APPENDIX 87
Memorandum from Dr Steve Gamblin, former
member of the MRC Task Force on the NIMR
In the following sections I address some of
the questions posed by the Select Committee to the MRC from the
viewpoint of one of NIMR's Task Force representatives. The MRC
selected some of the Task Force correspondence for publication
on its website, some of which is marked confidential and some
of which is not. I have illustrated some of my points with Task
Force emails that were not selected by the MRC to appear on its
website. I would ask that the Select Committee gives due consideration
to the appropriateness of this material being made publicly available.
Overall, I am disappointed with the process
and effectiveness of the Task Force. This is unfortunate given
the time and expense that went into it. The main problems I perceive
were the lack of hard evidence to support the conclusions reached
and the failure to keep the process focused on the key objectives.
The latter was largely a result of handing over responsibility
for the process to consultants, and the fact that the Task Force
chairman clearly had an agenda that was not revealed to the Task
Force at the outset. Our international Task Force colleagues are
probably too discrete to say it, but our efforts to base the Task
Force's work on data and evidence were largely a waste of time.
Ultimately, however, the real problem is that the decision being
taken forward is bad for science, bad for translation of our science
and poor value for money.
Q3.1 The Task Force concluded that it wanted
the renewed NIMR to pursue an interdisciplinary approach to biomedical
science.
Data were presented to the Task Force by the
NIMR representatives which showed the very extensive cross-disciplinary
interactions already in place within the Institute (Attachment
1). This analysis is consistent with the conclusions reached by
the MRC's strategic review of NIMR in 2000 (Attachment 2) that
noted "The "added-value" of the Institute environment
was clearly reflected in the number of high-quality integrated
programmes involving interactions between different divisions
and the sharing of expertise and technologies." The Task
Force was also presented with data describing NIMR's very extensive
external academic collaborations (Attachment 3).
3.2 I am not aware that any such analysis
was carried out to compare the effectiveness of NIMR's interdisciplinary
collaborations (internal or external) with co-located medical
research institutes.
Q4.1 The Task Force was initially presented
with evidence of the extent and range of NIMR's clinical collaborations.
Schematic diagrams outlined the number and distribution of the
extensive network of clinical collaborations (Attachment 4) with
NIMR. In response to this one member of the Task Force, Professor
Steve Tomlinson, asked the NIMR representatives to provide further
information about the clinical contacts because of his expertise
in this area. Consequently, two members of NIMR staff and two
collaborating consultants from The Institute of Child Health/Great
Ormond Street presented a detailed analysis of NIMR's clinical
collaborations to Professor Tomlinson. A synopsis of these discussions
was distributed to the Task Force (Attachment 5).
Professor Tomlinson was entirely satisfied by
the extent, depth and relevance of NIMR's clinical collaborations
and agreed that for the purposes of training and research there
were distinct advantages to clinician scientists having time in
a research environment that was physically removed from the pressures
of clinics and patients. He was particularly keen on the role
NIMR did and could play in clinician scientist training.
I am unaware of any comparable data provided
to the Task Force regarding the ability or output of medical research
institutes co-located with a HEI/Hospital to transfer their science
into clinical research.
NIMR staff undertook a series of discussions
with collaborating clinician scientists to get their input into
how the renewed NIMR could effectively increase its clinical collaborations
and training. Consequently, Professor Tomlinson assisted in the
development of six specific proposals that were sent to the Task
Force and later posted on the MRC's Task Force website (Attachment
6) (not printed). These proposals were never discussed by the
Task Force.
4.2 At the fifth TF meeting a majority
(four [PN, RAF, SJG and RLB], out of the seven, TF members
present) thought that the Mill Hill site was a potential long-term
option. Subsequently, a "majority" of the TF came to
the conclusion that it was not. The email that the Task Force
Chairman sent to Steve Tomlinson asking him to withdraw his suggestion
that Mill Hill be taken forward as an equal 3rd option (Attachment
7) (not printed) makes it clear that the pressure for excluding
Mill Hill as an option came from the MRC CEO and not from the
work of the Task Force or its consultations.
4.3 After the final Task Force meeting the
MRC CEO decided to circulate the draft conclusions of the meeting
to the Chairman of the MRC and the Director General of the Research
Councils, Sir Keith O'Nions, before the Task Force had agreed
to the final version. This meant that what these individuals,
and presumably other parts of Whitehall, first saw was the draft
statement that lacked the essential clause of conditionality about
the Task Force's preference for a central London location. This
statement, proposed by Richard Flavell and supported by the Task
Force, reads ". . . However, it will be essential to develop
a partnership for this move, more attractive than possible
with NIMR at Mill Hill." This statement reflects the
spirit and intentions of the final meeting; a move to central
London was preferred if it provided better facilities and environment
for NIMR's science than could be developed at Mill Hill. The
circulation of the draft version without this crucial conditionality
seriously misrepresented a key recommendation of the Task Force.
