Autumn Statement 2022

Baroness Blackwood of North Oxford Excerpts

Tuesday 29th November 2022 Lords Chamber

[Baroness Blackwood of North Oxford (Con)]

My Lords, I declare my interests as set out in the register and, of course, I welcome the Minister back to her place.

Others more expert than I have analysed the geopolitical drivers that underpin our current economic outlook. It is impossible not to hold very strong opinions about these and the domestic response that has played into the enormous economic upheaval we face, but my plea is for a focus on solutions that will restore faith in our economic future, not least because we are exhausted.

We are exhausted by having to keep rising up as a nation to respond yet again to crisis: first the financial crisis, then Brexit, the pandemic, Ukraine and now an energy and inflation-driven economic downturn. We will be judged not by assigning blame in this time of crisis—there will always be plenty of time for that—but rather by how we respond to put things right for the millions facing real hardship up and down the country. For this reason, I welcome the three key principles laid out by the Chancellor: support for public services, the need for fiscal responsibility, and the need for growth. In the time available, I will focus on the critical role that health and innovation have to play in our national recovery.

A healthy economy needs healthy people, but we have seen a spike of 500,000 British workers dropping out of work due to poor health since the pandemic. These figures shed light on why the labour market remains so tight. The Bank of England chief economist described this as a “real shock” that is fanning inflationary pressures. Here, I must disagree with my noble friend Lady Noakes: NHS Confederation analysis shows that investment in health is not a drain on GDP, as often represented, but rather boosts economic activity. The NHS is a net contributor to the UK economy; every £1 spent on health can generate up to £4 of economic growth and improving the health of just 1% of those not in work due to ill-health, a recognised proxy for general morbidity, could help 180,000 get back into work. It is therefore critical that our health system has the capacity to respond to this, so I welcome the further investment for both the NHS and social care that the Chancellor announced, as well as his commitment to an independently verified workforce plan.

On capital, I note that while it was protected in cash terms, the current 11% inflation means that the Government will have to review their plans for buildings, equipment and, critically, IT—94% of trusts admit they still use handwritten records in at least one department. From John Snow, who analysed dot maps to uncover the link between water pumps and cholera, to Florence Nightingale, who pioneered at-scale statistical analysis in patient care, and John Shaw Billings, who worked out how to mechanically analyse medical and demographic data collected during the US Civil War, we have known for some time now that improving health at an individual and population level requires good management of health data. It is no longer an advanced concept that you can predict the future performance of a company according to how effectively it uses its data, and the NHS is no exception.

At Genomics England, we are a living example of next-generation clinical care founded on the use of technology and data. We hold the largest whole-genome dataset in the world, the National Genomic Research Library, and through the NHS Genomic Medicine Service, whole-genome sequencing is now offered as a standard of care to rare disease and cancer patients. Recent research from Great Ormond Street demonstrates that these benefits for patients include providing additional information for diagnosis in 81% of cases; changed condition management in 24% of cases; and reclassified diagnosis in 14% of cases. Many a Minister has claimed that we are world-leading in all manner of fields, but in genomics, we can be proud that this really is the case.

If we get NHS data right, it will be the cornerstone of a sustainable, high-quality NHS which can respond to the exceptional challenges we face today. It will turbocharge growth and investment in life sciences and health research and it will empower the patient as never before. On that basis, will the Minister assure me that plans for investing in health technology and innovation adoption will be prioritised?

This matters for patient care, but also for life sciences and health research. The life sciences sector is one of, if not the, most productive and high-growth sectors in our economy, contributing almost £37 billion to UK GDP and supporting over 500,000 high-value jobs. It is critical to our national recovery. I am delighted that the Chancellor committed to increasing public R&D as planned, but getting the overall level of R&D investment up requires the right incentives for private investment too. That is why, like the BIA and the noble Lord, Lord Fox, I think that the reforms to R&D tax relief may turn out to be a false economy. They fall hardest on SMEs, as he said. I know the Treasury believes that there is abuse, but life science SMEs are our biotech engine, employing a quarter of the life sciences workforce. They are often loss-leading for years but they have enormous growth and life-saving potential.

As chair of Oxford University Innovation, I am privileged to see many of the UK’s most exciting life sciences spinouts mature to global standing. These include such companies as OMass, RQ Bio, Oxford Nanopore, Autolus, Nightstar and so many more. These are the innovators and innovations that will solve the great global challenges we face, just as they did during the pandemic. It is difficult to see the economic strategy in reducing support for one of our most knowledge-intensive and globally competitive sectors.

This matters now more than ever, because our traditional leadership role in life sciences is at risk. According to the ABPI, our overall share of global R&D spend is falling. If I were to identify one root cause, it would be a serious fall in clinical trials performance. Since 2017-18, the number of patients recruited into industry trials has fallen by 44% and the number of industry trials initiated in the UK has fallen by 41%. This is wholly unacceptable. Thankfully, it is also wholly fixable.

The excellent life sciences vision is critical for sectoral confidence. It also includes action on clinical research and a number of supply-side reforms, but it remains only partially funded. This does not send the right message of long-term certainty and commitment that we need to stimulate inward investment. Will the Minister commit to fully funding the delivery of the life sciences vision, including urgent action on restoring our clinical research capabilities?

In closing, I ask the Minister to remember that we have the power to unlock the full potential of health and innovation for the benefit of all. We know that we have a latent capacity for health and life sciences that is far greater than we ever imagined: we saw it happen in front of our eyes during the pandemic. This means that as we look to the challenges that we face today, we know we can solve them if we apply the same determination, prioritisation and leadership that we applied to develop and deploy vaccines for Covid in record time. We can lead on this, and we should lead on this.