The Wellcome Trust 1974-76 Eleventh Report 2 «j.:t -t^" of ^-^^e_J 22501470048 The Trustees© first meeting in the Board Room at 1 Park Square West, October 1974 L. to R.: Prof. H. Barcroft, Prof. R. H. S. Thompson, Dr. Edda Hanington (Deputy Secretary), Dr. P. O. Williams (Secretary), Lord Franks, Lord Armstrong, Sir John McMichael, Sir Michael Swann, Dr. C. E. Gordon Smith The Wellcome Trust 1974-76 Eleventh Report 1 Park Square West, London NWI 4LJ •V7——©7 CONTENTS I Introduction and Policy 7 II Grants Programme 13 A. SUPPORT OF MEDICAL RESEARCH IN GREAT BRITAIN 16 University Development 16 Departmental Support 16 Interdisciplinary Linkage 18 Research Leave 22 Subjects Selected for Development 24 Dermatology 24 Mental Health 27 Wellcome Senior Research Fellowships in Clinical Science 30 Clinical Sciences 33 Basic Sciences 55 B. SUPPORT OF MEDICAL RESEARCH OVERSEAS 83 Tropical Medicine 83 European Programme 99 Other Overseas Awards 112 C. VETERINARY AND COMPARATIVE MEDICINE 118 D. HISTORY OF MEDICINE 125 III The Trustees and their Staff 134 Wellcome Trust Advisory Panels 137 Appendix I Policy 1975-76 138 Index of Subjects 141 Index of Research Grantholders 142 The Wellcome Trust Board of Trustees: Chairman: The Rt. Hon. the Lord Franks, PC., G.C.M.G., K.C.B., C.B.E. Deputy Chairman: Professor Sir John McMichael, M.D., F.R.C.P., F.R.S. Trustees: Professor R. H. S. Thompson, C.B.E., D.M., D.SC., F.R.C.P., F.R.c.Path., F.R.S. Professor H. Barcroft, M.D., F.R.C.P., F.R.S. (Until December 1974). C. E. Gordon Smith, C.B., M.D., F.R.C.P., F.R.c.Path. Sir Michael Swann, F.R.S. The Rt. Hon. the Lord Armstrong of Sanderstead, G.C.B., M.V.O. Professor W. S. Peart, M.D., F.R.C.P., F.R.S. (From January 1975). Secretary: P. O. Williams, M.A., M.B., F.R.C.P. Deputy Secretary: Edda Hanington, M.D., M.R.C.P. The Wellcome Trust Staff of the Trust (as at 31st August 1976) Director; P. O. Williams, M.A., M.B., F.R.C.P. Medical Division: Edda Hanington, M.D., M.R.C.P., Assistant Director B. A. Bembridge, M.D., Assistant Director D. G. Metcalfe, Scientific Administrative Officer F. A. Griffin, Administrative Assistant Tropical Medical Division : B. E. C. Hopwood, M.R.C.S., D.P.H., D.I.H., Bar-at-Law Gillian Breen, LL.B., Administrative Assistant Finance Division: K. C. Stephenson, M.C., F.C.A., Finance Officer D. L. Freeman, Accountant Administrative Division: M. A. F. Barren, Administrative Officer D. G. Hooker, Office Manager Director©s Office: Pamela Bradburne, B.SC., Administrative Assistant Joan E. Masom, Director's Secretary The First 40 Years of The Wellcome Trust Sir Henry Wellcome died on 25th July 1936. The Wellcome Trust is therefore 40 years old. During this time it has allocated £34.5m for the support of medical research and medical history. Its growth is illustrated by the fact that during its first 20 years it distributed Elm, in the next ten years a further £8.5m and between 1966 and 1976 £25m. The Wellcome Trust is now the largest endowed charitable Trust supporting medical research in the United Kingdom and plays a significant role both in this country and the tropics. The present strength of the Wellcome Trust is the result of the expansion of the international pharmaceutical company, The Wellcome Founda tion Limited, which was founded by Sir Henry Wellcome and of which the Wellcome Trustees are the sole shareholders. I INTRODUCTION AND POLICY It is an essential requirement for every modern society that it should retain sufficient flexibility to be able to adopt new ideas and developments of importance. This necessitates the provision of opportunity, encouragement and continued appraisal of new people and new suggestions. Lack of such flexibility leads to a state of depression, so that new ideas are not put forward because it seems inevitable that they will not be financed. For many years we have watched the steady growth in expenditure on the Health Service, the Universities and the Research Councils although a closer look suggests that because of inflation much of this growth is more apparent than real. Nevertheless, until recently, within the budgets of these bodies there has always been the opportunity for new developments. During such a growth phase it did not, on the whole, cause concern that health care, higher educa tion and research had largely developed into government financed monopolies. During the past year the situation has changed. The Uni versities, the Health Service and the Research Councils have ceased to grow and in most cases, because of inflation, there has been an effective reduction in their resources. The result has been that the Universities have had to cut back on their staffing and running costs so as to keep within their budgets. The