Select Committee on Science and Technology Written Evidence


Memorandum from Professor Sanjeev Khrishna, St George's Hospital Medical School

  1.  I write to the Select Committee from the perspective of a Clinician-Scientist who is actively collaborating with groups at NIMR. My comments are therefore limited to this viewpoint, rather than addressing the wider and deeper implications of siting research carried out in NIMR. The goal of stimulating research that can provide clinically relevant benefits is a very important one that deserves to be pursued aggressively. Now that large-scale genome, gene expression and proteome databases are available, they are proving to be an invaluable resource for the study of the diagnosis and mechanisms of disease. For example, I work with Dr D Fernandez-Reyes (Division of Parasitology, NIMR) on the analysis of complex datasets from proteomic fingerprinting of serum samples to identify biomarkers of infection with tuberculosis. We will extend the work to patients with malaria. In this way, we are addressing a key challenge in the biomedical sciences to design mathematically robust methods of discovering relationships among complex sets of data derived from patients. The benefits for future diagnosis and treatment strategies are immediately obvious to those concerned with these important diseases. Our multidisciplinary approach relies on computational biologists, molecular biologists and clinicians being members of an interdependent research team. How do these observations relate to the proposed move for NIMR?

  2.  A National Institute for Medical Research that is an internationally recognised flagship of scientific excellence already provides a flexible scientific resource that is itself multidisciplinary and responsive to new collaborations. If NIMR were moved to an alternative site in proximity to a teaching hospital, it is difficult to see how busy clinicians concerned with the priorities of the NHS could find additional time to focus on cementing strong links with a new infusion of basic scientists. There is also a potential danger that a site considered "excellent" from the clinical perspective today, may lose that cachet when competing NHS priorities commit expertise away from research.

  3. I suggest an alternative approach. A rapid way in which science may be interfaced with clinical problems is to promote Clinician-Scientist positions in two ways. First, to increase their overall numbers, and secondly to stimulate support for work to be based in NIMR in collaboration with groups who would be keen to develop such links. In this way, an outstanding sheltered training environment becomes available for Clinician-Scientists. This will allow new relationships to form between clinicians and the basic scientists at Mill Hill, led by the importance of scientific questions rather than any lesser priority. If this view finds resonance, then there may be no clear national benefit from having NIMR in central London, either in terms of scientific productivity or value for money. Disruption of the current scientific programmes that would result from this move can be avoided.

22 November 2004

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