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7945 SIP AUTUMN 09 5/10/09 10:21 Page 1
sip
Autumn 2009
Medical Testing SCIENCE IN PARLIAMENT
Designs for Life
Nanotechnology
Carbon Capture and Storage
The Journal of the
Parliamentary and
Scientific Committee
www.scienceinparliament.org.uk
7945 SIP AUTUMN 09 5/10/09 10:21 Page 2
‘ Now more than ever we need to celebrate
our country’s achievements in science and
we need to foster new generations that
understand, appreciate and practise scientific
method. Hurrah for the Science Museum!’
Stephen Fry
Actor, writer, comedian, presenter
www.sciencemuseum.org.uk
7945 SIP AUTUMN 09 5/10/09 10:16 Page 3
sip
The Government has listened; the HoC Science and Technology Committee SCIENCE IN PARLIAMENT
is re-established and meets for the first time in October. It will have the
same Chairman and membership as the Innovation, Universities, Science
and Skills Committee had, which it replaces, although the Whips will need to
do a bit of work to fill the vacancies that exist.
On 23 September I attended the joint 10th Anniversary Celebration of the
University of Manchester Incubator Company (UMIC) and 5th Anniversary
Celebration of the University of Manchester’s Intellectual Property
Commercialisation Company (UMIP). However their success is measured
this ’portfolio of incubators, based around the Manchester city region,
catering for companies in the medical/life science and high technology The Journal of the Parliamentary and Scientific
sectors’ has been remarkably successful. Congratulations to all those Dr Brian Iddon MP Committee.
pioneers who were brave enough to launch the first Manchester Chairman, The Committee is an Associate Parliamentary
bioincubator in 1999, one of the first of its kind. Editorial Board Group of members of both Houses of
Science in Parliament Parliament and British members of the
The requirement for Full Economic Costs (FEC) in research grants in the UK European Parliament, representatives of
appears to be shifting some industrial research money away from British scientific and technical institutions, industrial
universities to universities abroad. In any case, what are our Vice-Chancellors organisations and universities.
doing with this money currently? When the call comes, will they be able to
produce it to keep their laboratories and workshops at the cutting edge,
which was the reason for requiring FEC in the first place?
As we enter the final straight leading to the General Election the dominant
discussion appears to be how each party will address the need for cuts to
pay for the debts caused by the ’credit crunch’. Will the science budget
remain ring fenced, even if Labour can earn a fourth term? In talks with
academics and other professionals in the education and health sectors I get
the impression that they are looking for cuts now. For example, the Science in Parliament has two main objectives:
University and College Union tell me that they are engaging in some 1. to inform the scientific and industrial
vigorous discussions with some of our Vice-Chancellors, who are proposing communities of activities within Parliament
of a scientific nature and of the progress of
significant ’restructuring’ in their universities.
relevant legislation;
According to the Trans Atlantic Think Tank for Toxicology at John Hopkins 2. to keep Members of Parliament abreast of
University in Baltimore the cost of REACH compliance may be six times scientific affairs.
previous estimates and use twenty times more animals. It comes as no
surprise therefore that animal rights activism is on the rise again. Novartis
employees have been targeted recently in France and Switzerland, with
renewed demands that the company severs its links with Huntingdon Life
Science.
CONTENTS
BIOETHICS AND DEMENTIA 2 CARBON CAPTURE AND STORAGE – POTENTIAL HAZARDS OF
Professor Albert Weale WILL IT WORK? 20 NANOTECHNOLOGY 38
SCIENCE AND ENGINEERING AT THE Addresses to the P&SC by Charles Hendry MP Professor Vicki Stone and Dr Rob Aitken
HEART OF A FUTURE CONSERVATIVE and Dr Andy Read SUSTAINABLE ELECTRICITY,
GOVERNMENT 3 ERGONOMICS AT 60 – TRANSPORT FUELS AND HEAT 40
Adam Afriyie MP A CELEBRATION 24 Gordon Taylor
STRIVING FOR EXCELLENCE 4 Reg Sell HOUSE OF COMMONS SELECT
Sir Alan Langlands POSTCARD FROM AUSTRALIA 26 COMMITTEE ON SCIENCE AND
Robert Freer TECHNOLOGY 42
REGULATING FORENSIC SCIENCE
QUALITY STANDARDS 6 CHINA – SCIENCE AND INNOVATION 27 HOUSE OF LORDS SCIENCE AND
Andrew Rennison Dr David Bacon TECHNOLOGY SELECT COMMITTEE 43
THE GRAND OPENING OF YOUR MIND8 SCIENCE AND EDUCATION AT THE HOUSE OF COMMONS LIBRARY
Dr Michael Dixon EDEN PROJECT 28 SCIENCE AND ENVIRONMENT SECTION
Professor Sir Ghillean Prance 44
KEW’S MILLENNIUM SEED BANK 10
Simon Linington BRITISH INDIAN OCEAN TERRITORY 30 PARLIAMENTARY OFFICE OF SCIENCE
Professor Charles Sheppard
AND TECHNOLOGY 45
MEDICAL TESTING – DO WE WANT
SELECTED DEBATES AND
MORE OR LESS OF IT? 12 DESIGNS FOR LIFE 32
PARLIAMENTARY QUESTIONS AND
Addresses to the P&SC by Professor Michael Baum THE PARLIAMENTARY AND SCIENTIFIC ANSWERS 47
and Professor Karol Sikora COMMITTEE 34 EURO-NEWS 54
NANOTECHNOLOGY – SHOULD WE BE EPSRC IMPACT! 35
WORRIED? 16 SCIENCE DIRECTORY 55
Addresses to the P&SC by Dr Alec Reader, ROYAL SOCIETY OF CHEMISTRY LINKS PARLIAMENTARY AND SCIENTIFIC
Dr Mike Fisher and Dr Stephanie Lacour DAY 36 COMMITTEE NEWS 63
SCIENCE DIARY 64
Science in Parliament Vol 66 No 4 Autumn 2009 1
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OPINION
BIOETHICS AND DEMENTIA:
A CHALLENGE FOR SCIENCE
Hope, Professor of Medical However, these criteria alone are Scotland but not in England or
Ethics at Oxford, spent almost not enough to make sure that Wales. The Council will be
two years considering the there is a fair distribution of discussing these findings with
difficult dilemmas that people research funding between the the major funders of research
with dementia, their carers and needs of very different parts of and others in the coming weeks.
