Work of the Forward Investment
Strategy Subcommittee
19. The FIS Subcommittee met four times before presenting
its report to the MRC Council in March 2003. In developing its
proposals, the FIS Committee took as its "primary scientific
reference point" MRC's ten year strategy, A Vision for
the Future. It then developed a template for optimal medical
research environments to deliver international excellence over
the next 10-15 years, based on the following principles:
- Importance of appropriate 2-way
academic, clinical, and industrial linkages;
- Ease and breadth of on-site interdisciplinary
collaborations;
- Issues of added value/opportunity cost;
- Optimal scale/size for MRC institutes;
- Financial flexibility—preserving scope
for MRC to move quickly to capitalise on new scientific opportunities;
and
- Focus on fewer locations with a view to providing
first rate infrastructure and crucial mass for training/career
development, but retaining scope to support high quality research
wherever it can best be done.[32]
Consideration of the options
20. The FIS Committee concluded that, when assessed
against this template, the case for maintaining Mill Hill on its
present site was "not strong".[33]
It gave two reasons:
NIMR at its present location may be too isolated
from clinical and other academic units to compete and remain as
attractive to scientists; and
The cost of maintaining the institute would have
significant implications for MRC's future financial flexibility.
21. Future research environments had to present significant
opportunities for multi-disciplinary work, strong clinical and
academic links and opportunities for translating research into
the health service and the commercial sector.[34]
It concluded that "in terms of opportunity cost, a new smaller
investment in a clinical multi-disciplinary environment for the
Institute would be likely to deliver a similar volume of science
and greater value for money in the longer-term".[35]
It recommended that the future scientific programme of NIMR should
be developed on a university/medical school site at Addenbrooke's
in Cambridge.
22. The FIS report is important to the current proposals
because it enunciated the principles upon which the Task Force
was asked to build in its consideration of a broader range of
options. In our view the report from the FIS committee does not
provide convincing evidence that it explored all aspects of its
remit with the vigour necessary to back up its conclusions. The
FIS committee did not appear to question in detail the principle
that interaction is necessarily improved by physical proximity.
The written evidence that we received was very divided on this
point: some, including Professor Rothwell, took the view that
interaction between clinician and scientist must be easier if
they are both based on the same site.[36]
Others argued that co-location could often lead to "a dilution
of focused effort"[37]
and that "translation is largely an intellectual process
that transcends distances".[38]
We recognise that the arguments are complex and deserve thorough
exploration in order to see if a consensus can be established.
Instead, it seems to us that the FIS committee took as its starting
point its perception of an ideal research environment, as derived
from the MRC ten year strategy, and did not question it. Given
this template, and the principles on which the committee based
its work, it was inevitable that the Mill Hill site would not
match up to the ideal environment for medical research, with its
focus on clinical/academic links. Professor Rothwell confirmed
that it would be "very difficult" for it to meet this
template.[39] The FIS
committee did not explore thoroughly the scenario whereby institutions
could retain independence whilst having the flexibility to pursue
their own relationships with multiple clinical centres of their
choice. We have not re-examined all the pros and cons of the principle
of co-location in great detail: the Task Force undertook this
difficult job. We would hope, however, that the argument put forward
by Professor North that Mill Hill was "physically becoming
isolated" was, given the progress of modern communication
technology, at least thoroughly explored by the FIS committee
before it reached its conclusions.
23. The issue of value for money was one which might
have been expected to be considered closely by the committee,
given that one of the drivers behind the FIS process was to meet
OST's demands for better long term capital investment planning
over a 15 year period and to underpin a bid for the 2004 Spending
Review. As we have mentioned, the FIS committee concluded that
one of the reasons for proposing a move from the Mill Hill site
was that the likely investment required for NIMR to remain viable
at Mill Hill had "significant financial implications for
MRC's future financial flexibility" and that "a new
smaller investment in a clinical multi-disciplinary environment
would be likely to deliver a similar volume of science and greater
value for money in the longer term".[40]
There is no evidence adduced in the report to support these conclusions.
