Science Research Funding in Universities (Science and Technology Committee Report)

Baroness Morgan of Huyton Excerpts

Wednesday 9th September 2020 Grand Committee

[Baroness Morgan of Huyton (Lab) [V]]

My Lords, it is a pleasure to take part in this debate, so comprehensively introduced by the noble Lord, Lord Patel, the committee’s excellent chairman. It was my real pleasure to serve a full term as a member of the committee; it was always stimulating and enjoyable. I was a member for this report. I draw attention to my entries in the register, specifically as chairman of Royal Brompton and Harefield Trust and master of Fitzwilliam College, Cambridge—I was previously at King’s College.

Of course, this report was written in a previous world, pre Covid, but the pandemic has served only to emphasise the vital importance of the UK’s science base and the main things that we highlighted in our report. It might be useful to look briefly at some of the themes partly from a Cambridge perspective, because sometimes tangible examples can help—others, frankly, probably know more about Cambridge than I do yet, and of course there are other fantastic examples around the country.

First, on impact, I will start with Covid. Cambridge is conducting hundreds of research-intensive projects. Specifically, there are 41 projects on Covid R&D, 36 on therapeutics, 16 on the effect on mental health, 15 on social behaviour during Covid, 15 on diagnostics, 14 on NHS demand, capacity and health, 11 on PPE and front-line facilities, 10 on Covid modelling and, crucially, 25 on post-Covid recovery, including 10 based on the economy. So they go much wider than just a narrow view of science.

There has also been a partnership with AstraZeneca on testing. Today, the university announced that it will be able to offer weekly Covid-19 testing for all students in college accommodation, to give confidence to them and to Cambridge more widely, as recommended by SAGE. One hopes that work will help in working out whether this is effective more widely across the HE sector.

Secondly, on place, we all know that we must enhance the role of universities in city and regional economies. Obviously, that has to fit with the Government’s industrial strategy—I confess that I am not completely clear where that is now up to, but it would be good to hear from the Minister how they fit together. Practically, it seems to me that universities have to provide cultural networks and professional expertise, financial support and market expertise to help nurture IP into commercially viable products, recognising however that there is still a capital gap, which the noble Baroness, Lady Young, talked about. We also need hard infrastructure and innovation districts, and, crucially, a resource and recruitment pool of highly-skilled students—that is fundamental.

Thirdly, innovation—a sort of magic dust—is very important in Cambridge, as it is everywhere else. Great universities need to attract and retain great people. In the Cambridge cluster, for example, 61,000 people are employed by more than 5,000 knowledge-intensive firms, with a total turnover of £15.5 billion. New initiatives and long-lasting initiatives both contribute to keeping great people. I cite the Whittle Laboratory, which has long done work with aviation and power, and, much more recently, Cambridge Zero, a new interdisciplinary climate change research project.

However, none of this research, impact and innovation is inevitable; it needs constant and consistent support from government, business and society. It is not a tap that can be turned on and off. Competition is global and fast-moving, and we need confidence for the future. Obviously, the spending review will be crucial. We have to maintain a focus on the funding of research and innovation, and broader investment in R&D. We need to maintain central funding and innovation funding—the whole, broad ecosystem. We need to strengthen existing partnerships and forge new ones around the world, and to be ambitious and global in our reach. Crucially, we have to invest in people, domestic and international; in STEM and STEAM at school; in post-16 high-quality pathways, teachers and technicians; and in high-quality HE courses. We have to be open and eager for international talent. We have to deal with the issues around visa and health costs, and consistently we have to mean what we say—and that means being joined up across government.

Life Sciences Industrial Strategy (Science and Technology Committee Report)

Baroness Morgan of Huyton Excerpts

Tuesday 23rd October 2018 Lords Chamber

[Baroness Morgan of Huyton (Lab)]

My Lords, I am pleased to be taking part in this important debate. I too was a member of the Science and Technology Select Committee which produced the report we are talking about, under the able chairmanship of the noble Lord, Lord Patel. It was a fascinating but very worrying inquiry. I draw attention to my interests in the register, particularly as chair of the Royal Brompton and Harefield NHS Trust, about which I will speak today. I will focus on the role of the NHS.

We all recognise that the NHS is vital to the success of the Government’s life sciences strategy. It is a unique asset that differentiates the UK from other countries. It is the big opportunity. The Government recognise this, but the challenge is not whether to recognise it but how to deliver on that opportunity. In our inquiry we heard extensively from industry that a silo approach to NHS budgeting and organisation makes innovation difficult, even when it is substitutive rather than additive —as my noble friend Lady Young said. In other words, even if a new treatment is an alternative and not an additional new approach, it is difficult to find a way through.

