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Following Dr Barber's letter1 relating to the mechanism for approval of Local Research Ethics Committees (LRECs), I have also had concerns over the intense pressure for a fast turn around for local approval. Projects may have been six months or more in the Multicentre Research Ethics Committe (MREC) process and then arrive on my desk with multiple telephone calls requiring turn around in a few days. Frequently researchers are not even aware of the number of copies we may require for perusal, and getting administrative details correct causes further delays.
If the process is to be truly ethical I believe that it must be performed with an appropriate number of people, always including a lay person, who, except in exceptional circumstances, should be in the same room together to get optimum examination of the issues. In addition, my understanding of the Good Clinical Practice (GCP) guidelines is that committees should do their business primarily by meeting. When our committee has spent considerable time developing standing procedures in conformity with guidelines and our own consciences, surely these should not be set aside on a case by case basis?
Members of the committee cannot override their normal commitments (particularly lay members who do not work for the National Health Service) instantaneously, and a considered response requires a certain amount of time. This is likely to be particularly pertinent in District General Hospitals where research is not the focus of the trust. I would not support excessive delays, but in my opinion, from the comments made to me by researchers, I feel that there are times when I am called upon to make up for delays elsewhere in the system. If MREC applications are to pass through LRECs (and I do mean if) then they cannot be considered as a rubber stamp, but must fulfil their collective ethical responsibility.