Examination of Witnesses (Questions 200-219)
PROFESSOR CHRIS
THORNS, DR
JOHN STEPHENSON,
SIR LESZEK
BORYSIEWICZ AND
MR STEVE
VISSCHER
31 MARCH 2008
Q200 Mr Cawsey: Chris, do you have
anything to add to that?
Professor Thorns: The VLA is an
important stakeholder in this because our virology department
is co-locating to the Pirbright site. We very much welcome this
but we have similar concerns. We feel that the cost is spiralling
almost out of control in terms of capital investment. We have
concerns on the effect that would have on reducing the scope of
the project but also, as Steve said, we are most concerned that
any future CSR bid includes the running costs of these organisations.
For me one of the major lessons learned from Pirbright is that
these facilities cost an awful lot to run and maintain and often
organisations like ourselves are given the capital investment
but then everybody forgets the extra money needed to run these
facilities such as expensive maintenance costs and annual capital
charges.
Q201 Chairman: You are not even being
given the capital funding. It appears to me as Chairman of this
sub-Committee that out of site out of mind yet again. We had a
major problem last summer; everyone runs around like the proverbial,
everybody accuses everybody. We have X number of reports which
have come from Callaghan et al and here we are saying nine months
later that we cannot put the capital funding together even though
the site at Pirbright is like a building site at the moment. Do
you share my frustration?
Professor Thorns: The VLA does
share your frustration. It is common knowledge that VLA, whilst
very much welcoming this, we have always preferred—as the
Anderson review says—a complete merger between VLA and IAH
in a new organisation with a new identity, but nevertheless we
fully support this. We, like Professor Martin Shirley, are finding
that more and more of our budget is going to fixed costs like
the maintenance budget and less and less to the science.
Q202 Mr Cawsey: You mentioned Anderson
and the idea that there should be National Institute of Infectious
Diseases. Is the future of the IAH now decided or is this still
up for grabs and, if so, would that be a desirable move?
Mr Visscher: In terms of being
decided, no is the firm answer. There is one other review which
is on-going at the moment which was commissioned by BBSRC from
a pool chaired by Sir John Beringer. This was to look at the risk
management funding and future governance of the Institute of Animal
Health. In that context it follows on very much from the Anderson
review which, as you say, is suggesting a single institute for
infectious disease. We feel that is a move in the right direction
and, as to the detail of how that institute is put in place, we
very much hope the work of the Beringer Panel will be able to
help us find some good solutions. Professor Beringer presented
his interim conclusions to the BBRSC Council in February and he
will report formally next week. I am sure that is a report that
can be made available to the Committee if you are interested.
Some of the key messages I expect will flow from the Beringer
report are the importance of having a stable, sustainable funding
stream with a profile of three to five years forward look so there
is continuity in funding. The governance arrangements do need
to be clarified and there are some suggestions emerging for an
interim way through the IAH governing body, inviting BBSRC to
act as a corporate trustee in the short term pending long term
arrangements. I think Beringer will also propose that there is
a clear animal health and welfare strategy for the science related
to this area. That is something that is missing at the moment
and we regard it as very good advice. In the longer term I think
he may well float the idea of bringing together a new agency that
pulls together the various interests both for surveillance and
research and tackling outbreaks into an expert group. If that
were to happen then one model would be for that expert body, with
its stable funding stream, to be responsible for managing and
overseeing the new institute with funders such as BBSRC providing
funding on a reliable basis.
Q203 Mr Cawsey: It strikes me that
we are perhaps putting the cart before the horse here. Should
we really not be deciding whether or not we have the IAH or we
have a National Institute before we get too bogged down with the
capital and the revenue funding of it. We seem to be going down
one line at Pirbright, trying to get the additional funds to make
that re-build work, but you seem to be saying that you need something
else anyway. Should we not make that decision first?
Mr Visscher: I think all these
components have to come together. The funding which has been going
into this area from the BBSRC has been rising and is set to rise
because we recognise it as an area of huge importance. I know
from talking with colleagues in Defra today, the Defra budget
is under some pressure and that poses real challenges going forward
both in terms of a long term view and the ability to commit when
there is still on-going funding uncertainty. I think all the components
of us being sure on the infrastructure and the funding for that,
the running costs and clear governance and a clear strategy for
the whole area are absolutely crucial to the way forward. We believe
we have a real opportunity here to put these new arrangements
in place which will serve the UK well for the future.
Q204 Chairman: We have had reference
to this lack of certainty over funding in terms of the replacement
for Pirbright and the Institute of Animal Health and Veterinary
Laboratory Agency, et cetera. Do you think we have sufficient
capacity in the UK for research on dangerous pathogens now and
in the future?
