Innovation (NHS)

John Glen Excerpts

Wednesday 12th October 2011 Westminster Hall

[John Glen (Salisbury) (Con)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. I requested this debate in order to raise important issues about the ongoing review of how the national health service extracts the full potential from innovative, commercially realisable ideas generated by NHS employees and to seek clarification from the Minister about the scope of the Carruthers review of innovation in the NHS announced this July.

I was led to the subject by my involvement with Odstock Medical Ltd in my constituency, a company that has grown from Salisbury NHS Foundation Trust. OML has pioneered a technique called functional electrical stimulation that produces contractions in paralysed muscles by applying small pulses of electrical stimulation. Having experienced it myself, I can attest that it assists walking. OML has developed a range of neuromuscular stimulators to improve the functional ability of people with neurological conditions such as multiple sclerosis. The devices have been developed during many years of collaboration among clinical engineers, clinicians and patients at the National Clinical FES Centre at Salisbury NHS Foundation Trust.

Last year, it came to my attention that, because OML is partly owned by the local NHS foundation trust, under EU rules, it cannot be classified as a small or medium-sized enterprise, and therefore cannot access grants and support through normal Department for Business, Innovation and Skills channels. That seems ludicrous. I met the Minister of State, Department for Business, Innovation and Skills, my hon. Friend the Member for Hertford and Stortford (Mr Prisk), who has responsibility for small business, along with Professor Ian Swain from OML. Little progress could be made, although attempts were made to access specific funds and schemes. It is a systemic failing.

Anxious to overcome that barrier and explore other aspects of innovation in the NHS, more recently, I met with Alun Williams, the CEO of NHS Innovations South West, who has an office in my constituency and is here today. Alun is wholly committed to the NHS and is passionate, as am I, about finding ways to develop streams of revenue for the NHS. I thank him for his support and advice as we have discussed the subject in recent months.

My key concern is this: as populations age, as the cost of drugs and treatments rises faster than inflation and as medical science, thankfully, finds ever more treatments for human ailments and medical conditions, the NHS must be more radical in exploiting the bright ideas of its staff to ensure that the commercial potential of those ideas are realised fully by the NHS.

[Mr Andrew Smith (Oxford East) (Lab)]

I congratulate the hon. Gentleman on securing this enormously important debate. I was brought to the subject by NHS Innovations South East. Does he agree that NHS staff can come up with innovations—examples cited to me include improvements in child protection investigations and adolescent mental health programmes—that do not readily or easily translate or crystallise into commercial benefit? Is it therefore not short-sighted for the Government to insist, as I understand they do, that innovation bodies must be totally self-supporting commercially?

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[John Glen]

I certainly contend that there are significant pockets of innovation. The challenge is bringing those ideas to their full commercial potential and getting them into the NHS so that they are cheaper for the user. The adoption and uptake of NHS-grown ideas is not wide or deep enough, few hospitals showcase their ideas and the wider benefits are not really felt across the NHS. Some ideas, when fully exploited, might realise significant streams of revenue, easing the cost pressures that I mentioned.

The review led by Sir Ian Carruthers, announced at the beginning of July by the Department of Health, will seek in its report next month to inform the strategic approach to innovation in the modernised NHS. However, it must not simply set up another framework or broad aspirations; it must deal convincingly with the gritty realities of what is needed to take a proven idea that has been honed, challenged and assessed by the innovation hubs to its full commercially realised potential.

The report must also recognise that, unless a way is found to invest in such ideas, their commercial potential will be exploited by private sector entrepreneurs who can move more rapidly and access finance more quickly. Intellectual property will thus be patented not by individual NHS trusts, as is desirable, but by the private sector, which will then charge the NHS for products and services at rates that the NHS would rather not pay. I urge the Minister to push the boundaries and ensure that we do not risk allowing the ideas of excellent NHS employees to be lost, thus losing the value and savings that could accrue.