We also heard from NHS England that living within a tough funding regime means that the centre has to be sure of the benefits to the NHS of any innovation before any change can be approved and funded. Both these contributions, though understandable, were concerning to the committee. On top of this, the danger of the new NHS settlement is that too much of it will be used to prop up the existing service rather than to attempt to transform. It is an inevitable conflict. I sympathise with the Minister dealing with that one—although the noble Lord, Lord O’Shaughnessy, is not in his place.

I thought it would be useful to use a real example to highlight the realities and choices around innovation. It is very easy to talk about theory and potentially hugely positive macroeconomic effects. The life sciences strategy is defined by Sir John Bell as the application and harnessing of biological sciences and technology. If it is handled well, whether via the use of data, genomics, new drugs and treatments, new devices and approaches, and so on, it is absolutely also about better patient care and outcomes. I do not want to repeat the excellent contributions of my committee colleagues, so I will choose one disease, cystic fibrosis, to illustrate my point.

The Royal Brompton and Harefield Trust is a leader in the treatment of cystic fibrosis in both children and adults. CF is a life-limiting genetic disease that is caused by a defective gene which codes for a protein in cell membranes and therefore affects multiple organs in the body. Life is limited due to progressive lung disease, and those with CF are informed by their clinical teams, from an early age, that maintenance and awareness of lung function is important to maximise their life expectancy. As a result, people with CF are expected to attend clinics at their specialist centre regularly, to monitor their lung disease and receive treatment to prevent, halt or slow disease progression.

Our patients travel from all over the UK for specialist care and, through patient experience surveys, they report that attending a clinic so frequently for monitoring is significantly impacting on their quality of life. They must take time off work, arrange childcare and fund the significant cost of travel into central London. In addition to this, CF outpatient services at our hospital and other specialist centres are busy and frequently overbooked. This is a growing concern because research in this area has predicted an increase of 75% in the number of adults with CF. The good news is that this is due to advances in medical care and associated increased life expectancy, and further new drug trials are in the offing. However, the increasing pressure on services increases, for example, the serious danger of cross-infection, which is a significant issue for this patient group. Coming to hospital more or for longer than they absolutely have to is not good for their overall health.

A recently published guideline from NICE on cystic fibrosis has urged healthcare teams to consider providing telehealth as an option for routine monitoring, with benefits recognised both to the patient experience and in allocating hospital resources. The clinical team at the Royal Brompton and Harefield Trust has developed an innovation project that aims to address these challenges by empowering the person with CF to monitor their own health from home. Providing self-assessment equipment and a technology app platform to share that data with the healthcare team unlocks the team’s ability to provide remote, virtual consultations and advice. It will allow people with CF to gain a greater awareness of their overall health and to see the impact of lifestyle changes or new medicines. It is hoped that putting data in the patient’s hands will start to equalise the power dynamic that exists between patient and the healthcare team that currently holds much of the data used for clinical decision-making. It offers the trust the opportunity to reduce the number of in-hospital clinic appointments and consider how to allocate resources better in view of the growing patient population.

Although there is a lot of evidence from clinical practice indicating that the impact of this innovation will hugely improve both the clinical management of CF and patients’ experience of living with and managing this serious disease, there is no clear evidence yet that it can be economically sustainable. It is too soon to make and prove that hypothesis. The team are currently both tendering for the services of a technology partner to develop the platform and exploring with the current commissioner—the payer for our services, NHS England—how to pay for it. The platform is likely to demonstrate fairly quickly that the number of outpatient consultations between CF patients and the clinical team, especially face-to-face ones, can be greatly reduced, saving the patient travel costs and freeing up capacity in the hospital. Over the longer-term, the platform will enable the patient and the clinical team to identify the symptoms of an imminent exacerbation of the disease, which can then be managed so as to minimise the need for the patient to be admitted to the hospital as an in-patient.

If these cost savings and efficiencies from this innovation could be applied over a large number of patients, there is clear potential for the overall current budget spent by NHS England on CF to be reduced. But, crucially, the cost of running the platform in its first one to two years, when added to the existing costs of service provision, are almost certain to increase the current budget for CF, at a time when NHS England is looking to cut back on specialist service provision more generally.

My point in raising this as an example is not special pleading to the Minister, although I am sure he is listening, but to try to give a concrete example—there are so many others—of how current commissioning will need to change in order to support innovation. Innovation cannot and will not happen as part of the current regime. The systems, incentives and funding models are not right. Yet at all levels, whether in the individual clinical team, at NHS trust board level, in academic and business partners or nationally, we all want to deliver change and efficiencies. To make this work we need to be round the table having a serious, grown-up conversation.

