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Medical Research

My Lords, I am grateful to my noble friend Lady Hayman for introducing this debate. We all appreciate her great personal interest in and commitment to this area. I congratulate the noble Baroness, Lady Fritchie, on her excellent maiden speech. It had everything that we admire in this House—expert knowledge, clarity of thought, and passion—and we look forward to many similar speeches of such quality in the future. I am also very grateful to the other contributors to the debate. I was very moved by the speeches of the noble Baroness, Lady O’Cathain, and my noble friend Lord Acton setting out their personal experiences. It is important that people do communicate these messages, because at the end of the day that is enormously important in encouraging researchers and showing the public how important this area of research is. The UK is a world leader in both industrial and academic medical research. The Government believe that it is a major national asset which should be strongly supported. That is why we have steadily increased funding to the Medical Research Council, whose budget has risen from £289.1 million in 1997–98 to £480.8 million in 2005–06, which represents an increase of 72 per cent I assure the noble Baroness, Lady O’Cathain, that we will continue to give full support to medical research in the future. I echo a number of speakers in the debate who said that UK university research in this area has an outstanding record. We remain strong internationally in terms of achievement, productivity and efficiency. The latest report of the Office of Science and Innovation shows that in the fields of preclinical and health research we rank second only to the USA, with a 12 per cent world share of citations, and in the field of biological and clinical sciences we have a 10 per cent share of citations. As someone pointed out, for a country with 1 per cent of the world’s population doing 5 per cent of the world’s science, that is an extremely good performance. It is also true that research funded by the MRC has led to some of the most significant discoveries and achievements of 20th century medicine. For example, Watson and Crick were based in an MRC unit in Cambridge when they made their discovery of the structure of DNA. Monoclonal antibodies have revolutionised biomedical research and sparked an international billion-pound biotechnology industry. The original techniques were devised in the MRC Laboratory of Molecular Biology in Cambridge. Again, it is clear that we have world-class research, but it is worth focusing on those two discoveries, because they have revolutionised medical research. They were both absolutely based on fundamental basic research, and one needs to always keep that relationship in mind. Translating the results of basic research into direct clinical and economic benefits is also of key importance. The MRC’s strategy for doing so ranges from support for experimental medicine to funding clinical trials and other population level studies. Translational research needs a vigorous exchange of ideas, methods, people and priorities between basic and clinical sciences, which the MRC actively promotes. In January 2006, it launched a call for centre grant applications to strengthen translational research in the UK. Some 22 applications were received, and the awards will be made in the autumn. Collaboration with industry is another important area for the translation of basic science into economic and medical benefits. The MRC does this through MRC Technology Ltd, which is responsible for exploiting the intellectual property rights from research in MRC research establishments. Between 1987 and 2004, the MRC received more than £102 million in income from exploitation of its intellectual property rights and granted around 457 licences. The MRC’s commercial income was £28.5 million in 2004–05 and expenditure on commercialisation was £9.3 million. This level of licence income is equivalent to 9 per cent of research expenditure in MRC institutes and units which, on the basis of the most recent comparative figures available, is more than three times the proportion achieved overall by US universities and around 15 times the level in UK universities. I am also glad that my noble friend Lady Hayman drew attention to the fact that the quality of our medical research is a key factor in helping to keep world-class pharmaceutical and biotechnology industries in this country. We are rightly proud of the past achievements of the Medical Research Council and we want to build on those. We also want to build on another huge advantage that the UK has in the translation of research into the clinic: the National Health Service. The NHS has a key role to play in determining the future health and wealth of this country and the Government are determined to harness its capacity to make the UK the best place in the world for health research, development and innovation. The Government’s new strategy for NHS research in England, Best Research for Best Health, aims to create a health research system that supports outstanding individuals, working in world-class facilities, conducting leading-edge research that is focused on the need of patients and the public. The NHS also provides researchers with potential access virtually to the entire population, through an integrated system of primary, secondary and tertiary care. This is a unique selling point for public sector researchers, charities and private sector organisations. Acting on reports from the Academy of Medical Sciences and the Bioscience Innovation and Growth