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Medical Research

My Lords, I thank the noble Baroness, Lady Hayman, for giving us this timely opportunity to discuss a very important subject. I also welcome the noble Baroness, Lady Fritchie, to your Lordships’ House. Her remarks about public health, in particular on research into ageing issues, were extremely interesting. I look forward to her participation in future debates. Every day my school bus passed a building that had probably been a Victorian workhouse or fever hospital. No one paid much attention to it until 1978 when it became the centre of the world’s attention. In that year it was where Louise Brown—to give her the full title: Louise Brown the first test-tube baby—was born. She was not born in Cambridge or London—I say in passing to the noble Baroness, Lady Murphy—and she was not born in America. Rather she was born in Oldham, with a clear view of the pitch at Boundary Park. It is a source of ongoing pride to the people of Oldham that she was born there and that her birth took place in an NHS hospital. Just why and how the remarkable team of Edwards and Steptoe created that remarkable breakthrough I leave for noble Lords to read in the forthcoming book of the noble Lord, Lord Winston. Some 25 years on, it is right to assess the position of our country as the place where brilliant scientists have the freedom to make breakthroughs. That we are able to do so is due in part to the quality of our academic institutions, the strength of our regulatory framework—although I listened carefully to what the noble Lord, Lord Winston, had to say—and the freedom we give researchers to pursue knowledge without unwarranted interference from religious or political interests. I mention religious interests because researchers are now coming from the United States to work here because of intrusions by some religious organisations. As noble Lords have said throughout the debate, the NHS provides a marvellous base on which to conduct epidemiological public health research. The announcement of the review by Sir David Cooksey is welcome in that it offers the potential to reduce fragmentation of funding and bureaucracy, the dual nightmare of researchers, as the noble Lord, Lord Winston, pointed out. It also promises a review of the research assessment evaluation exercise. In our debate on 27 April many noble Lords observed that it is so laborious and expensive that it acts as a curb on much research. However, the Treasury announcement begs a number of questions, and we should pose them in the run-up to the Comprehensive Spending Review. First, it would appear from the documentation that the DfES is not a part of this review—it does not appear in any of the press releases or briefing materials—but, given that academic medicine is such an important part of the whole research package, it really should be included. Fifteen per cent of the R&D performed in UK universities is funded by charities. As the aim of the review is to rationalise medical research funding and maintain the UK’s position, it seems rather strange that the DfES is not involved. The noble Lord, Lord Rea, spoke eloquently and at some length about the pressures on clinical academic staff. The great concern is that the teaching burden on them is increasing exponentially so that the time available for them to carry out research will not be there. That will not only impact on patient care but, I suspect, it will ultimately impact on the workforce. If our clinical academics do not find that space and time in this country they will go to other places, such as China and India, where they will be given those resources, and we will lose their knowledge and the diversity within the NHS which is one of its greatest strengths. The announcement on 31 March stated that the review of Sir David Cooksey is to consider whether some parts of the budget should remain within the relevant government departments. On what basis will that decision be made? There are important questions about the Haldane principle, to which the noble Baroness, Lady Warwick of Undercliffe, referred, and the need to keep these decisions at arm’s length from Ministers. The Minister will no doubt be aware that many of the medical research charities are concerned that the Department of Health funding will not be ring fenced. There is a further concern that, in the merged fund, research that has a greater commercial potential will flourish at the expense of research of a more theoretical nature or research which is more complex or longer term. I remember talking to one of my colleagues who, on becoming a lecturer at Cambridge, found himself having dinner with a number of his colleagues, among whom there were two Nobel Prize winners. Everyone was making a great deal of one of them but said nothing about the other. My friend asked, ““He has just won the Nobel Prize, why aren’t people making a fuss of this guy?””—to which he got what I gather is the standard answer at Cambridge, ““Well, it is not maths, is it?””. As many noble Lords have said today, it will be in fields which are not directly related to medicine that some of our biggest advances will come. Can the Minister tell the House whether the current review will address the concern about commercial drivers for research and, if so, how? As we discuss this matter, the courts are delivering their verdict on the animal rights activists who terrorised the Hall family in Derbyshire. I am a passionate believer in the right of people to practise animal research and the need for it to happen. Computer modelling, epidemiology, cells, tissues, imaging, screening and clinical trials are all alternatives to animal research. As the law currently stands, animal experiments cannot go ahead if the research can be carried out without animals and each laboratory that conducts animal research has an ethical review process. However, at present it is not possible to recreate the interplay of vital organs, the workings of the immune system or the likely toxic effects of a new medicine in non-animal experiments alone. It is imperative that in the review we maintain our support for those who are involved in the legitimate pursuit of the development of knowledge which will alleviate human suffering. Given that GSK had to go to court on Tuesday to protect its shareholders, what further steps, in addition to the legislation last year, will the Government take to ensure that life sciences research organisations are not intimidated out of existence in this country. It is widely recognised that gene therapy and drug development offer the greatest potential for treatment of conditions such as cancer. There is frustration within the medical research community that the NICE review process for medicines and medically assisted technologies is laborious and long. Yet if one listens carefully, there is widespread agreement that NICE, although far from perfect, independent as it is, is absolutely necessary to the integrity of scientific development. The alacrity with which the Secretary of State gave in to the campaign for Herceptin several months ago, a drug for which Roche had not even applied for a licence, was alarming. It did enormous harm to the standing of NICE. In this review of best practice, what role will NICE have in gathering together the scientific evidence base and will this present an opportunity, once again, for the Government to support NICE and its efforts? A number of noble Lords talked about the potential fracturing of research within the NHS because of the full-scale upheaval going on. We do not yet know whether PCT reorganisation and practice-based commissioning will have a beneficial or a detrimental effect. What steps will the Minister’s department take, along with the Department of Health, to ensure that research, specifically in specialist areas such as neurology and audiology, do not slip away and become lost as the big medical issues with the high profile and the popular image take over what limited resources there may be. Finally, I return to that Victorian building in Oldham. It is still there today, although it is part of bigger PFI premises. It is part of the Pennine Care NHS Trust which announced last week that 800 jobs are about to go in 400 hospitals, of which the Royal Oldham is one. I really wonder whether it would now be possible for a brilliant team, such as the one that was there in 1978, to appear, and with co-ordination, vision, flexibility and understanding, to produce such a momentous breakthrough as happened then. Whatever else comes from this reorganisation, I sincerely hope that we will remain a country in which brilliant scientists have the space and the wherewithal to do brilliant things.