Medical Research
Debate between Lord Hunt of Kings Heath and Baroness Buscombe
Baroness Buscombe (Con)
My Lords, noble Lords will appreciate that in the past however many minutes I have been asked a lot of questions. I may not be able to answer them all, in which case, I hope noble Lords will accept a letter. I will write in detail in reply. I thank all noble Lords, particularly the noble Lord, Lord Sharkey, for their valuable contributions to this important debate.
“The Government is committed to building on the UK’s world-leading science base—including more Nobel Laureates than any country outside the United States—and making the UK the go-to nation for scientists, innovators and investors in technology”.—[Official Report, 23/3/17; col. 310.]
That was quoted by my noble friend Lord Prior last Thursday in a debate on EU withdrawal and science. Our focus this evening is on the importance and value of medical research to this country as part of our science.
I am sure all those present would agree that the UK research base is world-class. With just 0.9% of the global population and 4.1% of researchers, the UK accounts for 11.6% of citations and 15.9% of the most highly cited articles. Times Higher Education ranks three UK universities in the top 10, and 12 in the top 100, with the University of Oxford in first place overall.
We have an enviable track record in medical research, and we want to keep it that way. How will we do that? We have to do it by continuing to strive to improve our knowledge in this area. That is why this Government have been, and will continue to be, so dedicated in supporting research, both research in general and specifically medical research. Our support for research overall can be seen in the 2015 spending review announcement, where we protected the science resource budget in real terms for the rest of the Parliament at its 2015-16 level of £4.7 billion. In the 2016 Autumn Statement we went even further and committed to substantial real-terms increases in government investment in R&D, rising to an extra £2 billion a year by 2020-21 to help put Britain at the cutting edge of science and technology. This is an increase of around 20% of total government R&D spending and more than any increase in any Parliament since 1979.
What funding has been provided for medical research in particular? Noble Lords have referred to some of the numbers this evening. In 2015-16, the MRC’s gross research expenditure, funded through the budgetary allocation of the Department for Business, Innovation and Skills and contributions from other bodies, was £927.8 million, providing support for world-class medical research to improve human health and enhance the economic competitiveness of the UK. Through the Department of Health, the Government are investing more than £1 billion a year in health and care research through the National Institute for Health Research. Funded by the Department of Health, NIHR benefits the future of health by: funding high-quality research to improve health; training and supporting health researchers; involving patients and the public in health research; providing facilities for research funded by other organisations; and working with the life sciences industry to benefit patients.
Through the NIHR, we have this year announced record funding to support our leading NHS and university partnerships. This includes the largest ever investment in health research infrastructure: £816 million over the next five years for 20 new NIHR biomedical research centres in our leading NHS and university partnerships across England. Each of these 20 biomedical research centres will translate lab-based discoveries into new cutting-edge treatments, technologies, diagnostics and other interventions in clinical settings for patients in a wide range of diseases, such as cancer and dementia. Through the NIHR, the Government are also investing £112 million over the next five years in 23 clinical research facilities for experimental medicine to help speed up the translation of scientific advances for the benefit of patients through dedicated and purpose-built facilities in the NHS with specialist clinical research and support staff. The NIHR has created a national clinical research network which co-ordinates and supports the delivery of industry, charity and other publicly funded research across the NHS in England. Annual recruitment to clinical trials and studies by the NIHR clinical research network has reached more than 600,000 people. To make it simpler for researchers to apply for funding, while retaining our commitment to research excellence, the NIHR will be rolling out a streamlined and faster application process from May. We are very encouraged by what the noble Lord, Lord Willis, said about improving outputs, but the important thing is talking about issues, such as linking data to discharge.
