Select Committee on Science and Technology Written Evidence



Memorandum submitted by the Academy of Medical Sciences

  The enclosed paper summarises the activities and achievements of the Academy of Medical Sciences in its first three years of operation. It owes its growing success and reputation to the expertise and energy of its Fellowship, the dedication of the Officers and Council Members, and the commitment and enthusiasm of the administrative team. Despite limited resources, financial and human, and a high degree of uncertainty about future funding, the Academy is making its mark. Increasingly sought for its views and comments on policy matters and on issues of medical science, the Academy is leading the way in tackling key issues relating to research infrastructure and careers, particularly the rejuvenation of clinical academic medicine throughout the UK. A pre-publication copy of the Academy's latest report, Clinical academic medicine in jeopardy is enclosed.

  The Academy is independent and, unlike the other learned academies, as yet receives no contribution from the Science Vote. It covers its core costs from a start-up grant from the Wellcome Trust, which comes to an end in 2003; from the subscriptions of its Fellows; from generous donations; and from income earned from the provision of services to the medical science community. The Fellowship is the Academy's most powerful asset: the Fellows' enthusiasm and commitment to the work of the Academy (unpaid) underpins the success of current activities. The Fellowship also provides 25 per cent of current income. A fundraising campaign is under way to raise funds to assist the expansion of the Academy's programmes.

  Looking to the future, the Academy is eager to extend its services to Parliament, to Government Departments, Industry and to other interested bodies; to undertake research and policy projects that will address the key medical and health issues of the day. Among our key objectives are (a) the implications and assessment of new techniques (genomics, proteomics, metabolomics) in both diagnosis of disease and selection of appropriate treatments, (b) bringing together a wide range of disciplines from medicinal chemistry to the law and social sciences to inform and address the medical and ethical aspects of scientific advances in an aging population, and (c) to enhance the collaboration between academics involved in biological and clinical disciplines with scientists in industry to promote the rapid translation of research into practice and expand the national industrial base. To achieve all of these objectives a grant of £1,000,000 per annum from government sources would be needed.

April 2002


  The Academy welcomes this opportunity to respond to the Science and Technology Committee inquiry. This paper will describe the background that led to the formation of the Academy in 1998, detail the achievements of the first three years and provide information about current levels of funding and resources, and set out the Academy's programme for the immediate future.


  As this paper will demonstrate, the Academy has a commitment to knowledge and policies that will improve health for present and future generations. The remarkable progress being made in the life and medical sciences bring the prospect of great benefit to healthcare but they have also given rise to much public anxiety. The Academy has a key role to play in the independent assessment of new developments and in informing policy makers and the public about the likely implications and any possible hazards. In recent years much concern has resulted from the high level of public exposure given by the media to maverick science. AIDS, BSE, GM foods and the MMR vaccine are all important topics where this has taken place. It has proved very difficult to persuade the public to give due weight to the consensus of properly conducted, peer reviewed science in these areas. The Academy, as an independent expert body, has an important role to play in serious, informed scientific debate on such contentious issues.

  Discoveries in basic medical sciences have not always been recognised promptly as having relevance to clinical practice and it can take considerable time, years and even decades, before some discoveries have been translated into benefits for patients. One of the major objectives of the Academy is to promote and facilitate the rapid application of research to the practice of medicine and to the advancement of health and welfare.

  In order to achieve these goals, is it is important that institutional structures and organisational culture are reformed in such a way as to facilitate and encourage a move towards conducting research and teaching on an interdisciplinary basis. Success is likely if there is the right mix of skills addressing medical research.


  Founded in 1998, the Academy of Medical Sciences is still relatively new but has already established a strong position within the UK's Academy group, alongside the Royal Society, Royal Academy of Engineering and the British Academy.

  The Academy of Medical Sciences was established following the report of the Atiyah working party to the Medical Education and Research Coordinating Committee (MERCC). It was formally inaugurated in November 1998 as a charitable company limited by guarantee.