I was struck by hearing evidence in the inquiry that genomics has been successfully developed as a comprehensive national strategy partly because it had, in effect, a separate organisation, so there was absolute focus and clarity around mission and delivery. If the life sciences strategy is to harness the power of the NHS and deliver both efficiencies and innovatory new treatments and approaches, it too will need absolute focus and accountability. It cannot be an add-on.

Sir John Bell’s excellent strategy and evidence to us identified a small window for us to get the incentives, the systems and the accountabilities sorted in order to realise the unique potential we have as an economy because of the power of the NHS. Can the Minister convince us today that the Government recognise this?

Science and Innovation Strategy

Baroness Morgan of Huyton Excerpts

Monday 23rd October 2017 Lords Chamber

[Baroness Morgan of Huyton (Lab)]

My Lords, I echo the thanks to the noble Lord, Lord Patel, for his excellent introduction to this debate. I am fortunate to serve as a member of the Science and Technology Select Committee under his leadership, which followed the able leadership of the noble Earl, Lord Selborne, who initiated this area of scrutiny for the committee. I draw attention to my entries in the register.

This House scrutinises and discusses this subject matter repeatedly. The future industrial strategy is of paramount importance to the UK economy and the big issue, of course, is implementation. What? How? Where? We will rightly hear a lot today about HE and science but in my brief intervention I want to talk about a component that is often not talked about quite so much—the need for a real, quality, deliverable skills strategy that meets the future economic requirements of the country and does not jump to ticking boxes and obsessing about big target numbers: I think about the 3 million apprenticeships. We have been here before. All Governments want to talk big numbers, but all in different ways have failed to deliver the content, quality and skill sets needed to go forward.

We have, of course, talked about this before. In many ways, it went wrong with the Education Act 1944 and our failure to set up technical schools. That established a mindset of academic top dog, and everything else being the poor relations. Like many of us here today, I hark back to the days of ONCs leading to HNDs at strong local polytechnics, which could then be topped up to degree level if wanted. All this was replaced for well-meaning reasons, but the replacement technical structures and qualifications were frankly inadequate. In addition, FE colleges have been woefully underfunded and inadequately staffed for many years. Typically, the recent review of FE colleges looked only at financial sustainability, not skill needs or quality of provision. Employers tell me regularly that they have to retrain young people who come to them supposedly ready for work.

In 2015, the UK Commission for Employment and Skills found that 43% of STEM vacancies were hard to fill due to a shortage of skills. That is the biggest challenge facing London’s tech businesses, while the Tech Partnership says that 72% of large companies and 49% of SMEs are reporting skills gaps, with significant impacts on productivity. Engineering and construction firms are finding the situation increasingly difficult, and that is without Brexit.

The recent productivity figures have to be a huge wake-up call for us all. Put Brexit on top and the need for a complete change of gear in this area and honest appraisal of what is needed is apparent. We spend most of our time and money talking about schools and HE. I give an example of the sort of focus needed by the Government—that is, delivery of technicians. By that I mean workers possessing levels 3 to 5 STEM skills. Technicians are workers who apply proven techniques and procedures to the solution of practical problems. They carry supervisory or technical responsibility and competently deliver their skills across the fields of science, medicine, engineering and technology. They are in very short supply already. Every employer in these fields is desperate. The Government, frankly, are not joining up the dots sufficiently. For example, very little of the advanced learner loans—basically, the only way 24-plus year-olds can get funding for technician awards—are going to level 4-plus courses. In 2015-16, it was £8.6 million out of a total of £162 million.

Paul Lewis at King’s College—I declare an interest as vice-chair of council—has undertaken an interesting and illustrative piece of research on the role of technicians in life sciences. I know that the Minister is particularly interested in this area. The life sciences strategy is, of course, both a strategy in its own right but also an important strand of the industrial strategy. His research found that, as industrial biotechnology, cell therapy and regenerative medicine remain in the relatively early stages of their development and heavily involved in research, the focus has been on graduate and postgraduate skill needs, which are also in pretty short supply. However, sector-level bodies and employers readily acknowledge that any movement in the future to full-scale manufacturing—as we hope there will be —will demand increasing numbers of specialist manufacturing and laboratory technician roles. Significantly, many of the emerging roles in the life sciences sector could, and probably should, be carried out by technicians. These roles are highly routinised but take place in accordance with strict guidelines and standard operating procedures from which people must not deviate. Such roles place a premium on attention to detail, care in following instructions and practical skills—for example, on cell cultivation—rather than on graduate-level theoretical knowledge.