healthcare professionals have to the population. We concluded
face on a day-to-day basis. that the major research funders
THE FUTURE OF
DEMENTIA CARE
These include: should explain more clearly how
and why they divide their The report ties in with current
• deciding when and how to
research funds between areas of policy discussions. A Green
communicate a diagnosis;
Professor Albert Weale FBA research that have the capacity Paper ‘Shaping the Future of
Chair of the Nuffield Council on • balancing a person’s safety to benefit very different groups Care Together’, published in
Bioethics and Professor of with their need for of the population. If necessary, July, sets out long-term reform
Government, University of Essex
independence and freedom; they should take active steps to proposals on how we as a
support and encourage society provide care for older
Chairing the Nuffield • deciding what is in the best
researchers to carry out high- people. To help them prepare
interests of the person with
Council on Bioethics, a dementia, for example when
quality research in dementia. for future debate around adult
position which I was making decisions about their
More research into the care, Parliamentarians and other
honoured to take up experience of living with policy makers are invited to
care and treatment;
dementia and how people with discuss the issues raised by
in January 2008 for • recognising that the needs of caring for people with dementia
dementia can be supported to
five years, is an the person with dementia may live the best possible lives is at the Council’s annual
exciting and unique sometimes conflict with the particularly needed. ‘Bioethics in Parliament’ event in
opportunity for needs of others, especially the Houses of Parliament. The
carers; RESEARCH event, to be held on 10th
someone like me who PARTICIPATION
• tackling discrimination against November 2009, is supported by
works on social values Evan Harris MP, Brian Iddon MP,
people with dementia; and People with dementia who
and public policy. Earl Howe and Lord Harries of
understand what is involved in a
• deciding what priority to give Pentregarth, and will entail
It allows me to debate particular research project
to dementia research. presentations and debate,
cutting-edge issues in science decide for themselves whether
and medicine, and to do so with The Working Party published or not to take part. Those who followed by a drinks reception.
some of the most interesting its report Dementia: ethical cannot decide for themselves For more information contact
(and pleasant) people in the issues in October 2009. It found may be able to take part as long Catherine Joynson at
UK. Eminent lawyers, scientists, that there are many ways in as a number of legal cjoynson@nuffieldbioethics.org.
clinicians, journalists and which we can work together as requirements are met. We Over the next two years the
philosophers are brought a society to help people with concluded that more should be Council will be considering the
together. After a thorough dementia, and their carers, have done to make it easier for those rise of genetic testing and online
process of consultation and a better quality of life. who have expressed a wish to medicine; the implications of
deliberation, the Council take part in research to do so. advances in biofuels; and the
publishes reports that aim to RESEARCH PRIORITIES For example, clinical trial donation and use of bodily
clarify bioethical issues and One important conclusion networks, which bring together material such as gametes, blood,
influence the development of was that the amount of funding doctors and people with tissue and organs in medical
policy. available for dementia research dementia who want to take part treatment and research. At a
appears low, given both the in research, should be time when the biosciences
THE ETHICS OF number of people with encouraged; and the possibility present us all with challenges
DEMENTIA dementia and the effect of giving welfare attorneys the and opportunities, all those on
Most recently, the Council dementia has on people’s lives. power to decide if a person with the Council hope that their work
considered the ethical dilemmas Research funding bodies rightly dementia should take part in will be of public benefit and
raised by dementia. An expert choose to fund research that is research should be considered. advance the public
Working Party, ably led by Tony important and high quality. At present, this is possible in understanding of bioethics.
2 Science in Parliament Vol 66 No 4 Autumn 2009
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OPINION
SCIENCE AND ENGINEERING
AT THE HEART OF A FUTURE
CONSERVATIVE GOVERNMENT
I was delighted to join with Second, with the latest Science and engineering
members of the Innovation, machinery of government belong at the heart of
Universities, Science and Skills changes, science now competes government policy, and I am
Committee to campaign for a for attention in a bigger deeply conscious of the
new science and technology department than ever before. contribution they will make to a
committee. And it was With both the Science Minister future Conservative government.
enlightening to speak at the and the Secretary of State That’s why I am taking action
recent Parliamentary Links day in tucked away in the Lords – now to raise the profile of the
support of the annual exchanges distant from the usual STEM subjects in the
between MPs and professional Commons scrutiny – I will Conservative Party.
Adam Afriyie MP
scientists. certainly look to the select
At this year’s party
committees for help in holding
These events reminded me conference I will be launching
ministers to account.
that Britain is not just a nation of the Conservative Friends of
bankers and borrowers. We also Third, Parliament will Science. The idea has been
have a proud scientific tradition. continue to rely on its select greeted warmly and
The expenses scandal That tradition deserves committees and organisations enthusiastically, and we’re
shook Parliament to its recognition in public life on such as POST to underpin the delighted that Simon Singh has
core. The fallout has more than merely historic rigour of scientific debate. In the agreed to say a few words at
grounds. course of the next Parliament, the reception. The group will
been extensive, and
MPs may be required to tackle a provide a forum for
there are now I have hopes that the new
range of tricky issues. This could Parliamentarians, party activists,
justifiable calls for Science and Technology
involve anything from the corporate and individual
change. Committee will rise to that
presence of nano-particles on members to debate scientific
challenge like its predecessors.
the high street to the use of issues and inform policy. And it
One area of In fact, there are at least three
genetic information by insurers. will enable members to help
Parliamentary activity reasons why the committee will
So Parliament will need a promote the STEM subjects
retains its vitality: probably gain influence over the
dedicated, cross-departmental alongside the many
science. Over the coming months and years.
select committee to weigh up organisations already active in
course of the year it First, the policy focus is quite the evidence and deliver sound the field.
has been a pleasure to rightly shifting away from the recommendations.
Effective policy is based on
work with POST (the failed economic model of the
This cross-departmental role sound evidence. That’s why
Parliamentary Office of past decade. Attention is quite
is critical. Science is not science and engineering matter.
rightly turning to the role that
Science and restricted to just one Whitehall The Conservative Friends of
science and innovation can play
Technology) to in rebalancing our lop-sided
department. Whether it’s social Science will be making a strong
develop a programme economy. Effective scrutiny of
science in the Home Office or case for science and engineering
of science literacy climate science in DECC, at the heart of Conservative
government science policy will
ministers, officials and policy-making.
training for new be essential in the years to
Parliamentarians all depend on
Conservative MPs. come.
reliable scientific advice.
Adam Afriyie is the Conservative MP
for Windsor and Shadow Minister
for Science and Innovation.
. . . events reminded me that Britain is not just a nation of
bankers and borrowers . . .
