Examination of Witnesses (Questions 200
- 219)
MONDAY 10 JANUARY 2005
PROFESSOR ALAN
NORTH AND
PROFESSOR NANCY
ROTHWELL
Q200 Chairman: What happened after
that? What did the Directors say or do?
Professor Rothwell: Nothing to
us.
Q201 Chairman: Nothing was said or
done?
Professor Rothwell: I had no direct
interactions with the Director.
Q202 Chairman: So do you think that
there was then constructive engagement with the NIMR staff; is
that your conclusion, looking back? Or would you do it differently
if you had to do it again, without thinking about the animosities?
Professor Rothwell: There is a
tendency to think you would do it differently and I have thought
this through quite a lot. I am not quite sure how you could do
it differently because the alternative is then to engage throughout
the process. I still think that might have been even more destabilising.
It is possible that there might have been a better outcome with
a slightly different approach or an earlier approach. That is
very difficult to say and it is very easy to be wise in hindsight.
But I still come back to the point that I think that when a group
is looking at a difficult issue, trying to engage NIMR staff at
all stages through it, I do not know if it would have been any
better or not. I am not convinced it would.
Professor North: It may be the
difficulty would have been that we would have had to engage the
Directors of all four Institutes because all four Institutes were
being considered by the Forward Investment Strategy.
Q203 Chairman: Was that discussed
at any point in your deliberations on the Committee?
Professor Rothwell: I think we
did talk about involving them more. The other issue then is whether
the engagement is just with the Director or with all of the 700
staff because the Director had been passing all the information
on to the staff—that is his choice, of course, as Director,
and he obviously thought that was his best course of action. But
we would then be trying to engage with 700 staff at NIMR and the
many hundreds at the other Institutes and, again, I am not at
all convinced that that would have been the right way to do it.
Q204 Dr Turner: Professor Rothwell,
you said effectively that you started out with an open mind and
that the Committee did not have preconceptions, but that is a
little difficult given that the MRC had just published its 10
Year Vision for the Future. That surely must have had some influence
on your thinking?
Professor Rothwell: That shaped
our general thinking about biology. We had the very strong preconceived
idea that we had to look at what was best for the future for NIMR.
We were not thinking of five or even 10 years, actually, we were
looking ahead to 20, 25 and 30 years, and of course driving that
was a lot of thinking about biology and how biology has changed
and how it is likely to change in the next 10 years. What we did
not have a preconceived idea about was whether NIMR should move,
where it should move, what size it should be, how it should
be shaped, and I think that the FIS, even at the end of its
recommendations, made a suggestion and made some general suggestions
but even then did not have detailed views.
Q205 Dr Turner: Having said that,
you evolved a template of what you thought the future pattern
of research should look like, and you could almost say, looking
at it, that it would be extremely difficult for Mill Hill in its
present form to fulfil the criteria if that template; would you
not agree?
Professor Rothwell: I would agree.
Q206 Dr Turner: Do you think it could?
Professor Rothwell: No, I think
it would be difficult in its current position and in its current
shape to fulfil that.
Q207 Chairman: Impossible, not just
difficult? Impossible?
Professor Rothwell: Slightly splitting
hairs. Very difficult.
Q208 Chairman: As an optimist you
would say that nothing is impossible.
Professor Rothwell: Of course!
We were looking at what would be best for Mill Hill 30 years from
now.
Q209 Dr Turner: When you were looking
at the shape of the MRC scientific future did you do any sort
of cost benefit analysis—for want of a crude word—because
clearly we are talking about investing large resources? Did you
consider which kind of option would provide the best value for
that investment in scientific terms for the future?
Professor Rothwell: The primary
driver was the scientific value. Any discussions about costs were
very much secondary and not in any detail at all. It was what
would deliver the best science, which was first and foremost in
all of the discussions.
Professor North: I think it is
really difficult to envisage a cost benefit analysis, which is
projecting 15 or 20 years into the future. I think we can only
be guided by what we felt would be the major drivers in terms
of improving the scientific environment, which were largely interactions—interactions
with clinical people, interactions with basic physicists, mathematicians
and so on.
Q210 Dr Turner: Clearly one of your
first considerations is in fact clinical links and the facilitation
of translational research. What evidence do you have to show that
actual co-location produces the best results?
Professor North: I think it would
be quite difficult to move forward on the basis of evidence because
if all science progressed on the basis of published evidence then
progress in fact would be rather slow.
Q211 Dr Turner: It is.
Professor Rothwell: It would be
even slower!
Professor North: It would be even
slower, so obviously where evidence exists one has to take it
into account. I think it is very difficult to look for evidence
of what will be more effective in 15 or 20 years' time. But I
think there was a sense around on the Committee that the way that
medical research is now being done and is likely to be done in
the next 10 or 15 years is changing, and it is changing very quickly,
and I think one of the reasons that it is changing quickly—one
of the reasons—is because of things like genomics. Technology
is changing extremely quickly. This means that it is much easier
now to make links between human disease and fundamental mechanisms
than it was 15, 20 years ago. I think it was the vision based
on this that was in many ways directing our ideas rather than
hard evidence that co-location of clinicians and basic scientists
works.