In practice, many manufacturing and lab support roles have hitherto often been filled by graduates. This overqualification can lead to difficulties. The graduates have greater theoretical knowledge than is essential, but they often lack the practical skills required to do the job effectively over a reasonable period of time. They often also become dissatisfied with the job, both with the highly routinised work and the relatively low pay. They may leave pretty quickly, which is frustrating for the employers, who have put the training in.

Apprenticeships could and should help, if planned properly. When it comes to planning and delivering apprenticeships, there are lessons from other specialist sectors, and it is now time to learn from them. We need small numbers. In any geographical area, small numbers make it difficult to get a training provider to collaborate properly under the current funding system. This needs to be planned properly. For example, we should look at centres of excellence, technician training that can cover a range of industries, more distance learning with residential blocks, involving the catapult centres, and so on. The point is that a practical, comprehensive piece of work needs to be done on this now.

I choose this issue of technicians to be illustrative of the wider issues. My plea to the Minister is that collectively we need to roll up our sleeves and deliver a properly thought-out, joined-up skills strategy—not have schools over there, FE here and HE somewhere else, planned by different departments at the moment with different Ministers and different civil servants. We need to try to avoid the big claims and the big numbers and plan a proper, detailed, quality provision that is absolutely essential for our economic future.

EU Membership: UK Science

Baroness Morgan of Huyton Excerpts

Thursday 23rd March 2017 Lords Chamber

[Baroness Morgan of Huyton (Lab)]

My Lords, I am pleased to take part in this important debate and particularly pleased to be a member of the Select Committee under the able chairmanship of the noble Earl, Lord Selborne. We are served by a strong team, and particularly by a specialist adviser whom we regard highly, who puts up with a great deal of trouble from some of us at times. He is truly an asset to us. I also draw attention to my relevant interests as outlined in the register, specifically that I am a chairman of the Royal Brompton & Harefield Trust and vice-chair of Council at King’s College London.

The committee’s report in April, ahead of the referendum, reflected the overwhelming balance of opinion we heard. The UK science community hugely valued the UK’s role and partnerships within the EU, was concerned about the loss of strategic influence—including positions of leadership in important areas of research—recognised the significant funding advantages enjoyed by the UK, the harmonised regulatory environment, access to research facilities, and the easy movement of talented individuals and teams.

It was right to return quickly post referendum to this subject—and no doubt we will do so again repeatedly. Indeed, I suspect that we would all argue that support for science—in its broadest definition—has become even more important since 23 June and will be vital to the success of a post-Brexit economy.

There are real concerns about future funding beyond the period of funding guaranteed by the Government. I do not doubt that government, particularly the Treasury and BEIS, understands the need to fund science and research, but the reality of the financial pressures piling up makes me extremely nervous. Scientists have heard the reassuring confirmations from the Government about funding in the near future, but collaborations take time to develop and, as we know, they can last for very many years. There is no certainty at the moment for that sort of period.

However, in my brief contribution I will focus on the area that most concerns me: attracting, growing, retaining, valuing talent—in other words, people. In the end, they are the most valuable resource. International funding follows brilliant people, and they in turn create strong teams and attract more funding and talent. It is a sort of circle of excellence.

Throughout our hearings for the April and December reports, we heard repeatedly from academia and from business—from start-ups to large companies—that attracting talented, highly skilled people was top of their collective agenda. I am aware of, and was pleased to read about in the industrial strategy Green Paper, the drive for technical education, whether through new post-16 qualifications or apprenticeships. This reskilling and upskilling of our population both at school and throughout life is essential to harness opportunities now and particularly in the future as it becomes, presumably, more difficult to attract workers from overseas and as jobs change fundamentally and require new skills. The report from the Digital Skills Select Committee, before the referendum, highlighted the priority that should be given to improving digital skills at all levels in our population and the need to enhance these skills throughout life, but digital is only a small part of the STEM story.

However, I am anxious that there is still a lack of proper “joined-upness” across government on all this. In particular, I am somewhat anxious about the involvement of the DfE in a coherent approach to STEM. One example is maths. Last year I chaired a commission looking at how to strengthen STEM teaching and outcomes for students in Haringey. Among a range of recommendations around attracting strong teachers, getting STEM into primary schools, creating new partnerships with the independent schools sector and greater specialisation post 16, we looked in particular at maths in schools. We were told very clearly by employers and economists—from Sir Roger Carr at BAE Systems through to very small local start-ups and local health employers—that they all were looking for a similar thing in young people. They were looking for strong basics, confidence and the ability to work in teams and to think and question—in other words, rounded, bright individuals—but they also all emphasised the importance of confidence around numbers, at whatever level these young people left formal education. That meant, they argued, that students should continue with maths for as long as possible to develop capability and confidence, whether or not it was to lead to a further qualification.

