Select Committee on Science and Technology Written Evidence


APPENDIX 100

Professor Iain Robinson, National Institute for Medical Research

  I write to submit my views on the future of the NIMR. I have worked at NIMR for more than 25 years and have seen how the MRC and this Institute perform under different CEOs and Directors in response to changing scientific and funding climates. As a current Head of Division (HoD), I have helped to construct, and strongly endorse, the views of the letters and statements from the HoD committee which you will have received, and I will not rehearse those arguments in detail here. Instead I would like to bring to your attention some broader concerns.

NIMR AND CLINICAL TRANSLATION

  1.  There is justifiable interest in evolving structures that will result in an increased pace and effectiveness of translating scientific discoveries into clinical practice. The question is how best to do this, and how NIMR could increase its effectiveness in this regard. I comment on this as a scientist long engaged in exploiting two way translation and training across the science/clinical translation interface, running a Division containing both scientifically and clinically qualified staff, and benefiting from many discussions with hospital-based clinical colleagues in the UK and overseas, engaged in this activity. The NIMR's written proposals to the Task Force for improving clinical translation were adopted in large part verbatim in the Task Force's final recommendations for this major driver for change. I contributed heavily to these proposals, which are based on the premise that changes to NIMR to bring about long-term increments in translational capacity must be achieved without damaging the environment that fosters the scientific discovery process, and involves moving bodies, not brickwork. Most of the investment in the London university biomedical sciences is already channeled to Institutions already embedded on campuses with Hospitals. If despite this physical proximity, we have not avoided a deficit in UK translational capacity, why would relocating NIMR to a hospital site (to produce more of the same) improve this? What evidence did the Task Force obtain that physical relocation of a multidisciplinary independent science Institution, already interacting with many hospitals, would improve its clinical interactions by being adjacent to one hospital as part of a single HEI?

  2.  The primary problem for clinician scientists is their training and career development within the clinical academic environment, and protection of their time both whilst they are performing science, and also once they return to an environment with heavy NHS demands. Without this, the next generation of clinical scientists will not be able to capitalise in practice on their training. This is not something that relocating NIMR to a hospital will address, and requires serious discussions between MRC and the relevant clinical training authorities and the NHS. Indeed, and as I can testify in practice, the effective insulation from NHS demands that the location of NIMR at Mill Hill currently affords its young clinical visitors in training, is highly prized: close enough for regular contact—not too close for conflicting distractions. It is essential that the MRC take a long hard look at what already works well in practice at NIMR and why.

  3.  MRC already has a major investment in its Clinical Sciences Centre (CSC) on a University/Hospital campus, whose focus is clearly towards clinical translation. It is not clear how the Task Force recommendations distinguish its vision of NIMR from that of the CSC, and how their location enhances their clinical translation activities, compared with those at NIMR. Does the MRC want to turn the NIMR into another CSC? If so, what would it lose and at what cost? If it is important to build more capacity in late-stage patient-based research (which can only be done on a hospital site) why no mention of the possibility of investing new funds on several embedded small clinical research facilities, at clinical centres of excellence in different specialties, rather than on a single hospital site, and making a separate smaller investment in developing the capacious Mill Hill site. Several senior clinicians, including those in Institutions bidding for NIMR have said to me that this would be a good way forward, not requiring the massive investment that moving NIMR would entail without any obvious increment in clinical research facilities.

SCIENTIFIC CULTURE

  4.  A difference in approach that has emerged in discussions with potential partners is worthy of discussion. NIMR addresses very many areas of science, with relatively small groups representing different areas of expertise. Experience has shown that this size allows ready interactions between all the Divisions on a daily basis—indeed it is difficult to avoid! The NIMR concentrates on forming critical mass in interdiscisplinary interactions, through its lack of internal funding barriers or competition. In discussions with several HEI colleagues, it appears they have placed more emphasis on intradisciplinary focus, for example wishing to house all the developmental biologists together in one place, the structural biologists in another, immunologists in a third etc. This is the antithesis of what we experience at NIMR, and in my view less likely to facilitate truly cross-disciplinary interactions. As most of the work in Universities is externally funded there is a level of competition amongst similar groups which can impede free exchange of unpublished data. The alternative collaborative culture at NIMR takes a long time to establish, and MRC risks losing this by embedding NIMR in a much larger HEI culture. This may be fine in principle, but in practice it will eventually lose its independence, not least in the minds of potential collaborators from competing HEIs.

BROADER MANAGEMENT ISSUES

  5.  I believe that the disaffection with the current MRC management approach extends beyond NIMR, and has lost the unquestioned confidence of the medical and scientific communities that once used to admire and respect this organisation. As an MRC PhD student 30 years ago I joined an organisation intent on encouraging high quality scientific and clinical research arising from the community to whom it listened. In my view the current MRC style sets too much store in an amateurish corporate ethos, where mission statements, vision statements, scoping exercises and target setting distract the organisation from concentrating all its efforts in finding and supporting the best science. Rather than listening to its communities before formulating policy, the MRC has drifted towards more directed research initiatives and strategies formulated by internal committees, communicating these in a top-down inappropriate fashion, both with its own staff and with the wider biomedical community.

  6.  As evidence, I cite the FIS review of NIMR. There was no consultation with the scientists at NIMR as to what their vision was, recommendations were made to move NIMR at half the size to Cambridge to "improve" clinical translation. This was decided without the FIS committee (who were Council members) informing themselves of any of the extensive existing clinical interactions that already existed at NIMR. Following a hasty public consultation exercise which condemned the decision and the process, this was abandoned. When I questioned senior MRC administrative staff about this, I was told it was better to announce a strategy without consultation and wait for potential criticism, rather than consult first. Why do I bring this up now? When the Task Force was set up, the FIS recommendations in respect of NIMR were to be set aside. I now understand that the evaluations of the relative merits of the bids specifically for the renewed NIMR will be guided by the principles of FIS, a steering committee of Council members aided by a consultant, and decided by Council without external advice on the real merits of the bids. There will be no further reference to the Task Force whose recommendations for a move were conditional on improvements over what could be achieved at Mill Hill. They presumably have some criteria in mind. What are they? This continued lack of clarity does not inspire confidence that MRC has learnt from its mistakes.

  7.  Whatever the rights and wrongs, the public record shows a clear breakdown of trust and respect between the MRC CEO and his staff at NIMR. I believe one underlying contributory problem is that the scientific/clinical members of MRC Council are drawn exclusively from the university-based part of the MRC funded community, so that the many intramural staff at MRC Institutes have no direct representation on Council. This has been justified as avoiding conflict of interest, but this is entirely specious, since the University-based members are often actual or potential recipients of MRC funding. They are not disinterested parties when considering intramural v extramural spend, or independent Institutes v embedded university groups. I do not for one moment suggest that Council members have behaved in anything other than exemplary fashion—they are eminent people working hard for MRC and have a difficult job to do. My point is that Council composition lacks balance. By having some input from its major intramural Institutes, some misunderstandings and lack of communication that now characterises the relationship between the MRC CEO and NIMR might have been avoided.

  8.  I hope that as a result of this enquiry, it will not be too late for the Council to think again about a straightforward open and transparent comparison of the costs and benefits of the Mill Hill option (not "an enhanced base case" ) with the other two bids from KCL and UCL, and to take some external independent experienced advice on the merits of the cases.

23 November 2004





 
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