Having run the review in the 1990s which led to a national budget for NHS R&D in England, Marc helped to pave the way for the British Department of Health to create the National Institute for Health Research (NIHR). He led the implementation of a framework of research governance in health and social care, including a national system of research ethics committees, procedures to streamline local research management, and preparations to establish the Health Research Authority. He initiated the national programme that led to the Clinical Practice Research Datalink. He was a member of the board of UK Biobank. Earlier in his civil service career, Marc worked for the Foreign and Commonwealth Office and on the British overseas aid programme, developed government policy on NHS finance and capital investment, and was Director of Finance at a DH executive agency.