Lord Hunt of Kings Heath
Main Page: Lord Hunt of Kings Heath (Labour - Life peer)
Lord Hunt of Kings Heath (Lab)
My Lords, first, I declare an interest as a trustee of the Royal College of Ophthalmologists, which of course has a keen interest in medical research. The noble Lord, Lord Sharkey, has made a very powerful case for the importance of medical research in the UK. This is very much under threat at the moment. No doubt the Minister will be tempted to read out a list of initiatives being undertaken by the Government to support research in the life sciences sector. Welcome though those initiatives are, I hope that she will focus her response on what seems to me to be the core issue, which is the imperfect relationship between the scale and quality of medical research in this country and the uptake and outcomes of that medical research.
The evidence is that the record of the NHS is very poor in actually adopting proven new medicines, treatments and devices. Of course, it is NHS patients who lose out. As noble Lords have already said, this is now being exacerbated by the unprecedented level of rationing that is taking place, both locally and nationally, in our National Health Service. A fairly recent report by the leading charities Breast Cancer Now and Prostate Cancer UK showed that NHS cancer patients are missing out on innovative treatments that are available in any comparative country in the world.
We then come to NICE. When the previous Labour Government set up NICE, it was actually designed to speed up the introduction of innovative new treatments. We are now seeing the Government develop NICE as, in essence, a rationer of treatments. I ponder whether the restrictions being brought in really are true to the legal position of NICE as established, and certainly to its moral position. We have already heard about the impact of the new £20 million cap. That will have a devastating impact on patients. At the heart of the problem of medical research is this: we rely hugely on the pharmaceutical sector for investment in R&D. How long can we expect that investment to continue with the incredibly poor take-up of the results of that investment by our National Health Service? That is the core question that the Minister has to answer. I believe that our medical research and life sciences sector is at risk. The Brexit issue has been well documented, but at the heart of this is that unless the National Health Service changes gear and is consistently seen to welcome and embrace the uptake of new medicines, the Government can talk about medical research and the life sciences sector, but all will come to naught unless they sort out the National Health Service and the incredibly debilitating rationing that we are now seeing take place.
Baroness Buscombe (Con)
My Lords, noble Lords will appreciate that in the past however many minutes I have been asked a lot of questions. I may not be able to answer them all, in which case, I hope noble Lords will accept a letter. I will write in detail in reply. I thank all noble Lords, particularly the noble Lord, Lord Sharkey, for their valuable contributions to this important debate.
“The Government is committed to building on the UK’s world-leading science base—including more Nobel Laureates than any country outside the United States—and making the UK the go-to nation for scientists, innovators and investors in technology”.—[Official Report, 23/3/17; col. 310.]
That was quoted by my noble friend Lord Prior last Thursday in a debate on EU withdrawal and science. Our focus this evening is on the importance and value of medical research to this country as part of our science.
I am sure all those present would agree that the UK research base is world-class. With just 0.9% of the global population and 4.1% of researchers, the UK accounts for 11.6% of citations and 15.9% of the most highly cited articles. Times Higher Education ranks three UK universities in the top 10, and 12 in the top 100, with the University of Oxford in first place overall.
We have an enviable track record in medical research, and we want to keep it that way. How will we do that? We have to do it by continuing to strive to improve our knowledge in this area. That is why this Government have been, and will continue to be, so dedicated in supporting research, both research in general and specifically medical research. Our support for research overall can be seen in the 2015 spending review announcement, where we protected the science resource budget in real terms for the rest of the Parliament at its 2015-16 level of £4.7 billion. In the 2016 Autumn Statement we went even further and committed to substantial real-terms increases in government investment in R&D, rising to an extra £2 billion a year by 2020-21 to help put Britain at the cutting edge of science and technology. This is an increase of around 20% of total government R&D spending and more than any increase in any Parliament since 1979.
What funding has been provided for medical research in particular? Noble Lords have referred to some of the numbers this evening. In 2015-16, the MRC’s gross research expenditure, funded through the budgetary allocation of the Department for Business, Innovation and Skills and contributions from other bodies, was £927.8 million, providing support for world-class medical research to improve human health and enhance the economic competitiveness of the UK. Through the Department of Health, the Government are investing more than £1 billion a year in health and care research through the National Institute for Health Research. Funded by the Department of Health, NIHR benefits the future of health by: funding high-quality research to improve health; training and supporting health researchers; involving patients and the public in health research; providing facilities for research funded by other organisations; and working with the life sciences industry to benefit patients.
