Life Sciences Industrial Strategy (Science and Technology Committee Report)

Baroness Neville-Jones Excerpts

Tuesday 23rd October 2018 Lords Chamber

[Baroness Neville-Jones (Con)]

My Lords, it is a great pleasure to follow our chairman in discussing our report on the life sciences strategy. I echo his thanks to our witnesses and to the clerks and advisers to the committee. I suppose that it is proper to say that all activities that one engages in when serving on a committee are interesting, but the reality may not always fulfil that. However, on this occasion I can say with pleasure and honesty that this was a particularly interesting subject to tackle, and one that is of importance.

The chairman has outlined the reasons why the strategy needs to be taken seriously. Before discussing some of the issues he mentioned, I want to say a word about the strategy’s place in the industrial strategy as a whole. We need to bear in mind that when taken as a whole, the industrial strategy is the centrepiece of the Government’s approach to the fourth industrial revolution, which is vital to this Government’s future prosperity. The industrial strategy and the various sector deals that will be published within its scope will be the main vehicle for collaboration with business and academia, which are the Government’s essential partners in the strategy. Obviously, the strategy will be the primary framework for public funding. The backdrop of Brexit only increases the importance of this national undertaking.

The Life Sciences Industrial Strategy is an excellent document, I have to say, for which we are indebted to Sir John Bell. It is one of the main strands of the industrial strategy and one where, as he rightly says, the UK has many of the assets needed to make this a leading element in its future prosperity and welfare. Sir John notes that,

“gains in health outcomes … will depend on … new scientific platforms … These will include digital tools, robotics, artificial intelligence … and gene therapy”,

and other therapies. He also said, rightly—the chairman also made this point—that transformation of the NHS is,

“a crucial objective over the next twenty years”.

Several people, including the noble Lord, Lord O’Shaughnessy, have used the word “crucial”.

There is no doubting the opportunity that lies before us. It is one where doing good for mankind can go hand in hand with wealth creation, which is not always the case. Sir John says that the UK is “powerfully positioned” for this, but in my view, that is only the case if we get organised. Having the necessary assets is not the same as using them to good purpose or maximising their potential.

The fourth industrial revolution, where data is key, demands integration. One of the themes that emerges from discussion of the strategy is that integration of the various elements in it is crucial to its success. You need to integrate the resources, the organisation and the outputs. It will not work unless you do that. It demands funding to underpin the science and technology. All of these things succeeding necessitates real partnership between government and business and the creation of a business-friendly environment. It obviously requires new skills in quantity and quality that have hitherto been highly desirable but are now absolutely essential.

This is a huge undertaking since its scope involves most, if not all, departments of central government and the active involvement of local authorities. Industry and government will have to work much more closely together than has historically been the case. We must also get regulation right. All those things are intertwined; they depend on each other. Finally, our education system will need to change in fundamental ways both to meet the demands of something like the life sciences strategy and, more generally, for the industrial strategy as a whole.

The life sciences strategy, coming early and being so important, is something of a test case of our ability as a nation to turn a good strategy into a comprehensive implementation plan. In their reply, the Government were keen to demonstrate how much progress had already been made since the strategy was announced and since the committee wrote its report. It is fair to say that their reply contained a large number of initiatives. However, I do not understand why Ministers maintain a refusal to adopt the strategy as their own. In official documents, they appear to accept it as the blueprint to which they will work, but they still refer to it as “Sir John Bell’s strategy”. I hope that they regard it as the Government’s strategy as well because it matters whether people consider that they have ownership, which means responsibility for success. Psychologically, the notion of ownership of this is quite important.

Sir John says in his report that the UK has considerable strengths in the life sciences. Thanks to the NHS, we have unparalleled longitudinal data to which we must organise properly controlled access. The chairman is absolutely right to say that we must take preventive action immediately to prevent the wrong things being done at the moment. We underspend on R&D by international standards but we get a good bang for our buck precisely because we have for some time been well and intelligently organised through the research councils, and now UKRI. That is an example of how we can maximise our assets if we are well organised, and the reverse is also true. Given the importance of technology, we need to continue to strengthen the research relationship with business, turning it into a strong triangle with academia. They seem to be key partners for the future.

On the skills front, although an important start has been made in recognising the importance at school of STEM subjects and revising parts of the curriculum, there is still a long way to go. It would be good to hear more from the Department for Education about its plans and how it will contribute to this country’s ability to respond to the scientific and technical skills we will need. Finally, as the chairman said, we must get immigration policy right.

