APPENDIX 128
Supplementary evidence from Professor
Colin Blakemore, National Institute for Medical Research
Comments on Sir John Skehel's Letter of
15 December (Appendix 125)
Comments are in italics.
1.
I'm puzzled. Sir John's copy of the Stoker
Report appears to have been specially edited to remove all references
to Stoker's strong support for a move of NIMR into association
with the CRC or its proposed successor—a new clinical research
centre with the Royal Postgraduate Medical School at the Hammersmith
Hospital. I have attached a pdf copy of the Stoker Report, so
that the S&T Committee can judge the accuracy of Sir John's
statement.
The sentence that I quoted ("This should
be achieved by the move of the NIMR"), which Sir John seems
to imply is an invention, appears in Para 3.4:
"As we have already pointed out, the
Council's original intention in establishing the CRC was that
there should be strong basic research on site and that this should
be achieved by the move of the NIMR to Northwick Park."
This clearly refers back to Para 2.14, from
which the other sentences that I quoted were drawn:
"We next examined whether, as the Council
had originally intended, it had indeed proved possible to bring
together at the CRC an `adequate and appropriately comprehensive
concentration of clinical and pre-clinical subjects' and were
agreed that in formulating this concept of linking clinical with
basic research it had shown remarkable prescience. Because of
the way medicine is developing it is of crucial importance, if
clinical research in the UK is to remain internationally competitive,
to apply the new techniques of the biological sciences—for
example those of molecular and cellular biology—as an integral
part of the study of an ever increasing number of clinical research
problems."
The S&T Committee will see from the unedited
Stoker Report that, contrary to Sir John's assertion, there are
many references to the suggested move of NIMR, throughout the
document. For example:
Paras 1.2-1.3: "We therefore turned
to the Council's memorandum, submitted to Ministers in September
1959, which sets out the arguments which led to the proposal to
create a new clinical research centre. At that time the Council
put forward as its ultimate aim the "bringing together in
one place of an adequate and appropriately comprehensive concentration
of relevant clinical and pre-clinical subjects . . . At that time
the Council examined the possibility of building a hospital at
Mill Hill in proximity to the existing National Institute for
Medical Research (NIMR), but did not pursue this as it was clear
that the surrounding area would not provide enough patients. However,
it was clear that the chosen site should have sufficient space
eventually to accommodate the transfer of the NIMR"
Para 4.1: "The new national centre
should be formed by merging the best of the CRC, the RPMS and
the NIMR on one site. This would provide a centre of excellence
where clinical research and postgraduate training can be pursued
to internationally competitive standards. The NIMR component would
provide not only a yardstick of excellence but also the skills
and techniques necessary to exploit to the full the unparalleled
scientific opportunities for advances in clinical science."
Para 4.3: "While there are in our
view exceptional attractions in suggesting that the essential
basic science component of the new centre be provided by the NIMR
from the outset, we have already established that its move is
only likely to be acceptable if the inevitable physical disruption
were reduced to a minimum. We urge however that the integration
of the NIMR into the new centre should remain a long-term objective"
Conclusions 6.1 vi: "There are great
attractions in providing the basic scientific component of the
new centre by moving some or all of the NIMR to form part of the
new institution. If this does not prove possible it should remain
a long-term objective."
I trust that the members of the S&T Committee
will ask why Sir John has misrepresented the facts in such a way
as to try to convince the Committee that I was lying and that
the Stoker Report did not recommend moving NIMR into association
with a research-active hospital.
I have it on good authority that no serious
suggestion of a move of NIMR to Northwick Park was made to my
predecessor and certainly neither on my appointment in 1987 nor
in the 17 years since then has the Stoker report or any suggestion
of transfer of NIMR from Mill Hill been mentioned to me by MRC,
until I was given the FIS subcommittee report on 31 March 2003.
I suspect that Professor Blakemore is wrong
in all his conclusions on the Stoker report and that as a new
CEO he may be fighting yesterday's battles for yesterday's men.
Again, this comment from Sir John is a curious
version of reality. Para 3.7 of the Stoker Report states:
"In his discussions with us, the Director
of the NIMR [ie Sir John's predecessor] was clear about the undoubted
benefits to clinical science of a merger with the CRC."