4.4 Towards the end of preparing the final
Task Force report it became apparent that the MRC secretariat
would not correct the text to reflect the views of all the Task
Force members. The MRC CEO took the decision to send to Council,
as the final agreed version of the report, a document that he
knew the NIMR representatives did not agree with. We had suggested
various compromises that would enable our views to be incorporated
but he decided arbitrarily to omit our views. Subsequently, the
two NIMR representatives wrote directly to MRC Council members
to point out the problems with the final version of the report.
This act of omitting our well-known views from the TF final
report completely marginalized us from the process.
4.5 Before the July meeting of Council the
MRC showed the Council briefing paper to NIMR and other Union
representatives (Attachment 8). This briefing paper makes no mention
at all of the possibility of NIMR being developed at Mill Hill
or of the conditionality in the Task Force's recommendations.
The primary information given to the MRC Council was then also
seriously flawed and misleading.
Q6. The Task Force had three main streams
of input from consultation exercises.
6.1 A formal consultation exercise was carried
out for the Task Force using a questionnaire designed by McKinseys.
This questionnaire was web-based (although other types of submission
were accepted) and there were over 1,000 respondents. The numeric
analysis of this consultation was carried out by McKinseys and
is provided here in graphical form (Attachment 9). A qualitative
analysis of free-format comments written by some of the correspondents
was undertaken by an independent analyst, Deborah Holman, but
was not available to the Task Force until after its final meeting.
These comments were essentially similar in nature to the results
of the quantitative analysis.
The overwhelming majority of respondents
(85%) chose a single independent site as their preferred organisational
model with 83% preferring Option 1—enhancing NIMR at Mill
Hill with a focus on basic and translational research. In the
Independent Report on the consultation exercise it says, in the
executive summary, "1,058 consultees responded to the questionnaire,
the vast majority individuals. The organisational response was
poor."
The views of Mill Hill staff and the vast
majority (83% of 1,036) of respondents to the formal Task Force
consultation were given no weight at all in the recommendations
of the Task Force or the conclusions of the MRC Council. More
than this, the preferred option of these stakeholders was explicitly
excluded as a possible option for further consideration.
6.2 The views of NIMR staff, relating to
the various options under consideration for the final meeting
of the Task Force, were sought in a series of group interview
sessions conducted by McKinseys at Mill Hill. Reports on these
interview sessions were presented to the Task Force prior to its
final meeting.
NIMR staff unanimously preferred the development
of the renewed NIMR at Mill Hill.
6.3 The views of various individuals were
gathered by the McKinsey consultants to represent the views of
certain organisations and presented to the Task Force as interview
notes. The individuals concerned were largely selected by the
MRC secretariat. The NIMR Task Force members provided a long list
of clinicians and academics for interview but only two interviews
were presented to the Task Force although we have subsequently
discovered that at least two other nominees were interviewed but
their views were not presented to the Task Force.
Q7. Early on in the Task Force process Paul
Nurse made the argument that moving the Institute outside of the
London area would constitute de facto closure of the Institute
because most of the staff would not relocate. Overall the Task
Force seemed to be of the opinion that retaining current staff
was important because of their high quality and relevance to the
future of biomedical research. Evidence was also presented to
the Task Force by the NIMR members showing that a high proportion
of the NIMR's clinical collaborations were with clinical specialities
in London. It would therefore be nonsense, from a clinical translation
viewpoint, to move the institute out of London. It seems the
Task Force took relatively little account of the importance for
NIMR of the wealth of collaborating clinical specialities in London
since, when the final Task Force report was being prepared, the
MRC secretariat refused to include a statement to this effect
in the executive summary.
There were two main sources of data available
to the Task Force concerning a move to central London on staff
retention and recruitment. Firstly, data were presented to the
Task Force showing the very high rates of application for animal
technician posts at Mill Hill. These figures are important because
of the difficulties in recruiting to these posts in central London.
Secondly, in the interviews conducted with NIMR staff by McKinseys
and the subsequent reports presented to the Task Force, it is
clear that most of the scientific staff have severe misgivings
about moving to central London. In some sense that is predictable
in that the scientific staff at NIMR have all chosen to come to
NIMR at Mill Hill as opposed to taking up positions elsewhere.
For these staff the scientific advantages of working at NIMR in
Mill Hill are decisive and if the Institute is going to be reconstructed
in central London they would probably consider all employment
options available.
Q8. Although the initial brief said that
the Task Force should start with a clean sheet and that the process
was not driven by financial considerations it soon became apparent
that the Task Force chairman believed that only a certain sort
of recommendation would be acceptable on financial grounds (Attachment
10). It is then all the more surprising that the options available
to the final Task Force meeting had no robust estimates of the
likely costs. In fact, the Task Force undertook no cost analysis
of its own at all regarding relocation options. Such "estimates"
of capital and recurrent costs that were presented to the Task
Force were provided by the bidders. Only in the case of Mill Hill
was an independent analysis of potential capital costs provided
by external consultants appointed for the Task Force. The likely
financial implications of the two central London options that
appeared in the final Task Force report were only available to
the Task Force a matter of days before the completion deadline
and were added to the report rather than being a part of the decision
making process.
23 November 2004
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