Professor Garry Courtney:

Deputy Collins asked about changing culture. When one says NIH to doctors, that means National Institutes of Health Bethesda in the United States, a wonderful research centre. However, in some parts of this country it means "not invented here", so if one has not invented it in that hospital, people are not interested. One must be very clever about it and make them think they thought of that idea in the first place, and they will do it. However, there is some resistance to change. Institutional rivalries come into this, as do professional rivalries. However, it is the patient who suffers at the end of the day.