Diana Leat
Leaving it all? (Part 1)
Anthony Tomei, Director of the Nuffield Foundation, stared out of the window of his office lit by the crisp sunshine of a cold January London morning in 2008. He had just put down the telephone after a conversation with a leading broadsheet journalist wanting a statement from the
Foundation on a proposal put to the House of Lords for the creation of a statutory, government-appointed, human bio-ethics commission. Since 1991 the Nuffield Foundation had funded the “Nuffield Council on Bio-Ethics”, an independent, free-standing council with the task of examining the ethical issues raised by research advances, promoting public understanding, and providing rigorously argued advice on policy. Was this the time for the
Foundation to exit? After all in most other areas the Foundation would regard take-up by government as success and a signal to exit, freeing up time and resources to move on to other issues. Was this case any different? Why,
Tomei asked himself, did he feel a reluctance to pull out? What should he recommend to the Board and why?
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Tomei picked up a pen and a pad of paper and left the office for a cup of coffee. Drinking his coffee Tomei began to review the original purposes – and achievements - of the Council, and where it fitted in the Foundation’s mission.
Was he merely holding onto the bathwater, or would exiting be to throw the baby out with the bathwater? Would a national, government-appointed council, as in other countries, achieve the fundamental purposes of the
Council and further the Foundation’s mission, or could such a council achieve neither?
Background: The Nuffield Foundation
The Nuffield Foundation was established in 1943 by William Morris (Lord
Nuffield), the founder of Morris Motors. The Foundation’s mission is to
'advance social well being', particularly through research and practical experiment with an income of about £9m a year. Its financial independence and lack of vested interests helps to ensure an impartial and even-handed approach to problems in the projects it funds.
The majority of the Foundation’s income is spent on research, practical innovation and development; the preference is “for work that has wide significance, beyond the local or routine” 1 . The Foundation looks to support projects that are imaginative and innovative, take a thoughtful and rigorous approach to problems, and have the potential to influence policy or practice.
It runs a number of grant programmes for specific purposes, including support for scientists and social scientists at the early stages of their careers.
The Foundation also sets up and runs projects of its own, of which the
Nuffield Council on Bio-Ethics had been one.
The Foundation’s funding of research is very clearly designed to influence policy, rather than simply advancing the state of knowledge. The Foundation is conscious that relative to government it has very limited resources to spend on research, but distinguishes between areas in which government can’t fund, won’t fund and shouldn’t fund. The Foundation sees its distinct niche as being in this last category, i.e., areas in which independence of government
(or corporations) is crucial to the task.
‘Enlightenment’ values are fundamental to the Foundation’s ethos. It believes that in order to advance social well-being we need first to understand the relevant issues, and this requires being clear-eyed, objective and truthful. The
Foundation sees its role as contributing an independent, impartial view based on the very best scientific knowledge. Independence, objectivity and access to expert knowledge are among its key resources. While the Foundation is willing to take risks in relation to likely policy impact it is ‘profoundly risk
1 www.nuffieldfoundation.org
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averse in the quality of the research funded’. Bad research, the Foundation believes, is positively harmful.
The Nuffield Council on Bio-Ethics: History and Achievements
The history of the Nuffield Council on Bio-Ethics goes back to the 1980s when the Foundation had on its Board a trustee interested in issues of medical ethics that went far beyond matters such as doctors sleeping with patients.
Interest in the field of bio-ethics was emerging but still at an early stage, and when Margaret Thatcher – then Prime Minister – turned down the idea of a policy advice unit at Number 10 Downing Street, the Foundation was approached with the idea of setting up some sort of body to explore bioethics. At that time there was little, if any, public demand for such a body but the Foundation saw that this was an issue likely to grow in importance and policy relevance.
After considerable discussion and diplomacy negotiating with the medical profession, the Nuffield Council on Bio-Ethics was finally established in 1991.
The Council was never intended to be a permanent body and in the early years it was funded year by year, later moving to five-year funding terms.
But funding of the Council was not the major issue – not least because it was not actually very expensive. The key issues in the early days were its relationship with government and with the medical profession, and, crucially, its public legitimacy and legitimacy with the scientific community. The
Council had no official standing and had to earn its legitimacy and its influence by the quality of its work and its independence.