  A founder fellowship of 351 fellows were nominated by the Royal Society (90); the Royal Society of Edinburgh (20); The Council of Heads of Medical Schools (90); the Academy of the Medical Royal Colleges (120); and MERCC (31). The current number of Fellows, following the elections of 9 April 2002, stands at 714.


  The Academy's prime purpose is to promote the translation of medical science into clinical practice for patient benefit. It is an independent, interdisciplinary body representing the medical science community and those involved in the delivery of health care: clinical academics, non-clinical scientists, veterinary scientists, dentists, nurses, and the professions allied to medicine.

  With such broad representation, the Academy occupies a unique position within the research community, with the potential to play a key advisory role to both the Office of Science and Technology and the Department of Health. The Academy currently enjoys excellent working relations with the R&D Department of the DoH. It also maintains regular contact with officials at the OST and is hoping to involve Senior Officers more prominently in a new initiative to be launched later this year. [See Next Steps].

  In bringing together these many disciplines, the Academy provides an intellectual focus for the medical sciences and seeks to influence national, fiscal and regulatory policy. Policy work is targeted at four key areas:

    —  research environment and infrastructure requirements;

    —  recruitment and training;

    —  research standards;

    —  research funding.


1.   Scientific advice

  A considerable amount of the Academy's effort and resources is devoted to providing expert advice to Government and policy makers. This takes many forms: printed reports, responses to consultations, representation on Government panels and committees, and evidence to parliamentary committees. The Academy has responded to the following:

    —  Regulation of Biotechnology;

    —  Code of Practice for Scientific Advisory Committees;

    —  R&D expenditure in Government departments;

    —  openness and animal procedures;

    —  Science and Society;

    —  Phillips report: Academy paper on issues of governance;

    —  livestock infections: written evidence to the Royal Society inquiry;

    —  use and disclosure of medical data;

    —  revalidation: a response to the GMC;

    —  modernising the SHO grade: a response to the Department of Health;

    —  Review of Appraisal, Disciplinary and Reporting Arrangements for Senior NHS and University Staff with clinical and academic duties: a response to the Follett report.

  The Academy participated in the inquiries into Complementary and Alternative Medicine and Stem Cells, providing oral and written evidence.

  In November 2001 the Academy was invited to provide a briefing on medical issues for the Science & Technology Committee of the House of Lords. Five key topics were chosen from over 90 suggestions submitted by the Fellowship:

    —  new, emerging and re-emerging infections;

    —  vaccination—benefits, risks and new potential;

    —  personal information, confidentiality and medical research;

    —  organ and tissue retention for research and teaching;

    —  stress—myths and realities.

  As a result of this briefing, the Select Committee will, in 2002, conduct an inquiry entitled "Fighting infection".

2.   Working parties and reports

  Academy investigations are carried out through dedicated working groups. Topics for study are selected from suggestions submitted by the Council and the wider Fellowship, drawing upon their collective knowledge and experience. Examples are listed below. For a complete list of publications see Annex B.

  Zinc Cadmium Sulphide dispersion trials: a report on these trials was prepared at the request of the Chief Scientific Advisor at the Ministry of Defence. The report has been published by the Ministry of Defence and a paper based on the findings has appeared in the Journal of Occupational Medicine.

  Career Structure And Prospects For Clinical Scientists: a working party chaired by Professor John Savill. [See section on Research Support.]

  Academic Medical Bacteriology: a working party chaired by Professor Brian Spratt. A group has been established under the chairmanship of Sir Richard Sykes to oversee and implement the report's recommendations and the Academy will be working closely with all the stakeholders, including the Department of Health.

  Non-Clinical Scientists on Short Term Contracts in Medical Research: the report of a working group jointly chaired by Professor Pat Jacobs and Professor Jim Smith.

  A detailed report was published in February 2002: it supports and extends the recommendations of the Concordat on Contract Research Staff Career Management, and offers some solutions.

