Sir, - Judging by the correspondence in your newspaper, Fintan O'Toole seems to have touched a raw nerve with Irish consultants with his articles of August 28th and September 4th on medical research in Ireland.
In particular, the consultants wish to defend themselves from the charge that they have a vested interest in preventing the creation of new research posts of consultant grade because this would mean dividing the private practice cake into smaller slices with a drop in income for those already in the system. On the contrary, they claim, consultants themselves have repeatedly pressured the Government to create new posts. This part of the consultant's defence is, I think, true. In any case, judging by my experience in Britain and Germany, the kind of research consultant Mr O'Toole writes about is generally not that interested in having a large private practice anyway.
However, I cannot agree with your correspondents' analysis of the state of medical research in Ireland. Several have presented with the "crisis, what crisis?" defence (e.g. Dr Bill Tormey, September 19th), the basic tenor being that there is very good research being done in Ireland as it is, so what is Mr O'Toole making all the fuss about? This reaction, it seems to me, stems more from a sense of wounded professional pride than anything else, for all go on to lament the lack of Government funding of research in Ireland. The fact is that, in spite of the excellent work of isolated individuals, often under very difficult and restricted conditions, there is an endemic lack of focused, high-quality biomedical research in the country. Anyone who doubts this should compare Ireland's research output to that of Israel, a country with a population and gross national product similar to our own, and with its own particular political problems to boot.
The main problem in Irish biomedical research is a structural one, namely the lack of a clear career structure and proper funding for physician-scientists who see their main commitment as research. This lack has roots both in the absence of a strong tradition of indigenous science in Ireland and in the traditional role of the health services. However, it is due also to the pace of developments in such disciplines as genetics and molecular biology, which has created a need for a new breed of specialist straddling the gap between medicine and what was up to now regarded as the domain of pure scientists. These difficulties are not insurmountable and are not unique to Ireland. They can and must be overcome: to maintain the quality of Irish medicine, and for economic reasons, it is important for Ireland first to catch up and then to excel in the biomedical race.
Many who received their medical training in Ireland, myself included, would, given the appropriate research possibilities, like nothing more than to return to make a contribution in their own country. However the creation of such possibilities requires a critical mass of interested individuals in order to allow proper formulations of government policy. To this end, I am interested in setting up a database of Irish medical researchers living abroad who would like to return to Ireland. Those who share this interest might like to contact me at the address below or at cullen@unimuenster.de. - Yours, etc., Paul Cullen,
Associate Professor of Clinical Chemistry and Laboratory Medicine, University of Muenster, Domaghstrasse 3, 48149 Munster, Germany.