Medical Research Council faces change in president, policy

CHARLOTTE GRAY Since the death of Dr. Malcolm Brown a strong cadre of researchers had been functions are being hived off to two in May 1977, the Medical Research established. new councils (the Natural Sciences and Council has been without a president. But as the MRC budget's growth rate Engineering Research Council and the Brown's successor, due to be announced declined from 1970 and inflation took Social Sciences and Humanities Re- soon, will inherit a low-cost administra- its toll, the MRC just didn't have the search Council respectively) "while the tion for the disbursement of federal funds to underpin innovative as well Medical Research Council will remain funds to biomedical researchers. But he as supportive action. It has therefore basically unchanged." will also take on the job as linkman concentrated on assisting projects ini- However, the new legislation does between the government and the scient- tiated within the universities and judged affect the MRC. First, it changes the ists at a point when inflation has eroded to be of scientific merit through its designation of the minister through the MRC's real resources, medical re- "peer review" system. Its criterion for whom the council reports to parlia- searchers are demoralized by the ap- the funding of health research there- ment. Instead of the minister of na- parent downgrading of their work and fore has been solely scientific excel- tional health and welfare the act reads the role of the MRC may be affected lence, with little reference to priorities "such member of the Queen's Privy by recent legislation. derived from actual health needs. The Council for Canada as is designated by Scientists, government officials and assumption is that there is a natural the Governor-in-Council to act as the politicians wait to see how the new progression from scholarly knowledge minister for the purposes of this act". president interprets his responsibilities to practical application, that good re- Second, the informal tricouncil coordi- in the light of changed government and search automatically yields useful tech- nating committee that the three grant- public attitudes to medical research and nologies. Its current budget of $56 mil- ing councils, on their own initiative, whether, under his guidance, the MRC lion represents more than half the total established in 1969 for liaison, under departs from its traditional role. of federal funds provided for extra- the chairmanship of each council's pres- The MRC. Dr. Brown always de- mural support for health science re- ident in rotation, will now become the clared, "is not a lobby acting on behalf search. Intercouncil Coordinating Committee. of an interest group to influence the This will report to the minister of state government, but an integral part of the Bill C-26 for science and technology and consist government itself." The function of of the presidents of the MRC and the the MRC, according to the 1969 act, It is against this background of the two new councils under the chairman- which confirmed it as an autonomous MRC's essentially supportive role in ship of the secretary (equals deputy Crown Corporation answerable only to financing biomedical research that minister) of MOSST. Third, the original Parliament, to which it reports through Bill C-26, "Government Organization exclusion of "public health research" the minister of national health and wel- (Scientific Activities) Act, 1976" which from the scope of the MRC has been fare, is "to promote, assist and under- has been passed but not yet pro- dropped. take basic, applied and clinical research claimed, should be seen. In introducing The main thrust of the new legisla- in Canada in the health sciences other the bill for its third reading in June tion, as Faulkner explained it, was to than public health research." During 1977, the then minister of state for put the financing of basic scientific the 1960s its contribution to total science and technology, Hugh Faulk- research on a sounder basis, to provide health research expenditure rose from ner, explained that he hoped the bill, the machinery for better regional dis- 28.5% in 1962-3 to 56.8% in 1968-9, which among other things reorg.inizes tribution of research capability and and it emerged as the most powerful the three granting councils (originally support of interdisciplinary research agency for funding university-hased the National Research Council, the and to allow the granting councils to medical research and training. Canada Council and the MRC), "will "exercise more leadership in providing As appropriations to the MRC open the way to a new relationship be- clearer objectives" for scientific re- doubled every few years, nearly all tween the government and the univer- search. sound research proposals could be sities in research matters." Mr. Faulk- During the rapid development of financed. In the atmosphere of optim- ner said elsewhere (Science Forum, universities in the 1960s the emphasis ism it seemed that the MRC would be December 1976) that the reorganization in all the sciences, not just those within able to undertake as well as assist re- would primarily affect the NRC and the MRC's parish, was on attracting search projects, once the foundation of the Canada Council, whose granting individual researchers of great ability CMA JOURNAL/FEBRUARY 4, 1978/VOL. 118 313 and then funding them in research of The Treasury Board has always handled in particular areas such as medical their own choosing. This "laissez-faire" the function of deciding how much genetics or hypertension. And through attitude led, Faulkner suggested