Speech at the Promoting excellence in health research conference - 11/05/2010

Good afternoon, and thankyou for the invitation to join you alongside such an array of prestigious speakers!

As this is likely to be one of my last contributions as Chair of the S&T Committee prior to my leaving parliament I am delighted to have the opportunity to make a modest contribution to your conference today.

As someone who is neither a scientist nor a medic I cannot do other than admire the sheer brilliance of medical research in the UK and to passionately advocate for its future.

And it is because your field is so crucial that the imminent general election takes on an even greater importance.

We now know the result will be close fought but whatever the result – the key question will be how do we make sure that scientific research, and in your case health and medical research continues to get the investment to realise the potential that clearly exists.

To row back after the progress made in the past decade, and in the face of massive new investment in the US, Germany, France, Singapore and China could perversely affect not only our standing as world leading in health and medical research but seriously undermine long term economic recovery.

So let me go on the offensive!

Our health and medical research base is world class.

MRC funded scientists including Dr Venkatraman Ramakrishnan, Dr Martin Evans, Sir Peter Mansfield, Sir Paul Nurse and Dr Tim Hunt have won Nobel Prizes for their research in the last ten years alone.

From the development of Optical Projection Tomography and other medical imaging technologies,

…to methods for producing therapeutic monoclonal antibodies

…to ground breaking techniques using stem cells

UK medical scientists are making huge contributions to national and global health care.

And thanks to increased investment from the taxpayer, medical charities and industry, which totalled £10bn in 2009, the UK has remained at the forefront of tackling many of the world’s greatest health challenges.

Of course so much of our success in this area is underpinned by a research infrastructure of internationally renowned universities and the world’s largest clinical data base – the NHS.

What is hugely exciting is that across some 50 universities scientists and clinicians are involved in world-leading research with an increasing emphasis on clinical trials and clinical application.

The building of the UK Centre for Medical Research and Innovation in St Pancras, bringing together Cancer Research UK, the Medical Research Council, UCL and the Wellcome Trust will further enable groundbreaking biomedical research and reinforce London’s position as a global scientific centre well into the 21st century.

Over the past ten years too, we have seen particularly with the introduction of OSHCR, a more joined-up approach to medical research

And the introduction of the Office of Life Sciences, and a Science Minister in the Cabinet ahs raised the Government’s game in this area.

(In fact, our medical expertise is so good that we have homeopaths who claim to be able to cure cancer, HIV and Malaria using water alone! But perhaps you shouldn’t get me started on that…)

So our research-base is strong. We are already world leading, and we have a number of opportunities facing the sector.

But obviously all is not rosy.

We are doing well but we could, and must, do better.

The development of research institutes in other countries, particularly India, China and Singapore, which offer cheaper options for research and access to drug trials have the potential to threaten the UK’s position in medical and health research.

A good example is Stem-cell research, where for the past decade the UK has been a world-leader in the field, aided by the ambivalence of the Bush regime in the States.

However, a confidential report by technology consultants Cels leaked last year suggested that only one UK research centre (London) made it into the global top 50, and that the US is again leading the way.

A position that will be strengthened given President Obama’s support and federal funding for embryonic, as well as adult stem cell research.

There remains a massive challenge of translating basic research into clinical applications as the recent LSE report made clear – as did David Cooksey in 2006

This challenge has fuelled the perceived conflict between curiosity driven and applied research.

This is not new, nor is it confined to medical research. In health however there is an imperative to move research into clinical trials more speedily - offering more immediate benefits to patients.

But to do so at the expense of basic research would be wrong.

The challenge of translation must be addressed as a separate issue and we must resist creating a false dichotomy between basic and applied research. Both need access to increased funding.

Indeed failure to commit long-term funding to basic research will undoubtedly harm patients’ interests and the UK’s standing in medical and health research in the long-run.

So let me turn to funding.

The Government’s Pre-Budget Report laid out plans to remove £600 million from higher education and science and research budgets.

My Select Committee is currently conducting an inquiry into the impact of these budget cuts on science and scientific research, and it would be wrong for me to pre-empt its conclusions.

However, all the written and oral evidence points to the same conclusions arrived at in the Royal Society’s report, The Scientific Century and

…the Council for Science and Technology think tanks’ report A Vision for UK Research; that cuts in curiosity-driven or applied science could seriously damage the UK’s standing as a world-leader.

With regards health-related research, we know that the Department of Health’s budget for the National Institute for Health Research and the Policy Research Programme has been ringfenced since the 2007 Comprehensive Spending Review.

However, the Department of Health told our committee that ‘in 2010-11, a departmental saving of £62 million will be achieved by transferring responsibility for research activity from other departmental policy budgets to the ring-fenced R&D budget.’

In other words, whilst Government retains a commitment to ringfenced budgets in science, that does not prevent them from moving new areas of responsibility into the ringfence, resulting in budgets being cut, subverted or stretched.

This is bad for science in principle and it just doesn’t make sound economic sense.

Of course a key area of concern for your sector is the level of investment in health research by charities (some £5bn between 2002-2008 by the AMRC) and the future of the Charity Research Support Fund is uncertain.

Let me be clear that my committee fully supports the Government’s introduction of full economic costs; however, the issue of working with charity research projects continues to be problematic.

The CRSF has been a useful device to support universities but given the current economic climate many funders have expressed concern that the Government’s ambition for the CRSF to reach £270m by 2010/11 will not be achieved.

