UK Diagnostics Industry and Covid-19 Recovery
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The Parliamentary Under-Secretary of State for Business, Energy and Industrial Strategy (George Freeman)
I congratulate the hon. Member for Kirkcaldy and Cowdenbeath (Neale Hanvey) on securing this important debate and thank him for putting on record some serious points, which I have listened to and will read with great interest. I also pay tribute to his own personal experience as a respected professional clinician in the fields of oncology and adolescent cancer in particular. His bringing this different expertise to the House is hugely valuable and I welcome his input. I am grateful for this opportunity to respond on behalf of the Government.
The points the hon. Gentleman has made are probably better answered by someone from the Department of Health and Social Care, and I will raise them with the Department, particularly his points on infection control in the new post-pandemic landscape and on the importance of learning the lessons from the pandemic procurement emergency and the lessons for a sustainable and vibrant diagnostics sector. I also note the concerns he raised on behalf of his constituent, Craig Inglis, about investments, and the issues around Omega, the reliability of the lateral flow tests and the new pathogens. The point made by the hon. Member for Strangford (Jim Shannon) was also well made: Belfast University in Northern Ireland is a diagnostics powerhouse. I am very well sighted on that in the heart of our science superpower and innovation plans, and I am looking forward to revisiting Belfast to see that work.
In the three minutes that I have, I cannot deal with all the points that have been made, but I will pick up the specific questions that the hon. Member for Kirkcaldy and Cowdenbeath has raised and write to him with an answer. It is worth saying that the covid pandemic was the most extraordinary unprecedented emergency that we faced, and the first pandemic that we faced as a generation—
George Freeman
I have until half-past? I will not detain the House unnecessarily, but that means that I do not need to rush quite so much.
If we cast our minds back to January and February 2020, the truth is that we were confronting completely unprecedented national decisions and emergencies. There was no playbook for this. Sadly, I was unable to bring my expertise in this sector to the Government at the time because I was liberated from the burden of office on 13 February, in the Valentine’s day reshuffle. In fact, my last Government role was to attend the first Cobra meeting on what was then called the virus emergency.
Neale Hanvey
I may be professionally slanted on this, but one observation I made was that we had lots of very “academic” academics involved in the decision making at Cobra. There are some extremely capable and experienced senior nurses and emergency clinicians who deal with major incidents day in and day out, and they are the ones who understand how to run an emergency and where the gaps might be. I have a bit of a professional hero in Louise Boden. She was chief nurse at University College London Hospital and she got us through the 7/7 bombs and the Admiral Duncan pub bomb. Unfortunately I was on duty for both of those incidents, which was not pleasant, but it was important to have someone of that capability there, and I would gently suggest that the Government have someone with that kind of major incident experience in the room when planning these things in future.
George Freeman
The hon. Gentleman makes an important point. Sadly, I was not a Minister at the time—I would love to have been—but I do not think it is a state secret to say that there were clearly mistakes made in that national emergency. That is why there is a proper and full inquiry. He has made some important points that need to be picked up, but I do not think he would expect me to give a running commentary here on the decisions that were taken. If we cast our minds back, there was a two or three-week period when we were worried that the lack of ventilators would be the great crisis. Innovative groups all around the country were stood up as part of the national challenge to try to design ventilators, with engineers working out how to do things. All that happened in very fast order, and all sorts of issues were raised and procurements flagged that we did not need in the end. I do not think anyone would say that it was a seamless process; it was a national emergency, and there were clearly many lessons to learn.
To deal with the hon. Gentleman’s bigger points—I will perhaps pick up the specifics in detail in a written reply—as a former Life Sciences Minister, I observe that the pandemic revealed that things that we had done seven or eight years earlier in the coalition Government had paid not just the four times return on investment that is traditional in this sector, but many times over that. The truth is that the reasons we were able to sequence the virus so fast were the launching of the genomics programme, which I was proud to have led back under the coalition, the accelerated access review we put in place, the parallel approvals process with the Medicines and Healthcare products Regulatory Agency, the early access to medicines scheme, and the setting up of Vaccine Manufacturing and Innovation Centre. John Bell and I suggested in 2016 that it would be a sensible piece of foresight to invest in vaccine manufacturing, which was clearly going to change. Of course, we had no idea that a pandemic would mean that that facility would suddenly become incredibly important.
