Health and Social Care Bill

Debate between Lord Ribeiro and Lord Patel

Wednesday 9th November 2011 Lords Chamber

[Lord Ribeiro]

I rather suspected that the noble Lord did. That is why I felt able to make that reference. None the less, I launched a big campaign at the time because here was a budget—part of the NPEC budget—for nurses, doctors and so on that was being raided. It should have been a ring-fenced budget for training, yet the money was taken out of that budget to meet the NHS deficit. There is a real danger for the present Government if a situation should occur whereby the £1 billion budget—and there is no reason why it should be more than that—that has been set aside for research, particularly as the Secretary of State has taken responsibility to promote research, was found to come under the auspices of the chief executive of the NHS Commissioning Board, and that at times of trouble and trial that that money could be used.

I wanted to speak in line with what I said yesterday, although some noble Lords may doubt that I have spoken briefly. However, I speak in strong support of Amendments 40 and 42.

[Lord Patel]

My Lords, my brief is brief—and I shall be brief. First, I congratulate the Government on putting the need to promote medical research at the centre stage of the Bill. We have criticised a lot of things and we may criticise some more, but the recognition that medical research is important to improve healthcare has been stated throughout the Bill.

It would be surprising if I said that I do not support these amendments—I support every one of them. By the way, I say to the noble Lord, Lord Ribeiro, that he was lucky that the noble Lord, Lord Darzi, was not in his place when he said that surgeons do not do research. He might have given the noble Lord, Lord Ribeiro, a tour around his department.

[Lord Ribeiro]

I gave a historical perspective. We started research in the 18th century. We may not have done it as well as the physicians, but that is when we started.

[Lord Patel]

I should also tell the noble Lord that his laparoscopic training is also historical because robots are used now.

I have brief comments, but I shall focus particularly on the amendment in the name of the noble Lord, Lord Warner, that refers to the need for informatics to be properly established to promote research in healthcare. One of the key areas in biomedical and clinical research in the UK is focused on translational research, as other noble Lords have said, to try to get research into clinical care.

Informatics plays a key role in our ability to do translational research. There are three domains of informatics in biomedical research—biomedical informatics, medical informatics and translational research informatics. Translational research informatics is about getting multidisciplinary research into clinical practice, with clinical trials being the first step to it. As we have heard, we have notable successes from our medical research into clinical translation. I say with hesitation that we think we are leaders in the world, but we are not quite the leaders—although we come pretty close. However, we can do better, and to do so we have to have what is required to promote research and its use into translation. Therefore, we will have to develop all three domains and incorporate what we already have—health information involving the medical records to which the noble Lord, Lord Warner, referred, and the development of electronic medical records. I know that other amendments address that issue. We should also be able to carry out statistical analysis.

The noble Lords, Lord Willis and Lord Warner, referred to the rapid sequencing of the genome—whole-genome sequencing—that will impact on the whole of medicine. Recent rapid developments in DNA sequencing technologies have dramatically cut the cost and the time required to sequence a human genome to a point that it will soon be easier and cheaper to sequence each patient’s genome and keep it in their notes. Every time they are diagnosed with or treated for a disease, a genome will be used to extract information. By combining that with our advancing understanding of genes and diseases, whole-genome sequencing is set to change the current clinical and public health practice by enabling more accurate, sophisticated and cost-effective genome testing.

Understanding the health impact of individual genomic variance presents a considerable challenge for analysis, interpretation and management of data. Managing that data will require bioinformatics to be established. The NHS should urgently develop clinical bioinformatics expertise and infrastructure to ensure clinical technical support for medical analysis and interpretation of genomic data. The amendment of the noble Lord, Lord Warner, that includes informatics is crucial in identifying that. If we are to succeed in applying the results of our research to patient care, we need to establish all these issues.

I should briefly mention Amendment 74 in my name. The noble Lord, Lord Willis, mentioned research in public health, as did the noble Lord, Lord Turnberg. My amendment relates to Clause 9 on,

“Duties as to improvement of public health”,

and the functions of local authorities and the Secretary of State as to improvement of public health. The amendment merely tries to,

“establish promotional research, and acting on research evidence into the causes of ill health”.

It is important that local authorities recognise that public health directors should be involved in research in the agenda that is being developed in the prevention of disease. Those are my brief comments.