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

Lord Turnberg Excerpts

Wednesday 9th September 2020 Grand Committee

[Lord Turnberg (Lab) [V]]

My Lords, I too congratulate the noble Lord, Lord Patel, and his committee on producing the excellent report. It is not his fault that it is now more than one year old. So much has happened since 2019 and we now have many new issues crowding in on us.

I want to focus my remarks on the devastating impact of Covid-19 on the medical charity world and how that now affects our capacity to undertake much important medical research. I express my interests as a past professor of medicine, as past scientific adviser—for almost 20 years—to the Association of Medical Research Charities and now as a trustee of a number of medical research charities, including the Wolfson Foundation. I should say that the Wolfson Foundation is relatively protected because it is an endowed charity and is doing its best to be as flexible as possible. But among the other charities, a huge number are suffering the most. Among the biggest, Cancer Research UK, the British Heart Foundation, and Diabetes UK are suffering, but a large number of smaller charities are finding it even more difficult to keep supporting niche areas of research that are ill-supported from other sources. I fear that research into childhood leukaemias will suffer, as will that into mental illness, tuberous sclerosis and the many rare and congenital disorders that rely on a single source for research support.

The figures are frightening. The 150 member charities of the AMRC expect a 40% fall in income. They currently offer almost £2 billion of support for medical researcheach year—more than the Medical Research Council and National Institute for Health Research put together. They will have a shortfall of several hundred million pounds. Noble Lords can imagine the impact that will have if they recognise that charities support 17,000 research workers’ salaries. It is little wonder that universities are facing redundancies in their research staff and that over half the 1,300 clinical trials they support are being stopped or delayed. These are devastating figures and facts. The problems caused to university research are exacerbated by all the other pressures being borne in on them by Covid-19 and a potential no-deal Brexit. Research collaboration across Europe is being threatened, as we have heard, and the longer-term future of the Horizon Europe and Erasmus schemes is far from clear.

The prospect that the UK will be able to afford to fill the gap as we emerge from a Covid-induced depression is diminishing by the day. It is certainly encouraging that the Government produced a £250 million grant extension in June and some longer-term low-interest loans. However, that was when the Chancellor was distributing largesse like there was no tomorrow. Now tomorrow is looming and it is payback time, when the UK has a £2 trillion national debt and the prospects for longer-term support are receding.

It is therefore of interest that the AMRC is proposing a joint funding programme with the Government. It calculates that if each side contributes £310 million per annum in matched funding, it will go some way to filling the gap in medical research charity funding that seems inevitable during the next four or five years.Will the Minister give careful consideration to this proposal? Now is certainly the winter of discontent in our precious university research, unless we do something more to support it. Will healso tell us how the Government will encourage the international research collaboration that we will certainly need post-Brexit? What efforts are being made to remove barriers to joint research with such research-active countries as the USA, Singapore and Israel? I use the example of Israel with its remarkably innovative life sciences, where enhanced co-operation would give added value to research in both countries. As we lose European research support, we need to spread our net.

Life Sciences Industrial Strategy (Science and Technology Committee Report)

Lord Turnberg Excerpts

Tuesday 23rd October 2018 Lords Chamber

[Lord Turnberg (Lab)]

My Lords, I too congratulate the noble Lord, Lord Patel, and his committee on this excellent and timely report. I hope I will not disappoint the Minister too much by saying that I will concentrate on the NHS and the huge effort that is needed to introduce innovations into clinical practice.

The Government’s response is strong on what they are trying to do to stimulate even greater innovation and it is hard not to commend them for describing their willingness to put more money in and to develop high-level administrative structures—albeit perhaps too many and too high-level—to encourage and oversee advances in the sciences. Their response is strong on efforts to implement the methods by which these aims might be achieved. But—there is always a but—everyone knows that we in Britain are excellent innovators and inventors but are much poorer at translating innovations into clinical practice for the benefit of patients. Here I echo the wise words of my noble friends Lady Young and Lord Hunt. We are pretty good at defining the problems that are preventing translation but much poorer at defining the solutions. We tend to have masses of data but a paucity of actions based on the data. I will use the example of an interesting effort to introduce a pretty simple innovation into preventive medicine.

I am indebted to Professor Trisha Greenhalgh, whom I heard speak about this recently. She is professor of primary care health science at Oxford and she told us about a trial she was involved with in Newham. The problem they were trying to solve was how to prevent patients with significant memory loss wandering off and getting lost—not too uncommon, you might think. Why not put a simple monitoring device—a GPS system—on their wrists? Let them wear it and whoever was monitoring them would always know where they were. This is a bright idea and so simple that you may wonder why no one has thought of it before. Of course, nothing is so simple. They tried it out on about 20 people with memory loss in Newham to see if it would work. They immediately came up against a series of problems and at the end of a very few weeks only four people out of the 20 were wearing the device, and they soon stopped.