Team, the Government created the UK Clinical Research Collaboration in 2004. It is a partnership of organisations, bringing together the National Health Service, research funders, industry and other stakeholders to develop joint actions to support clinical research in the UK and exploit the potential of the NHS more effectively. The UKCRC has had a successful first 18 months and has shown that the Government, working in partnership with the pharmaceutical, bioscience and healthcare industries, can not only increase communication and co-ordination between key stakeholders, but make things happen. I am glad that my noble friend Lady Hayman drew attention to what I think is a success story. More can be done, and at the time of the Budget, as noble Lords have mentioned, the Chancellor announced a single jointly held health research fund. The aim is to maximise the impact of the MRC’s funded medical research and the Department of Health’s R&D. It will build on the UK’s world-class medical science base and recent developments such as the development of the UKCRC and the Government’s new strategy for R&D in England, Best Research for Best Health. It has enormous potential. As noble Lords have pointed out, deciding on the best institutional arrangements for public funding of health research is difficult. Sir David Cooksey will be leading the review which will advise Government on the best way to take this forward. Perhaps I may say to the noble Baroness, Lady Fritchie, that, knowing Sir David very well, too, I am sure that we shall see some new and energetic thinking, which will be conducted extremely well. The noble Baroness, Lady O’Cathain, was slightly optimistic about the date. I hate to be in the position of suggesting that it may be a bit later, but the timetable will be slightly longer than the noble Baroness suggested. However, I am sure that Sir David Cooksey will complete the task as quickly as possible. He launched the consultation on 4 May, the details of which can be found on the Treasury website. I hope very much that the medical and clinical research communities will contribute strongly to that consultation. I wish to make clear that there is no intention in this move to alter in any way the balance between basic and applied research. I say to the noble Baroness, Lady Murphy, that what we want to do is not to change the balance but to make the research more effective. At least some people feel strongly that National Health Service R&D has been used to fund all sorts of infrastructure issues and that it is sometimes hard to see where the actual research has been carried out. We think that we can make this research more effective. I am sure that it will be carried out on the basis of excellence and relevance, not on geopolitical grounds. I should also tell the noble Baroness that there is no plan to cut the £1.3 million. The Cooksey review will look at whether the totality of £1.38 million should be included in a single budget, or whether there is still a case for some of that remaining with the National Health Service and be very much focused on the policy issues that it needs to address. There is certainly no intention of altering the Haldane principle. It is something that we all approve of—very strongly in my case. It is fundamental. However, when I asked my civil servants recently who Lord Haldane, the person who introduced the principle, was and where it was written down, no one was able to find out. The answer is that it is not Lord Haldane the scientist but Lord Haldane the Cabinet Minister. However, it is a principle that we all accept, and it is in the 1980 report on the machinery of government. It is a very good idea and we totally support it. Another fundamental issue raised during the debate was the question of regulation. I agree with my noble friend Lady Hayman that we have to get better at a key aspect of this—that is, working in Europe to make certain that any regulation that comes from there is sensibly drafted so that it does not cause us problems. My noble friends Lord Turnberg and Lord Winston talked eloquently about the restrictions that they feel are hindering research. The Department of Health is aware of this problem and I agree that there is an issue here. I shall be meeting my noble friend Lord Winston to see whether there is any way in which changes can be made to ensure that we get good regulation. We do not want to get rid of regulation—good regulation is fundamental—but there is a difference between regulation and bureaucracy. The latter achieves nothing other than to hold up important work that needs to be done. I cannot agree with the noble Lord, Lord Colwyn, that our IP policies, or the Patent Office policies, are in any way holding up the exploitation of our research. They are very similar to those in the United States. We make certain that all the IP goes to the people who carry out the research, which is what happened in the Bayh-Dole Act in America. I know of no cases where it is felt that we have problems in that area. The noble Lord, Lord Ramsbotham, raised the question of research into mental health problems in prisons. I am very glad to hear that in my absence my charitable trust, the Sainsbury Centre for Mental Health, is continuing to do good things. Unless things have changed in my absence, I assure the noble Lord that the charity is very keen to do research but it does so only if it leads to policy changes. Unless that has changed while I have been away, that will continue to be the case. The noble Baroness, Lady Murphy, and my noble friends Lord Rea and Lord Parekh raised the important area of clinical