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Medical Research

My Lords, I thank the noble Baroness, Lady Hayman, for obtaining and initiating this important debate. She and I first met when we were fellow chairmen of NHS hospital trusts. I remember meeting her when I was the Chief Inspector of Prisons and was shocked by the treatment of women prisoners at Holloway, who were kept in chains while they were in labour in the hospital of which the noble Baroness was the chair. She was as appalled as I was at what was going on. I discovered that rather than just being appalled, she was actively doing something about the matter and was trying to improve the conditions. I was particularly interested to find that the noble Baroness was actively promoting research into other ways of treating prisoners; namely, that information on what was wrong with them could be video-linked to a doctor in another hospital and analysed there, rather than undergoing the expensive process of taking people under guard from prison into another hospital. Therefore, it does not surprise me at all to find the noble Baroness energetically pursuing the cause of medical research in many areas, not just in general scientific development. It is a huge pleasure and privilege to follow the maiden speech of my noble friend Lady Fritchie. She and I were appointed to this House on the same day. I remember looking at her CV and being absolutely gobsmacked by its breadth. Having heard what she had to say, I can see exactly why so many organisations wish to have her on their pay roll. I should like to pick up three points that have been made so far. First, I should like to pick up the point made by the noble Baroness, Lady Hayman, that the research that we support should be directed at areas which have been neglected in the past, and her concern about fragmentation in the NHS when matters are followed up. I want to focus on a poor relation in this scene; namely, prisons. Finally, I refer to the noble Baroness’s point about cross-fertilisation, co-operation and partnership between patients and public being so hugely important. I refer to two points made by my noble friend Lady Fritchie: first, the importance of deciding the priority of research; and, secondly, her point about research development and implementation going together. I wish to raise that because prisons and the prison population are the newest part of the United Kingdom population to join the NHS. It has been a matter of much concern that a very large number of people in prison are suffering from a huge variety of mental health problems. Until very recently nobody seemed to be picking up the responsibility of doing research into the incidence but also the implications of what they were suffering from and what ought to be done about it. No one was taking the lead in questioning whether imprisonment was making the condition of the patient either better or worse. As far as I was concerned, on inspecting it with my psychiatrist, it was invariably made worse because the conduct of imprisonment made for conditions which were completely against the proper treatment of a mental disorder. Coupled with the fact that there was totally inadequate psychiatric staffing, it meant that people were inevitably going to get worse. I am absolutely delighted to declare an interest, in that I have been co-opted as an adviser by the Sainsbury Centre for Mental Health, which announced recently that one of its priorities was going to be research into every aspect of prison health, which so far has been neglected. I pick up the points made by the noble Baroness, Lady Hayman, and my noble friend Lady Fritchie because it seems to me that the Sainsbury Centre’s work needs to have a priority put on it, but the priority should not necessarily be the priority of the centre—it should be the priority of the user. In theory, the user is the public, because all the prisoners are going to come out of prison, and their mental and physical health is a matter of public interest. It is also a matter for the Prison Service and the Home Office, to make certain that what could be done for people in prison is done, and it is a matter for the NHS, which will have to provide care. What concerns me is that there does not seem to be agreement in the direction of the research coming from the Home Office and the NHS, to see that those people for whom they are responsible are having what is needed identified and prepared. It is no good just going into the research side; the implementation must go with it. Therefore, on behalf of the Sainsbury Centre, I am recommending that we should work together with the Prison Service and the NHS to find out what they feel is the priority in what should be looked at, and then enable that to be done, but only if there is a clear understanding that we are not just doing so for the sake of it, but are identifying what needs to go into the mainstream on behalf of the public and the patients.