in the money goes to each council. So long the establishment among its 17 grants House, to a wide dispersion of research as the councils report to Parliament committees of committees for cancer competence spread thinly over most through different ministers we will and biomedical engineering, disciplines which do and little coordination of probably each continue to make_ our not really encompass homogenous fields university research objectives region- own case to Cabinet for research of research but demonstrate MRC ally or nationally. Scholarly projects in finance." interest in these areas, Dr. Roxburgh all fields of science were judged almost But what about Mr. Faulkner's ref- is confident that the MRC has ad- entirely on the competence of the ap- erences to a more "activist approach" vertised its particular concerns, con- plicant and the scientific feasibility of by the granting councils, to "leadership cerns 'that reflect nationally recognized the project. Although emphasizing that from the councils" and "clearer ob- problems. "the goal of university research must jectives for research support"? How "Within the small area of flexibility continue to be excellence assessed by is the MRC going to incorporate into that the council has for peer manoeuver, the review system", Faulkner now its granting system some of Mr. Faulk- we have demonstrated priorities and proposed, in the third reading of the ner's suggested objectives for all three directions although Bill - one can argue C-26, "'the time has come for a councils: research with the potential whether we have done it to the right more activist approach by the granting of contributing to the solution of na- extent or achieved councils enough," Dr. Rox- to the determination of re- tional problems, balancing regional dis- burgh says. "It is always questionable search priorities and to the Creation of parity, and the support of interdisciplin- policy to alter the policies way the peer review new and programs which will ary research? system works in order to build in give university research an even greater Dr. Roxburgh says that, as far as is priorities opportunity or targets. The peer review to respond to national possible within the system of peer re- system is the only way to judge the needs. Bill C-26 is important because view and the pursuit of excellence, the quality of research, but the balance it creates a new and dynamic frame- council has already taken significant of research, especially period work in which this in a of vital, evolutionary initiatives. On regional disparities, he restraint, involves more than this. This change in the direction of councils can says the council has been concerned is the council's function to take place." decide." for some time about the disparity be- So it is possible to interpret Bill C-26 tween medical schools. "Eleven years as indicating little change ahead for Effect on MRC ago we established the development the MRC. But despite Dr. Roxburgh's grant program specifically to promote assurances about initiatives taken by What do these changes mean for the research in those schools of medicine, the MRC, 82% of its 1976-7 grants MRC? Will it remain "basically un- dentistry and pharmacy where research program of $40 million still went to changed" as Faulkner said? Unlike the activity was thought to be inadequate." research programs initiated by research- other councils, no inner restructuring In 1976-7 this program received ers in the field. And its awards pro- of the MRC is required by the bill, and 2.37% of the total MRC budget. Dr. gram of another $10 million finances the change in designation of the min- Roxburgh also emphasises that the individual researchers rather than spe- ister is left open with no overt sugges- MRC has been concerned to encourage cific projects. tion that the minister will be other than specific areas of research. The standing the minister of national health and wel- committee on priorities selection and fare. Dr. J.M. Roxburgh, MRC director review was established in 1972 to "as- No mention of budgets of grants and administration, suggests sist council in maintaining an overview that the reference the minister When Bill C-26 was discussed, criti- to and of the health sciences, identifying and cism from Opposition spokesmen other minor alterations to the original reviewing scientific priorities for subse- and statute are included in the bill only quent examination the scientific community centred not to by council" and in on Faulkner's talk of "new research conform to the wording that applies to particular to identify "areas of special the other councils. priorities", but on the fact that despite Elimination of the opportunity or special need". "This the minister's "other than public health" clause year," Dr. Roxburgh references to "stability just points out, "we of funding" the bill does not mention makes the always permissive boundary have established the heart research de- between MRC-funded research and the budgetary levels of the new coun- re- velopment grant program as a result cils. The erosion of the MRC search funded by the Department of of a survey commissioned by the stand- resources National Health and Welfare over the years has been a topic of more ing committee last year, which con- public concern for some years permissive, he added. "Neither change cluded that we had the resources and now, appears to be significant at as evidenced by the formation of Cana- present, opportunities to undertake significant dians though perhaps they could be in the research for Health Research in 1975 and in this area. The council has frequent outcries from scientists. future." now