Memorandum from Professor Chris Higgins,
MRC Clinical Sciences Centre
1. As Director of the MRC Clinical Sciences
Centre (CSC), one of the three MRC Research Institutes alongside
NIMR and The Laboratory of Molecular Biology in Cambridge, my
personal perspective may be useful in your deliberations.
2. As MRC employees, all Unit/Institute
Directors expect the MRC to review their establishments regularly,
both for research quality and for strategic priority. A particularly
thorough strategic review of any major Institute would be expected
immediately preceding the retirement of its Director or when substantial
capital expenditure is likely to be required.
3. The current strategic review of NIMR
is appropriately separate from the quinquennial reviews of research
quality, and has used different review bodies. Thus, although
some might take issue with details of the process, the ongoing
strategic review of NIMR by the MRC is entirely appropriate and
is to be welcomed.
4. Independent scientific reviews have concluded
that many of the NIMR research teams are at the international
forefront. It is therefore important for the UK that this expertise
is retained. I know from personal discussions that many NIMR scientists
will move overseas (many are receiving generous offers) if relocated
outside London or if NIMR is disbanded.
5. London offers the only location in the
UK where there is sufficient critical mass of clinical research
excellence across the board, and a sufficiently large patient
base, for all the scientific Divisions of NIMR to enhance critical
mass and clinical links.
6. I therefore concur with the MRC conclusion
that NIMR science should be renewed in some form in London.
7. Achievements in basic research over the
past 50 years (many of which have been MRC-supported) now provide
a significant knowledge base. The MRC has both the opportunity
and obligation to exploit this knowledge base to enhance clinical
research and deliver healthcare benefit. I therefore strongly
endorse the proposed change in the strategic mission of NIMR,
which calls for enhanced clinical and translation research alongside
the existing strengths in basic research.
8. Based on my experience as an MRC Director
implementing a similar mission, I have no doubt that the renewed
mission for NIMR cannot be effectively delivered by status
quo, or by "appending" a few clinicians to the existing
Institute. It has been amply demonstrated that translation of
biomedical research progresses most effectively through iterative
interactions between clinical and basic scientists working closely
together as a mix of equals, sharing laboratories, ideas and opportunities,
and understanding each others "culture". This is the
model being adopted in leading Centres in the US. This model also
enhances the quality of basic research which benefits substantially
from ideas derived from patient-based research. As clinical research
cannot be pursued effectively away from a strong patient base,
and there is no prospect of a patient base at Mill Hill, if the
proposed mission for a renewed NIMR is adopted there is no option
but that NIMR basic research should be relocated.
9. In the above context it is important
to recognise that the renewed mission for NIMR will not be delivered
simply by relocating MRC scientists to a new building close to
an academic hospital unless:
(i) the research strengths and patient base
at that hospital/institution complement the research strengths
of the basic science, and the Institution also brings additional
and essential strengths in increasingly critical areas such as
chemistry, physics bioengineering and computing; and
(ii) the Institute is fully embedded in the
host Institution with appropriate joint governance enabling joint
research strategy and appointments, shared facilities and coffee
rooms, co-investment and integrated laboratories. A free-standing,
self-governing building, even on a hospital campus, will not realise
the proposed new missiona few metres can be as isolating
as a many miles.
RENEWED NIMR IN
UK BIOMEDICAL RESEARCH
10. If the UK is to continue to compete
at the international forefront of biomedical research, NIMR science
should not be considered in isolation. Despite its influential
past and the international standing of many NIMR scientists, the
interdisciplinary nature of modern biomedical research, the need
to effectively link to clinical practice, and the increasing role
of "big" science and expensive facilities, require that
a "National Institute for Medical Research" is more
than a relatively small and isolated Institute with limited clinical
or medical infrastructure. NIMR is, after all, only around 5%
of MRC activity and very small compared with the NIH campus in
11. In my view it would be a missed opportunity
if, in renewing NIMR, the UK did not "think big" and
take the opportunity to establish a true "National Institute"
which can compete internationally in the modern world.
12. No single Institution in London (or
elsewhere in the UK) offers the range of scientific expertise
(including physical sciences and engineering), clinical research
excellence, and patient base to fully complement and strengthen
all the Divisions of NIMR. Thus, in my opinion, scientific advantage
would best be achieved by embedding individual Divisions of NIMR
at the three or four distinct locations in London which best complement
the Divisional research strengths. This would provide new opportunities
for both NIMR scientists and cognate University researchers. A
robust, overarching Governance and Management could ensure effective
co-ordination of the research of these Divisions of the Institute.
13. Additionally, it is sometimes forgotten
that there are other MRC activities in London whose research also
complements a renewed NIMR and, in sum, are more-or-less equivalent
in size and activity to NIMR. These include my Institute (the
CSC at Imperial) and the MRC Clinical Trials Unit and the MRC
Laboratory of Molecular Cell Biology at UCL. The renewal and relocation
of NIMR offers a unique opportunity to co-ordinate all of these
MRC activities with those of NIMR under an overarching governance
"umbrella", for example as Divisions of a new and much
stronger Research Institute.
14. Co-ordination of the MRC intramural
programmes across London would also serve to strengthen effective
links between the MRC the developing NHS Clinical Research Collaboration.
In conclusion, I personally believe that the
proposed renewal of NIMR, if distributed across three or four
sites in London, provides a unique opportunity to develop a research
Institute for the 20th century. Co-ordination of all relevant
MRC activities, the NHS CRC, and the consequent co-operation and
collaboration between more than one leading academic Institution,
could put in place a research base which can truly compete on
the world stagea true National Institute.
23 November 2004