Over the years the environment changed. Interest in the social and policy implications of scientific advances rose; new bodies were created dealing with related issues but none covering the wide ground of the Council; and the
Council developed a reputation for high quality, objective research and sound recommendations. As the Council’s reputation grew, so its networks, expertise and influence grew, and these then fed back into the work of the
Council. The Council also had a degree of luck – or perhaps far-sightedness – in choosing issues to explore that later became ‘hot’ policy topics. It had produced widely respected reports on ethical issues associated with genetic screening, uses of human tissue, xenotransplantation, genetics and mental disorders, and genetically modified crops.
The Council had always put quality before speed, and, typically spending around two years working on a topic, it had had to resist the expectation from government and others for ‘quick solutions’. Nevertheless the Council had
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achieved a number of directly attributable successes in informing and influencing policy.
A government appointed council?
While jotting down his notes and reflecting on history and achievements of the Council, Tomei remembered the time when two other funders - the
Wellcome Trust and the Medical Research Council – had joined the donor consortium. Still, the Nuffield Foundation remained the majority funder, continued to pick up the indirect costs of the Council, continued to house the
Council and continued to employ the Council staff. In other matters, however, including for example its choice of topics, its choice of experts and its recommendations, the Council remained independent of its funders.
Furthermore, Tomei noted, members of the Council were appointed as individuals in their own right rather than as representatives of a constituency/interest, and included both ‘experts’ and lay people. A government-appointed council would clearly not have this freedom, could become unwieldy and would certainly be under pressure from the Churches
(one source of the current proposal for a national council). As an independent council there was also no danger of political appointments as had happened in some other countries.
The Council, Tomei felt, had earned very high levels of trust and legitimacy via the high quality of its work and precisely because it was independent of government and other vested interests, at a time when the public was increasingly sceptical and cynical about the reliability of statements from those in power. These were advantages, Tomei reflected, said to be envied by members of similar national, government-appointed councils in other countries.
Tomei finished his coffee and returned to his office. He called Hugh – the
Director of the Council – and arranged to meet the following morning to discuss the pros and cons of supporting the idea of a government-appointed national council.
Later that afternoon, at the launch of a new book, he ran into a colleague,
Tony, from the Wellcome Trust handling the Council on Bio-Ethics grant.
Chatting about current Council topics Tony remarked: ‘You know that grant is very special for us. We have nothing else quite like it. Normally, we would be looking for someone else to take over, and after a couple of large grants the governors would be asking about the exit strategy – that doesn’t happen in this case.’ Tomei nodded, ‘So what’s different?’. Tony replied: ‘Well clearly
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we don’t want the research agenda to be controlled by politicians – we both know what that can lead to. But I think it’s also a testament to the quality of the Council’s work and the broad church it establishes. If government ran it, not only would we run the risk of politicians’ values influencing issues, but putting together the membership would be a nightmare – how many members would Wales get, and Scotland, which churches would have to be represented, and so on. I suspect it suits government very well that the
Council exists but they don’t have to run it.’
Leaving it all? (Part 2)
‘Hugh,’ Tomei said next morning while meeting the Director of the Council,
‘I’m going to play devil’s advocate and list all the reasons why we should exit from the Council and support the proposal for a national, government appointed council. Your job is to persuade me that I’m wrong. This issue isn’t just about the Council; it goes to the core of the Foundation’s role and ways of working’.
‘Neither the Nuffield Foundation nor the Council are democratically elected bodies – so where do we get the legitimacy to make policy suggestions in such an important and delicate area? Do we really contribute to democracy by existing as an independent unelected body?’
‘Our philosophy as a Foundation has been that we advance social well-being by, among other things, encouraging development of scientific knowledge, public understanding and providing independent, impartial, policy relevant information. Couldn’t the proposed body do that just as well?’
‘A government-appointed body would mean that government would have some ownership of the issues and recommendations from the start. It couldn’t say, “Well, that’s interesting ….” and then ignore the recommendations.’
‘By having a government-appointed national commission we would be following the line of other countries.’
Tomei continued: ‘The Board could argue that we have done our job. We never intended to fund this forever, but only as long as it was needed to advance social well-being. In other situations when the need is recognised and government – or someone else – makes adequate provision, we as a foundation exit and move on to other issues. Isn’t this a case where we have succeeded and should now leave it to government?’
Hugh looked at him, thought for a while and started to extemporize…
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Strategies for Impact in Philanthropy was kindly funded by:
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