Science in Parliament Vol 66 No 4 Autumn 2009 3
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STRIVING FOR EXCELLENCE
I have taken on the Chief categories in England has recent data show that the UK
Executive’s role at the Higher increased from 1.57m in 1998- arts and humanities community
Education Funding Council for 99 to 1.99m in 2007-08. The publishes nearly as many
England (HEFCE) at a testing higher education participation scholarly papers as the US –
time – universities and colleges rate increased by two 33% of the world’s output is
face very tough financial percentage points to 43.3% from the UK versus 37% from
conditions and yet they are between 1999-2000 and 2007- the US in the period 2006-
crucial to delivering the country’s 08. 2008.
twin aims of a vibrant economy
Universities in England are FUTURE CHALLENGES
and a just society. HEFCE has a
autonomous, self-governing
Sir Alan Langlands FRSE key role to play in promoting This strong position achieved
bodies. They derive income
Chief Executive, high quality, cost effective in recent years is at risk from
Higher Education Funding Council from multiple sources and the
teaching and research to meet intense competition from many
for England overall turnover for 2007-08
the needs of students, the other countries, reductions in
(the most recent year for which
economy and society. This growth in public spending,
full figures are available) was
needs sustained investment and threats to university income and
£19.4bn. HEFCE funding in that
of course university funding will fluctuations in the financial and
year was £7.37bn. HEFCE
be centre stage when the fees property markets affecting
therefore funds about 37% of
review gets under way later this endowment funds and the
the total activity in universities.
year. In the mean time, it is redevelopment of our
This level of investment –
important to galvanise the campuses. In these times of
coupled to the Government’s
intellectual, financial and physical hard choices, Government, the
long-term commitment to
assets in higher education to universities, employers, the
science and publicly-funded
best effect, striving for excellence Research Councils, HEFCE and a
in all that we do. research, and the introduction of wide range of representative
variable fees – has enabled UK bodies need to work together to
VITAL STATISTICS universities to maintain their build on the international
HEFCE recurrent funding for international competitiveness standing of higher education. At
2009-10 is £6.4bn – including whilst supporting the the very least this means striking
£4.7bn for learning and Government’s policy of a new balance between public
teaching, and research widening participation in higher expenditure and student/
allocations of £1.6bn. We also education. employer contributions,
provide non-recurrent funding of There are 17 UK universities developing a sustainable system
£1.5bn including capital in the world’s top 100, 14 of of student support and, even
allocations of £1.2bn. Separate which are in England. The UK with some further
arrangements exist in the rest of played host to 284,260 improvements in efficiency,
the UK, vested in the Higher international students in 2007- recognising that quality may well
Education Funding Council for 08 and the UK share of have to be protected at the
Wales, the Scottish Funding international trade in higher expense of increased volume
Council and the Department for education is stable at 11%, the and new initiatives which fall
Employment and Learning in second-highest country share outside our core mission of
Northern Ireland. HEFCE funding behind the United States. With higher education and research.
has grown by 60% in real terms 1% of the world’s population,
since 1998-99 and the total ACTION NOT WORDS
the UK achieved 12% of the
number of students in all world’s scientific citations, and The debate about higher
education funding will take its
course over the next twelve to
twenty-four months but there is
. . . With 1% of the world’s population, the UK achieved plenty to do in the mean time
and I envisage that HEFCE,
12% of the world’s scientific citations. . . universities, colleges and other
partners will work hard to
ensure that the quality of
4 Science in Parliament Vol 66 No 4 Autumn 2009
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teaching continues to be trusted RESEARCH IN HIGHER
for the future, that we maintain EDUCATION
excellence in research and that
we work with others for positive
The plurality of funding for . . . higher education has proved
university-based research, from
economic and social results.
public and other sources, is a to be an asset at national,
QUALITY AND major strength of the UK
regional and local level –
STANDARDS system. HEFCE funding,
The quality and standards
provided as one leg of dual generating value of £55bn to
support, enables institutions to
achieved in higher education the economy. . .
maintain a dynamic and
have been in the spotlight over
responsive research base of
the past year with no shortage
world-leading quality. This
of media comment about
enables ground-breaking basic
admissions criteria; the role of
research, with the potential to
the Quality Assurance Agency WORKING WITH OTHERS benefit 50,000 people and
drive future innovation and
for higher education; and 11,700 businesses. Universities
respond quickly to changes in In return for all this public
concerns about a dumbing- and colleges have also
the external environment. investment higher education has
down of academic standards. demonstrated an ability to
Challenges include: proved to be an asset at
The House of Commons stimulate new markets through
national, regional and local level
Innovation, Universities, Science • maintaining the balance programmes which are co-
– generating value of £55bn to
and Skills Select Committee and between funding for curiosity- funded by employers. In 2008-
the economy, and promoting
a high level sub-committee of driven research and for work 09, employers will be funding
important health and social
HEFCE have recently reported. targeted on identified national £7m towards the course costs
benefits.
The emerging consensus is that needs and priorities. The of 6,000 FTE on top of HEFCE’s
there is no evidence of systemic leading funders (HEFCE, the HEFCE, working with BIS £17m. We expect this to
failure in the present UK Research Councils, the encourages close working increase to the target of 35,000
arrangements, but that some NHS and major charities) are relationships between higher entrants by 2010-11.
improvements need to be committed to working together education and business, public
made. and engaging with industry to services and the voluntary AND FINALLY………
achieve this sector. The higher education Over nearly twenty years I
Action is required to ensure innovation fund (HEIF) has have worked for about half my
that: • developing the new research
been used to establish an time in and around Whitehall
excellence framework – the
• the QAA has a more public- institutional infrastructure for and half as the Principal and
REF – to assess the quality of
facing remit, re-assuring the commercialisation, innovation Vice-Chancellor of a University.
research outputs, their impact
non-expert and adopting a and enterprise. Universities and My task now is to help broker
on the economy and society
more flexible approach in its colleges generated £10.3bn in the partnership between
and the vibrancy and
audit methodologies value from users in the period Government and universities
professionalism of the research
2001-07; and the return on the and colleges to ensure that we
• applicants, students, parents environment. A consultation
HEFCE investment has been make best use of public money
and employers should have document on this new
evidenced at between £4.9-£7.1 and have the high level skills
ready access to information approach to assessment has
for every £1 of HEIF. and the research base we need
about programmes of study just been published
Higher education also plays a for long-term success. I doubt if
and what is expected of
• continuing to develop the life will be dull………….
students who undertake these fundamental role in delivering
infrastructure and human
programmes the knowledge and skills
capital required to support
required in a rapidly changing
• the external examiner system industry collaborations, Sir Alan Langlands was formerly the
economy, through the supply of Principal and Vice Chancellor of the
(a key part of the system of technology transfer and inward University of Dundee (2000-2009)
graduates but increasingly
self-regulation and peer review investment and Chief Executive of the NHS in
through flexible higher education England (1994-2000). He also has
at institutional level) should be
Strong basic research is a designed around the needs of a particular interest in the scientific
reviewed and sharpened up basis of health services and he
cornerstone of Britain’s success employers. Universities have
chairs the boards of UK Biobank –
HEFCE and universities will and, over time, it can make a real shown that they can respond a major genetic epidemiology study
also maintain their commitment difference to our everyday lives. It quickly to business needs, funded principally by The Wellcome
Trust and The Medical Research
to promoting study in science, is valued by industry and by leveraging an additional £31m Council – and the Health
technology, engineering and society but it will continue to on top of HEFCE investment of Foundation, a UK-wide charity
mathematics – boosting need long term commitment, £25m to offer rapid support for committed to improving the quality
of healthcare. He is also a co-opted
demand and provision to meet time and money. There are no business and graduates through member of the Office for the
the needs of employers and short cuts on the journey from the Economic Challenge Strategic Co-ordination of Health
Research.