  The Academy of Medical Sciences has also collaborated with The Royal Society and others on areas of common concern.

  The Medical Uses of Cannabis: a report produced by a joint working party with the Royal Society chaired by Peter Lachmann and published in 1999.

  Scientific Fraud and Misconduct: a NAPAG (National Academies Policy Analysis Group) working party chaired by Peter Lachmann. A paper was presented to NAPAG in January 2002.

  Transmissable spongiform encephalopathies: a statement by the Academy of Medical Sciences and the Royal Society. Published May 2001.

  The Academy has also published discussion documents on Diet and Diseases: Facts and Fantasies; its response to the House of Lords select committee on Complementary and Alternative Medicine; and a position paper for the Chief Medical Officer on "Vaccines: current status and future needs".

3.   Research Support

  The Academy's influential Savill report (published April 2000) led directly to a Department of Health initiative to support mid-career clinical scientists. The DH scheme is offering eight awards a year for five years until a steady state of 40 fellowships has been reached. The Savill report estimated that, when fully established, some 300 clinician scientists should be supported in the UK. The importance of this initiative should also be seen in the context of the rising numbers that will require clinical training in the future to meet the anticipated need for doctors. The Academy has also set up its own Clinician Scientist programme and is currently seeking additional awards to expand its research portfolio. Current partners in the Academy scheme include the MRC, The PPP Foundation, Leukaemia Research Fund, Arthritis Research Campaign, and the Primary Immunodeficiency Association.

  The Academy is a member of the National Clinician Scientist Monitoring Committee (chaired by Sir John Pattison, FMedSci) and provides a professional mentoring service to the UK's Clinician Scientist Programme for which it receives a support grant from the DoH.

4.   Meetings and lectures

  The Academy has developed a broad programme of meetings. It holds events associated with the major corporate events in the Academy's annual calendar (new Fellows' admission day, the Annual General Meeting), meetings around the UK for the Fellows and colleagues, and a programme of interdisciplinary single-topic meetings.

  Regional meetings are designed to provide a forum in which local fellows can discuss the affairs of the Academy with the Officers. This business meeting is then followed by a programme of scientific talks and an open discussion on a controversial topic. Meetings have taken place in Edinburgh (1999), Cambridge (1999), Manchester (2000), London (2001), Newcastle (2001), and Cardiff (2001). Further meetings are planned in Leicester, Southampton and Birmingham.

  There is an annual lecture in memory of Jean Shanks, supported by the Jean Shanks Foundation. A full list of meetings is attached at Annex A.

5.   External relations

(a)   In the UK

  While the Academy of Medical Sciences is firmly rooted in its expert fellowship, it also has a role to play in the wider society in which it operates. For the Academy to achieve its objectives, interactions with external agencies and with the wider public are vitally important. At all times it seeks to complement (not duplicate) the activities of other institutions.

  Working relationships and alliances have been established with the following organisations:

    —  Parliamentary Select Committees;

    —  Universities UK;

    —  Council of Heads of Medical Schools;

    —  Higher Education Funding Councils;

    —  Royal Colleges;

    —  Medical Research Council;

    —  Health Departments—and different divisions within those departments;

    —  governing bodies of the professions allied to medicine;

    —  British Medical Association and others;

    —  Private Sector: research charities and trusts.

  The Academy collaborates regularly with its sister Academies, either through the National Academies Policy Analysis Group (NAPAG), or through specific activities. For example: the Academy is officially represented on the Royal Academy of Engineering's Biomedical Engineering Focus Group. Examples of collaboration with the Royal Society and The British Academy through meetings and reports are listed elsewhere in this paper.

  The Academy believes that much needs to be done to improve the presentation of medical science, particularly in the press and media. The Academy's working group on media relations recommended that the Academy should develop a professional and comprehensive communications strategy in order that it can make its views available to the public. The Academy will be seeking funds to support this strategy.