excellence. This area has been neglected in the past but, due to some excellent work by Mark Wolpert of the Wellcome Trust, there is now a real focus on solving the problems there. One problem is the length of the training that people have to undergo if they are to do clinical research. They have to get the qualifications that a researcher would have—that is, a PhD—and then they need the clinical experience that a clinician would have. That means that only very late in their lives do people get to do any clinical research, and there are very uncertain career prospects after that. Mark Wolpert has done some excellent work on this and the issue is now being focused on. I think that we can raise it up as it is an area that has been neglected and we need to do something about it. My noble friend Lord Parekh also raised some other important and interesting ideas concerning the clinical area. I shall certainly read in Hansard what he said and give it some thought. My noble friend Lord Bhattacharyya raised the question of a council for technology, but I would be rather against that. We now have the Technology Strategy Board and the technology programme. Those are clearly focused on what they should be doing—that is, applied research and research carried out in collaboration with industry, with a clear focus on competitive advantage. It is very difficult to do both applied and basic research within one organisation. It is much better if they are carried out by different bodies as they are managed and evaluated in different ways. The noble Baroness, Lady Warwick, raised the question of MRC money being on a UK basis and National Health Service money being on an English basis. That is exactly the kind of problem and snag that we have asked Sir David Cooksey to help us with. The noble Baroness also asked whether we could expect to see a greater increase in medical research in the comprehensive spending review. As she will know very well, there are two answers to that. If it were my decision, the answer would be ““yes””, but the official government response would be ““wait and see””. My noble friend Lord Rea asked whether clinical researchers will continue to be funded by the NHS. I believe that discussions are taking place between the Department of Health and the Higher Education Funding Council for England to secure how best to make certain that that funding is made. The noble Baroness, Lady Barker, raised the question of animal rights extremists. We have done a lot both on the legislative front and in terms of forming a special police unit under assistant chief constable Anton Setchell in 2004 to take a national view of the issue. I think that after some considerable time the unit is now beginning to get on top of this problem. A lot of prosecutions are now taking place. There is still a lot to do but the Oxford biomedical facility will be built. Is it encouraging to see young people taking a stand in favour of scientific progress. Scientists are now speaking up about the vital work they do, and ordinary individuals are signing up through the people’s petition to express how vital they believe that work is. The noble Earl, Lord Howe, raised a key question: the supply of young creative scientists. The position on young scientists in this country is much better. Indeed, it is very good, both compared with the past and compared with other countries. The question of people turning away from science and engineering is an almost universal problem. It includes Japan, Germany, South Korea, and so on. In this country, the figures show that the number of first degrees obtained in SET subjects grew by 43 per cent between 1994–95 and 2003–04. That includes very strong growth in subjects allied to medicine and biological sciences. The growth in PhDs in 2004 compared with 1994–95 is 88 per cent The situation at undergraduate level is rather good. Surprisingly the percentage of the total undergraduate population taking science degrees has gone up rather than down. I agree that there is a problem at A-level. I do not think that that is all to do with disruption by pupils. The question of the qualifications of teachers is enormously important. Far too many young people are taught physics and chemistry by people who do not have relevant qualifications. We have taken some strong steps to change that in terms of conversion and getting new people in. We have taken another extremely important decision, which is to make certain that the very brightest children can do triple science, which has not always happened in the past and also appears to correlate with how well people do at A-level. I was pleased that my noble friend Lord Haskel raised the question of knowledge transfer networks. We now have 18 such networks, which are doing extremely well in a diverse range of fields. We have always said that we do not have intermediate organisations for translating basic research into helping industry. We now have 18 in important modern areas, which are proving very successful. This has been an important debate, which has highlighted both the strength of Britain’s medical research and its contribution to society as a whole. This country’s future medical research depends on making the best use of highly talented people and the unique potential of the National Health Service as a platform for clinical research to bring benefits to patients. The extra funds that the Government have given to medical research, the action that we are taking to improve our funding system and the translation of basic research into clinical and economic benefits demonstrate the Government’s support for this great national asset.