Also important was the establishment of NHS Digital. One of the lessons of the pandemic is the importance of really good data and of both national and local data sets. As a Norfolk MP, I remember being frustrated that we did not have the granularity of data or the ability to do public health by cities or districts; it was instead by big, clumsy Government regions. There are all sorts of lessons there about how an emergency requires not only national implementation and measures but the subtlety of local control, empowering local experts on the ground who are best equipped to work out how to contain and control.
I want to focus on where I can add perhaps most value in this debate and on the hon. Gentleman’s points about the importance of the diagnostics industry. One of the great lessons of the pandemic, which has absolutely been taken to the heart of Government, is that we must recognise that globalisation will drive more and more infectious disease challenges. God forbid we have another pandemic of this type, but over the past 10 or 15 years we have had zika, Ebola and covid. It is likely that we will see more such things. Hopefully they will be local or regional, but if we are not ready to contain them, we could see outbreaks of disease.
Globalisation will drive the release of new pathogens, which is why pathogen detection is one of the technologies that I am putting at the heart of our three-year plan going forward. Indeed, I am working with the chief scientific adviser Sir Patrick Vallance on how we can ensure that we harness our leadership in genomics for broader pathogen detection across animal, plant and human health and make sure that we build that network off the back of the pandemic.
The hon. Gentleman made a more specific point that in the NHS, the care system and the life sciences industry—I say this as someone who spent 15 years in the sector before coming to Parliament—diagnostics was for years the slightly poor relation. Drug discovery and the pharmaceutical sector tended to raise the big money and have the higher profile, but the pandemic revealed that diagnostics is absolutely key to getting on top of the disease. The life sciences industry is moving to recognise that if we want to deliver real value and reduce the cost of disease, which is the real key to the economy and the health system, we need to build in diagnosis much earlier. That means both the easy diagnosis—if I may call it that—of easily detectable and treatable diseases and the deeper science of longer-term diagnosis of tomorrow’s conditions.
That is why, in the update to our life sciences industrial strategy that we set out last year, we have insisted on closing the gap over the next 10 years between the traditional dichotomy in Government—the Department for Business, Energy and Industrial Strategy sponsors the research and the Department of Health and Social Care does the procurement, licensing and approvals—to try to build a much more integrated model through which we focus on diseases in places and the patient pathway and bring diagnosis, treatment and prevention together around the eight disease missions. One thing I hope and intend that that will do is put the diagnostics industry at the heart of those missions; traditionally, it has been an industry that has tended to be about the black box that sits on the hospital ward, but these days it is becoming integral to the life sciences industry and to working out how to treat, understand and detect disease. Those missions are completely key.
Let me reassure the hon. Gentleman and other colleagues here this evening by saying that we are also investing heavily, in this next phase, in the mRNA technologies that are key to the next phase of detection and diagnosis, and in new treatments. VMIC, which we set up as an academic unit to work on future vaccine manufacturing technologies, suddenly became an urgent facility for onshoring during the pandemic. I am pleased that we have transferred VMIC into the hands of Catalent, a world leader in mRNA diagnostics, therapeutics and treatments. So we have established a much more robust national supply chain in dealing with both flu and other respiratory diseases, and other pathogens. Many of the lessons have been learned, but obviously there is more to do.
We have set out in our latest life sciences vision an £8 billion commitment to research, including work with the Medical Research Council, deep research on my side of the portfolio at the Department for Business, Energy and Industrial Strategy and putting some £4.5 billion into the Department of Health and Social Care and the National Institute for Health and Care Research. The NIHR, where we are talking about £1 billion a year, is the sort of engine of research under the NHS. Crucially, we have said that, at its heart, diagnostics has to be central to that landscape. I refer not only to the detection of influenza and other respiratory pathogens, but to molecular diagnostics, biomarkers and genomic insights into disease. That is because the NHS is a huge procurer daily of blood tests for individual conditions, as the hon. Gentleman knows well. If we properly integrate that, we will be building up a database of deep expertise in biomarkers and understanding the early signals of disease, and we can harness that to make the NHS much more of a diagnostics research engine.
The dream and aim in respect of those eight disease missions is that we will be able to mobilise patients much more quickly, through digital technologies, into trials. Patients, through charities, will be able to enrol in clinical research. Using that spine of the biobank and molecular diagnostics, we can start to give industry much quicker access to the patients who are on the frontline of the conditions we need to treat.
