After nine years, the head of the Health Research Board moves on to new challenges Ruth Barrington changed the HRB but now feels it's time for a change for her, writes Muiris Houston, Medical Correspondent
One measure of the progress made by the Health Research Board (HRB), since Dr Ruth Barrington took over as its chief executive in 1998, is somewhat unusual.
"When I came to the HRB first, one of the duties of staff after the closing date for research applications was to stand in the hallway to relieve the pressure on the post box on Saturday and Sunday . . . the post box wasn't big enough to cope with the volume of applications," she recalls.
Now, with a highly developed HRB website, the research community can download application forms or file their applications for research grants online. And the image of staff members spending their weekends fielding unwieldy packages can be consigned to the historical scrapbook.
Barrington steps down as head of the HRB at the end of this month after nine years in charge. She plans to spend some months sailing her yacht to northern Spain and back, before taking up the post of chief executive of the Dublin Molecular Medical Centre (DMMC) in the autumn. She is also a governor on The Irish Times Trust.
Among the many HRB-funded research achievements during her tenure was the discovery of a naturally occurring antibiotic with the potential to treat drug-resistant MRSA, by Prof Bernard Mahon of NUI Maynooth. The research team has now engaged with Enterprise Ireland to help scale up production of the antibiotic.
Researchers at Beaumont Hospital and the Royal College of Surgeons in Ireland (RCSI) used HRB funding to identify a gene mutation that causes motor neurone disease, a progressive and ultimately fatal neurological condition.
And the decision to fortify bread products in the State with folic acid was based on research backed by the HRB into the link between folic acid deficiency in expectant mothers and the development of neural tube defects such as spina bifida in their children.
Other areas where significant breakthroughs have been made with assistance from the HRB include the discovery of an early-detection biomarker for colon cancer, the development of the first electronic patient record system for patients with epilepsy and the identification of a clear cross-generational link between the educational status and health status of Irish people.
"I would like to think that health research is now a more important part of the health service," Barrington says, adding that the primary function of health research is to improve the health of the people.
And the people who work in health research here are one of the keys to ensuring a quality research environment. She is especially pleased at the recent development of the Clinical Scientist Awards - describing them as "the icing on the cake for us" - which enable leading Irish hospital consultants to dedicate a significant portion of their time to conduct research in their specialised field.
"We are now funding seven clinical scientist posts which are held by consultants working in the health system . . . they keep three of 11 sessions for service commitments and have eight sessions a week to work on their research interest."
With plans for 30 posts, the HRB clinical scientists are unique in the community of health researchers, providing a link between clinical practice, the discovery of disease mechanisms and new diagnostic and therapeutic interventions.
Although delighted with the quality of the applicants, Barrington says the HRB is frustrated that "because of the prolonged, inconclusive consultant contract negotiations, we cannot offer these awards to people outside of Ireland who want to come back.
"But rather than keep on cursing the dark, we said we would light a candle and offer them to consultants already in posts here."
Earlier this month, four HRB clinical scientist awards were announced. Prof John Crown, of St Vincent's Hospital and Dublin City University (DCU), will work on developing targeted molecular therapies for breast cancer.
Hospital-acquired infection in the form of the bug clostridium difficile will be the focus of research by Dr Lorraine Kyne, a consultant in medicine for the older person at the Mater Hospital.
Dr Louise Kenny of Cork University Maternity Hospital aims to improve the early detection and management of first-time mothers who develop serious complications in late pregnancy.
And Dr Orla Hardiman, consultant neurologist at Beaumont hospital, who was one of those who identified the gene in patients with motor neurone disease (MND), will spend the next five years looking at the pathways involved in the development and progression of MND and another related conditions.
According to Barrington, "the benefits for patient clinical care [ of these projects] is that the educational environment improves enormously and there is also the possibility of developing products that can be taken to market and add value for Ireland Inc. So we see it as a win-win situation."
Emphasising the importance of having top class clinical research infrastructure here, she says the HRB is proud of the agreement it has with the Wellcome Trust, an independent UK research charity, to develop a clinical research centre in the Republic. Under a deal worth €20 million, the Wellcome Trust is funding the infrastructure while the HRB will provide money for the research activity.
"To our intense delight the Dublin application led by DMMC - a combination of TCD, University College Dublin, RCSI and their associated hospitals - came second only to Cambridge in open competition," she says.
"The new facility will be both a research centre, which will open in March 2009 on the campus of St James's Hospital, and a network linking [ the hospitals] together to form a really powerful platform for clinical research."
What practical benefits for patients might emerge from the new centre? One project involves the collection of samples from patients with prostate cancer from hospitals across Dublin, with the ultimate aim of designing molecules that target the cancer genes in particular groups of patients. "You are beginning to get into individualised medicine where drugs and interventions will be able to target the prostate tumour depending on its genetic make-up," the HRB chief says.
The National University of Ireland, Galway (NUIG) just missed out on Wellcome Trust funding but agreement has been reached to set up a clinical research centre there, with Health Service Executive (HSE) funding the building and HRB meeting the cost of research. It is hoped that a similar agreement can be reached with the NUI Cork.
Barrington acknowledges the infrastructure for primary care research here is poor. In response to a detailed report by Prof David Mant of Oxford University, the HRB hopes to fund a number of virtual health research centres linking different disciplines and institutions including the Irish College of General Practitioners and academic departments of general practice.
As a third generation public servant, Barrington has a particular commitment to public service. Her grandfather was a civil servant in the Department of Industry and Commerce, while her father was the first director of the Institute of Public Administration. With a PhD in health policy she worked in the Department of Health as an assistant secretary prior to joining the HRB. "I do enjoy working in the public sector . . . there is a patriotism there and a great commitment to the people of this country."
She is pleased to have contributed to the setting up of the Ireland/Northern Ireland/US Cancer Consortium, in the wake of the Belfast Agreement in 1999. President Clinton encouraged experts from the National Cancer Institute and the National Institute of Health in the US to become involved in establishing an all-island cancer network which now encompasses some 270 investigators, north and south.
Barrington's strong sense of public service means that she is concerned about ongoing inequalities in the health system here. She has doubts about the ability of the current hospital co-location plans to provide additional capacity in the public system.
And despite the HRB having over €100 million committed to health service research at present, Barrington's wish for the future is for Ireland to emulate the Finns who commit close to 2 per cent of their total health service spend to research and development. "At 0.3 per cent, the Republic is still low by other country's standards," she says.
It is clearly a case of a lot done in the last decade but a lot more for her successor to aim for.