Through the NIHR, we have this year announced record funding to support our leading NHS and university partnerships. This includes the largest ever investment in health research infrastructure: £816 million over the next five years for 20 new NIHR biomedical research centres in our leading NHS and university partnerships across England. Each of these 20 biomedical research centres will translate lab-based discoveries into new cutting-edge treatments, technologies, diagnostics and other interventions in clinical settings for patients in a wide range of diseases, such as cancer and dementia. Through the NIHR, the Government are also investing £112 million over the next five years in 23 clinical research facilities for experimental medicine to help speed up the translation of scientific advances for the benefit of patients through dedicated and purpose-built facilities in the NHS with specialist clinical research and support staff. The NIHR has created a national clinical research network which co-ordinates and supports the delivery of industry, charity and other publicly funded research across the NHS in England. Annual recruitment to clinical trials and studies by the NIHR clinical research network has reached more than 600,000 people. To make it simpler for researchers to apply for funding, while retaining our commitment to research excellence, the NIHR will be rolling out a streamlined and faster application process from May. We are very encouraged by what the noble Lord, Lord Willis, said about improving outputs, but the important thing is talking about issues, such as linking data to discharge.
The contribution of charities is hugely important to this and it would be inappropriate to neglect that contribution to medical research. Noble Lords referred to it this evening. REF 2014 demonstrated the outstanding contribution to clinical medicine and to the world-leading position of the UK in biomedical science and clinical/translational research, and it highlighted that much of this work was underpinned by the vast charitable investment made in clinical medicine in the UK, with more than a third of the income over the period derived from UK-based charities. Members of the Association of Medical Research Charities have together invested more than £1 billion into UK medical research in each of the past seven years. We of course want to encourage this investment to continue, which is why the research councils and NIHR work closely with charities on many large projects. For example, noble Lords will know of the Francis Crick Institute, which is a partnership between the Medical Research Council, Cancer Research UK, the Wellcome Trust, UCL, Imperial College London and King’s College London. In addition to funding the cost of building the institute, the founders will provide ongoing research support. The Wellcome Trust will fund interdisciplinary research spanning biology, chemistry and bioengineering. The world’s largest health imaging study—UK Biobank—is jointly funded by the MRC, the Wellcome Trust and the British Heart Foundation. It will create the biggest collection of scans of internal organs and transform the way scientists study a wide range of diseases, including dementia, arthritis, cancer, heart attacks and strokes.
Many charities are greatly appreciative of the Charity Research Support Fund, part of the quality-related research funding administered by the Higher Education Funding Council for England. HEFCE determines how much to provide for this fund from within its overall allocation from BEIS, and has maintained it at £198 million per annum through to 2016-17. Once UKRI is established, decisions on the priorities for funding and how much to allocate for this will be a matter for Research England.
My noble friend Lord Dundee asked questions regarding product development partnerships, but they are more within the scope of DfID, so I will write to reply on that point. He also asked about neurological research for Alzheimer’s. As part of the Government’s 2020 dementia challenge, they are increasing research funding for dementia. This includes the Dementia Research Institute—which is being co-funded by the MRC, the Alzheimer’s Society and Alzheimer’s Research UK—the new Dementias Platform UK and the NIHR Dementia Translational Research Collaboration, which has been set up to catalyse dementia research across world-leading NIHR biomedical research centres.
Our position post the EU referendum was of concern to all noble Lords taking part in this debate, quite rightly. Leaving the EU allows us to make fresh choices about how we shape our economy and presents an opportunity to deliver a bold, long-term industrial strategy that builds on our strengths and prepares us for the years ahead. The Green Paper we launched in January marks the beginning of a dialogue to develop this strategy and to make sure the UK remains one of the very best places in the world to innovate, carry out research and do business. We are putting the UK’s strengths in science, research and innovation at the heart of our industrial strategy. We have highlighted the life sciences industry as a key area of future success for the UK. We are delighted that Professor Sir John Bell has agreed to lead the development of a new strategy for the long-term success of UK life sciences, and we hope this can lead to an early sector deal.
Funding is hugely critical, as the noble Lord, Lord Sharkey, mentioned in his opening speech. The Government have made a series of announcements to provide assurance and certainty to stakeholders in the research community since the referendum. The Treasury has made it clear that it will underwrite all successful bids for Horizon 2020 funding that are approved by the Commission, even when specific projects continue beyond our departure from the EU. This gives British participants and their EU partners the assurance and certainty needed to plan ahead for projects that can run over many years. It is too early to speculate on the UK’s future relationship with Horizon 2020 and successor programmes, but noble Lords can be assured that the UK Government are committed to ensuring that the UK remains a world leader in international research and innovation.