We were told that there was an assumption in the FIS committee
that London might be more expensive[41]—not
an argument that the Task Force found persuasive—but we
saw no supporting evidence or research to back up this assumption.
The level of investment required to maintain the buildings at
Mill Hill was later the subject of some dispute in the Task Force
and did not seem to be the subject of an informed estimate by
the FIS committee.[42]
Given the conclusion referred to above about value for money,
we were surprised to hear from FIS Subcommittee members that costs
were not considered "in any detail at all".[43]
Professor North told us that it would be difficult to envisage
a cost benefit analysis projecting forward for 15-20 years.[44]
There was some discussion of the potential of co-located institutes
to share infrastructure costs but "no detailed financial
considerations".[45]
Witnesses explained that the primary driver was scientific value
and getting the best research.[46]
24. Like other Research Councils, MRC has a responsibility
to delivering the best science it can using the resources made
available to it. No research funding council can sensibly divorce
its consideration of the different options for delivering its
science from the costs of each one. There may have been a case
for the move to Addenbrooke's based on the reinvestment of the
revenue accruing from the sale of the Mill Hill site at a different
location or locations. But such a case was not set out in the
proposals. Cost should not necessarily be the driving force behind
change in any review of investment in science but it has to at
least be carefully considered. We were told by members of the
committee on the Forward Investment Strategy that their work was
"not about money", and yet cost was one of the two reasons
given for its conclusions. It is regrettable that confusion over
the justification for the conclusions of the FIS review was allowed
to develop.
25. Similarly, we are not persuaded that the recommendation
of a move to Addenbrooke's was thoroughly thought through. In
the FIS committee's report, the suggestion is made right at the
end in the context of investment at Addenbrooke's. There is no
indication that other locations outside the golden triangle between
London, Oxford and Cambridge were considered, or that the implications
for existing staff at NIMR were considered. This was a major omission,
given that the Task Force subsequently concluded that the importance
of maintaining a critical mass of existing scientists at NIMR
was such that a move away from London could not be considered.
Professor Rothwell told us that London was considered but was
thought to be too expensive.[47]
She made a distinction between the FIS report, which put ideas
down for consultation, and the work of the Task Force, which carried
out "a much more detailed in-depth analysis".[48]
We accept this distinction but it shows that MRC were prepared
to put forward firm proposals without conducting the in-depth
analysis necessary to justify and explain them. Our concerns about
the superficiality of the FIS process were reinforced by Professor
North, who told us that it was "difficult to proceed"
on the basis of the evidence.[49]
He argued that science would not progress very quickly if evidence
was needed to be produced to support any change to the status
quo. The break-up of a world renowned national institute and
relocation elsewhere is a risky strategy. It should not be proposed
without the most careful consideration and assessment of all the
costs and benefits. The FIS Subcommittee report did not provide
the level of detailed consideration that was required to support
such a radical proposal.
26. It could be argued that the FIS report was only
a consultation document. At the time, the MRC Council described
it as a "valuable starting point for discussion with a wide
range of stakeholders—this consultation is therefore the
start of an ongoing dialogue. MRC Council intends that the report,
and the discussions which now follow, will provide a template
for more detailed planning to be developed at the four sites,
as well as a backdrop for discussions on future partnership opportunities
at other sites".[50]
Although ostensibly for discussion, the report's tone suggested
that the consultation was not to be on the necessity of a move,
but on the details of negotiation with potential partners. For
some, it had an air of certainty about it which proved difficult
for MRC to dispel until the proposals were withdrawn following
the consultation exercise.
27. The remit of the FIS Subcommittee was focussed
very specifically on investment at four sites. This did not allow
the committee to consider the relationship between MRC policy
in taking forward its strategic goals with investment at these
sites. We repeatedly asked MRC what other methods of achieving
its goals of increasing its focus on translational and multi-disciplinary
research were considered, apart from the move of NIMR. For example,
the MRC could have explored the potential for reorganising its
funding to establish new research units in hospitals; or for altering
its criteria for awarding research grants; or for refocusing of
the aims of other institutes, such as the Laboratory for Molecular
Biology. Asked whether MRC had put as much effort into considering
these other possibilities as it had into investment in institutes,
Professor Rothwell said that "I think it probably has in
different ways",[51]
but MRC did not provide us with any evidence to support this.
