King’s Speech

Baroness Greenfield Excerpts

Friday 19th July 2024 Lords Chamber

[Baroness Greenfield (CB)]

My Lords, as a neuroscientist I welcome consideration of mental health in the gracious Speech. I declare an interest as founder and CEO of a biotech company, Neuro-Bio Ltd, where we are striving towards a novel and effective treatment for Alzheimer’s disease. I was therefore sadly disappointed that no measure was made in the gracious Speech of the urgent issues relating to such a devastating health problem.

Why must the Government make dementia a priority? Almost 1 million people are living with the condition in the UK, and we expect this to rise to 1.4 million by 2040, due to our ageing population. Dementia costs the UK £42 billion a year, rising to more than £90 billion by 2040. One in three people born today will develop dementia, and it is a leading cause of death.

As things stand, dementia presents us with three broad challenges. The first is social care, an issue that many noble Lords have already touched on as a clear omission in the gracious Speech. Seventy per cent of residents in older-age care homes in England have dementia, while only 45% of care staff are currently recorded as having any level of appropriate training, so what could be the solution? A long-term workforce strategy: social care staff should be required to undertake dementia training, mapped to the Dementia Training Standards Framework or equivalent.

Secondly, there should be a sustainable funding model for quality personalised care, which pools the risk of care costs and is centred on achieving affordable care for everyone living with dementia.

The next challenge is diagnosis. More than one in three people living with dementia in England are currently undiagnosed. There is a significant regional variation in diagnosis rates, moreover, by more than 40%. What could be the solution? A target for a more ambitious dementia diagnosis rate should be a government priority. Secondly, there should be a commitment to better training for healthcare professionals. Thirdly, there should be funding for public awareness campaigns. Fourthly, there should be increasing quality and quantity of diagnosis, data collection and publication.

The final challenge is treatment. There are drugs that, for the first time, can slow the progression of Alzheimer’s disease in the earliest stages of diagnosis. Tens of thousands of UK citizens could potentially benefit from these drugs if they were approved. However, the healthcare system is not yet ready to deliver such treatments, due to the lack of early diagnosis and specialist diagnostics. What could be the solution? First, a satisfactory plan should be developed by NHS England and the Department for Health and Social Care to be thoroughly prepared and ready to start to deliver these new treatments for dementia. Secondly, the current drugs being assessed are just the beginning. Though welcome, they do not halt the neurodegeneration process; they only slow it down. However, there is the very real prospect—still at the research stage, admittedly—of innovative treatments that could do far more and be much more effective, perhaps even halting cell death altogether. The biggest barrier to progressing such game-changing therapy at pace is, quite simply and inevitably, inadequate funding.

To conclude, dementia is the biggest unmet clinical need of our time and, as such, it surely should have been a high priority in government plans in the gracious Speech. While diseases such as cancer are serious, often disabling and frequently terminal, you can still reminisce over old photographs and still spend meaningful and precious time with your grandchildren. These life-enhancing moments are gradually closed off for an individual with dementia, and it is a spectre that haunts us all. We need to invest funds immediately in rising to the three challenges of social care, diagnosis and, above all, innovative and effective treatment, so that we could finally offer, perhaps, the prospect of our grandchildren one day asking, as we did in the past for smallpox and polio, “Was Alzheimer’s ever a problem?”

Teachers: Academies and Free Schools

Baroness Greenfield Excerpts

Monday 12th September 2016 Lords Chamber

[Baroness Greenfield (CB)]

My Lords, I join other noble Lords in welcoming the noble Baroness, Lady Finn. I enjoyed her speech, wish her well and look forward to her further contributions. I also commend the noble Lord, Lord Storey, for the opportunity to debate this important and timely issue. I declare an interest as the recipient of a research grant from what was the Centre for British Teachers and is now the not-for-profit Education Development Trust. Our goal was to explore aspects of evidence-based teaching practice. At the time it was the first large-scale multifactorial controlled trial of an educational intervention, led by a collaboration between teachers and neuroscientists.

My basic point this evening is that evidence-based education theories should be integrated into teacher training, not just in academies and free schools but as part of a teacher’s qualifications wherever they practise their profession. Since 1987, funding has allowed local education authorities to train teachers. College courses have in general been reorganised to focus more on classroom strategies. This apprenticeship model has been positive overall: it stands to reason that a complex function such as teaching can be fully learned only by doing the actual job. However, there have been negative consequences, arguably such as the unintended implication that nothing can be learned from education theory.

