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Is the NHS research ethics committees system to be outsourced to a low-cost offshore call centre? Reflections on human research ethics after the Warner Report
  1. M Epstein1,
  2. D L Wingate2
  1. 1Institute of Health Sciences Education, Academic Unit for Human Science and Medical Ethics, Barts and The London, Queen Mary’s School of Medicine and Dentistry, University of London, London, UK
  2. 2The Wingate Institute, Barts and The London, Queen Mary’s School of Medicine and Dentistry
  1. Correspondence to:
 Dr Miran Epstein
 Institute of Health Sciences Education, Centre for Health Sciences, Academic Unit for Human Science and Medical Ethics, Barts and The London, Queen Mary’s School of Medicine and Dentistry, 40 New Road, London E1 2AX, UK; m.epstein{at}

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The recently published Report of theAHAG on the Operation of NHS Research Ethics Committees (the Warner Report) advocates major reforms of the NHS research ethics committees system. The main implications of the proposed changes and their probable effects on the major stakeholders are described.

The Ad Hoc Advisory Group (AHAG) on the operation of NHS research ethics committees, set up in November 2004 by Lord Warner on behalf of the Department of Health, submitted its report in June 2005.1 The report advocates major reforms of the research ethics committee (REC) system. The primary aim of the report is to streamline the processes around the approval of research projects and to pursue conformity of governance across Europe. Implicit in the report is the contention that failure to achieve this objective would be harmful to everyone with vested interests in improving health and social care. Moreover, it is stated that the reforms will enhance the mechanisms that protect the interests of all parties concerned.1

Being mindful of two published critiques of the Warner Report, we suggest that its alleged benefits should not be taken at face value.2,3 In fact, the reformed system will give rise to moral failings akin to those of the existing system, but will differ from the existing system in its effect on the stakeholders. Thus, whereas the outgoing system has given each stakeholder a unique mixture of benefit and harm, the incoming system offers benefit only to sponsors and researchers and nothing but detriment to participants in research and consumers of its products.

In the light of this conclusion, we finally suggest that the Warner Report be construed not merely as an ill-considered document, but rather as an ideological reflection of a long-established hegemonic contract fine-tuning itself to contemporary global challenges.

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  • Competing interests: ME and DLW are members of a research ethics committee within the North East London Strategic Health Authority.

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