The Stoker report, as the S&T Committee
will see, makes it clear that the MRC had planned since 1959 to
move NIMR into association with a research-active hospital, and
the Stoker Committee strongly recommended that such a move should
eventually take place:
Para 4.3: "We urge however that the
integration of the NIMR into the new centre should remain a long-term
objective"
Stocker's recommendations included:
"There are great attractions in providing
the basic scientific component of the new centre by moving some
or all of the NIMR to form part of the new institution. If this
does not prove possible it should remain a long-term objective."
It was the cost of a move a the time that
led the Stoker Committee to conclude that it should be delayed,
and they pointed out that the fabric of the building at NIMR "can
be expected to last without major repair for some twenty years."
That was written nearly 20 years ago.
Again, I ask the S&T Committee to consider
why Sir John misrepresents the facts in this way.
2.
John Savill gave simple factual evidence
to the Committee. He pointed out that there are only nine clinically
active scientists out of a total of about 750 staff at NIMR, while
the Clinical Sciences Centre had recruited 54 clinical fellows
(out of a much smaller total staff) at its quinquennial review
this year, Professor Savill's own Centre for Inflammation Research
in Edinburgh, with only 200 staff, had recruited 33 clinical training
fellows and 13 more senior clinicians in the past five years,
and UCL has 189 clinical training fellows and 22 clinical scientists.
Sir John quotes an anonymous source at the CRC as saying that
"many Hammersmith clinicians are affiliated with the
CSC". This does not, however, explain away the surprisingly
poor record of NIMR in attracting bright young clinicians for
research training. Why are so few clinicians affiliated to NIMR?
(b)
I was not at the MRC at the time of the last
QQR of NIMR, but what I can say is that it was concerned with
scientific achievement from 1996-2001 and with specific proposals
for research from 2001-06. What Sir John and the senior staff
at NIMR still seem unwilling to recognise is that the strategic
review conducted by the MRC, through the work of the Forward Investment
Strategy committee and the Task Force, is concerned the coming
20-50 years. When Drs Lovell-Badge and Gamblin were asked at the
first meeting of the Task Force to describe the mission of NIMR
they said that NIMR had no explicit mission. It just did "good
science". The OST requires that Research Councils conduct
strategic reviews of their institutes, specifically examining
their scientific missions and asking, in each case, whether and
why an institute is needed to fulfil the mission. In the case
of NIMR, both the FIS committee and the Task Force recommended
that the long-term vision for NIMR lies in more translational
research, in close partnership with a university and medical school.
This vision has been unanimously endorsed by the Council. I do
not understand why Sir John is appealing to funding decisions
that were made nearly five years ago.
To some extent Professor Savill and the CEO
are importing an issue, which will of course be addressed by NIMR
in the appropriate future reviews. This is also the case for Professor
Blakemore's additional comment on the proportion of NIMR budget
that derives from sources other than MRC. Our performance and
strategy in this regard were also endorsed by MRC for the 2001-06
period.
Again, I cannot comment on endorsement on
performance nearly five years ago. I simply pointed out a fact—that
the fraction of NIMR's income that derives from other sources
(about 9%) is low compared with most MRC units/institutes. The
hope of the Task Force was that this could be improved by a move
into close association with an HEI/hospital and by appropriate
governance arrangements.
3.
I draw the attention of the S&T Committee
to the conclusion of the Stoker report in 1986, namely that the
fabric of the building at NIMR "can be expected to last without
major repair for some twenty years." The Ove Arup survey,
to which Sir John refers (described in an appendix to the Task
Force report), concluded that, over a 20-year period, "Strategic
refurbishment (to `well-found' standards) and limited new construction"
on the Mill Hill site would cost £159.9 million, including
maintenance and utilities, while "phased replacement of existing
buildings by new construction" would cost £172.8 million.
It would be very unfortunate, in my opinion,
if the MRC were to make such an important decision about the future
of its largest single recurrent investment simply on the basis
of the capital cost. Over a 20-50 year period, the recurrent costs
(currently £33 million per annum) will enormously exceed
the capital cost of refurbishment or a new building. If a new
building in central London significantly enhances the future potential
of the institute, as concluded unanimously by the Task Force,
it must surely be the right thing to do. And in any case, with
the possibility of a significant contribution to building costs
from the host HEI and with a probable contribution from the capital
value of the Mill Hill site, it seems certain that a new building
in central London would be less costly to the public purse that
the major refurbishment or rebuild that will be needed at Mill
Hill in the 20-50-year time-frame.
December 2004
| 