That should drive a virtuous circle, in which we detect earlier, treat earlier and attract investment, and ultimately, as the hon. Gentleman says, we move from a paradigm where the NHS, under cost pressures, is a low-price and often late procurer to a scenario in which it does not have to be a high-price payer because it is giving industry an even more valuable thing: access to patients, charities and disease and patient consent for research. The NHS’s role in this sector is, thus, as a research engine. I have made it clear to industry that we will never, in a publicly funded healthcare system, be the highest-price payer—it would not expect us to be—but that the promise I can make it is that we will move heaven and earth to be an earlier adopter, an earlier tester and the best place in the world for it to come to test and diagnose its new treatments, and get the data on which patients they work in. Industry will then be able to use that to go around the world and sell to other countries. That is the vision of the NHS as a 21st-century research engine.
Jim Shannon
The Minister referred to Queen’s University Belfast, and I know he has a particular interest in being there and being involved with it. Will he indicate whether Queen’s University Belfast, or any other university in Northern Ireland, has been involved in this type of research and partnership? It is so important to take advantage of the massive amount of knowledge in the sector.
George Freeman
The hon. Gentleman makes an important point and invites me to signal again my support for what is going on in Northern Ireland. If we look at the cancer outcomes in Northern Ireland, the Queen’s University team that has been working on biomarkers and earlier detection has ended up driving not just investment, but much quicker and better outcomes for the people of Northern Ireland. The real power of the sector is that it delivers better healthcare for everybody within the values of the NHS, but also attracts investment and drives industry. I would go so far as to say that in the new landscape, companies such as Randox will develop affordable consumer diagnostic kits that can help drive earlier detection, building on to a digital interface. We can then support patients to get into trials earlier and drive research medicine. Belfast is on the frontline of that.
Rachael Maskell (York Central) (Lab/Co-op)
This evening’s debate has been excellent. In York, we had a company that was developing aptamers to be used in the diagnostic process. The Government did not have a grip on the governance or an understanding of what could be produced and the quality that that would bring. How is that mapping being done to ensure that every part of the manufacturing process is brought together?
George Freeman
The hon. Lady, not for the first time, makes an important point. As I am not a Minister in the Department of Health and Social Care, I had better defer to them on where they are on that specific mapping point. In terms of my responsibility at the Department for Business, Energy and Industrial Strategy, we are looking to grow the innovation economy by mapping the clusters of expertise around the country, including BioYorkshire, which I visited recently, and to ensure that we are aware of and supporting those clusters of research. Given that I have been invited to comment on other geographies, I will highlight how proud I am that the Norwich research park was the first place in the country to establish a local testing facility and local testing infrastructure to support it.
One thing the pandemic revealed was that, whether it is test and trace, data or epidemiological control, the best people to get on top of it are those on the ground locally. One of the lessons of the pandemic is that, yes, we need strong national leadership, but we also need to free up and trust the clinical and professional judgment on the ground.
For the record, it is important to speak about the scale of the diagnostics challenge in the pandemic. At peak, more than 700,000 PCR tests and 74,000 genomic sequences were done daily. It has been the most extraordinary turbocharging of our diagnostics infrastructure. I think everyone is aware of what we owe the diagnostics industry—that needs to be put on the record—but also that the infrastructure must be maintained for future events.
Genomic sequencing technology has been fundamental. The groundbreaking analyses of the combined SARS-CoV-2 genomic sequences and epidemiological data have supported the uploading of 2.7 million of 10.7 million genomes in GISAID—the global initiative on sharing avian influenza data. We are leaders in the global networks for genomic sequencing because of that genomics investment. More than 2 billion lateral flow tests have been provided across the UK.
I am conscious of the time. With permission, I will deal with the detailed questions that the hon. Member for Kirkcaldy and Cowdenbeath has raised in writing. I hope that I have reassured colleagues that we have absolutely learned the lesson that the diagnostics industry will never again be the poor relation. Emergencies require us to learn the lessons—we will not have got everything right, and the official inquiry is important. I would like to take the politics out of it and ensure that the clinical lessons are learned. I assure the hon. Gentleman that we are determined to ensure that the industry is put at the heart of our life sciences vision.
Question put and agreed to.