Select Committee on Science and Technology Written Evidence


Memorandum from Professor Adrian Newland, Royal College of Pathologists

  1.  The MRC's remit of strengthening Clinical Research is an important one in the current climate. This is particularly crucial, at a time when Academic Medicine is under acute pressure, with the loss of over a third of the lecturer posts, and professorial vacancies approaching 80. It is increasingly apparent that research should not only be basic, but needs to link in with the clinical research undertaken in teaching hospitals, with a significant element of translational research, with more focused clinical goals. The stated aim of the proposals of the MRC for the National Institute of Medical Research, in increasing the number of Clinician Scientists with closer clinical links, will help achieve this. It is clear that a major lead in this area from the MRC will send an important message to the Government and to the academic community.

  2.  There are a number of potential options for the relocation of the site at Mill Hill. Of course, it should be considered as to whether Mill Hill should remain as the main academic site, but it is clear that, over the last few years, although producing some reasonable research, has rather lost its way, and has become isolated from the main academic community, and has provided less of an academic lead, as would have seemed appropriate for an institution of this size and importance.

  3.  The option of re-providing the development on a single site, in association with an academic clinical institution, is attractive. This would retain the intra-institutional interactions currently seen at Mill Hill, but would have the added value of clinical links.

  4.  The single site would be the preferable option; however, if this is not viable on cost grounds, then consideration could be given splitting the institution into smaller coherent elements, and placing these where they would get added value. It would, however, have to be considered whether the loss of interaction between the units is important, and this would, of course, have to be considered following an assessment of to what degree and with what success this currently occurs. It would have to be considered whether this loss would be offset by the value of placing the units within institutions most likely to enhance their value, and would, of course, bring other additional links into play.

  5.  There needs to be considerable flexibility in considering the future of the NIMR and its research direction. Flexibility is the key, as in an envolving research environment, priorities change, and there needs to be an ability to adapt and exploit these. This however, would occur on the background of an established research direction, with appropriate technology that would not differ much from the current areas of research. Although Cancer is widely supported in academic research, there could be value in adding the Cancer agenda into the research themes, but the actual direction should be left to a new Director, with his advisory team.

  6.  The importance of the proximity of a teaching hospital cannot be overestimated, as the development of strong clinical links in achieving the strategic remit of the MRC, is vital. In order to properly exploit translational research, close links with a hospital would be important in developing the contacts and having the discussions that make such a transition possible. In addition, in order to increase the number of Clinical Scientists, which is the stated aim of the project, to attract them and use them most efficiently, such close clinical links are crucial. This would be difficult to achieve on a remote site.

  7.  An important role of the renewed institute, particularly with its potential increase in size, would be to be involved in the training of clinical academics, and could be the focus of the development of the National Training Numbers for Academics Scheme currently being considered by the Academy of the Royal Colleges.

  8.  A major role of the institution would be by acting as a focus for training clinical and non-clinical scientists. Co-ordinating key areas of biomedical research is also important, as by having appropriate areas of expertise, it would be possible to flexibly respond to any sudden new developments. This can be illustrated by our inability to react and exploit the few cases of SARS in the UK when they occured, which was unlike some of our European counterparts.

  9.  The development of the new institution should not be at the expense of basic scientists, but there should be an increase in Clinical Scientists, while maintaining those basic scientists with whom they would work and interact. The increase in numbers would take into account movement into newer areas such as Cancer.

  10.  The management of the new institution would be crucial and it will be key to attract a Director of international standing, with enough scope to direct the institute, but with an influential scientific advisory board, who can shape the elements of the institute over time. If the institute is to achieve excellence in a number of areas, then there needs to be a strong advisory board, although it is clear government by committee is rarely successful, and there needs to be a strong director to lead and shape the institution. It goes without saying that there needs to be a strong professional team to take the scientific aims forward.

  11.  The institute, as it currently stands, has become relatively insular, and isolated from clinical progress and translational research, and has not been the leader that would be anticipated for an institute of its size and reputation. A renewed institute with strong clinical links, is crucial for the development of academic research and in supporting academic medicine. In order to achieve, this co-location with a research active hospital is vital. This could be on one site, if such can be identified, or, as a secondary option, could be on more than one site, alongside one or more universities and their associated hospitals. However, this would not be the preferred option.

  12.  The MRC has made a bold attempt to reinvigorate the research output from the NIMR, which has understandably met opposition from internal vested interests. There is an element of complacency in the response to this, and the committee needs to make a bold attempt to support this development and allow this exciting endeavour to be taken forward. This can only be to the benefit of academic medical research in this country.

17 November 2004

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