number of new posts becoming available in academic medicine is therefore small and such as occur are inevitably related to the requirements of patient care and teaching. In the past, a deficiency of this kind might have been cushioned by a transfer of funds from the Health Service or the Medical Research Council. Such alternatives are no longer readily available. The overall effect on those in post is mainly of significance because they have to spend more of their time, since fewer colleagues are available, on clinical work, teaching and administration and hence less on the pursuit of innovation and research. The impending shortage of Government funds for running expenses and technical assistance for research work of high quality will make it even more difficult for university staff to undertake research. The virtual cessation of the provision of equipment grants will, in due course, create real difficulties especially as costs rise. This is the general situation which we can anticipate will continue for several years. It has perhaps not been surprising that the growth which we have seen for many years should cease and so we should, in any case, have had to learn to deal with the situation that now exists. Unfortunately the growth period has not been sufficiently long to reach the position where retirement will create enough vacancies for a reasonable level of recruit ment. The pressure on the Medical Research Council to economise and to give permanent appointments to its staff has also resulted in a reduced number of posts becoming available. Opportunities are very limited for young men and women who may be considering making their future in academic medicine. Not only are suitable posts in short supply, but so also are the financial rewards which are relatively much less good for university staff than those in the Health Service. Despite these deterrents to a career in academic medicine, there are still young men and women who are so enthusiastic about the importance and interest of medical research that they are prepared to accept the risks in their career prospects and make financial sacrifices so as to pursue their ideas. The attractions of posts overseas once more become highly significant. The position is inevitably more difficult for those without a medical quali fication, as the alternative of a clinical appointment in the last resort is not available. We have therefore reached a no-growth situation when medicine and higher education are largely a monopoly of government. Charitable funds provide an alternative but the quantity clearly can never be sufficient to have a major impact on the general situation. However, focused on particular prob lems, private funds have a special opportunity to assist in preserving the high quality of British academic medicine just when it is needed. The Wellcome Trust has carefully considered its policy in the light of present events. It has found that the suggestion made in its last report that Trust funds should be used to help Universities to develop their own innovative plans did not receive the response that might have been anticipated. The reason, apparently, was the inability of the Universities to plan new developments in such a shifting situation. It was as much as they could do to keep within their budgets. During the past two years, the Trustees have been very conscious of these and other factors that are having an adverse effect on medical research. In order to keep them selves informed, they have held numerous informal con sultations with individuals and groups in the Universities and with organisations such as the Committee of Vice- Chancellors, the University Grants Committee and the Medical Research Council. They have also kept in touch with the world of Foundations and Charities through the Standing Conference of Medical Research Charities. In addition, they held two meetings in which every university medical school participated to obtain views on the present problems and likely requirements for the future. Dr. Williams personally visited the Universities of Oxford, Cambridge, Birmingham, Bristol and Dundee and the Medical Schools of St. Mary's, Charing Cross, King's, St. Thomas's, the Royal Postgraduate Medical School and the London School of Hygiene and Tropical Medicine for dis cussions on Research Policy at meetings of Departmental Heads and others. He also saw the Deans or other repre sentatives of most of the other medical schools. The results of all these contacts were brought together at two major policy meetings of the Trustees held in July 1975 and May 1976. At these meetings, the Trustees examined their policy on a variety of topics and decided how best to allocate their resources for the future.