Lack of career structure in the area of medical research

[Speaking in the Seanad during Second Stage of Senator Sean Barrett’s private member’s Bill Universities (Development and Innovation) (Amendment) Bill 2015]

I thank Senator Barrett for allowing me the privilege of seconding this worthy legislative proposal. If and when somebody sits down to write the history of this Seanad, he or she will acknowledge that the Senator has been one of the most serious, insightful and informed legislators we have had in this House over the last four years. He certainly exemplifies the best traditions of this institution.

The Minister has probably heard me rant in the past about the bizarre health structure in this country, including our structure for hospitals, careers and medical education, with so many medical schools producing doctors for export in a nation that employs the lowest number of career level doctors per head of population of any country in the OECD. The paradox goes further, however, to include the career structure in health care in universities and, more generally, in science and other areas where research is a focus. There are an extraordinary level of incentivised dysfunction in these areas which Senator Barrett’s Bill would go a long way towards correcting.

I returned to Ireland in 1993 with a huge desire to develop a clinical research structure in this country. I am not claiming I started anything because many fine individuals were carrying out wonderful research prior to my return but there were a few big niches, such as clinical research and no department of medical oncology or cancer medicine anywhere in my university hospital or in any other university at the time. This was not unique to my area; it also applied to cardiology, endocrinology, etc. We had a poorly developed structure and developing a research focus required us to establish a parallel structure outside of the university and, to an extent, outside of the hospital.

Some of the more prominent research in Ireland which are either hospital affiliated or on the campus of hospitals have a tenuous connect with the medical school or university which is allegedly their parent organisation. This leads to all kinds of unbelievable conundrums. I was, for example, fortunate to have the opportunity to recruit a cohort of wonderful nurses who were trained in oncology, had bitten the bug of cancer research and wanted to become clinical research associates and clinical research nurses. Clinical research involving patients simply cannot take place without such expertise. They made the brave commitment to step outside of the protective mainstream career structure offered by the HSE as a personal investment of faith in the unit I was trying to develop.

However, for understandable legal and regulatory reasons it became apparent after several years that we needed to formalise our arrangements. Even though I was raising money from other sources to pay their salaries, and they thus cost the State nothing, payroll had to be formalised through the hospital’s system. Then, of course, the meltdown occurred followed by the embargo on public service appointments and audits of the numbers working in the public services. Although we had people who were doing pure research work in a hospital associated with the largest university in the country, they were working neither for the hospital nor the university. They were providing an unbelievable service which brought in the equivalent millions of euro to the hospital every year because our reputation got us free drugs and support. I found, however, that I was being gently encouraged to let them go because there was no other way to supervise the payment of their salaries through the hospital system or, for a long time, through the university. Even though I was not asking anybody to pay for them, one of the agencies – I stress it was not a university – suggested to me at one stage that it was perhaps unwise to employ senior experienced people because after a number of years of employment they had legacy entitlements to tenure and it would be harder to get rid of them. I said that I did not want to get rid of them. They were wonderful, so why would I do anything other than try to incentivise them to remain? I am thankful to the medical faculty in UCD and my friend and colleague, Professor Michael Keane, who made special arrangements so that aspects of the payroll for these individuals would be covered even though they are not strictly speaking university employees.

I have also raised grants or philanthropic funding for brilliant young researchers who made commitments to work with me and who have churned out research and supervised PhD students. They have no career structures in their university, however, and exist from grant to grant. If I emigrated or had a heart attack in the morning, they might find themselves unemployed. They have no security, with the result that several left over the years to become administrators. They had mortgages and personal responsibilities and there was no career structure which would allow them to stay in research. If we are going to be a knowledge, research and innovation based economy, we have to address this issue. The independence and security which Senator Barrett’s Bill offers would lay the groundwork for developing the nurturing environment our young researchers need.

I know of one fine researcher in a biomedical institution in Ireland – I was going to name names but I will not do so – who won a five year grant to develop a programme in virology. The grant expired at the end of five years, as grants do. He probably could have obtained further grant and peer-reviewed support to maintain individual projects, but the job was no longer available because it was only available as long as the grant was in place. He then had to travel to another country to continue his research and, as a result, we lost him.

There is a tendency for those on the other benches to look at Bills from these benches as being deficient or, if they are good, to take them on at a later stage. Will the Minister step outside the aisle, so to speak, to examine the merits of this Bill and consider supporting it? This is the expertise Senator Sean D. Barrett brings to the two Chambers in the Oireachtas. He identifies problems that may not be apparent to other Members. I urge the Minister, as well as my other friends and colleagues in the House, to support the Bill.

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