Professor Rothwell: Could I just
add that I think a lot of the decisions were based on the collective
experiences of the Committee, which, put together, were really
quite extensive. I think most, if not of all, of us have had experiences
of working on single sites and on large sites. I worked in fact
in a hospital and medical school but it was an isolated hospital
and medical school and I would never want to go back to that situation.
I did clinical research and what I did not have there was the
link with the fundamental scientists. Co-location does not automatically
mean collaboration but it makes it easier. I have just moved into
a new building where I am co-located with a lot of colleagues
and within weeks it has made a difference to me, just having the
students able to bump into people. It will not automatically help
but it certainly can help.
Q212 Chairman: Are you saying that
none of this went on at Mill Hill?
Professor Rothwell: No, I am not
saying that none of it went on, nor am I saying that isolated
sites do not produce outstanding science; what I am saying is
that the likelihood of it improving is significant with co-location.
Q213 Dr Turner: Is there not a risk
with co-location that it can also be, as it were, straightening
because not all clinical institutions cover the entire spectrum
of clinical science, they all have their specialities and their
areas of excellence, whereas you are taking an Institute of basic
research which covers a very wide range of disciplines? So although
translational research and collaboration may be facilitated for
a part of that Institute by putting it next to whichever hospital,
is there not a danger that you may inhibit or change direction
for the rest of the Institutes?
Professor Rothwell: Quite the
reverse actually. A major part of our rationale behind relocation
was inter-disciplinary fundamental research. It is interesting
that you called it an Institute of basic research; it is an Institute
of Medical Research—that is its name. So it was not just
the translational clinical, it was also the proximity to basic
scientists, to physical scientists that was considered to be important.
Professor North: I think it is
an important point that you have made, that Mill Hill focuses
on a few things, which it does spectacularly well; but it does
not cover the whole breadth of basic medical research. Clearly
for an investment of £27 million a year you do not get more
than a few strengths in focused areas.
Q214 Dr Turner: Did you actually
as a Committee regard the future of the Mill Hill site as unsustainable?
Professor Rothwell: I think it
is summarised very well in our report that we did not find compelling
evidence for it to stay there. It may be in the end that in any
decision you identify your three best choices and none of them
work out, for a variety of reasons; but I think the statement
was a very true reflection of what that Committee felt, that there
was not compelling evidence that this was the best place for NIMR
to be, and I still think that is true.
Professor North: In 15 or 20 years'
time.
Q215 Dr Harris: The MRC Vision talks
about this move towards more translational research and indeed
even though the Vision was published around the some time you
were doing your work you probably would have been aware of that
shift. It could be said that you decided, or it was the view of
both the FIS and to a certain extent the Task Force that that
means co-location and that is the be all and end all in the move
to translation, if you can show the OST and the DTI that you are
doing that, and tick the boxes. I would like to ask how much consideration
was given within the FIS and indeed generally to issues around
how grants are awarded as a way of ensuring that there is a move
to translational areas or individuals or the focus of other Institutes
as well.
Professor North: I do not remember
any discussion of that kind in FIS. In fact I do not remember
any discussion about OST. It was in the Vision and we certainly
took the Vision seriously.
Q216 Dr Harris: But the remit was
just to look at it?
Professor Rothwell: The remit
was to look at the long-term future of these four research Institutes;
that was the specific remit. The issues about grants are being
dealt with under other Committees or by Council itself. Coming
back to your point, I think the OST probably would not be happy
with ticks in boxes, the OST looks for actual outcomes and looks
for discoveries and translational discoveries and ability to treat
disease. So I do not think co-location is the solution.
Q217 Dr Harris: That comes a bit
later. What I am saying is that if they see that the MRC are taking
radical steps of considering big capital projects that might be
seen to be in a way that is more discernible than other things
which are much more fluid to be acting on this initiative. I am
not saying it is a bad thing.
Professor Rothwell: It was not
part of our consideration.
Q218 Chairman: But did your considerations
change during the meetings with FIS? Did the remit change? You
started looking at Mill Hill in the light of the Director's retirement,
and then it seems to me that you moved on to other research institutes
as well—MRC Institutes.
Professor Rothwell: No, the initial
remit was the long-term future of the four research institutes;
that is what we were set up to do.
Q219 Dr Harris: Do you think that
the MRC has put as much work into these other issues, like the
focus of Institutes, whoever they are, and grant policy as it
is put into issues around the long-term capital investment and
co-location and issues like that in respect of the agreed need
to move to translational research?
Professor Rothwell: Yes, I think
it probably has in different ways. I am no longer a member of
Council, I am a member of the Training Board and that has paid
a lot of attention to translational and clinical research. But
it has been in other parts of its activities. There is no doubt
that NIMR has taken a huge amount of time for staff serving on
the sub-committees of Council and Council and perhaps more time
might have been spent on the other issues if this had not taken
up time. This has taken up more time than I think was predicted.
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