new industries. the laboratory to the marketplace. Investment Fund. The fund will
Science in Parliament Vol 66 No 4 Autumn 2009 5
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REGULATING FORENSIC
SCIENCE QUALITY
STANDARDS
What are the challenges I These three facets do not nothing but help and support
face as the Forensic Science operate in isolation but are, for from the forensic science
Regulator? This is a common the vast majority of forensic community and from wider
question and one that I science, interdependent and in stakeholders such as the Crown
regularly ponder on as my terms of oversight and Prosecution Service. I have the
role matures and the assessment benefit from a benefit of continuous and
challenges become clearer; I single process that is designed constructive advice from my
stepped into the role in to assess all three, more on this Forensic Science Advisory
February last year and always later. Council, the Association of
knew it would take time to Forensic Science Providers, and
In England and Wales we
Andrew Rennison MSc unravel all the issues and the Forensic Science Society as
now have a commercial supply
Forensic Science Regulator challenges to be faced in a well as expert advice from the
market with the police operating
changing forensic science many and varied members of
procurement frameworks
landscape. My principal task is the specialist groups I have
leading to contracts with a
to set and monitor quality established to work on different
number of commercial
standards for forensic science aspects of the standards
suppliers. We also have the
used in the investigation of framework. Naturally there are
police and other law
crime and prosecution of issues to be debated and
enforcement bodies providing
offenders in England and different views to consider,
aspects of forensic science
Wales. From the outset it was which is why consultation is so
services through their own in-
clear that any standards had important. I like to think that I
house resources. In Scotland
to be UK-wide so we have am able to reach all those that
and Northern Ireland all forensic
reached agreements with the want to be consulted and that
science services are provided by
Scotland and Northern Ireland their views are heard.
the police and government
authorities to work together
laboratories. Suffice to say that But why do we need a new
such that any standards we
we have different supply models standards framework?
develop can and most likely
with a mix of police, state and Historically, and prior to the
will be adopted in those
commercial provision, all of commercial market for forensic
jurisdictions.
which, in my view, should science, achieving quality and
In setting quality standards I operate within a single quality standards at the laboratory level
want to be sure that standards framework. was one of the responsibilities
organisations have effective of the Chief Scientist of the
The notion of a single quality
quality management systems, Forensic Science Service (FSS).
standards framework for all UK
that their forensic science The FSS was a leading member
forensic science is, to me, an
practitioners are competent and of the European Network of
obvious one. I am pleased to
that the science methods they Forensic Science Institutes
say that in developing such a
use are valid and fit for purpose. (ENFSI) set up in 1995 to
framework I have received
establish common quality
standards for European forensic
science laboratories. I applaud
the work done by ENFSI and the
. . . The notion of a single quality standards framework for role the FSS played in setting
all UK forensic science is, to me, an obvious one. . . high standards for state, and
now the commercial
laboratories, across the UK, all of
which are accredited by the
United Kingdom Accreditation
6 Science in Parliament Vol 66 No 4 Autumn 2009
7945 SIP AUTUMN 09 5/10/09 10:17 Page 9
Service (UKAS) against the general and understandable
standards recommended by concern is that of the costs
ENFSI. I also applaud the work associated with assessment by
undertaken by the Custodian of UKAS against the standards
the National DNA Database to leading to accreditation. UKAS
set high standards for the use of are by far the best equipped . . . A challenge has been to
DNA technology used to supply organisation for this role and
develop a standards framework
DNA profiles to the database. By save me the expense and
working closely with UKAS the logistical problems of that meets the needs of the UK
Custodian improved on the establishing a compliance team.
ENFSI standards such that all UK Accreditation by UKAS covers in criminal justice systems and to
DNA laboratories are accredited depth and in a single process
achieve the support of all
and constantly assessed against the three aspects I covered
what I think are world class earlier: organisational stakeholders. . .
standards. competence, the individual
competence of practitioners and
However, much of what we
the validity of the science they
term as ‘forensic science’ is
use.
conducted outside of the
report following that review new framework and have
laboratory environment, for When I arrived in post we
recommended a standards received broad support. We are
example police crime scene had the Council for the
model that did not include currently considering the
examinations for forensic Registration of Forensic
CRFP; the report is available on excellent and varied responses
evidence, and some law Practitioners (CRFP) as a body
my website as are the we received following
enforcement bodies have small setting and monitoring
responses I received following publication and will have a final
in-house forensic laboratories; competency standards for
publication1. The net result is version available for publication
most police forces have individual practitioners.
that the police, whose staff by the end of this year.
fingerprint development Established in 1998, with full
made up the majority of the
laboratories using process and government support, CRFP had A challenge has been to
registered pool, decided to
methods to develop and a role to assess the competence develop a standards framework
withdraw from CRFP. This in turn
enhance finger and palm prints. of individual practitioners and to that meets the needs of the UK
led to significant funding
Most of this work does not register those that were found to criminal justice systems and to
problems and the CRFP board
operate within the same be up to standard in their work. achieve the support of all
were left with no choice but to
accreditation based standards CRFP had, since its inception, stakeholders. There is still fine
cease trading (CRFP operated as
framework that the larger failed in its targets to register the tuning to be done, but with the
a company limited by
laboratories do. The police do majority of forensic practitioners continued support I have
guarantee). In my view,
operate ISO 9001 quality and to become self-financing. received so far and with the
supported by other stakeholders
management systems for their CRFP made no assessment of continued involvement of the
and in advice I gave to Ministers,
fingerprint analysis with some organisational competence or of broad range of experts and
losing CRFP caused no risks to
forces extending this to cover all the validity of the science used practitioners that we rely on we
the criminal justice system.
