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| Dr. Mark Lewis Director R&D of the King's College Hospital of the King's Consortium. |
Can you tell us how you came to Biomedical Investigation field and what you're doing?
I am formally a research scientist with a PhD and an MBA. I have first been researcher and lecturer at the University then went to the funding of research and now I am at the research development at the King's College Hospital. At the moment I am doing little research on organisation.
Could you describe us the current research funding, problems of the system and maybe issues?
Resulting of an analysis of the problem, that the reformed health funding brought about in Britain specifically the separation of providers-hospitals from purchasing Health Authorities, the question was how to ensure the research is funded within the National Health Service. An announcement was carried out, that there should be separation of research funding from the funding of traditional care. A process by which that was implemented is the creation of a pot of money, a levy or a budget which is now allocated to each of the hospitals undertaking research or using support of our medical research that uses NHS resources. Research is situated at the interface between university and hospital. Research supported by grants is generally led from universities. But they require hospitals to provide infrastructures and the opportunity for patients to become involved in research. Largely we are talking about clinical research, clinical investigation, clinical trials… To this research to take place you must have a partnership between universities and hospitals, even though as institutions they are funded separately.
Now the research division is funded separately from the rest of the hospital. How does the government specifically allocate the budget for research?
Hospitals now are encouraged to establish research division so with research directors for managing the budget. The money can vary from 0.1 to 25% of the total of the hospital income, so an extremely wide range. This money is allocated to them following a process in which the director tells the government how much research is being undertaken and how much money is required to support it. The government then looks at that bid and assesses its quality and if it thinks it shall be supported at x % then you will receive x% of the budget. You might loose a large proportion of it.
Such issues selection does not give room for long term research but on the opposite it would generate competition in identical fields, wouldn't it?
We are not talking of competition between institutions, we are talking about competition for research funding and you succeed in that competition if you are a high quality researcher. The government says that we should be concerned with issues that must be addressed now for two or three years. One of the major problems in the interface between universities and trusts is that universities very much think about knowledge in the long term. I think that the answer is that universities need to have a portfolio of projects in which is contained research without any obvious application. Very often clinicians are not training to research and need help on really pure medical projects: that would be another part of the portfolio. The word is partnership. Together we will be able to produce fruitful results. If you are a Hospital, and you want to have a strong team of research, you have got to start right from the point of recruitment to select people who are good at research. And more and more the university should be listening to what kind of persons the hospital would need.
We talked about multidisciplinary co-operation in Trusts. How could you introduce other health bodies in research?
By encouraging them to be trained as researchers, by involving them in projects in the nursing, the therapies' aspects of the research we want to do. Very often putting the research into practice is going to be done by a multidisciplinary team. A lot of the research will be delivered by the Primary care. For example, I am the director of the King's consortium that is a major hospice, a cancer terminal care institution, two general practices and a small district general hospital. There is a whole vertical integration of care, primary care to tertiary. This could be another parallel Trust to those established now for primary care.