However, we found that there was a widespread under-the-radar approach, whereby only students with an A at GCSE were being allowed to take maths in sixth forms. This is obviously the negative effect of blunt accountability—I confess that I speak with history on accountability—where head teachers are anxious about their students not getting a high enough grade at A-level, affecting what is out there in the public realm, and so are not allowing them to take maths post 16, coupled with difficult finances in schools. The Institute of Physics, among others, said that it was aware of, and concerned about, this approach. It thought it was wrong and limited participants in higher-level STEM studies across the piece. Limiting students who take up maths to only those who get the top A-level grades goes against the stated government intention of increasing STEM skills at all levels. I hope very much that the maths review headed by Professor Sir Adrian Smith makes clear recommendations around this issue, and in particular I hope that the DfE recognises its responsibility to sort this out.

When our Select Committee heard from Sir Mark Walport this week about UKRI, we asked about the promotion of STEM in schools. His reply gave little comfort that his team had any links with the DfE. He said that it would produce a “narrative” about why STEM is important. That is not to criticise Sir Mark but, rather, to emphasise the need to understand the whole picture of education and training rather than segment it according to government department. But of course the attraction of highly skilled individuals to university, post-doc and beyond, and to industry is crucial. We know that the intertwining of universities and industry is fundamental to the UK’s future success and in particular to less favoured, non-golden-triangle regions and sub-regions of the UK. The industrial strategy Green Paper is pretty weak on the attraction and development of high-level skills and I hope that it will be strengthened post consultation.

We know that EU students make up about 5% of the UK university population, with non-EU international students making up about l4%, the figure being particularly high in the postgraduate sector, but in leading research universities the proportions are much higher. I know that at King’s College London, for example, across the student body over 14% are from the EU and a further 22% are from countries outside the EU. Among academics, 28% are from EU/EEA countries. I have been involved in interview processes already where candidates are hesitant about either staying here or, in particular, moving here from another EU country, and even people outside the EU are now affected by the general uncertainty.

At the Royal Brompton and Harefield NHS Foundation Trust, I have had a look at the relevant figures. The starkest figures are that 52% of nurses and 20% of doctors are EU nationals, and in cardiology the figure rises to over 26.5%. The reason that that matters is obvious: the Royal Brompton and Harefield trust, like other highly regarded specialist trusts, is important both to the delivery of healthcare and to the standing of the UK. It delivers top-end, innovative treatment, and it works with its academic partner, Imperial College, to push the boundaries in respiratory and cardiac medicine. That needs bright and highly capable people. The UK needs such places and such people as beacons post Brexit.

However, when I talk to colleagues at the hospitals and at King’s College, they report insecurity, nervousness and instability. That is hugely damaging for teams that rely on each other to deliver results in research and treatment. Such reactions are not surprising. To be blunt, at its best, they are getting mixed messages from government and throughout the media. The cacophony is confusing: positive one day and negative another, depending on the Minister, the department and the press reaction. They read distressing personal stories about long-standing residents of the UK being ejected, and they wonder what that means for them.

The Government say that it is important to attract the brightest and the best but then say that they collect statistics on students so that local authority services can be planned. That really does not wash. We already know that existing visa arrangements for non-EU students and highly skilled employees from non-EU countries are cumbersome and at best unfriendly. I have talked personally to many post-doctoral students moving away from the UK. In other words, as we heard very elegantly from my noble friend Lord Winston, we train them and then we lose them, and these are our new trading partners of the future. It is crazy.

It seems to me that the real problem is this: people are not run by algorithms—even scientists. They are not 100% rational. They have emotional reactions and are affected by stories and rumours and by someone saying something unpleasant on the train, in the supermarket or outside the school gate. They wonder whether their families will really be welcome here and whether they should take the risk of coming to the UK or of seeking their next post or promotion here. Should they limit the risk by seeking their next job in France or Germany instead of living with a level of insecurity? Crucially, they are asking whether the UK is the place they had understood it to be. There should be no more mixed messages and justifications, and no more concerns about Daily Mail reactions. This needs to be sorted out for our economic future but also for our collective values as a country. I look forward to the Minister’s response.