Responses of local research ethics committees to a study with approval from a multicentre research ethics committee

culties rather than the substance of ethical review itself. 6 The multicentre research ethics committee system was set up to deal with such procedural difficulties. Improvements in the system have occurred. However, local research ethics committees have been reluctant to abandon their autonomy sufficiently to allow efficient functioning of this system, and this has been identified as a potential reason for continuing concerns about the new system. 7 Whereas administrators of local research ethics committees face significant problems in trying to achieve turnaround targets that may be unrealistic without important new resource input, substantial frustrations remain for researchers working within a system that at times presents an unethical barrier to potentially beneficial research.