their forensic science work. I am by individual practitioners. Their will have a world leading quality
grateful for the on-going support role was reviewed by the Home We are now moving from an standards framework for forensic
and advice I receive from the Office in 2004; Ministers then ad hoc and largely unco- science. The UK has a proud
police lead on forensic science, decided to continue with grant- ordinated approach to quality reputation for innovation and
Chief Constable Chris Sims, also in-aid but with a very clear and standards to one based on use of science in the
from the Chief Executive of the stipulation that this was to end a single coherent framework, in investigation of crime and the
National Policing Improvement by March 2010 as CRFP turn with a single compliance prosecution of offenders. The
Agency, Chief Constable Peter registered more practitioners assessment mechanism. An most obvious and best example
Neyroud. Both recognise the and achieved self-financing. example of the lack of co- of this is DNA technology. As the
need for a standards framework When I started in my work CRFP ordination was the competence new model for the supply of
that includes the police. Mr Sims had registered about 3,000 assessment of senior scientists forensic science services
recently wrote to all chief people making up about 35% within the laboratories that was continues to develop we can be
constables to explain my of the current forensic duplicated through UKAS assured that a new and up-to-
proposed standards framework practitioner population and was accreditation and CRFP date quality standards
and received general support unlikely to meet the targets set registration, added to which the framework is also developing.
but with some requests for in 2004; soon after I started junior scientists were covered by
further work to understand the they wrote to Ministers seeking accreditation but were not 1 http://police.homeoffice.gov.uk/
impact, in terms of costs and further funding at which point I eligible for CRFP registration. I operational-policing/forensic-science-
regulator/
benefits, for the police if they was tasked with reviewing the have published the standards I
move to adopt the standards. A registration of practitioners. My propose to be the basis for this
Science in Parliament Vol 66 No 4 Autumn 2009 7
7945 SIP AUTUMN 09 5/10/09 10:17 Page 10
THE GRAND OPENING OF
YOUR MIND
THE SCIENCE OF • we explore the deep sea to catastrophe. It has never been
NATURE understand how environmental more important to understand
changes affect this important our planet and to engage as
Our science, taxonomy and
ecosystem many people as possible with
systematics, underpins all of the
appreciating and protecting the
natural sciences and is a vital • we study mosquitoes to help
natural world. This is why we
part of the nation’s science prevent such diseases as
opened our state-of-the-art
capability. We also work on more malaria and Dengue fever
Darwin Centre on 14 September,
applied science, such as the • we study nanoparticles to named after Charles Darwin to
control of parasitic diseases, support safe use of this mark his bicentenary and
sustainable mineral extraction revolutionary technology
Dr Michael Dixon celebrate his work that continues
and forensic entomology. We are
Director, by the Museum as we look from
supporting the development of • we study comet dust to trace
Natural History Museum the origin to the future of
innovative technologies in the origins of the solar system
species.
emerging areas such as the use • we are working with the first
of nanoparticles. Darwin Centre is a hub of
Indian space mission to reveal
world-class scientific research,
Our science is firmly rooted in the geological history of the
For more than 200 allowing visitors to marvel at the
the collections themselves. We Moon.
amazing diversity of life on our
years, scientists at the are focused on six main lines of Next year, the Museum and planet, to view our science in
Natural History enquiry: our science will be centre-stage action, understand the extent
Museum have been • assembling the Tree of Life as we, with support from Defra, and research use of our
exploring and studying will run the 2010 International collections and to explore the
• the relationship between Year of Biodiversity UK
the natural world, natural world for themselves.
genetic diversity and Partnership that aims to promote
using our incredible environment and evolution wider understanding of our
The visitor experience in this
internationally • how large-scale geological impacts on our planet.
new London landmark will begin
in the spacious atrium, where
important collection of processes have influenced
people can orientate themselves
over 70 million evolution THE DARWIN CENTRE
while admiring the views into the
specimens to address • what determines biological Today we are facing a large- wildlife garden and the
the big questions of diversity scale biodiversity crisis and enormous cocoon towering
our time, such as potential environmental above. The climate change wall
• the relationship between
tracing the origins of biodiversity and ecosystem
our solar system or functioning
monitoring and • the interactions between hosts
assessing the impact and parasites and their impact
of climate change. on disease.
Until now, most of this We have active research
work has happened programmes that look at
providing answers to
behind the scenes
contemporary issues, for
without many people example:
knowing that we are
• we study Madagascar’s tree
more than a beautiful ferns to find out how climate
building with historical change impacts the world’s
specimens on display. precious rainforests
8 Science in Parliament Vol 66 No 4 Autumn 20097945 SIP AUTUMN 09 5/10/09 10:17 Page 11
specimens. More than 200 THE ANGELA MARMONT role to play in assisting the
scientists will be working in the CENTRE FOR UK generation of and distribution of
Cocoon and the adjoining BIODIVERSITY vital knowledge.
multidisciplinary facilities, carrying
Housed on the lower ground Since free admission was
out their research in the
floor of the Darwin Centre, the reintroduced in 2001, we have
molecular and imaging labs or
Angela Marmont Centre for UK welcomed over 25 million
specimen preparation areas.
Biodiversity will become the visitors to the Museum and
Through viewing decks, video
leading national venue for the expect that with the opening of
and intercom, visitors will be able
collaborative study of UK natural the Darwin Centre we will
to see and interact with some of
history. The Museum receives receive a record 4 million visitors
our staff – opening up the
around 30,000 public enquiries this year.
hidden world of scientific
each year and visitors will be The Darwin Centre is a bold
research. There is no other
encouraged to bring their finds statement about our ambitions
museum in the world that brings
to the new centre, where and a demonstration of our
the public and scientists together
dedicated staff will guide them ability to deliver large, complex
in this way or on this scale.
is an interactive collage of through the reference material projects. It is also an excellent
screens displaying films, and collections. Much of the example of using public funding
THE ATTENBOROUGH Museum’s UK collections will be
specimens and images to allow to leverage wider support for
STUDIO available for amateur naturalists
users to explore the reality of public benefit.
climate change in their lives. Based on the research and to study, including 4,200 drawers
Visitors can also collect a free collections of the Museum and of butterflies and 6,200 drawers We would like to express
NaturePlus card, which uses new the legacy of Sir David of flowers. This access will offer thanks for the invaluable support
barcoding technology to enable Attenborough’s filmmaking, the new opportunities for the UK’s and contributions we have
them to save video clips, images new Attenborough Studio will many wildlife groups and received from many
and weblinks throughout their
journey through the Darwin
Centre and access them on line
back home or in the classroom.