In answer to our specific question MRC replied as follows: "The
increasing emphasis on translational approaches, in MRC as in
most medical research funding agencies in the UK and around the
world, gathered momentum in 2002-03 and was articulated in the
MRC 10-year Vision published in 2003 following stakeholder consultation.
The strategy has had and will continue to have implications across
the MRC portfolio, not just at NIMR."[52]
We find it surprising that MRC is unable to say what these implications
might be. They were certainly not considered by the FIS Subcommittee.
Indeed, the proposal for the establishment of the FIS Subcommittee
made no reference to the strategic review which was the subject
of consultation at the same time. Witnesses told us that the Subcommittee's
focus was on the future of NIMR rather than the wider picture
of the role of the institute in the reorientation of MRC's strategy.
They did not discuss this latter issue at all. We were told that
it was for other committees to consider policy relating to grant
awards.[53]
28. The MRC has a range of policy levers it can use
to implement its vision for the future but each has an impact
on the others and they need to be used in a co-ordinated way.
The review of its physical infrastructure is one such lever, but
it appears to have been considered in isolation. There seems to
have been a recognition at MRC that the ten year strategy would
have an undefined impact on policy. However, MRC would not constitute
a coherent attempt to devise a set of policies which, taken together,
would ensure that the strategy was implemented. By asking the
FIS committee to focus only on how its facilities might best meet
the vision it has established, MRC fuelled concerns in the minds
of some there was a preconceived agenda in relation to Mill Hill.
More importantly, it did not given the impression that it was
taking a holistic and comprehensive approach to realising the
vision of the future that it had agreed with its stakeholders.
Relationship with Quinquennial Review
29. The 2000 quinquennial review of NIMR is cited
by many of those opposed to the move of NIMR as evidence that
the institute was performing well: the review recommended no strategic
shift in its research. The Director of NIMR refers to the last
review and states that he recalls no discussion at the time on
the need for any additional review.[54]
In its evidence, MRC points to a distinction between the focus
of the quinquennial reviews on research strategy and quality for
the following five years and the demand for a strategic review
of capital investment for the longer term. It also states that
the strategic review was needed well in advance of the retirement
of the Director in 2006. It describes the ongoing review of NIMR
as part of the MRC's "normal approach to forward planning
and strategic review of its intra-mural investment".[55]
Professor Denton, a member of the Task Force, suggested that quinquennial
reviews were "not the perfect vehicle for tackling strategic
longer-term considerations" and argued that a review of the
mission, site and size of major institutes every twenty years
was vital.[56] Professor
Rothwell told us that quinquennial reviews often look at long-term
infrastructure issues, although not in detail, and noted that
the 2000 review of NIMR raised some specific concerns on this
front.[57]
30. It was clear from the evidence we received that
the proposals for NIMR to move were viewed in many quarters as
an implicit or indirect attack on the quality of science there.
The vast majority of the submissions we received commented on
the high quality of the science conducted at Mill Hill; only three
raised any criticisms.[58]
In evidence, MRC witnesses told us that the reviews were not about
the quality of science.[59]
Professor Blakemore's private view was given in an email to Professor
Tomlinson in March 2004 in support of his argument for a federated
option in London for NIMR. He said: "Mill Hill has lost its
edge. The work there is good, but not consistently world-class.
