APPENDIX 63
Letter from the Committee Specialist from
Professor Bruce Ponder, Professor of Oncology, University of Cambridge
Thank you for your letter of 25 May. In answer
to your questions:
1. I enclose a reply from the Addenbrooke's
Trust Director of R&D[34]
which I hope gives you the information you need about the decisions
and spending of the R&D allocation. Briefly, decisions are
taken by a Committee within the Trust; the Department allocation
is decided by an apportionment of the total budget according to
estimated costs attributable to R&D under different headings.
The problems if you are in my position are:
(1) That the allocation is a lengthy and
unwieldy process with a lead time of many months, if not years;
(2) The headings under which the R&D
is apportioned are very largely "structural", which
makes it extremely difficult to withdraw R&D to meet the needs
of new projects; and
(3) The overall R&D allocation has nowhere
near kept pace with the expansion of research activity at Addenbrooke's
in Cambridge. In my case, I have felt this particularly because
I am starting up a new enterprise and so I am asking for funds
to be diverted from completely different areas of work, rather
than simply within my own Department.
2. I have investigated further the wait
to start radiotherapy for breast cancer patients[35].
First I should emphasise the this is not a typical example, and
that I was using it not to illustrate a point about waiting times,
but rather to illustrate the difficulties of engaging NHS Consultants
in supporting research when they have other more immediate problems
on their minds.
I have made more detailed inquiries of my colleagues
in the Radiotherapy Department. They tell me: (1) that the 20
week wait to which I referred was the projected situation after
one of our four radiotherapy machines suffered a long-term break
down, and other machines were intermittently out of service. When
it became clear that within a short time we would have a waiting
list of 20 weeks, various solutions were sought and in the end
we extended the working day in the Radiotherapy Department by
introducing an earlier start and a shift system extending into
the evening. As a result of this (fairly drastic) action the waiting
list was stabilised at about 13 weeks at the peak. Subsequently,
the defective machines have been repaired, the extending working
day has been continued, and the waiting list for breast cancer
treatment is now about five weeks on average.
I have not made systematic inquiries of different
hospitals, and will not have time to do this because I am about
to go to the USA. But the radiotherapy superintendent at Addenbrooke's
tells me that she thinks that waiting lists for breast cancer
radiotherapy in the NHS at present average somewhere between about
four and 10 weeks.
3. You invited me to add any additional
information on any aspect of the Committee's inquiry. There is
one topic which has come into focus since I appeared before the
Committee and that is the question of cancer registration. We
have recently received a letter from the Oxford MREC, telling
us that in effect all of the genetic epidemiology studies which
form a large part of our work, are in their opinion illegal. It
seems that they have come to this conclusion (which differs from
their conclusion when similar studies were presented last year)
because of doubts whether cancer registration itself is legal;
our studies depend upon use of the cancer registries. I have drawn
this problem to the attention of colleagues in the cancer registry
network, and to the attention of Professor Nick Day, until recently
Director of the Institute of Public Health at Cambridge and now
MRC Professor of Epidemiology. I hope they will be making written
submissions to the Committee, and that there may be the possibility
for one of them to present spoken evidence at the "open"
session which is planned shortly. In my view, this is a very serious
issue which threatens a large area of cancer research. It is important
that it be resolved at the National level, and not become a matter
for protracted argument by individual ethics committees.
June 2000
34 Not printed. Back
35
Paragraph 2.10 of Memorandum. Back
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