Proposal to combine basic and clinical research funding into one agency sparks disagreement over how to manage the money
By Stephen Pincock | August 2, 2006
The British government's plan to combine the research budgets of the primary funding agency of basic biomedical research and the state-run health service -- the Medical Research Council (MRC) and National Health Service (NHS), respectively -- has been largely welcomed this week by the country's scientific establishment. But strong differences of opinion remain about how the funds should be administered.
On Wednesday (August 2), the Royal Society and the Academy of Medical Sciences published a joint report supporting the plan, which was first announced in March by Chancellor Gordon Brown. The combined fund will reach at least £1 billion a year and be jointly held by the Department of Trade and Industry and the Department of Health.
In recent months, a review chaired by David Cooksey, a former governor of the Wellcome Trust, has been examining how the single fund would be implemented. In their submission to that review, the Royal Society and Academy of Medical Sciences point out that the UK's recent achievements in basic biomedical science have not been matched by developments in clinical research.
"Therefore we recognise the advantage of linking two organisations to administer the budget and in doing so harnessing the resources represented by the NHS and the world-class status of the MRC," Keith Peters, President of the Academy of Medical Sciences, said in a statement.
Perhaps the biggest benefit of the plan is that it could make better use of the £750 million allocated each year to research and development in the National Health Service, said Ole Petersen, vice president of the Royal Society and a physiologist at the University of Liverpool.
"The reality is that nobody knows how much of that money is actually used for research," Petersen told The Scientist. In fact, most ends up being diverted for delivering patient services and maintaining infrastructure, he said. "Under the new arrangements, the hope is that the allocation of money will be transparent. That's why most people see it as an opportunity."
By bringing together basic biomedical science funded by the MRC with the bedside clinical studies possible within the NHS, the single fund also offers a chance to bridge the spectrum of research from "the bench to bedside and back again to the bench," noted Leszek Borysiewicz, vaccine researcher and deputy rector of Imperial College London. "By bringing these two areas together there is a chance for real synergy," he told The Scientist.
The tough question is how the fund will be managed. "There are a variety of different models being proposed," said Borysiewicz. "I think there's a genuine debate going on about them...and this is a very difficult challenge for David Cooksey to bring them all together."
The Royal Society's view is that two councils should jointly administer the money -- the MRC and a new Health Innovation Council -- under a unified board. One benefit of this is that it avoids disruption of current operating procedures in the MRC.
For its part, the MRC said in its response to the Cooksey review that a key aim should be to build links between basic and applied research, and stimulate the transfer of scientific discoveries into clinical benefits for patients. It also urges that however the joint fund is managed, it should be at "arm's length" from government.
Meanwhile Research Councils UK (RCUK), the strategic partnership of the eight Research Councils, added that from its perspective, the new funding should be part of the RCUK partnership.
The Russell Group of research intensive universities also feels that the best approach is one that has two separate councils -- the MRC and some other NHS R&D Council -- working together under a single overarching body.
This approach would deliver several benefits, said Christopher Edwards, vice-chancellor of Newcastle University, a member of the Russell Group. For one thing, it would avoid a situation where applied research is funded to the detriment of basic science, which is what some scientists fear will happen. "I think the feeling was that if you simply put all this together...there would be political pressure to move things in the applied direction," Edwards told The Scientist.
MRC chief executive Colin Blakemore conceded that combining clinical and basic research could lead basic work to become overshadowed. "Of course there are risks, we shouldn't be naive, but I think the opportunities outweigh the risks," he told The Scientist. It's important that whatever structures evolve to administer the funds, "it is vital that we facilitate the linkages between all parts of biomedical research, from the most basic to the most clinical," he said.
Indeed, every effort should be made to avoid damaging the MRC, or causing harm to hospitals by suddenly removing funds they use to maintain services, Edwards said. "Our worry has been that if they're not careful, there will be serious collateral damage."
David Cooksey is not expected to report back to the Government on how the fund should be implemented until some time in October or November, in time for the 2006 Pre-Budget Report.
Links within this article
Response to the Cooksey Review of UK Health Research
MRC--Single Health Research Fund
Research Councils publish response to Cooksey Review of single health research fund