The contribution of charities is hugely important to this and it would be inappropriate to neglect that contribution to medical research. Noble Lords referred to it this evening. REF 2014 demonstrated the outstanding contribution to clinical medicine and to the world-leading position of the UK in biomedical science and clinical/translational research, and it highlighted that much of this work was underpinned by the vast charitable investment made in clinical medicine in the UK, with more than a third of the income over the period derived from UK-based charities. Members of the Association of Medical Research Charities have together invested more than £1 billion into UK medical research in each of the past seven years. We of course want to encourage this investment to continue, which is why the research councils and NIHR work closely with charities on many large projects. For example, noble Lords will know of the Francis Crick Institute, which is a partnership between the Medical Research Council, Cancer Research UK, the Wellcome Trust, UCL, Imperial College London and King’s College London. In addition to funding the cost of building the institute, the founders will provide ongoing research support. The Wellcome Trust will fund interdisciplinary research spanning biology, chemistry and bioengineering. The world’s largest health imaging study—UK Biobank—is jointly funded by the MRC, the Wellcome Trust and the British Heart Foundation. It will create the biggest collection of scans of internal organs and transform the way scientists study a wide range of diseases, including dementia, arthritis, cancer, heart attacks and strokes.
Many charities are greatly appreciative of the Charity Research Support Fund, part of the quality-related research funding administered by the Higher Education Funding Council for England. HEFCE determines how much to provide for this fund from within its overall allocation from BEIS, and has maintained it at £198 million per annum through to 2016-17. Once UKRI is established, decisions on the priorities for funding and how much to allocate for this will be a matter for Research England.
My noble friend Lord Dundee asked questions regarding product development partnerships, but they are more within the scope of DfID, so I will write to reply on that point. He also asked about neurological research for Alzheimer’s. As part of the Government’s 2020 dementia challenge, they are increasing research funding for dementia. This includes the Dementia Research Institute—which is being co-funded by the MRC, the Alzheimer’s Society and Alzheimer’s Research UK—the new Dementias Platform UK and the NIHR Dementia Translational Research Collaboration, which has been set up to catalyse dementia research across world-leading NIHR biomedical research centres.
Our position post the EU referendum was of concern to all noble Lords taking part in this debate, quite rightly. Leaving the EU allows us to make fresh choices about how we shape our economy and presents an opportunity to deliver a bold, long-term industrial strategy that builds on our strengths and prepares us for the years ahead. The Green Paper we launched in January marks the beginning of a dialogue to develop this strategy and to make sure the UK remains one of the very best places in the world to innovate, carry out research and do business. We are putting the UK’s strengths in science, research and innovation at the heart of our industrial strategy. We have highlighted the life sciences industry as a key area of future success for the UK. We are delighted that Professor Sir John Bell has agreed to lead the development of a new strategy for the long-term success of UK life sciences, and we hope this can lead to an early sector deal.
Funding is hugely critical, as the noble Lord, Lord Sharkey, mentioned in his opening speech. The Government have made a series of announcements to provide assurance and certainty to stakeholders in the research community since the referendum. The Treasury has made it clear that it will underwrite all successful bids for Horizon 2020 funding that are approved by the Commission, even when specific projects continue beyond our departure from the EU. This gives British participants and their EU partners the assurance and certainty needed to plan ahead for projects that can run over many years. It is too early to speculate on the UK’s future relationship with Horizon 2020 and successor programmes, but noble Lords can be assured that the UK Government are committed to ensuring that the UK remains a world leader in international research and innovation.
Another important issue was referenced by the noble Baronesses, Lady Morgan and Lady Masham. As noble Lords have said, attracting talent is absolutely key. We are in a strong position but it is important that we attract the best talent, and stakeholders have made clear that funding on its own is not sufficient. A lot has been said, some of it perhaps in a hurry, post the EU referendum, and I appreciate that there has been a misconception that the UK is no longer welcoming to overseas researchers. This is simply not true. As David Davis has said:
“We will always welcome those with the skills, the drive and the expertise to make our nation better still”.