allocated specific funds and in- This Roxburgh does not regard establish- vited applications year's increase in the MRC's budget, for them." And built which is in line with the annual ment of a formal Intercouncil Coordi- into the fellowships program (to which rate nating Committee as a radical depar- 760 of inflation, has not compensated for $3 988 or 7.22% of the total MRC 5 years of increases below the ture from present practice: "It will be budget is allocated) is a provision that inflation' the same faces around the table, al- .llows preferential rate. "We thought Faulkner would an- treatment for a lim- nounce a long-term funding though under a different chairman. ited number of applicants on the policy And the secretary of MOSST has been grounds of their "relevance which would put health research in to the spe- Canada on the same basis an informal member of that committee cial goals of the council's training as that in for some years. The ICCC as con- program.,. the States," comments Opposition stituted health spokesman Dr. Paul Yewchuk. is only a consultative commit- The MRC groups program, designed tee. As yet there is no indication, as "All that we heard about was the in- to encourage development of teams of sertion into the established granting some have suggested, that it will give investigators in what appear to be advice on financial allocations between mechanism of two new councils and a especially productive areas, now sup- new committee (the ICCC). The intro- the councils or make representations ports 10 groups on its budget of nearly to the Treasury Board on their behalf. duction of another layer of bureaucracy $5 million and has stimulated research will just cream off some of the funds 314 CMA JOURNAL/FEBRUARY 4, 1978/VOL. 118 that could be going into research. The however, is the overall effect of the direct improvement in the health serv- scope of the MRC has been increased, low level and unpredictability of MRC ices for Canadians. but there is no appropriate increase in funds. "Whatever the funding program, This debate has been raging for the budget. And how can we discuss at least let it be stable so that teams some years. While at the DNH&W, new priorities when we can hardly and programs can be built and kept Marc Lalonde published in April 1974 maintain funding for current projects functioning." his "A New Perspective on the Health on present budget limits?" Yewchuk Scriver recommends that the govern- of Canadians" in which he discussed calls C-26 "an unnecessary bill - you ment budget a certain percentage of new objectives and strategies for health could even call it useless. It's just a total health costs for research to guar- research in Canada. He suggested that juggling act which has not genuinely antee some continuity, and that the some health research objectives might improved the scientists' lot, or clarified scientists themselves should decide how be directly derived from statistics of any long-term science policy." the dollars are allocated, without poli- morbidity and mortality and the pros- The appointment of a bureaucrat to tical pressures - "scientists are not pects for reducing them and thus the chair the ICCC worries Dr. Yewchuk: irresponsible; they want science to be "economic burden of ill-health". Later "One might construe this to be the first important in Canada and part of a the same year the Science Council of step by this government in an en- national agenda." Canada issued its "Report on Science deavour to place [sic] total and complete The concern of scientists and the for Health Service", which indicated control over scientific research in this parliamentary Opposition with budget- that the rapid progress in biomedical country, undermining the traditional ary levels has meant that the long-term science and clinical research was not academic freedom which scientists have implications of the administrative matched by appropriate development of thus far enjoyed," he said in the House changes in C-26 have not received other areas of health research, partic- in December 1976. Dr. Yewchuk sup- much attention. For the bill does far ularly in regard to the prevention of ports the theory that scientists should more than just establish two new re- disease and the promotion of good establish their own objectives, and search councils, or fail to talk actual health. argues that they should be given more figures in federal research expenditure. adequate means to do so, while de- Its very existence and the discussions Allocation of funds ploring the government's apparent in- surrounding its readings reflect some ability to develop a coherent science of the issues of science policy that have The main effect of these two docu- policy. been exercising politicians, bureaucrats ments was on the allocation of funds Even if one does not concur with and scientists for at least a decade - from the other main federal source of Dr. Yewchuk's analysis of medical re- issues that the Senate science commit- extramural health research finance - search needs in terms of international tee, headed by Senator Maurice La- the Department of National Health and comparisons (he comments that per montagne, has been keeping in the Welfare's national research and devel- capita health research funding in Can- public eye during the 9 years of its opment program, which attempted to ada is only about a quarter of that in existence. Some of these issues were extend research into these areas. The Sweden or the US), the picture is fair- discussed at length in the CMAJ 3 rationale for the department's total ex- ly bleak at the moment. Because of the years ago (110: 1388 and 111: 