Sir Leszek Borysiewicz: That is
a good question and it is one I posed originally to ensure that
we created a group with the Health Protection Agency to examine
how much capacity and what is the projected requirement for capacity
for the very reasons already identified, which are that the costs
of running these facilities are extremely high and we have to
make sure we use them effectively. I am looking forward to receiving
that particular report. For the work the MRC is currently undertaking,
there is sufficient capacity. We would obviously invest in more
if there was a greater call for it. At the present time our Category
4 and Category 3 facilities deal with the capacity that we require
as a research council.
Q205 Chairman: Dr Stephenson, do
we have sufficient capacity in your view, particularly at Level
3 and Level 4 containment facilities?
Dr Stephenson: At the moment,
if all the facilities which we have in hand are capable of running
at full capacity I believe we do, but that is a very big "if".
As Sir Leszek has pointed out, the MRC and ourselves are running
a review right now chaired by Professor George Griffin, Chairman
of ACDP, to find out exactly what the capacity is and what the
future requirements are.
Q206 Chairman: Do you not find it
strange that we do not know that? The Government does actually
not know that. We found it difficult finding out how many laboratories
there actually were and where they were situated. Do you not find
it strange that we now have to have George doing a full inquiry
to try to find out whether we have sufficient capacity?
Dr Stephenson: I think that we
have sufficient capacity for what we want to do at the moment.
At Porton we are in the position that our current facilities are
ageing and that is why we have a site development plan which I
think you saw on your visit a few weeks ago. We are looking ahead
and at the moment we are finding that because those facilities
are ageing the downtime for refurbishment and maintenance is getting
longer and longer and longer. At the moment we are just about
okay but looking into the future—which is what this review
is focussed on—we want to ensure that we have capacity.
Crystal ball gazing is difficult and therefore we want to include
as many people in that as possible. We have a variety of issues
to consider. In the last 20 years there have been 60 new human
pathogens which have been discovered, some of them with fundamentally
different biological properties—as Dr Gibson pointed out
for the prions—where we cannot use our standard inactivation
procedures so we have to have different inactivation procedures.
With global warming coming on the scene as well there will be
more pathogens coming into this country which we do not have the
facilities to handle at the moment. We want to look to the future
and that is what this review is about. If we do it now then hopefully
we will not be wrong footed.
Q207 Chairman: Professor Thorns,
let us just say that there is a huge expansion of blue tongue,
the virus really starts to spread. There are 40 million sheep
in the UK and if we get the sort of outbreak that is quite possible,
do we have the capacity to deal with that?
Professor Thorns: I think we do.
Q208 Chairman: At the same time African
horse sickness suddenly starts to appear.
Professor Thorns: I would not
want to see an explosion of CL 3 and CL 4 facilities in this country;
I would rather see the current facilities maintained and updated
properly. IAH and VLA working together have demonstrated that
we can deal with large animal disease crises such as foot and
mouth disease and blue tongue and I think we should focus on the
facilities that we have, making sure that we have not just the
facilities but the skills and expertise of the experts in dealing
with that. For me Professor Griffin's review will be extremely
informative.
Q209 Chairman: Should we have one
strategic organisation that looks after all Level 4 animal and
human containment laboratories so there is one organisation that
pulls all that together? Is that your solution?
Professor Thorns: No, but I think
there should be a strategic overview where people can interrogate
a single database to identify where those facilities are in the
UK. I think it is more about smarter using of what we have and
maintaining to the top notch quality what we have.
Q210 Chairman: Between your two organisations
are you quite capable of doing this? Do you speak to each other?
Dr Stephenson: Indeed we do. In
fact there has been a major new grant on pandemic flu which is
funded by the Department of Health, and peer review carried out
by the Medical Research Council which has substantial input from
both the Health Protection Agency and our Centre for Infections
and from the VLA laboratories at Weybridge. We work very closely
together. I sit on the Statutory and Exotic Viruses Committee
for the VLA and there are many, many cross-fertilisations there.
I think there is a difference between setting up a common regulatory
framework; I think that is viable and highly desirable. To set
up one enormous organisation to cover everything I think would
be too big; the demands on the veterinary community are different
from the demands on the human community and that would be too
large to be workable. We need to continue to work closely together
as we are doing at the moment.
Q211 Chairman: Let us discuss human
pathogens in large animals. There was going to be a new facility
at Pirbright which was going to deal with that area of research;
this has now been shelved. Does that mean that we do not regard
that as a threat? Or is it purely because UK plc can no longer
afford to have these high level facilities?
