Ageing: Science, Technology and Healthy Living (Science and Technology Committee Report)

Lord Winston Excerpts

Wednesday 20th October 2021 Grand Committee

[Lord Winston (Lab)]

My Lords, it was a huge pleasure to have the noble Lord, Lord Patel, as our chairman yet again for this inquiry, which was conducted with some challenging difficulties that were faced. He was, as usual, remarkable in his leadership and what we did. As the noble Lord, Lord Browne, and others have just emphasised, the findings show very clearly that the biggest single problem with ageing in the UK is widespread deprivation, which means that the Government are failing to reach their targets of trying to extend longevity.

There are many processes that we looked at which are associated with ageing. Multimorbidity, of course, is one of the key issues, where these processes between organs have a connection and are often responsible for what is happening. Unfortunately, there are not enough specialists doing regular connected medicine. This is one of the things that needs to be looked at in the health service. How many geriatricians who are specialised are available for this service in the United Kingdom at present? Do the Government feel that, given the manifestations of ill health, which are so interconnected, there should be more people of this kind? Perhaps that could be confirmed at the end of this debate.

An important aspect of this report was the science behind ageing. It is complex and surprising. I remember 35 years ago in my own lab we found that a human embryo, just three days after fertilisation, showed processes of ageing and that cells were changing and being destroyed. As we age, that process is not so efficient, so abnormal cells often appear in the adult human.

The committee identified a wide range of other mechanisms, including mutations in mitochondria—the battery packs of nearly every individual cell—which are an important aspect of ageing, the shortening of chromosomes, changes in DNA and in its repair, the loss of stem cells and, importantly for many of us in this Room, the process of inflammation, to which older people are much more susceptible. These and other issues are reported in the excellent chapter 3 of the report. I recommend that people read it because one of the most important aspects is changes in the immune system; of course, this aspect has been absolutely relevant during the Covid pandemic. We learned a great deal more about ageing, rather supporting some of the things we have been looking at. It turns out that these things are critical in all aspects of ageing in nearly all tissues and most organs, but they are not understood.

I should declare an interest that I have not declared before and which is not listed in the committee’s report: that of my own recent experience. Before the pandemic, I knew that I had cataracts in both eyes. An optician did not see anything else wrong with my eyes. I was therefore happy to continue reading on my computer without thinking about it, and I felt that my general processes were not impaired when I was doing stuff in Parliament; of course, your Lordships may have other views of my efficiency in that respect. I found that, while reading continuously on my computer, I was able to see films and re-read Dickens, Hazlitt, Hardy and many other authors. I did not really read newspapers.

In the past few weeks, however, I have suddenly found that I cannot read newsprint and am increasingly unable to read a printed book. In fact, I cannot read a printed book. I also cannot see road signs—I do not drive, obviously—and I do not recognise people. At the recall of Parliament, the only way I could identify noble Lords—even those on the same side of the division between the two major Benches as me—was by the sound of their voices. I realised that something was seriously wrong, particularly when I looked at my computer and saw that horizontal straight lines were no longer straight but wavy and often changed; I also saw black spots, of course, and colours such as green and red were all rather entrancing but very different. It seemed that something rather serious might be going on.

Of course, not being able to recognise your Lordships by sight and not being able to read a speech is really a blessed relief. I must say, if a few more noble Lords were in the same position, it might be quite good for the Chamber, but there we are. Unreadable speeches are not a great thing. At least when the noble Lord the Whip comes to say that I have been conducting myself too long, I will not recognise what is happening and so can go on wittering in this way.

I rapidly turned to Moorfields hospital and was very fortunate to meet Professor Adnan Tufail. He happens to be a notable international expert in retinal disease—oddly enough, particularly in my rare manifestation of age-related macular degeneration, which is quite common. My condition—seeing as I have not written a speech, I say this for the purposes of Hansard, because I like to tease them—is called reticular pseudodrusen age-related macular degeneration. Unfortunately, it seems to be a rare genetic kind of this disease and is particularly aggressive. Anyway, I was immediately sent for treatment by Professor Tufail, who was amazing. I had a treatment that noble Lords may have seen in “Un Chien Andalou”, a surreal 1929 film by Buñuel, where things are injected directly into the eye—although in my case, it was a monoclonal antibody, not a knife. It was done efficiently and without pain, but that treatment will have to be continued for some time.

To cut a long story short, I went to the lab and was able to see exactly the problems that they face. They are doing a huge amount of research at Moorfields—it is internationally recognised—and so many of the chemical processes that they are looking at, which are extremely complex in the eye, particularly in the retina, are exactly the same processes in the rest of ageing.

Multimorbidity with eye disease is one of the problems because people who are really short-sighted tend to fall down and break limbs, and are much more likely therefore to have other health problems as a result. Some become isolated, of course, and may not be able to get their brain in motion; dementia is therefore much more likely.

This is a massive problem because age-related macular degeneration, which may in different circumstances be very different, is still the commonest cause of blindness in the United Kingdom. We are not doing a great job, particularly among deprived people who, unlike me, do not have access to medical care in the same way because they are not medically qualified. What number of age-related macular degenerations are seen in the United Kingdom? What is the possible cost of this, both with and without treatment? How might we do something about this?

There is a real need to do more research. I must say, I found that there was very little public research at Moorfields. It was mostly from venture capital and other commercially derived areas. This is not good for widespread research, which can be immediately available to medicine. I commend Tufail’s team for carrying on. Finally, how much money is available from the Medical Research Council for retinal disease and cell therapies to treat those diseases?