In the Budget, we announced that over £100 million will be invested in global research talent over the next four years to attract the brightest minds to the UK and help maintain the UK’s position as a world leader in R&D. This includes £50 million of NPIF funding ring-fenced for fellowship programmes to attract global talent in areas that align with the industrial strategy, and over £50 million of existing international funds to support fellowships that attract researchers to the UK from emerging research powerhouses such as India, China, Brazil and Mexico. We have also provided assurance about postgraduate support through the Research Council studentships, which will remain open to EU students starting courses in the 2017-18 academic year. The funding support will cover the duration of their course, even if the course concludes after the UK has left the EU.
As the Government have made clear previously, there has been no change to the rights and status of EU nationals in the UK or of British citizens in the EU as a result of the referendum. The Prime Minister has been clear that during negotiations she wants to protect the status of EU nationals already living here. The only circumstances in which that would not be possible is if British citizens’ rights in European member states were not protected in return.
I know I am running short of time but I want to speak briefly about collaboration and very quickly refer to some of the questions. We have taken no final decisions on our future relationship with the EU on research. The White Paper made it clear that we would welcome an agreement to continue to collaborate with our European partners on major science, research and technology initiatives. The noble Lord, Lord Kakkar, talked about the ecosystem, which is quite complex—believe me, I have been on something of a learning curve here—and it is critical that we collaborate. We are considering a number of options, but I stress that international collaboration is nothing new.
We are thinking through how UK researchers can best be able to continue to work with the best of their international counterparts, both European and more widely. As long as we continue to be a research powerhouse, other nations will continue to collaborate with us. As I have set out, the Government are working hard to ensure that we continue to build on our reputation.
The noble Lord, Lord Patel, talked about regulation and data privacy.
Lord Hunt of Kings Heath
The noble Baroness is clearly not going to respond on the NHS. Does she not realise that none of this means anything unless the NHS uptakes these new medicines? This is the core argument that we are putting to her, but she is not responding to it.
Baroness Buscombe
If I may, this debate is about how we maintain medical research.
Baroness Buscombe
I am trying to get to the point, if I may, but perhaps it would be better if I write to the noble Lord in detail specifically on the new proposals for NICE and the cap. I think that would be better in the circumstances.
The noble Lord, Lord Patel, talked about regulation, data privacy and data transfer post Brexit. We will take seriously his wise recommendation to work with researchers and regulators to ensure that our data privacy is a world leader, proportionate and pragmatic. My noble friend Lord Ryder talked of the pressing need to reform the 2007 paediatric regulations, whereby there is an avoidance of trialling cancer drugs for children. I will certainly take that back to the department.
There was reference to NHS England’s research plan. It will be published in the next few weeks. Publication of the plan and monitoring of progress on its delivery is one of the deliverables on research in the Government’s mandate to NHS England for 2017-18, published on 20 March. The research plan will be followed by development of a comprehensive research strategy. NHS England will engage with its stakeholders during the spring and summer to support development and plan delivery of the strategy. The implementation of the AAR and the industrial strategy includes talking to industry about the changes. Positive features include a fast-track process and a threshold weighted by gain.
There were a number of other questions that I wish I could answer quickly. The noble Lord, Lord Willis, asked about CLAHRCs. Collaborations for leadership in applied health research and care are funded by NIHR with £120 million. There are more than 13 of them around England. The Department of Health is currently examining options for future funding after the current contract. This includes asking current CLAHRCs about what is working and what could be done better to support applied health research.
To conclude, it is clear from what we have heard this evening that the UK’s medical research is world-class and something that we should be proud of. Retaining and building on our science and research base remains a top priority for this Government. We will continue to work with stakeholders and parliamentarians to achieve it. I again thank the noble Lord, Lord Sharkey, and all noble Lords who have taken part in the debate this evening.