Professor Thorns: I am sure you
will ask Martin Shirley afterwards. My understanding was that
there was never to be an ACDP 4 large animal facility in the new
Pirbright programme. Currently there are plans for a small research
laboratory and a small animal facility for working on mice and
other small animals. I have to question whether we need a large
animal facility for ACDP 4 in this country. I think we would need
to consider facilities in Europe and elsewhere.
Q212 Chairman: As far as the human
health research community goes you feel there is sufficient level
for facilities and therefore you would not be looking for a new
one with any new facilities.
Sir Leszek Borysiewicz: At the
present time what is important is that we actually maintain the
facilities that we have got, bearing in mind the specific needs.
I would like to come back to the example that you gave about blue
tongue becoming endemic in the United Kingdom. What would happen
then is almost certainly the categorisation of blue tongue would
also drop down and therefore you could handle it in facilities
that are much lower than Category 3 and Category 4. What is really
important with Category 3 and Category 4 is to be able to predict
how many of these facilities we require in order to handle those
rare and very dangerous pathogens. Over and above that we must
make sure we have the right security systems around those as they
are developed. That is why I say that at the present time the
MRC is quite confident with the capacity that we have got. We
are also confident about expanding that capacity within the experimental
frameworks in which we operate. When you get into the large questions,
that is precisely why we joined with HPA to carry out this review.
Q213 Dr Iddon: To carry on the Chairman's
line of questioning, could I ask you whether it would be possible
to carry out a post mortem, if it proved necessary, on either
a large animal or a complete human being in any of these Category
4 facilities, assuming it was a Category 4 virus?
Dr John Stephenson: In terms of
human beings post mortems would not be carried out in the Category
4 research facilities but we have one high containment hospital
at Coppetts Wood and we are developing another high containment
hospital on the Royal Victoria Infirmary site at Newcastle. At
Coppetts Wood there is the possibility to carry out a post mortem
on a whole human body but not in research facilities, they are
not designed to do that and that would not be the appropriate
place to do it.
Q214 Dr Iddon: What about animals?
Professor Thorns: In animals there
is very limited facility to deal with post mortems at Category
4 level.
Q215 Chairman: Is there any?
Professor Thorns: I do not believe
there is any in this country. That particular situation will often
be dealt with in situ where the animals may well be incinerated
or buried depending on the local risk assessments.
Q216 Dr Iddon: Is it not considered
necessary by the professionals to have such facilities for animals?
Professor Thorns: It is not my
particular expertise but nobody has come to me yet to say that
we need large animal Category 4 facilities.
Q217 Dr Iddon: I think I have seen
photographs of one such facility in Germany.
Professor Thorns: Yes.
Sir Leszek Borysiewicz: Could
I just add one thing? Where it is a Category 4 pathogen for animal
transmission alone, I would be in favour if we require this sort
of pathology, especially where the safety of the operator is a
concerned. Where there is a possibility of transmission between
species, particularly to the operator—then there is a need
for such a Category 4 facility. I do not think anyone would be
implying that we would carry out such a post mortem in the field
and put operators themselves at risk.
Q218 Dr Iddon: Let me turn now to
the location of Category 3 and Category 4 facilities. We obviously
cannot give the positions of where they are at the moment, but
are they in the right places at the moment or is there any consideration
being given to perhaps putting one where one is thought necessary
but absent now?
Professor Thorns: For me I think
the location of Category 3 and Category 4 laboratories is part
of an overall risk assessment. It is one important component.
There are other equally important components which include availability
of scientific and support expertise, the availability of maintenance
staff, the closeness to emergency services and other support teams
and communication links. Also what is very important is getting
the right builders and designers in the first place. For me the
location does not always have to be in the middle of a city or
a suburban area; it is part of the risk assessment. Personally
I do not have a problem with a Category 4 facility sited in a
fairly highly densely population provided the risk assessments
are transparent and have been carried out properly.
Q219 Dr Iddon: Is that the general
view or do other panel members dissent from that? First of all,
are they in the right place? Should we have them in large cities?
We have met some controversy about this from other people giving
evidence and everybody knows, Sir Leszek, that your organisation
is thinking of bringing one into central London, although there
are, we are told facilities in central London now.
Sir Leszek Borysiewicz: There
are and I would just repeat my previous comments in relation to
this. At the present time, as I stated at a previous meeting of
the Committee, we have not put in a specific proposal in this
regard. We are awaiting the considerations of a scientific committee
to determine whether that science is actually necessary on that
site and obviously before going further full security and other
requirements would have to be considered. It is very important
that we are not pre-judging the need or otherwise of such a facility
as I made clear on a previous occasion.
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