Another important issue was referenced by the noble Baronesses, Lady Morgan and Lady Masham. As noble Lords have said, attracting talent is absolutely key. We are in a strong position but it is important that we attract the best talent, and stakeholders have made clear that funding on its own is not sufficient. A lot has been said, some of it perhaps in a hurry, post the EU referendum, and I appreciate that there has been a misconception that the UK is no longer welcoming to overseas researchers. This is simply not true. As David Davis has said:
“We will always welcome those with the skills, the drive and the expertise to make our nation better still”.
In the Budget, we announced that over £100 million will be invested in global research talent over the next four years to attract the brightest minds to the UK and help maintain the UK’s position as a world leader in R&D. This includes £50 million of NPIF funding ring-fenced for fellowship programmes to attract global talent in areas that align with the industrial strategy, and over £50 million of existing international funds to support fellowships that attract researchers to the UK from emerging research powerhouses such as India, China, Brazil and Mexico. We have also provided assurance about postgraduate support through the Research Council studentships, which will remain open to EU students starting courses in the 2017-18 academic year. The funding support will cover the duration of their course, even if the course concludes after the UK has left the EU.
As the Government have made clear previously, there has been no change to the rights and status of EU nationals in the UK or of British citizens in the EU as a result of the referendum. The Prime Minister has been clear that during negotiations she wants to protect the status of EU nationals already living here. The only circumstances in which that would not be possible is if British citizens’ rights in European member states were not protected in return.
I know I am running short of time but I want to speak briefly about collaboration and very quickly refer to some of the questions. We have taken no final decisions on our future relationship with the EU on research. The White Paper made it clear that we would welcome an agreement to continue to collaborate with our European partners on major science, research and technology initiatives. The noble Lord, Lord Kakkar, talked about the ecosystem, which is quite complex—believe me, I have been on something of a learning curve here—and it is critical that we collaborate. We are considering a number of options, but I stress that international collaboration is nothing new.
We are thinking through how UK researchers can best be able to continue to work with the best of their international counterparts, both European and more widely. As long as we continue to be a research powerhouse, other nations will continue to collaborate with us. As I have set out, the Government are working hard to ensure that we continue to build on our reputation.
The noble Lord, Lord Patel, talked about regulation and data privacy.
Lord Hunt of Kings Heath
The noble Baroness is clearly not going to respond on the NHS. Does she not realise that none of this means anything unless the NHS uptakes these new medicines? This is the core argument that we are putting to her, but she is not responding to it.
Baroness Buscombe
If I may, this debate is about how we maintain medical research.
Baroness Buscombe
I am trying to get to the point, if I may, but perhaps it would be better if I write to the noble Lord in detail specifically on the new proposals for NICE and the cap. I think that would be better in the circumstances.
The noble Lord, Lord Patel, talked about regulation, data privacy and data transfer post Brexit. We will take seriously his wise recommendation to work with researchers and regulators to ensure that our data privacy is a world leader, proportionate and pragmatic. My noble friend Lord Ryder talked of the pressing need to reform the 2007 paediatric regulations, whereby there is an avoidance of trialling cancer drugs for children. I will certainly take that back to the department.
There was reference to NHS England’s research plan. It will be published in the next few weeks. Publication of the plan and monitoring of progress on its delivery is one of the deliverables on research in the Government’s mandate to NHS England for 2017-18, published on 20 March. The research plan will be followed by development of a comprehensive research strategy. NHS England will engage with its stakeholders during the spring and summer to support development and plan delivery of the strategy. The implementation of the AAR and the industrial strategy includes talking to industry about the changes. Positive features include a fast-track process and a threshold weighted by gain.
There were a number of other questions that I wish I could answer quickly. The noble Lord, Lord Willis, asked about CLAHRCs. Collaborations for leadership in applied health research and care are funded by NIHR with £120 million. There are more than 13 of them around England. The Department of Health is currently examining options for future funding after the current contract. This includes asking current CLAHRCs about what is working and what could be done better to support applied health research.
To conclude, it is clear from what we have heard this evening that the UK’s medical research is world-class and something that we should be proud of. Retaining and building on our science and research base remains a top priority for this Government. We will continue to work with stakeholders and parliamentarians to achieve it. I again thank the noble Lord, Lord Sharkey, and all noble Lords who have taken part in the debate this evening.