Technical and Further Education Bill
Debate between Lord Hunt of Kings Heath and Baroness BuscombeMonday 27th February 2017
(7 years, 2 months ago)
Grand CommitteeRead Full debate Technical and Further Education Act 2017 View all Technical and Further Education Act 2017 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: HL Bill 88-III Third marshalled list for Grand Committee (PDF, 86KB) - (27 Feb 2017)
Lord Hunt of Kings Heath
My Lords, I join the noble Lord, Lord Baker, in saying that, at heart, we want to hear how this will operate, because that will inform our future debates. Like my noble friend Lord Knight, I have no problem at all with competition where it can drive quality and innovation. However, that depends on the nature of the market and the capacity and nous of the commissioning body. Frankly, my concern is that government procurement has not usually shown itself able to have the agility that my noble friend asked for. The constraints put upon public sector procurement drive you to award tenders on a crude price basis. Ministers always sign up to concepts of value for money and outcomes, as the noble Lord, Lord Baker, said. But as anyone dealing with the Government will know, the reality is that it always comes down to price. The noble Baroness, Lady Wolf, made a very convincing argument on the principles, but the real question is on the practice of procurement and licensing.
There was a tension in what the noble Lord, Lord Lucas, said. He had two worries: one was that the franchising system envisaged would allow too little time for a provider to invest morally, intellectually and financially in the very long term; equally, the other was that because of the single-provider approach, there will be little competition at the end of the franchise period. I suppose he would say the risk is that we end up with the worst of all worlds, with low-quality provision and a provider that is not interested in the long term, and the institute having no choice at the end of the day.
It comes down to capacity. We are talking about an institute with 80 people. I hope that most of their time will be spent overseeing standards, because I for one simply do not trust the approach that is being taken. How can we rely on employers, given that their record in this country is so dismal? I hope the institute will have people who can talk to and challenge the panels. But who will be left to oversee these contracts? The record of government and public sector bodies in procurement is dismal.
My other question is to the noble Baroness, Lady Wolf. In its deliberations, did the review look at the ability of the public sector to commission in a sensible, grown-up way, rather than the usual crude way that is taken? My noble friend Lord Adonis is in his place, and I am tempted to invite him to talk about some examples of that in rail franchising. The noble Lord, Lord Lucas, mentioned this at Second Reading, and clearly there are a number of examples of where the Department for Transport has gone for a bid that was overambitious from the company concerned and has had to come to the rescue. There are also examples of the argument around whether a franchise can be extended to enable the train operator to invest in the future development of services. I hope that the Minister’s department will look at that experience before getting into this sort of system. For me, it is not so much about the principle but about the capacity of the institute to handle what could be a very difficult issue.
Baroness Buscombe
My Lords, I thank all noble Lords, and in particular my noble friend Lord Lucas, for this very helpful debate on these amendments. My task is to try to reassure all noble Lords that we are on the right page and that we are not talking about what we have had in the past, which was all about a race to the bottom. That was the reason the Sainsbury review was set up in the first place. I hope I can reassure noble Lords that we are trying to achieve the right thing, and I shall explain in more detail how this is going to work.
On Amendment 17, good-quality standards developed by employers and other relevant experts are at the heart of the apprenticeship and technical education reforms, and we must ensure that they are fit for purpose. In future, standards will form the basis of both apprenticeships and technical education qualifications in the reformed system, and they must be appropriate for both pathways. One of the cornerstones of the apprenticeship reforms has been to move away from a qualifications-based system—in the past, apprentices have collected a number of small, often low-quality, qualifications throughout their apprenticeship—to a single end-point assessment that tests all-round competency in the occupation.
By mandating, as the amendment proposes, the inclusion of a technical education qualification in each standard, we would be moving back towards this system, and reintroducing something which was a significant factor in the decreasing quality of apprenticeships in the past under the framework model. There may be some cases, such as degree apprenticeships, where including a qualification is appropriate, but we should not require it in every case. The purpose of the apprenticeship reforms is that they are employer led, so employers and other experts should have their input for each standard.