The translation and commercialisation of innovation has historically been one of our weaknesses. They are being addressed in a number of ways including, with Treasury support, a focus on patient capital. As said by the chairman, in their reply welcoming the committee’s conclusions on this subject, the Government sadly misunderstood what we said. Increasing entrepreneurship skills is undoubtedly important; the Government made that point but the committee was making a slightly different one. We meant that in a country with developed capital markets of the sort in the United States, in the UK, unlike in the United States, there are too few investors—that is who we were talking about—with sufficient understanding of science and technology to have the confidence to invest at early stages so that a start-up can become a scale company and remain in this country. Our point is that we are not bad at start-ups but we are still quite poor at getting from start-ups to scale companies. That is where investment in this country is very important so that companies remain here instead of going abroad or being bought up. That is an important part of the long-term future of the life sciences strategy. I cannot help feeling that although Sir John Bell’s vision of several British unicorns is very enticing, it remains distant.

So what about NHS transformation, which Sir John says is crucial? Like the chairman, it is here that my anxieties begin. The Government’s reply announces various strategies and initiatives aimed at increasing the capacity of the NHS to innovate. It is very good news that they understand that getting the NHS to increase its capacity to innovate is at the heart of things. For instance, there is the creation of a single NHS Innovation and Life Sciences Group, as well as that of something called the AAC under the noble Lord, Lord Darzi. I gather that the AAC is committed to helping with the Accelerated Access Review. I could mention a number of other acronyms that are cited as having contributions to make to better and faster innovation take-up in the NHS, all of which are welcome. However, the Government have rejected mandating take-up and it is hard to see how the myriad initiatives proposed will do better at removing the blockages in the system than has been the case in the past. The problem is that the NHS trusts are becoming ever more financially strapped and lack the time and financial headroom to give priority to new ways of doing things at the expense of existing contracts and obligations. One can understand and sympathise with the task of the trust manager. He does not want to be put into special measures, so of course he is going to go for his contractual obligations of the day. That is very hard to reconcile with the demand to innovate and do things differently when you do not have the resources.

The committee spent a good deal of time taking evidence on governance issues. Those were related to the implementation of the strategy as a whole and within the NHS. What our witnesses said left me— and I think many other noble Lords—feeling worried, and unconvinced that those who spoke felt confident about their role. Sadly, I do not think that the Government’s reply provides enough comfort in this area.

This is what is proposed for implementation. The Government are setting up two huge committees. The Life Sciences Council, with no fewer than 27 members, appears largely advisory, although it does not say in the reply to whom the advice will actually go—presumably it must be somewhere in government as well as somewhere in industry. Then there is the Life Sciences Industrial Strategy Implementation Board, on which my noble friend the Minister sits as co-chair. That, as its title implies, is charged with implementation and delivery of the strategy via—it would seem—a series of sector deals. This body has 24 members and it will meet quarterly; the membership is axed towards Government and the NHS, which I think is right, but I wonder about some of the other detail.

I would not claim that the committees’ recommendations—we made a number which the Government’s reply does not discuss—were the only possible governance structures. But we did try to suggest ones that had a chance of driving the bus. The Government have not taken them up and have gone ahead with what they intended to do in the first place. I have been inside government and on boards long enough to know that boards of over 20 people, which is well above the Government’s own recommendations for good governance, meeting only intermittently will find it very difficult to generate the necessary sense of ownership, focus and cohesion to drive implementation, and this really worries me.

Moreover, it is not clear how this big board will direct those below it. To deliver its central role, the NHS needs something more than lots of initiatives at varying levels of seniority and influence. The numerous NHS witnesses the committee spoke to had only part of the picture under their personal control, or, if they had a bigger part, were often not clear on the extent to which the strategy would affect their responsibilities. The practical difficulties they faced on a daily basis loomed very large with them. I also worry that the lack of metrics in the Government’s approach reduces the incentives to adapt.

I have been quite critical but I think this is a very good and important strategy which I hope will not, through lack of drive and delivery, fall below its potential and our expectations. In so complex a landscape it is easy to lose the thread, and in my view a small senior committee—largely but not exclusively a government steering committee—is needed to get on with the job on a day-to-day basis, and I hope something like that will evolve. Such big projects cannot be treated as business as usual—they have to be driven.

So I have a plea to put to my noble friend the Minister, to which I hope he will reply in terms when he comes to respond. In his capacity as co-chair of the implementation board, I hope he sees to it that the milestones mentioned and which the Government are going to engage—a road map, a timetable and a plan—will be set by the committee, against which progress can be measured. This will go a long way towards ensuring there is a measured tread. I hope he will also take a view after a period of time as to whether the governance system is delivering, and advise accordingly. He will be in a unique position to take on this task, and I hope he does, because the UK cannot afford to fail to seize the opportunity of becoming a world beater in life sciences.