THE COCOON
At the heart of the new
Darwin Centre is a 65-metre-
long, eight-storey-high cocoon
that safeguards many of the
Museum’s treasures, including
from our Entomology and
Botany collections – 17 million
insects and 3 million plant
combine scientific expertise, societies and will nurture, inspireorganisations and individuals,
public dialogue, film and and excite naturalists of all ages.including: the Department for
interactive media in a venue Culture, Media and Sport, the
specially built to create a truly THE FUTURE Heritage Lottery Fund, the
accessible environment. Excellence in applied science Wellcome Trust, the Weston
Pioneering technology will allow depends on support for pure Foundation, the Cadogan family,
visitors to engage in real time science, like taxonomy and Professor and Mrs Anthony
link-ups with Museum systematics. We believe that with Marmont, GlaxoSmithKline, and
researchers around the world, or an informed and engaged public, the Rufford Maurice Laing
influence projected 3D images in science can fully play its crucial Foundation.
our interactive film Who do you role in boosting competitiveness, The Darwin Centre will
think you are? A free, daily enhancing our quality of life and change perceptions of what
programme of screenings, ensuring a sustainable future. In museums of natural history can
discussions and events will a time when humanity is facing be and I hope you are able to
include films specially created by massive environmental visit us in the near future, so you
the BBC Natural History Unit to challenges, like climate change, can personally explore this
celebrate wildlife filmmaking. we and our peer institutions magnificent addition to the
have an even more important Museum.
Science in Parliament Vol 66 No 4 Autumn 2009 97945 SIP AUTUMN 09 5/10/09 10:17 Page 12
KEW’S MILLENNIUM SEED
BANK: A VITAL RESOURCE
FOR AN UNCERTAIN WORLD
Simon Linington
A week is a long time one is planned. It needs modest
in politics. But seeds financial support and, to achieve
this, it needs to build on the
can span even human
political support received to
generations with ease, date.
a feature that gives us
Seed banking is a simple and
a vital opportunity to robust technology. For seeds of
prepare now for the most species, drying greatly
‘perfect storm’ of increases longevity. This drying is
environmental often carried out in a low
problems predicted by humidity room at cool
temperatures. Additional cooling
the Government Chief of the dried and hermetically-
Scientist. sealed seeds further increases
storage life, though there are
Dr Paul Smith, Head of the Millennium Seed Bank, sharing his seed
For most plants, on which all diminishing returns as the knowledge with the partners
life depends, seeds provide a temperature drops. Many banks
1803 who was ‘relieved’ of Britain today. Furthermore, the
means of surviving this storm. such as Kew’s Millennium Seed
them by British privateers. The fact that we take these benefits
By ‘banking’ them now, future Bank have cold storage rooms
seeds passed via the Admiralty so much for granted would
generations will be able to draw running at domestic deep
to the Tower of London and perhaps have shocked
on the widest range of plant freezer temperatures; others use
eventually into the current someone with an existence
diversity and fashion plant-based cryo-storage in liquid nitrogen.
National Archives where they more obviously bound to plants,
solutions to problems of human But just how long can these
were recently discovered and much as it is still in large parts
well-being thrown up by a seeds live under bank
sent to us to attempt of the Developing World. Of
dramatically changing world. In conditions? By extrapolating
germination. Their germination is course, things may go full circle.
this, its 250th anniversary year, from experiments that speed up
an exceptionally rare event for With human population racing
the Royal Botanic Gardens, Kew seed ageing, there is good
seeds of such antiquity. towards seven billion, finite
has successfully conserved seed evidence that many of the MSB
agricultural land and increasing
from 10% of the world’s collections will still be Storing seeds for two
water shortages, food insecurity
flowering plant species. The germinated two hundred years centuries will enable us to
is likely to spread. We may
Millennium Seed Bank Project, from now. Added to this, we bridge a phenomenal period of
quickly retreat two hundred
which is led by Kew and have even germinated seeds technological, sociological and
years in this respect. Therefore,
international in its scope, has that were collected in the environmental change, the
we will need to be able to call
achieved this significant Napoleonic era and stored conclusion of which is difficult to
on every botanical reserve
milestone on time and within under much more adverse imagine. Over the last two
available to create new crops
budget. It is a conservation conditions than those offered in hundred years, there have been
and to put new genes into
initiative of which the UK should the state-of-the-art MSB, though huge improvements in human
existing crops. Rightly or
be very proud. While a admittedly, few of them wellbeing as a result of greater
wrongly, we are already
tremendous start has been germinated. These 200-year-old access to plant diversity, in
returning to plants as a
made, a great deal more needs seeds found their way to us which Kew has played its part.
renewable source of fuel.
to be done if we are to make a after a remarkable journey. They An early Nineteenth Century
Commodity shortages would
real impact on the erosion of were in the possession of a Briton would be staggered at the
certainly reawaken latent
plant diversity. A new ten year Dutch merchant on passage out variety of fruit, vegetables and
awareness of the human
project that builds on the current from the South African Cape in plant-based drugs available in
10 Science in Parliament Vol 66 No 4 Autumn 20097945 SIP AUTUMN 09 5/10/09 10:17 Page 13
survival value of many plants Project was launched with a seed collecting work, mainly in seed banking operation lean and
and could drive an grant of close to £30 million dry vegetation, has brought focused, a challenging target has
unprecedented wave of from the Millennium together each nation’s been set of bringing the species
conservation and innovation. But Commission. The matching conservation priorities in a way stored up to 25% of the world’s
by that time we may have funding for this landmark project that has helped deliver the flora by 2020. Obviously,
already depleted the botanical came from the Wellcome Trust, project’s species target. At the difficulty of locating and
resources that can help us Orange plc, Kew itself, the public heart of targeting have been collecting new species increases
adapt. Plant diversity is being and many others. A fine new endangered, endemic (for which with the law of diminishing
eroded by habitat loss due to facility, the Wellcome Trust countries have a unique returns. Additionally, and in line
urbanisation and agriculture. Millennium Building, was built at responsibility) and locally with Kew’s Breathing Planet
Climate change may exacerbate Wakehurst Place with a large economic species. The capacity- Programme, the new project will
this erosion and has led to the underground storage vault, building activities have centred focus on using the collections
prediction that up to two thirds processing and research on training both here and sustainably including on the
of all plant species may stand laboratories, public interpretation abroad, and assistance with the repair of damaged habitats.
on the abyss of extinction by the designed to show the design and equipping of partner Demonstrating new uses of
end of this century. We cannot conservation process unfolding, seed banks. The latter species drives the financial
rely on conserving plants where and residential accommodation encourages ex situ conservation imperative to conserve. We have
they grow. Therefore, off site (ex for visiting scientists. It was in the country where the plants a unique chance to do
situ) conservation is necessary. opened by HRH The Prince of grow; consequently, Kew’s something about the gathering
Of the techniques available, only Wales on 20 November 2000. storage role is one of safety storm. There is still significant
seed banks allow us to conserve Simultaneously, Kew worked duplication. Underpinning this plant genetic diversity left in the
billions of genetically different with the voluntary sector to project is an unparalleled seed wild but it won’t be there for
individuals for hundreds of years collect samples of most of the research programme that seeks long. We have the drive,
and relatively cheaply. UK’s seed-bearing species; a to improve the effectiveness of expertise (Kew alone has over
world first for a national flora storage and our ability to recover 500 person years of seed
Long-term seed banks were
that encouraged other countries the full genetic potential of the banking experience), the
first established for crop diversity
to follow suit. collections by breaking seed technology and partners to
in the middle of the last century.
