Health: Medical Innovation

Baroness Warwick of Undercliffe Excerpts

Wednesday 16th January 2013 Lords Chamber

[Baroness Warwick of Undercliffe]

My Lords, when I read just before Christmas the cri de coeur of the noble Lord, Lord Saatchi, about the lack of progress in finding cutting-edge treatments for cancer, I had huge sympathy, which has been reinforced by his passionate speech today. I remember a similar sense of anger, frustration and bewilderment at the lack of speedy diagnosis and then effective treatment of my mother’s cancer, albeit some years ago now.

I hoped that the science would move on. I knew how good our scientists and our clinical researchers were, so there was no question in my mind that our scientists could produce results so long as they were given the means and the encouragement to do so. Sadly, the improvements have been patchy and, in some cases, stubbornly resistant. A few months ago, I noted in a debate on pancreatic cancer that there had been virtually no change in treatments over the past 20 years, although it is about not just drugs but early diagnosis and access to surgery.

There are many reasons why progress has been less speedy than we might have hoped. The noble Lord, Lord Saatchi, has identified one important area—the effect of medical negligence claims and the risk-averse culture that they generate—and I wish him good speed with his Private Member’s Bill.

Another area often cited as a brake on innovation is regulation. I declare an interest as chair of the Human Tissue Authority. I want to offer some thoughts on how regulation might be a force for good and need not stifle innovation. It is vital that all bodies involved in the health service do all that they can to facilitate high quality medical innovation. Innovation in medicine leads to improved healthcare and quality of life, and can have significant economic benefits.

Sir David Nicholson’s recent report, Innovation, Health and Wealth, provides us with a clear picture of what needs to change if we are to encourage further innovation in medicine and healthcare. In his report, Sir David makes a passing reference to regulation as a “top-down pressure” on innovation but, importantly, he does not identify regulation as one of his six,

“barriers to innovation in the NHS”.

No one doubts that regulation has value in providing assurance for quality, safety and efficacy, and regulation can sometimes be a driver of innovation. None the less, and notwithstanding the exclusion of regulation from Sir David’s six barriers, it is clear that some regulation, if it is excessive, complex, unclear or inflexible, can impede innovation. I believe that we should review all healthcare regulation in terms of design, implementation and enforcement, to ensure that unnecessary barriers are removed. The regulators should be challenged and, just as importantly, should challenge themselves to ensure that they are not creating barriers to innovation.

I shall finish with a few words about the approach to regulation used by the Human Tissue Authority. Of particular relevance to this debate is our remit relating to the use of human tissue for patient treatment and the development of regenerative medicines, where we work very closely with the Medicines and Healthcare products Regulatory Agency. The HTA is very supportive of research and ensures that effective regulation supports good practice and high-quality science which, in turn, leads to improved healthcare.

There is no doubt that some of the regulation in this area is complex, primarily because the science itself is complex, as is the legislation underpinning that regulation. Complex does not have to mean burdensome, however. At the HTA we believe that a key role of a regulator is to provide clarity and to support organisations in working through the quality and safety regulations. I urge the Minister to reinforce the point that, if done well, regulation can yield significant benefits. It provides assurances about quality and that products can be used safely for patient treatment. It promotes faith in the efficacy of products. Will the Minister confirm that regulators should be committed to doing all that they can to support innovation in medicine? This is certainly true at the HTA, and I hope that the Minister will encourage all regulators in the sector to have such an enabling approach.

In my last few seconds, I should like to raise a related topic. I learnt this morning of a proposal in the European Parliament that the minimum duration of a medical training programme should be increased to six years. This could have serious consequences for graduate-entry programmes in the UK. Medical schools will probably not be able to recruit arts graduates, and surely we need creative people in the profession if we want to be more innovative, especially when evidence shows that they make as good doctors as do science graduates. Will the Minister take this back to his colleagues and ask them to do all that they can to prevent the requirement being increased in this way before the vote on 24 January?