Joe Collier

Research

He interspersed his junior medical training with two days a week at a laboratory situated in the Royal College of Surgeons in Lincoln's Inn Fields, run by John Vane. In 1969, Collier confirmed, with Dornhorst, Lands' findings of β1-receptors in the heart and β2-receptors in the airways, in humans, and "suggested that the respiratory stimulation produced in man by β-receptor stimulants is a β1-action and is not linked with bronchodilatation." In 1971, he co-authored a paper with Rod Flower showing that therapeutic doses of aspirin reduced prostaglandin E and F in human semen.

His early research included looking at the veins of the back of the hand, and the behaviour of human peripheral blood vessels, being first to develop methods for studying how human veins respond to drugs and natural mediators in vivo and developed the idea that human veins and arterioles have very different pharmacologies. Through this work he classified vasoactive drugs as veno-selective, arteriolar-selective or non-selective, and that depending on their selectivity they would have different effects in disease.

He later looked at the role of nitric oxide and angiotensin converting enzyme in controlling blood vessel tone. In 1987, he set out with Patrick Vallance to investigate whether human blood vessels demonstrated endothelium-dependent relaxation, a term coined in 1980 by Robert F. Furchgott and John V. Zawadzki after discovering that a large blood vessel would not relax when its single-layered inner most lining was removed. They subsequently showed that the occurrence was mediated by what they called endothelium-derived relaxing factor, later found to be nitric oxide, and it was subsequently shown to occur in a variety of animals. Using veins from the back of a human hand, Collier and his team reproduced Furchgott and Zawadzki's findings. They then demonstrated that the human arterial vasculature is actively dilated by a continuous release of nitric oxide. In 1996, Vallance presented his and Collier's findings at the Goulstonian Lecture of the Royal College of Physicians, where he gave details of the connection between nitric oxide and blood pressure.

Commission for Racial Equality Collier became a whistleblower in 1986 when, following his report published jointly with psychiatrist A. W. Burke, he informed the Commission for Racial Equality (CRE) that software used for medical-school admissions selection at St George's had been developed to intentionally discriminate against women and ethnic minorities, by mimicking methods of previous admissions officers. It was creating a lower score for women and those with non-European (Asian, African and Arabic) names so reducing their chance of being called for interview.

Collier's findings led to an enquiry, both internal by St. George's and external by the CRE, and a subsequent report was published entitled Medical School Admissions: Report of a formal investigation into St. George's Hospital Medical School (1988). Like Collier and Burke, the report also raised the question of what might be happening in other London medical schools; St. George's already had a higher than average intake of students with non-European names. Collier was initially shunned within the institution and denied a due professorship. As attitudes changed, his position improved; he was promoted to professor and eventually the medical school publicly thanked him. He discussed his experience in an article in the British Medical Journal in 1999 when he recalled that he "was ostracised, became invisible, told I [he] had brought the organisation into disrepute". Changes in admissions procedures to institutes of higher education have since been made throughout the UK and Collier has since been acknowledged for contributing towards greater equality in recruitment practices.

National policy In his national policy work, he raised awareness of how drugs are priced, brought to the market and regulated, in addition to how they are evaluated, licensed and promoted, and how drug safety advice is produced and revised.

In 1993, he was appointed lead adviser on medicines to Parliament's Health Select Committee. In 1998, he was appointed to the Medicines Commission. In addition, he worked to ensure that members of governmental advisory committees published their conflicts of interest.

Drug and Therapeutics Bulletin Collier began working for the Drug and Therapeutics Bulletin (DTB) in 1969. In 1972, he became its deputy editor and member of the DTB's Advisory Council, after at first being associate editor. He succeeded Andrew Herxheimer, who founded the bulletin, as its editor in 1992, and over the following 12 years shaped the bulletin in response to new challenges of the time, including the growth in electronic information, evidence-based guidelines, a growing demand to engage the public and healthcare workers and the establishment of the National Institute for Clinical Excellence (NICE).

Drug safety In 1985, he complained to the Association of the British Pharmaceutical Industry that of 28 drug advertisements in the November 1985 issue of the British Medical Journal, 11 were in breach of the Medicines Act of 1968.

Known to frequently question evidence and arguments accepted by others, under his editorship in 1998, the DTB opposed the Department of Health's view and supported the provision of sildenafil on the NHS.

With regards to off-label prescribing of drugs for children, Collier argued that "the validity of such an approach is questionable because there are such great differences between adults and children, and even between children of different ages, with regard for instance to the pharmacodynamic and pharmacokinetic responses to drugs, […], and the effects of drugs on normal growth and development".

Other roles Collier is a Fellow of the Royal College of Physicians. He was elected president of the International Society of Drug Bulletins in 2002 and is a former member of the British Medicines Commission. They married in 1968 and had three sons, the eldest of whom died suddenly in 2013. They have one grandchild. Following retirement Collier has become an active blogger and fluent in French.

Selected publications

Papers

Books

The Grey Book; Guidelines for the management of common medical emergencies and for the use of antimicrobial drugs. London; St Georges's University of London, February 2015, 62nd edition