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Science, Technology and Engineering

My Lords, although I suspect that a debate with this title would be important at any time, I congratulate the noble Lord, Lord Haskel, on his timing, because there is, as many noble Lords have said, a great sense of urgency about the subject. Part of the reason for that is the point which he himself made about this being a time of recession. Those who succeed in such times are those who can look beyond the recession and identify what is needed, innovate and be ready for it. In many cases that will be the scientists and technologists. As many noble Lords also said, there is also the crisis of climate change, where again we need technological innovations. We have some major issues to address on how to fund and implement those innovations. However, I want to talk about medical science, and I shall focus on putting research into practice and actually ensuring that things happen for patients and for the health of the population. We have a great and illustrious history in this area. Many great scientists and clinical scientists have enhanced not only the health of the UK but our position in the world. Perhaps I may mention just one individual: the late Professor Philip Poole-Wilson of the National Heart and Lung Institute, whose memorial service is being held as we speak, where I would have been now were I not here. Philip exemplified three things that are important to us in this debate. He was a great cardiologist, but he was also a great clinician, great researcher and great teacher. In this field, we often need those three sets of qualities together. We have an excellent environment in which we can bring together the clinical, the research and the teaching: the National Health Service—in which I declare my interest as a former chief executive—which is an excellent environment for learning and research. The noble Lord, Lord Drayson, has recognised that and, as I understand it, one of the issues in his current work is to ensure that we draw sufficient research and scientific development from our extraordinary integrated health service to enable us to put it into practice and understand it in practice. I pay tribute to the recent developments in the Department of Health and the NHS in making sure that research is much better co-ordinated. Under the leadership of Dame Sally Davies, we have the Office for Strategic Co-ordination of Health Research, which is making sure that there is more effective translation of health research into health and economic benefits for the UK. It is very important work that could be taken much further. I was interested to hear that, from his new Office of Life Sciences, the noble Lord, Lord Drayson, will be producing a life sciences blueprint in July. It will be interesting to hear how he wants to take that further forward. We know that health research has an economic benefit for the country. An interesting study was done a year or so ago, entitled What’s it Worth?, which estimated the economic benefits of medical research in the UK. It made some broad estimates in a number of areas, but in the one that it considered in some detail, cardiovascular disease, it estimated that there was a 9 per cent rate of return annually on the research. That is a significant rate of return and one that it is important that we understand when talking about the importance of medical research. I want to draw attention to three points. One comes directly from that area of research. Anyone who has read that study—I have, and I had better declare another interest as a trustee of RAND Europe, which was one of the authors of the study—can see how difficult it was to evaluate the impact of medical research, because there are so many confounding factors and so many ways of measuring. I hope that in the new Office of Life Sciences, attention will be paid to how we effectively evaluate the impact of medical research—not just the quality of the medical research itself, but its impact on real life. That will be an important way to help inform policy for the future. I ask the Minister to comment on that. The second point on which I ask the Minister to comment, and to tell us whether the life sciences blueprint will refer to it, concerns the spread of practice once research has demonstrated what works. We often talk about getting things from the laboratory to the bedside. The study to which I just referred stated that in cardiovascular disease, it took 17 years on average to get things from research to the bedside. I am interested in the time that it takes not just to get things from the laboratory to the bedside, but from one bedside to every bedside, making sure that it is normal practice everywhere. I suspect that we do not pay very much attention to that. Part of that is about how we spread best practice; and part of it is knowledge transfer. That may be a particular issue for medical sciences, but I suspect that it is true elsewhere. There was a famous article in the Lancet that said that if we applied all the knowledge that we have today, we would have more impact than any medical breakthrough that we may be likely to have in the next 10 years. I suspect that that may be true elsewhere and that we may not pay enough attention to that latter bit—getting it from one bedside to every bedside. It is not just about spreading good practice. The noble Lord, Lord Jenkin, made a point about the social sciences and natural sciences interface. We know that there is resistance to the findings of science among the population in all kinds of ways. The noble Lord, Lord Haskel, made the point—his words were very interesting—that in the great MMR controversy, people were judging us on our values and the reasons for which we were making the change. They were making judgments about the people who were saying, "You should have this vaccine", and not making a scientific judgment. That is true in all kinds of different areas of medicine. We know that about 30 per cent of drugs do not get taken by the patients for whom they are prescribed. That seems to be universal in developed countries. The social sciences can help us to understand how to get the products of natural sciences into action, so that we can get better evaluation and results for the population. My second question for the noble Lord, Lord Drayson, is how he sees the interaction between the natural and the social sciences. How important does he see that in the life sciences, particularly the question of how to spread practice from one bedside to every bedside? My third point is again health-related, but may have other relevance. Anyone who has had responsibility for managing health services will know that there is an ultimate tension between prevention and treatment. We often get dragged down to the far end of treatment when we want to be spending a bit more resource on prevention. There are issues here for the direction of science in medical research. I think particularly of the pharmaceutical industry. To what extent are we expending great effort on developing drugs for the latter stages of treatment and less attention to the biological markers of diagnosis? For example, we know that if we can catch cancer early and treat it early, we have a much better chance of the patient surviving and that it is a much cheaper option, whereas if you catch it later it is much more expensive and the patient has much less chance. We should of course try to prevent cancer, but there is also an argument for improving the way in which we handle diagnosis. Does the Minister feel that there is room for greater emphasis on what Sir Bill Castell described as early health as opposed to the treatment of late disease? Should that be where we should be thinking about going in medical research? More emphasis on that would not, of course, prevent the emphasis on late disease.