It is completely possible nowadays to achieve qualified teacher status while employed in a school that is connected to no university, and with no coverage of learning theory or education research. It is also clear that there is a wide range of curricula on offer. Some courses take a broad view of education theory, which may include the psychology of learning integrated with the sociology of education, while others present an almost exclusively sociological view of schools and schooling. Moreover, education research in the main has been dominated by qualitative methods, with the occasional large-scale quantitative but uncontrolled analysis. To make matters worse, publicly funded education research initially appears in journals that teachers cannot readily access. In addition, little replication in education research takes place to confirm the findings in question—not least due to the tiny budgets available for projects compared to those in, say, my own area of medical research.

These challenges, together with a growth in research related to teacher effectiveness and pupil outcomes, have led to what has been called the evidence movement, or knowledge management movement, the culmination of which is exemplified by the work of the Education Endowment Foundation. It has commissioned more than 100 randomised controlled education trials in England. Then there is the initiative reported on in Closing the Gap: Test and Learn, which has delivered collaborative trials across nearly 1,000 schools in England. To have real value, these data surely need to be passed on to teachers—rookies and veterans alike. Perhaps one day there could be a more sophisticated teacher-training curriculum than at present, where research-informed topics would feature. For example, findings suggest that in-depth collaborations between teachers, schools and neuroscientists could yield substantial benefits in moving towards a more evidence-based culture in schools, as I have witnessed first-hand.

However, to attain this goal, specific techniques will need to be taught to teachers—be they trainees or more experienced—if they are to be effective. Continuous professional development is central to teaching as a profession but surveys suggest that it is unable to prevent a number of myths pervading the education system that are likely to be unhelpful and certainly costly. This is most notable for findings from my own field of neuroscience, as information is lost in the translation to education. For example, almost half of teachers in the UK apparently believe that we use only 10% of our brains. Yet were that to be the case, your Lordships may consider for a moment that we could readily witness up to 90% complete brain damage in individuals with no apparent malfunction. That is clearly not the case. An even greater number of teachers, an astonishing 93%, think that children learn better when taught in their preferred learning style—visual, auditory or kinaesthetic—despite no evidence at all to support this claim. Most important of all here, there needs to be training in scientific method and critical thinking more generally, so that teachers are equipped to evaluate both established and new ideas.

In addition to the content of CPD, there are concerns about the form it takes, namely: periodic inset days; generic workshops with little continuity or opportunity for application; the transfer of knowledge from so-called experts to teachers; and pull-out strategies or add-ons rather than integrated practice. These approaches are focused on fixing problems rather than developing the teacher. This may of course be a direct consequence of the current status of initial teacher training. However, different models of CPD have been proposed which, first, focus on raising the self-awareness of existing strengths and weaknesses; secondly, promote team activity; and, thirdly, encourage and financially support attendance at events and appropriate training for specific individuals. By involving teachers in devising bespoke development plans, it could be expected that they would engage more with the development process. However, where this is in doubt other options have been shown to increase engagement. For example, financial incentives for participating in specific CPD activities, with teachers earning stipends for demonstrating certain levels of competency, have already proved effective in upskilling teachers in core IT skills.

In conclusion, this approach, incorporating in particular evidence-based education theory, could foster engagement in teachers who would in turn have higher job satisfaction and commitment to their school, higher retention, which ultimately prevents skills loss and financial outlay on recruitment, and better individual and team performance, which would in turn enhance student outcomes. Most exciting of all, it would show the highest possible levels of innovation.

Education: Social Mobility

Baroness Greenfield Excerpts

Thursday 13th March 2014 Lords Chamber

[Baroness Greenfield (CB)]

I would like to congratulate the noble Lord, Lord Nash, on introducing this highly important topic for debate. As a neuroscientist, I can appreciate only too well the impact that the environment, and thus the experience in the home and the classroom, can have on the physical brain processes, and subsequently on the unique individual that each child will become. The human brain is astonishingly “plastic”, which is why we as a species occupy more ecological niches than any other on the planet.

Our brains are constantly adapting to wherever we are placed and to whatever we are doing. Even thinking alone can drive an observable physical change in the brain. An intriguing study, which is much cited, showed this very well. It involved three groups of volunteers, none of whom could play the piano. Over a five-day experiment, the control group was exposed to the experimental environment but not to the all-important factor of five-finger piano exercises, while a second group learnt the exercises. Even within five days, you could see an astonishing change in their brain scans. However, the third group was the most remarkable. In this group the subjects were required merely to imagine they were playing the piano, and their brain scans showed almost identical changes to those who did the physical practice. Therefore, the important issue here is not the contraction of the muscle but the thinking that preceded it.