And there is no formal commitment to the CRSF beyond 2010/11.

The continued existence of the CRSF affects the entire medical research landscape in the UK. A 'stop start' approach would do considerable damage and we will be spelling that out in our Report.

Of course in typical UK fashion whilst we are discussing cuts to spending, elsewhere nations are seeing investment in science as a way to tackle the global recession. (economic stimulus)

US President Obama pledged ‘the largest commitment to scientific research and innovation in American History’ –some $21 billion.

France, a €35billion investment in the knowledge economy

Germany, €12bn and China, a 20% year-on-year increase in science spending.

This table from the Royal Society shows science investment in national stimulus packages as a percentage of GDP.

The UK does not even feature.

By contrast, £12.5bn of the UK’s £15bn economic stimulus went on a VAT cut to stimulate retail spending.

So the signs are ominous for the UK’s continued place at the forefront of medical and other research

So what can we do about it?

One controversial solution, proposed by Sir Leszek Borysiewicz at the MRC was supporting Lord Drayson’s idea of industrial activism, or ‘picking winners’.

Something that Lord Drayson has a bit of a reputation for…!

Sir Leszek’s intervention may not have won universal approval, but the reality is, faced with stand-still budgets, the UK must direct its resources to where our research is world-leading or where the UK is the research-partner of choice.

Medical and health research comes into both of these categories, and this is a debate that must be continued irrespective of who wins the next election.

It is an issue too for our universities – the current model of allowing a thousand flowers to bloom will be challenged. The UK cannot in my view sustain world class research in 150 institutions.

It is arguably whether health related research can be sustained in 50. So ‘picking winners’ may also come nearer to home as public sector budget cuts bite.

This challenge must be met head on and the sector must use its assets to far greater advantage.

I make this point because the UK, alone amongst its competitors has an asset envied by all our competitors

- access to a strong and comprehensive National Health Service.

We should be using this invaluable resource far more effectively than at present.
The UK Clinical Research Collaboration was established in 2004 to streamline applications for clinical trials.

It has led to significant improvements in the applications process through the national clinical research networks and the provision of an advisory service and model agreements for clinical trials.

The establishment of the Integrated Research Application System in 2008, in conjunction with the National Research Ethics Service, which provides for one data entry point for applications, has also received positive feedback from the research community.

However, the proportion of UK patients in global trials fell from six per cent in 2002 to two per cent in 2006.

Yes, because of traditional attitudes, but largely because the process remains bureaucratic and time-consuming.

This is partly due to the way in which the EU Clinical Trials Directive, aimed to simplify and harmonise the rules governing clinical trials in the EU, has been applied in the UK.

And because of the complexities surrounding confidentiality and consent in the sharing of medical data for research purposes.

And it’s not only clinical trials that are tied down in bureaucracy.

I recently visited the stem cell laboratories at UCL, and was concerned to hear how much their work is restricted by the hoops they are made to jump through.

For example, for a stem cell therapy derived from embryonic stem cells which could be used to treat Parkinson’s disease, the research establishment would need:

-A license from the HFEA
-A license from the Human Tissue Authority (HTA)
-Approval from a research ethics committee (REC)
-The approval of the local National Health Service Research and Development (NHS R&D) office

The researcher also has to:

-Seek approval from the UK Stem Cell Bank to deposit the stem cell line in that bank
-Get approval for animal testing from the Home Office (Animal Licensing Directorate)
-Engage with the MHRA about testing cells in MHRA-approved labs (before clinical trials begin) and then get MHRA approval for clinical trials
-After successful clinical trials, apply to the European Medicines Agency (EMEA) to obtain Marketing Authorisation to use the therapy as a standard treatment

We simply cannot go on suffocating our brilliant research with paperwork.

But it looks as though the number of bureaucratic hoops facing scientists is only set to increase.

The proposed REF increases the importance of demonstrating the historic and future impact of research, through the ancient science of form-filling.

As Lord Drayson argued at the RSC debate on Wednesday, there needs to be accountability in the way money is being spent.

“It is taxpayers’ money, it is charities’ money, and it is important to demonstrate that it’s being spent wisely”.

Whether the science community agree or not, it looks as though demonstrating ‘impact’ is something that you are going to have to address.

Nowhere is this more evident than when considering the apparent ‘value’ of collaboration.

A forthcoming report by Evidence, a division of Thomas Reuters will show that the UK research base has grown faster than health sector research and that collaboration now accounts for 1/3 of all outputs.

This increase is positive, partly because, while university average citation impact is higher than health sector impact, the impact of collaborative output is on average higher still.

Collaboration is associated with higher research quality. There is a correlation between the citation impact of health sector research and the proportion of outputs that have a co-author in the UK university sector.

This could be because university researchers only collaborate on work they perceive to have broader impact, or it could be that the benefit of university collaboration is more direct.
The benefits of collaboration are clear.

There has been increasing collaboration between the NHS, the Higher Education sector and private research sectors, but more can be done to consolidate this alliance.

Understanding impact – placing a value on collaboration – will be vital for persuading politicians eager for savings, that investment in health and medical research will deliver those savings AND create wealth too.

That is your challenge.

You have the evidence – the track record – and an electorate who want you to succeed.

With an election looming make sure every prospective candidate understands what is at stake!