It's not as good as LMB [Laboratory of Molecular Biology], yet
its "mission", to the extent that it has one, is very
similar to that of LMB. So, it's hard to justify continuation
of the huge slice that it takes from MRC funds without a reorientation
in a way that defines a distinct scientific mission and that makes
it more effective as a NATIONAL facility".[60]
Witnesses from the FIS committee confirmed that their job was
not to judge the quality of the science there and that this message
was repeatedly put across to staff at NIMR.[61]
Whether this message got through to staff there and the wider
medical research community is open to doubt. We have gained the
impression that staff there felt under threat from the start,
rather than being engaged in an exciting process of renewal of
their valued institute. The perception that the work of NIMR
was under attack by the FIS process was allowed to build up. The
inability of MRC to convince the staff at Mill Hill that it valued
the work conducted there contributed to the deterioration in relations
that was to occur over the ensuing months and represents a regrettable
management failure.
Engagement with NIMR
31. There have been suggestions that NIMR did not
engage fully with the FIS process as it continued and thus that
the proposals that emerged came as something of a shock. MRC's
evidence states that the principles on which the FIS committee
based its work were agreed at its first meeting in November 2002,
after which the Directors of the Institutes affected were invited
to discuss them with the committee. The FIS committee had a meeting
with NIMR staff and with the Director before developing its detailed
proposals which were published in April 2003. It is not clear
how far the nature of the proposals under development was discussed
at this meeting, but NIMR reports that until 31 March 2003 "we
were unaware of any proposal to relocate NIMR and, therefore,
had not engaged in the development of this proposal".[62]
32. Each of the Directors affected by the FIS report
was sent an advance copy of the report on 31 March, with visits
by MRC management planned for the following day—two days
before publication—to explain and consult. The MRC evidence
states that "in the event, the Director chose to circulate
the report to all staff at NIMR in advance of the meeting. Heads
of Division walked out of the meeting without any engagement.
Subsequent engagement with staff, including some meetings between
NIMR scientists and FIS members, demonstrated that resistance
to the FIS propositions was implacable and led to the decision
to take a different approach to engaging NIMR staff in discussions
in the Task Force".[63]
The NIMR evidence states that the Heads of Division walked out
of the meeting when the MRC Chairman "failed to reassure
the Heads of Division of the possibility of reversing the FIS
recommendation by consultation".[64]
Subsequently, NIMR reports that it participated fully in the consultation
process.
33. Professor Blakemore's experience was somewhat
different. In the visits to Mill Hill that he made in order to
meet staff before he took up his position he noted the "unwillingness
of Sir John and senior staff to engage with the MRC".[65]
Members of the FIS committee told us that there was engagement
with staff at NIMR, for example, on visits to Mill Hill, but acknowledged
that the Director was not consulted until near the end of the
process.[66] Professor
North, a member of the FIS committee, told us that when the committee
visited NIMR around the time of the publication of the proposals
"there did seem to be a perception around that minds had
been made up" in spite of committee members' assurances that
this was a draft for consultation.[67]
34. The FIS committee did consider whether to give
the institutes involved more information about its developing
views before publishing the consultation paper but decided against
it. Professor Rothwell thought that this would have been more
destabilising and "even more damaging".[68]
Even in hindsight, she was not convinced that this would have
been a better option. We disagree. Earlier informal discussion
with NIMR staff may have given the FIS committee some indication
of the pitfalls of their proposals which were brought out in the
subsequent consultation process and were serious enough to cause
MRC to withdraw the proposals.
Conclusion on FIS process
35. We have already discussed how the different rationales
cited for the FIS process may have cast doubt on its integrity
in the minds of some at the outset. Even without such doubts,
it is essential for any organisation contemplating radical
change to engage with those affected from the start in order to
persuade them of the case for change and to maintain the morale
of the workforce. MRC failed to do this adequately in the case
of the FIS Subcommittee and thus passed up the chance to work
with NIMR to effect change in a consensual manner. Greater engagement
throughout its work may have fostered a more co-operative attitude
at NIMR from the start, although there is evidence to suggest
that some staff there were intent upon resistance, whatever the
merits of the case. By seeming to impose change on a surprised
and unconvinced work force, MRC lost the confidence of the staff
of its largest institute. This in turn coloured the attitude of
NIMR to the future efforts of MRC to consider the issue afresh
and contributed significantly to the increasing fragility of their
relationship.
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