APPENDIX 73
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
|