dormancy. This can be a major make a huge impact. With a
Work by Kew and in Spain in the In addition to the priceless
problem with seeds of wild price tag of £77 million, fund-
1960s showed that this seeds conserved and the
species and there is still much raising is proving difficult in this
technique could be applied to a thousands of samples
to be learnt. Such new data will time of financial stringency.
much wider array of wild species distributed for unique research
not only benefit seed banks but However, it is money that must
and, in 1974 Kew created a and habitat restoration, perhaps
horticulture, agriculture and be found if the world is to have
seed bank for wild species at its the greatest legacy of this
habitat restoration. the tools to thrive in an
Wakehurst Place garden in West unique project has been the
uncertain future. It would be a
Sussex. From the early 1980s international co-operation The safeguarding of so many
fitting tribute to this country’s
the bank focused on plants from engendered. In some countries plant species by the partnership
foresight if the people of the
the world’s dry lands which had partnerships have been is both a major achievement
23rd century looked back to this
received little attention from catalysed between institutes that and responsibility. But there is
moment as the one when their
conservationists and yet which have never worked together so much left to be done. Kew is
botanical legacy was secured.
supported nearly a fifth of the before. The partnership now now galvanising support for a
world’s people, providing comprises 128 institutes in 54 successor project that will start
everything from local foods and countries. Furthermore, there is in January. In order to keep the
medicines to building materials now collaboration that is
and fencing. In the early 1990s independent of Kew – a sure
a challenge was made by Kew’s sign that the network is
Trustees to expand sufficiently established. In 16 of these
the work to make a significant countries a major collaboration
impact on the problem of has been established with
genetic erosion and species loss. botanical, forestry and
The result was a plan for the conservation agencies based on
seed collection of 24,000 legally-binding agreements that
species in ten years. Kew had clarify the expectations of both
recently established a strong parties and cover collecting,
fund-raising foundation and, capacity building and research.
fortuitously, the UK was These agreements helped
preparing to celebrate the exemplify the implementation of
Millennium. In December 1995 the 1992 Convention on A scientist putting the collected seeds into the vault at the Millennium
the Millennium Seed Bank Biological Diversity (CBD). The Seed Bank
Science in Parliament Vol 66 No 4 Autumn 2009 117945 SIP AUTUMN 09 5/10/09 10:17 Page 14
MEDICAL TESTING - DO WE WANT MORE OR LESS OF IT?
Meeting of the Parliamentary and Scientific Committee on Tuesday 16th June 2009
BREAST CANCER SCREENING
SHOULD ROUTINE SCREENING BY MAMMOGRAPHY BE REPLACED BY A MORE SELECTIVE
SERVICE OF RISK ASSESSMENT/RISK MANAGEMENT?
biases of screening that give a “Breast screening: the facts—or opportunity and we have
false impression of benefit and maybe not” by Peter C Gøtzsche witnessed a drop in mortality of
secondly the over-detection of and his colleagues from the 30%-40% both in the age group
cancer “look-alikes” that if left influential and independent, that are invited for screening
undetected might never threaten Nordic Cochrane Centre.1 (>50) as well as for the younger
a patient’s life. The survival from woman. So perhaps the correct
In this paper they describe a
cancer is measured from the number might be 1:3,000. (See
synthesis of all the papers that
time of detection until recurrence table 1).
describe both the benefits and
and death. If a frame shift in the Absolute value screening
harms of screening using
chronology of the disease due to 10,000 women for 10 years
absolute benefits (ie number
Michael Baum
screening occurs, then survival is assuming two estimates of
needed to screen) rather than
Professor of Surgery Emeritus and automatically extended even if relative risk reduction and
visiting Professor of Medical
RRR, that makes it easier for
the ultimate outcome is the assuming that unscreened
Humanities, University College women to comprehend and
London same; this is called lead-time symptomatic women receive the
conclude as follows. If 2000
bias. Next, bearing in mind that best of modern therapy.
women are screened regularly
the interval between screens is
for 10 years, one will benefit Whatever the number, that
INTRODUCTION anything from one to three years,
from the screening, as she will one woman who benefits from a
it is inevitable that the fast
The majority of lay people avoid dying from breast cancer. decade of screening has a life of
growing tumours with a bad
could be forgiven for believing (The independent United States infinite worth and if screening
prognosis will appear during the
that one of the mainstays in the Preventive Services Task Force were as non-toxic as wearing a
intervals whilst the slow growing
fight against cancer is “early derived a similar number in seat belt there would be no case
tumours with a good prognosis
detection”. In the vanguard of this will sit around until found by 2004.2) However even the to answer. However there is a
campaign, the NHS screening figures 1:2,000 might be an downside and that is the
mammography; this is called
programme for breast cancer over-estimate. Remember these problem of the over-diagnosis of
length bias. There is also another
(NHSBSP) by mammography data were derived from the trials “pseudo-cancers”. 3, 4, 5, It is
subtle bias that can be described
has been lauded as a triumph. If as the “self selection” bias. In that that were mostly started in the deduced by the Cochrane report
nothing else the introduction of 1970s and reported in the late that for every life saved 10
women who accept invitations
this programme has improved 1980s. Since then improvements healthy women will, as a
for screening might be
the service for the diagnosis and demographically different to in treatment, such as the consequence, become cancer
treatment of all women with adoption of tamoxifen and patients and will be treated
those who ignore the invitation.