(b)   Overseas

  The Academy was invited to the Inter-Academy Panel in Tokyo in May 2002 and was a co-host with the Institute of Medicine and the Japanese and Mexican Academies of Medicine of the first meeting of the world's Academies of Medicine and Medical Sciences that followed the IAP meeting. It has recently been involved with the first global meeting of the Inter-Academy Medical Panel in Paris 20-22 March 2002 which debated the topic Confronting infections and antibiotic resistance around the world.

  The Academy has joined the European Federation of Academies of Medicine. Peter Lachmann was elected vice-president for 2001-03 and will automatically become president for 2003-05.

  The Academy has close relations with the Académie des Sciences and the Académie de Medicine in Paris, co-operating in a number of issues affecting the EU such as grace periods for Patents, the Clinical Trials Directive, the Data Protection Directive, and the Copyright Directive. There have been three joint meetings: on TSEs, on Ageing and a meeting on stem cells.


  The Academy has an ambitious programme. Three key areas are currently under development.

The Academy of Medical Sciences Forum

  The healthcare sector is highly complex with numerous interactions and partnerships, public and private. The Academy recognises the need to work with all players and is currently looking at mechanisms to increase the involvement of the industrial sector in the Academy's activities. Later this year, the Academy will launch the Forum. Its membership will be drawn from pharmaceutical, biotechnology, medical engineering and medical IT companies and will also embrace health products, the medico-legal and financial sectors. Government departments, Research Councils and other sponsors of research will be invited to join.

  The key tasks of the Forum will be to deliver the benefits of medical research more rapidly to patient care, to foster the economic benefits of research, and to support the medical research profession. It will be a unique facility for:

    —  interaction;

    —  information exchange;

    —  collaboration;

    —  joint action.

  In the long term the project will be self-sustaining, supported by the subscriptions of its members; in the short term, however, funds are urgently being sought to pump-prime the project.

The Research Integrity Initiative

  There has been widespread discussion over the last few years on the problems of the management and treatment of fraud and misconduct in research. This has focused largely, but not exclusively, on scientific research and, within science, particularly on the medical sciences. The Academy's proposal for a Research Integrity Initiative has the support of the medical profession and the Department of Health. A small working group is currently being formed which will include representatives of the major stakeholders, including Universities UK, and there are early indications that the DoH will be willing to provide funds to support the initiative.

Academy inquiry into "Impediments to medical research"

  Following the successful presentations to the House of Lords Select Committee on Science and Technology in November 2002, the Council of the Academy has decided to conduct its own inquiry into the impediments to medical research. The start-up costs of the project will be met from sponsorship and additional funding to cover the inquiry and publication costs is currently being sought.


  These three new projects represent a significant step change in the Academy's developing programme and will go far to meeting the aspirations and expectations of the medical science community which provides such strong support for the organisation. However, additional funding is urgently required and the Academy will be looking to Government sources, amongst others, to support this work.


  The Academy is a registered charity and a company limited by guarantee. The work of the Academy is overseen by a Council of 22 members elected from the Fellowship. This number includes the four Officers of the Academy:
President:Professor Peter Lachmann
Vice president:Lord Turnberg
Treasurer:Sir Colin Dollery
Registrar:Professor Mark Walport

  The head of the Administration is the Executive Director, Mrs Mary Manning


  The Academy's Fellows donate their time and expertise without compensation. Its fixed cost is largely that of the professional secretariat housed at 10 Carlton House Terrace (rent-free until 2003). The annual running costs of the Academy are currently around £400,000 but will increase significantly when the rent-free period expires next year.

  A small team of five staff run the London office.

  The Academy is supported by the subscriptions of its Fellows, generous grants from Trusts, particularly the Wellcome Trust, by income earned from services and by donations and sponsorship for specific activities. However, any further expansion in the scale and scope of the Academy's work (including the projects mentioned above) will require considerable additional resources.

Mary Manning

April 2002

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