58, penditure of $39 million this year (on budgetary limits, 12.5% of the MRC 1974). intramural and extramural research; grants had to be made terminal in $20 million is spent extramurally) re- 1976-7 although the work was con- Question of freedom flects the department's responsibility to sidered to be of sufficient quality to obtain information pertinent to "... all be continued, and 40.5% of new ap- The question at issue is how far matters relating to the promotion or plications for MRC grants were turned scientists should be free to pursue their preservation of the health. .. of the down although they were considered to work on their own terms: how far people of Canada over which the be of sufficient scientific merit to be should they be accountable to the tax- Parliament of Canada has jurisdic- funded. Thanks to this year's budget payers who support them? When there tion" (NH&W Act, page 5). In other increase, the comparable figures for was enough money to go round in the words, whereas the MRC has up to 1977-8 are 7.5% and 25.5%: some 60s, the pursuit of scientific knowledge now existed to advance the state of improvement, but still a discouraging could be regarded as an end in itself, knowledge, on lines decided by the prospect for any researcher hoping for for which the federal government pro- scientists themselves, the departmental federal support for his work. vided the means. But in the present programs relate the level of funding to economic gloom, when every tax dollar the importance the government attaches Slowdown appalling must be seen to be well spent, how to the potential contribution that re- far can we afford to allow scientists search may make to the achievement It is this slowdown of research that such freedom? Is a new science policy of politically determined objectives. The appals prominent scientists like Dr. needed, to ensure not only that high department's health research and de- Charles Scriver, a principal investigator standards of research are maintained, velopment program disburses $1 1.3 in the MRC group in medical genetics but also that applied research pays off million of that total extramural budget at McGill University, who has twice in direct benefits to Canada? on research related to the health care appeared before the House of Com- This line of argument unnerves and delivery system, lifestyles and health mons standing committee on health, irritates many a scientist working in promotion, environmental health ha- welfare and social affairs to support the more arcane branches of quantum zards and the health status of popula- funding for basic (biomedical) research. physics and astronomy: researchers in tions. As Dr. Gerry Hill, director gen- Scriver maintains that even in the pres- the health sciences feel a great deal eral of the program, explains, "Our ent period of austerity we cannot afford more vulnerable. The MRC is already program is already mission-oriented. to abandon basic science in favour of responsible for "applied and clinical" From the beginning our program's aim investigations geared to the solution as well as basic research in the health has been to foster and support research of specific problems, because basic re- sciences; its domain is now extended to of interest to the department rather search yields at least as many answers public health research, and it is oper- than the scientist, although in practice and benefits as clinically orientated re- ating in a field where any advance in we often act on scientists' suggestions. search. What he finds most disturbing, the state of knowledge may lead to a Like the MRC, we judge applications CMA JOURNAL/FEBRUARY 4, 1978/VOL. 118 315 for funds on standards of excellence search, he says, applied studies would for public health" clause as a move and significance, but we also review be just "wheels spinning in a vacuum to free the department from the obliga- them in terms of their relevance to the But he argues that by developing a tion of support and training in "public department's needs for information - framework in which all research pro- health research" so it can concentrate which has never been a criterion for jects can be evaluated in terms of the on research of direct and immediate the MRC." value of the research team, the state relevance to the health of Canadians The program's clientele is not con- of knowledge in the subject, the prob- at an increased level? Or will he regard fined to the biomedical scientists who ability of a breakthrough and the po- the bill and surrounding discussions as also form the MRC's clientele; it in- tential for reduction of the economic confirmation of the MRC's position as cludes sociologists, economists and burden of ill-health, research effort the granting council for research un- systems analysts who can make a con- could be better coordinated and more trammelled by political objectives, in tribution to health care research. Thus fruitful. which role the academic community this program is already directed toward Dr. Fraser's analysis of research as views it, while research that is more fulfilling the objectives outlined by the a "classic economic activity" and his politically profitable because it is di- "new thinking" in health research, as use of terms like "program account- rected toward regional parity and na- articulated first by Mr. Lalonde and ability" (although he is also adamant tional needs is a departmental respon- more recently by Mr. Faulkner. that "research activities, by their very sibility? Or will he keep the MRC tick- Liaison between these two major and nature, are characterized by a high ing over as it is, since its basic