[Vulnerability of scientific research in university medical centers]

In 1995, the Health Research Council of the Netherlands (RGO) published a report on the efficiency and efficacy of medical research in the Netherlands. One of its conclusions concerned the formation of multidisciplinary research institutes around various themes. The medical faculties and university hospitals responded by forming integrated university medical centres, which placed a considerable emphasis on patient care during their first few years of existence. However, the deans of the respective medical faculties realised that these organisational changes might form a threat to fundamental research, due to a lack of financial resources. They produced a common statement to protect and support fundamental research. This was discussed at a meeting of the Royal Netherlands Academy of Arts and Sciences in December 2000. Several speakers addressed the question as to whether (fundamental) research in these university medical centres should be regulated in a 'top-down' manner whereby directions and priorities are formulated by a centre's management, or whether the (clinical) researchers should formulate the direction of the research ('bottom-up'). Managers wanted a 'top-down' approach and researchers a 'bottom-up' approach.