue than the Funding Councils and the Universities
themselves. However, we believe the Funding Councils, together
with UUK, do have a role in taking a strategic and coordinated
approach to the continued provision of subjects of strategic national
or regional importance; this should not be left to the individual
Universities to decide on their own. However, this is not a simple
matter. Universities must have the freedom to re-shape their Departments
or other internal structures to meet national needs and to respond
to developments in the science. It is not simply a matter of keeping
say Chemistry Departments as they are; the types of chemist needed
in 10-15 years' time may be very different from those needed now.
This requires a long-term view of what national needs will be
in the future and how the markets for graduates will develop.
For example, the country's "need" for phycisists would
not be met if all physics graduates found employment in the city.
All this leads to the conclusion that the Funding Councils should
use their financial powers to achieve the strategic goals, and
that not all funding should be formulaic.
SUSTAINABILITY OF
THE RESEARCH
BASE IN
BIOMEDICAL AND
HEALTH SCIENCES
10. Biomedical disciplines have clearly
benefited from the overall increase in investment in life sciences
research, and life sciences have not suffered the drop in numbers
of students at undergraduate level experienced in mathematics
and the physical sciences. However, there are particular areas
of the academic base, discussed in detail below, which give cause
for concern. Weaknesses and the shortage of research capacity
in these areas must be addressed if investments in scientific
research are to deliver benefits for health, healthcare and the
economy.
INTEGRATIVE PHYSIOLOGY/PHARMACOLOGY
11. In vivo experiments using animal
model systems are required to build on past investment in genomics
research and develop a full understanding of the function of genes.
Progress in drug discovery and development also requires in vivo
work to test the rationale and safety of new therapeutic approaches.
The reductionist focus of biological research in recent years,
combined with the activities of animal rights activists and the
increasing costs of animal work has led to a significant decline
in the numbers of people experienced in, and able to teach, whole
animal work. The Association of the British Pharmaceutical Industry
(ABPI) identified a lack of graduates or PhDs with experience
of in vivo work as the most crucial skills gap experienced
by their members. ABPI has found that in 2004 only eight UK academic
departments provide in vivo education at undergraduate
level, and that 30% of all academics qualified to teach in
vivo work will retire within the next five years. Concern
is so great that a consortium of pharmaceutical companies has
set up a fund to support in vivo research and training,
and is looking for partnership with Research Councils (MRC and
BBSRC), charities and HEIs to address this problem, and it is
important that RCs are able to support this initiative.
CLINICAL AND
TRANSLATIONAL RESEARCH
12. Several recent reports[38]
have identified the need to strengthen clinical research capacity
in the UK, both to ensure that benefits of the explosion of knowledge
of basic disease mechanisms can be translated into benefits for
health and the National Health Service, and also to ensure the
UK remains an attractive location for the pharmaceutical industry
to invest in R&D. This has led to the establishment of the
UK Clinical Research Collaboration and the commitment of significant
additional funding via DH for clinical research infrastructure.
The ability to deliver clinical benefits based on the basic science
research MRC has funded is threatened by a shortage of experienced
clinical and translational researchers and a lack of recruitment
of young doctors, dentists and other clinically qualified staff
into a research career. A 2003 survey[39]
of UK Medical and Dental Schools showed that since 2000 there
has been a 30% decline in the number of clinical lecturers in
Medicine and Dentistry in and a 17% loss in the overall number
of clinical researchers. Many clinical academic posts remain unfilled
at a time when the teaching burden in medicine and dentistry is
set to rise significantly (eg a projected increase of 40% in the
number of medical students). Shortages of academic trainees are
particularly acute in certain disciplines, for example pathology,
obstetrics and gynaecology, dentistry and public health medicine
(see below). A recent report from the Royal College of Paediatrics
and Child Health[40]
also highlighted a shortage of research capacity in paediatric
pharmacology, which maps onto a UK Clinical Research Collaboration
priority area. These capacity problems require concerted action
from the Royal Colleges, the Department of Health, HEIs and the
major funding bodies in medical research to address issues of
career structure and other barriers to clinical research careers.
MRC is actively involved in various stakeholder groups trying
to find a solution to these issues, and additional funding for
training and capacity development in clinical and translational
research will be required. MRC proposed various initiatives in
our SR2004 clinical research bid, including the development of
a cadre of "research translators" with new skill mixes.
PUBLIC HEALTH
AND HEALTH
SERVICES RESEARCH
13. The Wanless report[41]
identifies the weakness of the evidence base on the effectiveness
and cost-effectiveness of public health interventions as a major
constraint to further progress in improving public health and
the effectiveness of the NHS. A DH survey in 2001[42]
concluded that, although research capacity in this area had increased,
there was still a lack of expertise in statistics, epidemiology,
social sciences and health economics. The CHMS report shows that
public health medicine has been particularly badly affected by
the recent decline in clinical academic staff, with a 32% decline
overall and a 59% decline in clinical lecturers between 2000 and
2003. A recent DH committee reported a significant shortage of
health economists, estimating an unmet demand of at least 50.
The weakness in public health research is due in part to its low
status in the medical and research community (and in the RAE)
and the lack of commercial or financial rewards from this type
of research, which means that the majority of investment has to
come from public funds. MRC has had a major initiative to increase
investment in "Health of the Public" research since
1998 and has been running an earmarked fellowship scheme jointly
with DH to help increase research workforce capacity for some
time, but further action is undoubtedly required.
DEPENDENCE ON
THE RESEARCH
BASE OUTSIDE
MRC'S REMIT
14. MRC endorses the point made in the EPSRC
annex that progress in medical sciences depends on a strong research
base in the physical sciences. There is a particular need for
people trained to a high level in mathematics and physics to apply
their skills to medical research questions, in areas such as mathematical
modelling, structural studies, imaging and informatics. A strong
research base in chemistry is also necessary for sustaining progress
in medical research, not only to underpin development of new therapeutic
and diagnostic agents but also for the design of new molecules
used as research tools for manipulating biological systems. MRC
is therefore also concerned about the sustainability of the research
base in physics, chemistry and mathematics.
38 Strengthening Clinical Research, Academy of Medical
Sciences, Oct 2003. Bioscience 2015: Improving National Health,
Increasing National Wealth. Bioscience Innovation and Growth Team
(BIGT) 2004. Back
39
Clinical Academic Staffing Levels in UK Medical and Dental Schools,
Council of Heads of Medical Schools and the Council of Deans of
Dental Schools, May 2004. Back
40
"Safer and Better Medicines for Children-Royal College of
Paediatrics and Child Health; May 2004". Back
41
Securing Good Health for the Whole Population, 2004. Back
42
National Academic Public Health R& D Capacity Survey for
England 2000/01 J.Weeden et al. Back
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