In addition, this approach may also blur the lines between the two pathways, which are intentionally different. For those on an apprenticeship, the individual primarily gains the knowledge, skills and behaviours set out in the standard through learning on the job and 20% off-the-job training, which is then tested through a single end-point assessment. A technical education qualification is taught largely in a college environment, often supplemented by a work placement and other steps leading to the new TE certificate. By including a technical education qualification in all apprenticeships—which would be the effect of the amendment—we would lose the essential flexibility of standards developed by employers and others and limit the breadth of skills that can be obtained through an apprenticeship.
I noted that a number of Second Reading speeches, particularly that of the noble Baroness, Lady Morris of Yardley, were very strong on this point of flexibility. Several noble Lords have touched on this this afternoon. We do not want to lose flexibility through this process, and we must have some clarity.
The apprenticeship end-point assessment is the equivalent of the technical education qualification for those who have undertaken an apprenticeship, but also captures a wider range of skills and behaviours as well as knowledge. It needs to be given time to gain the value and worth with employers that many currently associate with qualifications. Including a technical education qualification would undermine this by narrowing an apprenticeship so that the measurement is more focused on a knowledge-based qualification and less on occupational competency.
I can, however, reassure the noble Lord that our apprenticeship system is flexible and that qualifications can be included in apprenticeships where that is what employers need, in circumstances, for example, where failing to include a qualification would put the learner at a disadvantage in the workplace or where it is a statutory requirement. We do not believe that technical qualifications should be included in all apprenticeships.
Amendments 26 to 30 relate to copyright. I understand the concerns my noble friend Lord Lucas has raised on copyright, and I hope that I might be able to provide an explanation that will put his mind at rest. My noble friend has proposed that the institute should retain the copyright for standards and common qualification criteria rather than for relevant course documents. Amendments in the Enterprise Act, due to come into force in April, already make provision for the copyright for standards to transfer to the institute upon approval. It follows that the institute would own the copyright for any common qualification criteria that it has produced. By common criteria, we mean design features of the qualifications that are the same, irrespective of the route studied.
The qualifications system in England is unique. Qualifications that attract public funding are developed and supplied not by the Government but by awarding organisations. Our reforms will see the institute taking responsibility for ensuring that only high-quality technical qualifications that match employer-set standards are approved by the institute. This will see the institute working with employers and other relevant stakeholders to set the content of qualifications. There will be a number of people involved in this, on the different panels, including ex-apprentices.
While we recognise that it is a departure from the current system, the transfer of copyright for relevant course documents is an important feature of the reforms. The scope of the licences for the delivery of qualifications and the details of relevant course documents will be established in due course. These may well include a specific technical assessment design specification, as well as other documents that are key to the make-up and assessment of a qualification. We would expect the institute to work closely with key stakeholders, as we propose to do, to make sure that the detail is right. This will, of course, include the organisations that develop qualifications.
If copyright for relevant course documents does not reside with the institute, we could end up with a technical education system where any innovation and employer needs are undermined by commercial interests. While we believe absolutely in competition, we want competition to raise quality and standards. If an organisation other than the institute holds the copyright for a particular qualification indefinitely, this would effectively create a stranglehold that would make it difficult for other organisations to enter the market. This would clearly not be in the public interest or fair value for the taxpayer.
However, we do not want an inflexible system. The institute will be able to grant a licence to an organisation or person for use of documents for which it owns the copyright. This could include granting a licence back to the organisation that has developed the qualification. There are also important safeguards provided for in new Section A2DA.
Amendments 28 and 29 seek to clarify that the institute may grant more than one person a licence or be assigned a right or interest in any copyright document. I would like to reassure noble Lords that it is precisely our intention that more than one person may be assigned a licence if in particular circumstances this is appropriate. I would also like to draw noble Lords’ attention to Section 6 of the Interpretation Act 1978. This stipulates that, unless it is clear that there is a contrary intention, wherever there are words in the singular these include the plural and vice versa. This means that the institute may grant a licence, right or interest in any copyright document to more than one person, should this be appropriate.