structure complementary sources of federal degree of uncertainty") enrage scientists and reliance on peer review does not health research funding is close; they like Dr. Charles Scriver, who sees the allow for a radical change in its grant- are, after all, located in the same build- imposition of targets or objectives on ing policy and criteria? ing. "The department has defined the researchers as a dangerous distraction. boundary between us," explains Dr. -Dr. Fraser has demonstrated that the Roxburgh, "but it is very flexible." treatment of accidents is the second Plurality preferable largest item on Ontario's health bill and suggested that research fund allo- No one would wish the MRC to lose Provincial government funding cators should therefore consider this its autonomy or lose sight of its obliga- their second priority. "But we don't tions to biomedical scientists. Branko In addition to these sources of gov- have the techniques for research on Belovic, director of policy and program ernment funding there are the provin- accidents," argues Dr. Scriver. "How planning at the NHRDP, argues that cial governments' expanding expendi- can we target research when we don't the present plurality of funding bodies tures on health research. This is in the know where we are going?" is preferable to a more centralized range of $15 million, largely from Other scientists are more receptive to system of funding - "it contributes Ontario and Quebec, and Ontario's con- the idea of a different base for research toward a wider spectrum of research tribution is being boosted by a further funding. Professor Louis Siminovitch, and towards the realization of diverse $15 million available as one-off grants of Toronto University's department of objectives." over 5 years from the proceeds of the medical genetics, who is a member of Dr. Roxburgh concurs. In a speech provincial lottery. The Alberta govern- both the MRC and Ontario's Council to the recent Canadians for Health Re- ment has announced it will spend some of Health, is aware that all the indica- search meeting, he said, "The national of its oil revenues on health research, tions for a future increase in funding (health) research effort is a complex but projects funded to date have been are negative, and says "the scientific affair in which a number of interest disappointing. The concern of the pro- community must look at different groups participate, each with its own vincial governments, even more than models and scenarios for the future in particular point of view. This is as it their federal counterpart, is to stimu- order to maintain its strength in the should be in my opinion, and the na- late research that is specifically targeted long term." tional research effort is the stronger rather than curiosity-based; as Dennis Given the efforts of the federal for it." The challenge now, as Belovic Timbrell, Ontario's minister of health health department and the provincial sees it, is "to maintain the present high remarked recently: "We are looking governments to direct health research level of medical research, to health while bring- researchers for maximum re- funds into projects likely to yield prac- ing the effort up to a similar level in sults from every dollar spent... We tical benefits, and Mr. Faulkner's plea the areas where some of the principal are especially receptive to projects that to university researchers, under the problems now appear to lie." hold promise of reducing health care granting councils' leadership, to address costs, or improving the quality of themselves But the political pressure for the to "national needs", the MRC to go some way toward health services, without increasing these MRC may find itself under pressure meeting costs." this challenge, to partake in Mr. Faulk- to shift its own priorities. How far it is ner's "evolutionary change", and The Ontario government's distribu- prepared to encourage targeted research to tion of health research funds has move along the supportive/interven- been and define research objectives, in addi- tionist spectrum of granting largely determined by the priorities sug- tion to fulfilling its primary obligation policy gested by its Council of Health's towards a more active role has been re- to support research that advances the present for some years, search and development committee. state of health science knowledge, will and Bill C-26 One of the committee members is be up to the new president. would appear to be giving it the man- date to do so. What worries some of Queen's economist Dr. Rod Fraser, How far will the frontier between whose argument that efficient use of the actors on the health research stage the council and the department be is how far the "program accountability" the limited research funds required altered? Will the new president inter- some measure of "cost-benefit anal- line of thinking has entered into Cab- pret the MRC's broadened mandate as inet attitudes to medical and health ysis" of applied research projects was making it the sole government agency incorporated into Lalonde's "New Per- research funding in general. Will the responsible for health science research, MRC have to justify its budget estim- spective". Fraser does not suggest that with the new ICCC existing to facilitate the present level of funding for basic ates in terms of practical outcomes, if Mr. Faulkner's recommended move it wants to maintain the level of fund- health research should be reduced: into interdisciplinary research? Or will without some basic biomedical ing that the scientists themselves are re- he see the elimination of that "except demanding?u 316 CMA JOURNAL/FEBRUARY 4, 1978/VOL. 118