NHS: Association of Medical Research Charities Report

Lord Kakkar Excerpts

Thursday 27th June 2013 Grand Committee

[Lord Kakkar]

My Lords, I join in thanking the noble Lord, Lord Turnberg, for having secured this important debate and the Association of Medical Research Charities for having undertaken this very important work. In so doing, I declare my interest as professor of surgery at University College London, as chair for quality of UCLPartners, which is one of the five designated academic health science centres, as a member of the General Medical Council, and as vice-chair of the All-Party Parliamentary Group on Medical Research.

This report is fundamentally important because it highlights three vital issues with regard to the future of research in our NHS: that we must develop a culture, as we have heard from the noble Lord, Lord Turnberg, so that every patient is given the opportunity to participate in research; that all those who work in our healthcare system are made aware of those opportunities and are given the opportunity to develop as researchers; and finally, that the NHS, having promoted and facilitated all that important research actually adopts its findings to improve clinical outcomes and, indeed, to ensure that we use vital resources for healthcare much more effectively.

There is no doubt that Her Majesty’s Government need to be congratulated in this regard, because for the past three years, we have seen a relentless commitment to medical research in the legislation that has been brought before this Parliament. In particular, for the first time, legislation enshrines in statute the obligation of the Secretary of State to promote research and provides for the new arm’s length bodies to have a statutory obligation for research, which is vital. The reasons for this are clear. In terms of health gain, there is no doubt that the adoption of innovation into routine clinical practice will help us improve clinical outcomes for large numbers of patients, while in terms of the efficient use of resources, there is no question that some of the currently available innovations will help us to ensure that the funds available for routine healthcare can be used more effectively.

In broad economic terms, we know, for instance, that the life sciences industry—another area of government focus—is vital to future economic development in our country. As an industry, it is responsible for about £50 billion of economic activity annually, with 160,000 employees in this country. We also know that it is a net exporter, bringing in vital revenue to the country of some £7 billion per annum, and that from the point of view of investing in research, be it public or charitable funds, every £1 invested will provide 39p in economic return in perpetuity to our economy, so that is vital too.

It is not only in economic terms that the Government have started to look at the opportunities here. They have also done so in terms of the structures that might be provided to facilitate research, which is where this important research provides vital insights. However, a large number of bodies have been created recently to promote research in our NHS. We have heard about the academic health science centres. There are, of course, also academic health science networks, which will appear across the NHS in England and bring together academia, industry and the National Health Service. We have the clinical research networks, which are there to promote research at the local level within the footprints and geographies of the academic health science networks. We have the local education and training boards, which will play a vital role in the education of future academics and those who wish to participate in research, both clinicians and other healthcare professionals. We also have the centres for leadership in applied health research and care, which will promote research into outcomes in the NHS. How are these important structures to be co-ordinated at a local level to deliver the benefits envisaged?

We also have, at national level, Health Education England, which will have an important role in training academics and in setting a national priority in that regard. We have the Health Research Authority, the Medical Research Council and the Department for Business, Innovation and Skills, where the Higher Education Funding Council’s funding for medical schools rests. Again, those important national bodies will, with the National Health Service Commissioning Board and NHS England, all have an important role at national level to ensure that vital funds and resources are properly co-ordinated. How are we in this Parliament to know that all these new structures are working successfully and delivering what is envisaged? What metrics have been defined at the birth of these organisations with regard to their performance in research in the NHS? How will this Parliament hold those organisations, and indeed Her Majesty’s Government, to account regarding the investment of public money in those organisations and the outputs that are achieved?

For the first time, the Health and Social Care Act includes an obligation on clinical commissioning groups to promote research. What measures were undertaken in the authorisation of CCGs to ensure that there was a definition of their contractual obligations to NHS England to deliver that research agenda? How will the CCGs be held to account? If they fail to promote research, what sanctions are available against them to ensure that they deliver the research agenda?

I come finally to the question of regulation. I have spoken a number of times in your Lordships’ House about the problem of the European clinical trials directive. We heard about the deterioration in research activity in clinical trials, which is a result of the application of that directive over 10 years. What progress has been made regarding the renegotiation of the clinical trials directive in Europe?