A whole range of issues was raised. Would people with dementia be happy to wear the monitoring devices? Who would do the monitoring? Family members might be at work or elsewhere. Nurses and social workers are already extremely stretched and overworked. Some even voiced their opposition to people wearing monitoring devices on the basis that it would interfere with individual liberties. They raised the spectre of state interference. They also wondered whether a GPS device of this sort might be a medical device needing approval by the Medicines and Healthcare products Regulatory Agency and, if so, what sort of regulation would be needed. If someone complained, would it not be important for the professionals to get indemnity insurance first?

If this simple device came up against a whole range of hurdles, what hope is there for more complex interventions? It is always the case, I am afraid, that interventions are going to be perceived as disruptive by those who have to introduce them—both the patients and the medical professionals—and they are being introduced in a system that is constantly evolving anyway and many of those who are in it are overworked and stressed, as we have heard. We have reached a situation where it is now at least as valuable, if not more so, to put money into research on delivery uptake—that is jargon for accepting innovations—than on original discovery.

I started by saying that it is much easier to describe the barriers to translation than it is to produce solutions so I will point to where solutions may be found. The first is the recognition by those with the novel bright ideas that these barriers exist. It is no use complaining about the reticence and resistance to change of a backward-looking profession, as there is a tendency to do, I fear. This is a particularly cynical accusation when so many of the innovations that are introduced are the result of efforts by the medical profession itself. The first condition that has to be accepted by all these wonderful high-level committees and authorities that encourage innovation is that on the ground in our hospitals and general practices everyone is overstretched and distracted. The reality is that to gain the interest and confidence of busy doctors and nurses you have to ensure that all the systems are fully worked out; that all the support, technology and personnel are in place to make it simple and straightforward to introduce the innovation; that all the regulatory processes are fully approved; and that the patients are fully informed, their illnesses are suitable for any novel treatment and they are entirely willing to receive it.

Most importantly, if all those are in place and everyone is happy, it needs to be shown not only that the innovations can be used and that they work but that the outcome for patients is beneficial. That is the key. So when some remarkable advance is announced by the Secretary of State or anyone else, and he then stands back and waits for the service simply to get on with it, he will be missing the mark. There are many steps and hurdles to be overcome when one understands the reality of the health service. What we need is research into the ways in which we can overcome the barriers to adoption and how translation into practice is currently prevented. We need that research just as much as the research that goes into invention and innovation. Without it, we will continue to underachieve.

I am delighted that the noble Lord, Lord O’Shaughnessy, has been given the responsibility of simplifying the innovation landscape and developing policies to encourage the adoption and spread of proven innovations. The Government’s response document talks of innovations being adopted “at pace and scale”—everything now has to be at pace and scale. I wish him luck with that.

There is a recommendation in the report that financial incentives should be offered to encourage acceptance of innovations on the ground. I am sure that that would be helpful but I fear that it will be insufficient. Early in the Government’s response comes a statement that we have, I think, heard before:

“Our globally-renowned NHS will be a key partner in delivering the deal”—


and so say all of us. But before you can begin to change to early adoption of innovations at real pace and scale, it has to be accepted that the reality of day-to-day pressures on the ground just gets in the way.

I hope the Minister recognises the difficulties and will tell us how he believes they can be tackled. I hope he will be able to address at least some of the problems I have outlined.

Higher Education and Research Bill

Lord Turnberg Excerpts

Committee: 7th sitting (Hansard): House of Lords
Monday 30th January 2017 Lords Chamber

[Lord Turnberg (Lab)]

My Lords, I too support the amendments. I am afraid I did not speak in the Second Reading debate—I was detained unavoidably elsewhere—so I express my interest as having recently retired from 19 years as the scientific adviser of the Association of Medical Research Charities. I clearly outlived my usefulness there. I am also a member of boards of a number of medical research charities.

It seems incredible that the charity sector is not mentioned and represented in this group of activities. We know that Cancer Research UK funds the majority of research into cancer. The British Heart Foundation funds the majority of research into heart diseases. It has buildings and professors of cardiology. The Wolfson trust funds a large number of research buildings in universities around the UK. Arthritis Research UK funds the majority of research into arthritis. There is also the Wellcome Trust Sanger Institute, where a huge amount of work is going on, supported solely by the research charity sector.

Another element to this is that many of the charities are funded solely by raising funds from the public—from patients and their carers. In a way they represent that constituency. It is a vital sector, yet they are not represented in UKRI. We must correct that. I hope the noble Lord will take these amendments seriously.

[Baroness Neville-Jones (Con)]

My Lords, a number of points have been raised in this group of amendments. I hope when he replies my noble friend the Minister will not lose sight of the extremely pertinent questions asked by the noble Lord, Lord Willis, about the ability of research councils to form partnerships and to do so without having to seek permission.