Such endless neuronal updating on a “use it or lose it” basis is particularly marked in critical timeframes during development within the first 10 years or so of life. So, if that is the case, what would be the ideal educational outcome in terms of mental prowess? For example, the Education Minister, Michael Gove, has suggested that all young children should learn a poem, but surely the more important, and harder, goal would be that they should understand it. There is a temptation sometimes to adopt the Gradgrind approach from Dickens’ Hard Times to aim simply to transmit facts. After all, you can readily train a brain—in certain cases, even that of a parrot—to give the right responses to a given input and to answer factual questions with factual answers. However, such success in, for example, activities such as Trivial Pursuit or pub quizzes is not regarded by even the most enthusiastic fans as the apotheosis of intellectual endeavour. Facts on their own are not enough; information is not knowledge. While collecting information may be simply gathering dots, knowledge is being able to join them up, seeing one thing in terms of another, and thereby understanding each component as part of a greater conceptual whole.

I would like to suggest that the more connections you can make in your brain across an ever wider and disparate range, the more deeply you will understand something. This connectivity, which is achieved through the plasticity of neuronal connections during development, could then be the key feature that defines real learning, and which sets the human brain above and beyond the information processing of a computer.

The work of the late educational neuroscientist John Geake provides hard evidence for this proposition. Geake’s imaging studies on gifted children revealed that their brains showed greater interconnectivity than the brains of those with average cognitive ability. Specifically, Geake’s findings led to the idea that giftedness is linked to analogical reasoning: for example, the analogy of the extinction of a candle with the extinction of life, as in the famous soliloquy in Macbeth. This ability to make connections where they did not exist before—to connect the dots—probably accounts for exceptional talents and creativity in many areas, including art, philosophy, mathematics, science and music.

So, how can the education system best provide an environment conducive to making such connections? Some might think the answer lies in digital technology. One meta-analysis of 46 different original studies involving a total of more than 36,000 students showed significant positive effects of computer use on mathematics achievement. Similarly, a recent large-scale analysis reviewed how educational software programs could beneficially affect reading outcomes in some 84 studies based on more than 60,000 students. Yet a report commissioned by NESTA in 2012, entitled Decoding Learning, concluded:

“In the last five years UK schools have spent more than £1 billion on digital technology. From interactive whiteboards to tablets, there is more digital technology in schools than ever before. But so far there has been little evidence of substantial success in improving educational outcomes”.

How can we reconcile these seemingly conflicting perspectives? I think it is done by flagging one all-important additional factor. The findings of the meta-analysis had indeed suggested that various reading programs, predominately computer delivered, generally produced a positive, but small, effect on reading skills. However, the really significant factor to emerge time and again has been that innovative technology has much more positive impact when accompanied by teacher support, so the greatest promise of digital devices lies not so much in the software and screen delivery themselves but in their use in close connection with teachers’ efforts. For anyone who has read The Prime of Miss Jean Brodie, or Goodbye, Mr Chips, this will come as no new insight. Nothing beats an inspirational teacher—not even an iPad.

Education research and practice supports this argument too. Sir Michael Barber has stated that the quality of an education system cannot exceed the quality of its teachers. Meanwhile, Pearson Education, in a recent report on worldwide school attainment, states that there is no substitute for good teachers. This conviction would seem nowhere more relevant than in schools in low-income areas. Take, for example, Mulberry School in Tower Hamlets—a non-selective, fully comprehensive school in which 76% of the pupils are entitled to free meals. The school has a policy to concentrate its resources on developing teachers and using as much of its budget as it can to pay for extra teaching and support for learning in a multitude of ways so that it maximises the amount of focused attention which pupils receive. The results have already shown considerable success. GCSE results doubled between 2005 and 2011 from 34% gaining A* to C with English and maths, to 78%, and, most commendable of all, 80% of students at this school now go to university.

So when it comes to giving a child the best start in life, to realise their potential irrespective of their background, we need to focus on ways of helping the young brain to join up the dots and to understand deeply what they are learning. This is best done by someone who can interact with them personally and act as an intellectual guide—a mentor. A mentor has been defined as someone who believes in you more than you believe in yourself. Could not more of the education budget go on ensuring that those key players—the teachers—have the best possible pay and conditions, so that they can focus on being much needed mentors, especially in cases where, as the noble Lord, Lord Northbourne, has already flagged, a child comes from a background where perhaps they have not been able to believe in themselves at all?