I hope that that goes some way towards reassuring noble Lords. In addition, I would like to touch on one or two of the questions—all of them if possible. If I do not reassure everybody, I would be very happy to write to noble Lords. My noble friend Lord Lucas questioned this single route, but each route will include a number of qualifications, each based on a cluster of occupations. If an awarding organisation fails, the institute’s copyright arrangements will allow another awarding organisation to step in. What is important is that this primary legislation does not tie our hands. Panels will be starting work this summer on the detail of the different courses. The noble Baroness, Lady Wolf, who is, sadly, not in her place, has explained in detail why the commission decided to depart from the existing system and say that it is much better to have one organisation.
Baroness Buscombe
First, it is not being handed over to the Government but to the institute, which is funded—
Lord Hunt of Kings Heath
My Lords, there is no such thing as independent bodies in this area. All the bodies listed are going to be in one way or another under the heavy influence of government. The very fact that we are legislating for it means that, in the end, Ministers will take responsibility for what the institute does. There is no other way the Government can discharge accountability. Clearly, the Government will use the usual public sector tendering approach, which is a dead hand and will not, in my view, allow for innovation.
I do not know what the noble Lord, Lord Lucas, is going to do, but one thing that has struck me about the meetings we have had so far is that we have not really met the institute or its acting chief executive or the board members. I think it would be invaluable to listen to them to understand how they are going to take this process forward. We have not been convinced that the institute, to which I assume all the usual public accountabilities will apply, will have the actual capacity to handle the kind of sophisticated tendering that is required. That seems to me to be the problem.
Baroness Buscombe
I am sorry that the noble Lord seems to be taking quite a negative approach to this. As I said earlier, this Bill is for primary legislation to set a framework. Of course, there may be a situation where Ministers may have to have oversight, but the reality is that we want this to work as charged by the Sainsbury review. We are responding to a situation where we want to turn around something that has clearly not worked, and has clearly not been successful or provided the best outcomes for young people going into the world of work. We are trying to change that.
All I can say at this point is that we are happy to write to noble Lords to explain in more detail what we are trying to achieve through this process. As I said earlier, the legislation will not tie the hands of the institute. Flexibility and quality are key words in how this will develop.
Baroness Buscombe
Yes, that is right. It would be absolutely outside the scope of the Bill.
Lord Hunt of Kings Heath
My Lords, this has been an interesting debate, with two completely separate discussions. On the issue of copyright, a meeting would be helpful. I am puzzled, because the Government are saying they would encourage those people who wish to bid for work to be innovative in the bids they put forward, but actually the reward for innovation is to be stuck in a competitive tendering exercise—and, by the way, at the end of the tendering period we will nick your ideas. That does not seem to be quite what we want. Surely we want some partnership here and some commitment from the private sector to commit to R&D and innovation, but they must have some share of the proceeds. The idea that they can get that back in the short tender period that is going to operate is, at the least, problematic.
It seems that the Government are relying on the institute to be the innovator and then to tender that out. Okay, if that is the way it is going to work then we should be explicitly told that, but I do not think they can have it both ways. It would be interesting to have that debate.
On Amendment 20, regarding resits, I take what the Minister has said—that many of those young people who resit their GCSE maths and English as a result of the new policy introduced in 2014 now have grade C —and that is a good thing. However, we know there are thousands and thousands of young people who resat but are never going to get their GCSE maths and English. My point is that this can be a very discouraging process for both students and teachers, and I am looking for a more imaginative approach. I acknowledge it is important that someone going into employment can add up and understand percentages and percentiles, but this does not necessarily mean they have reached the GCSE qualification.
Some clarification is required as there is a point I am not entirely clear on. Is it the case that for someone who goes on to an apprenticeship under the auspices of the institute and continues to resit, and can satisfy the employer at the end-point assessment, because they do not have their GCSE maths they are not going to be able to qualify as an apprentice? I may have got that wrong, so having a letter in response to that would be helpful—I am certain I have got it wrong because officials are telling me so.