breast cancer of any age and any The only way to account for adjuvant chemotherapy, have unnecessarily. These women will
stage. However we cannot narrowed the window of have either a part of their breast
these biases is to consider all the
remain complacent and continue clinical trials of screening versus
uncritically with a service based no screening and look for the TABLE 1
on a limited number of trials that pooled results described in terms 10,000 women 25% Relative 15% Relative
are more than 20 years out of of mortality ie the number of aged 50 screened risk reduction 6 risk reduction1
date. Our understanding of women dying in the screened for 10 years (HR 0.75) (HR 0.85)
breast cancer has moved on group compared with those
Cancer incidence
since then and as a result our dying in the control group rather
(2 per 1,000/year) 200 200
attitude to screening is worthy of than case survival. The results are
a fresh look. then described as relative risk Cancer deaths
reduction (RRR) or hazard ratios without screening at
THE ILLUSIONS AND (HR). There is in fact a modest median follow up 5 years 9 20 20
DELUSIONS OF “EARLY advantage to screening looked
DETECTION” Cancer deaths with
upon in those terms, (RRR 15% screening (20 X HR) 15 17
Let us start by considering two or HR 0.85) as described in the
separate but related issues; firstly recent publication in the BMJ; Absolute benefit 5 3
12 Science in Parliament Vol 66 No 4 Autumn 20097945 SIP AUTUMN 09 5/10/09 10:17 Page 15
or the whole breast removed, rarely wound healing carries on of an integrated programme. The recruitment into RCTs for the
and they will often receive too long and leaves an ugly first step is to set up a facility treatment of cancer that is the
radiotherapy and sometimes keloid scar. Virchow, the father of nationwide for risk assessment major contributor to the dramatic
chemotherapy. modern pathology, himself once using one of the modern fall in breast cancer mortality in
described cancer as the wound computer programmes. Women the UK over the last two
AN EXPLANATION FOR, that never heals. Prolonged would then be offered, not decades. If we can now add to
AND THE NATURE OF, latency followed by catastrophe compelled to accept this service. this the prevention of the disease
THE OVER-DIAGNOSED should not be all that surprising. Initially a practice nurse could and a risk adjusted screening
CANCERS administer this questionnaire but programme then everyone is a
Screening for breast cancer is
IS THERE A REASONABLE it would be quite easy to transfer winner.
now adopted as an unequivocal
WAY OF MODERNISING this to a web- based programme References
good by most of the members
THE NHS SCREENING for the computer literate [1] “Breast screening: the facts—or maybe
of the EU. Invitations for
PROGRAMME THAT members of the community. not”, Gøtzsche PC et al BMJ 2009, 338;
screening promote this activity by
ENHANCES THE BENEFIT From the read-out an initial triage 446-448
being economical with the truth.6
AND REDUCES THE could be agreed. Those at the [2] U.S.Preventive Services Task Force.
One of the uncomfortable truths
HARM? most extreme end of the risk Screening for Breast Cancer:
spectrum could be invited to a Recommendations and Rationale. Ann
concerns the over-diagnosis of Since 1997 when I resigned Intern Med 2002;137: 344-6.
both in-situ and invasive breast from the NHSBS committee I clinical genetics consultation. At
the other extreme those with a [3] Rate of over-diagnosis of breast cancer
cancers in screening have publicly expressed my
15 years after end of Malmö
populations.3,4,5 Over-diagnosis concerns on the issue of low risk might be reassured and mammographic screening trial: follow up
of breast cancer doesn’t mean informed choice for women given lifestyle advise on diet, study. Zackrisson S, Andersson I, Manjer J
false positive rates but the invited for screening. I take no alcohol, tobacco and exercise and Garne JP, BMJ 2006;332:689-92
detection and treatment of particular pleasure in the fact that that might not only impact on [4] “Should I be tested for Cancer?”
cancers that left undetected NHS has at last accepted the the risk of breast cancer but also H.Gilbert Welch, University of California
on the more important risks of Press, 2004, ISBN 0520239768
would never threaten a woman’s point and agreed to rewrite the
life and with which she would letters of invitation. cardio-vascular disease.7 Those in [5] Incidence of breast cancer in Norway
between could then be invited to and Sweden during introduction of
live, in blissful unawareness, until
My concern is that they will a special clinic for the second nationwide screening: prospective cohort
she died naturally of old age. We study. Zahl PH, Strand BH, Maehlen J.
repeat the mistakes of the past if step. At this clinic women of say
had always assumed that there BMJ. 2004 Apr 17;328(7445):921-4.
we leave this task to those with a 45 or older would be invited to
was an over-diagnosis of duct [6] Screening and choice: Informed choice
conflict of interest. Furthermore have a mammogram. Those with
carcinoma in-situ (DCIS), some for screening: implications for evaluation.
it’s not for me to prejudge what radiological abnormality at this
of which had the potential of Les Irwig, Kirsten McCaffery, Glenn Salkeld,
level of benefit and what level of stage would be investigated in Patrick Bossuyt: BMJ 2006;332:1148-
progressing to an invasive and
harm might influence the the accepted way. In addition 1150,
life-threatening phenotype.
average woman to accept the those who were pre-menopausal [7] Bunker JP, Houghton J and Baum M;
However, there is now clear
invitation. For this reason I think might be offered prevention with “Putting the risk of breast cancer in
evidence that anything between
there are two related areas of tamoxifen and those who were
perspective”. BMJ, 1998; 317:1307–1309.
10% and 50% of invasive
research. First, the development post-menopausal could be [8] Prevention of Breast Cancer in
cancers detected and treated
of an information pack that offered entry into the IBIS II trial,
Postmenopausal Women: Approaches to
radically as a result of screening, Estimating and Reducing Risk: Steven R.
includes decision aids. This could a study comparing tamoxifen
would never threaten life.1, 3,4,5 Cummings, Jeffrey A. Tice, Scott Bauer,
be used in a person preference with arimidex for the chemo- Warren S. Browne, Jack Cuzick et al; J Natl
As a result the overall
study where well women might prophylaxis of breast cancer. A Cancer Inst 2009;101: 384 – 398
mastectomy rate rises after any
be offered sliding scales of recent paper in JNCI supports the
country implements screening in [9] Howell A, Cuzick J, Baum M, Buzdar A,
benefits and harms to find the validity of this approach.8 Dowsett M, Forbes JF, Hoctin-Boes G,
contrast to the message in the
point at which screening is Houghton J, Locker GY, Tobias JS; ATAC
NHSBSP leaflet, “breast cancer
the facts” that implies that
judged acceptable. These data CONCLUSION Trialists' Group.
might then inform the next area Results of the ATAC (Arimidex, Tamoxifen,
screening saves breasts. It To carry on regardless is no Alone or in Combination) trial after
of research on more efficient completion of 5 years’ adjuvant treatment
doesn't. I would therefore like to longer acceptable, neither is
ways of using scarce resources in for breast cancer. Lancet. 2005 Jan 1-
argue that some of these screen political spin the answer. Women
the NHS such as risk 7;365(9453):60-2.
detected “cancers” if left are now getting smarter.
assessment/risk management.
unperturbed, would not progress However the changes I have in
to a disease with lethal potential. The beauty of a risk mind are not nihilistic but
In other words there are latent assessment/risk management constructive. The NHSBSP has
conditions, which under certain approach is that it provides a indirectly lead to the provision of
conditions might progress, platform for the management of the best specialist services for the
remain stable or even regress. all women in an attempt to diagnosis and treatment of
Other biological processes reduce all causes of mortality as symptomatic breast cancer in the
behave in a similar way. Wound well as mortality from breast world, riding on the back of the
healing starts with the knife and cancer where mammographic screening units. The centralisation
ends when it needs to, although screening is only one component of care has lead to the rapid
Science in Parliament Vol 66 No 4 Autumn 2009 13You can also read