[Margot James (Stourbridge) (Con)]

I congratulate my hon. Friend on securing this important debate. Does he agree that, although it is important for the NHS to realise the commercial value of innovation, it is also fundamental to the improvement of patient care that innovations take hold more rapidly? Did he see this morning’s comments by Professor Williams, president of the Royal College of Surgeons, who warned of a 20-year wait before innovations start saving lives if we base innovation progress on previous experience? He cited reduced deaths from bowel cancer as a result of keyhole surgery, which took years to become widespread practice.

[John Glen]

I thank my hon. Friend for that extremely helpful intervention. I met Professor Williams last week, and he made that point to me. That is the nub of the matter. If the NHS does not move quickly on such ideas, someone else will, and it will cost more. My hon. Friend is absolutely right. The impact on outcomes is negative. We must move matters forward so that the advantages can accrue to the NHS.

It is important to realise that, in the big picture of NHS politics, there is an almost pathological fear of doing anything that could imply the use of the word “cut” or the even more toxic P-word, privatisation. I am not arguing for either, but I am saying that, unless we adopt savvy practices to incubate and develop proven concepts more speedily, I fail to see how the NHS can deal with the increasingly more intense systemic supply and demand pressures that it will face. Efficiency savings and ring-fenced budgets, although welcome, will not be enough to save the NHS and provide the money that it needs to continue in its present form. We need more realism about that and a radical solution that has the potential to create more money.

I recognise that it should not be the NHS’s primary objective to develop income streams from medical devices, new treatments or services. Equally, given that great ideas are an unintended by-product of taxpayer investment in providing a world-class national health service, it would surely be wrong not to look hard at making innovation work to the NHS’s advantage. So many ideas derive from employees whom the state pays quite handsomely.

Furthermore, after initial investment, funding innovation could be self-financing, using royalties from previous successful investment. It just needs to unlock that potential. Alongside producing efficiency savings, this significant reform need not require significant capital outlay at the outset.

It feels as though successive Governments have been so concerned to avoid the tag of allowing the waste of capital on ideas that do not immediately point to a return, or being portrayed as blurring the boundaries of the NHS, that they have not fully established the means and mechanisms of making ideas realise their potential. Lip service is paid to the desire to innovate, but practical measures that make it possible on anything like the scale that is possible are not in place. It is more a question of whether the NHS can afford not to exploit the potential savings and revenue streams presented by these ideas.

I am aware that the current position is not completely bleak. The Minister will be able to cite a pipeline of ideas and he will know that the UK has established capabilities in this field. The medical device sector alone makes a significant contribution to the UK economy, with an industry turnover of £13 billion and 55,000 employees. That industry, however, is generally a supplier to the NHS. We need to move to a situation in which the NHS itself generates devices that can save—with a small s—the NHS from bearing the full commercial costs of products that the private sector has developed in its place. Why is it not possible for the Government to establish an innovation strategy with a real focus on extracting value from the pipeline?

I am not suggesting that there should be centrally driven, random speculative investment of taxpayers’ money in half-baked ideas suggested by any clinician. The regional innovation hubs are already primed to sift ideas. For example, NHS Innovations South West has criteria that each product has to meet before it can receive further assistance. First and foremost, it must bring significant benefit to patients in terms of better outcomes and quality of life. It must also be patentable. The return on investment must meet a minimum threshold and it must be commercially viable—that is, there must be an assessment of a global need for the technology, making it a worthwhile investment for commercial partners.

Once that has been established, the issue is how to develop the ideas to their full potential. Several ideas exist in the south-west. A cancer diagnostic endoscope and meniscus knee repair device are both, subject to completing clinical trials, able to meet the criteria to which I have referred. Given that oesophageal cancer is one of the fastest growing cancers globally and early diagnosis can have a significant impact on savings in the NHS, it is highly desirable that that progresses quickly. The meniscus device should significantly improve patients’ quality of life and postpone the need for an expensive total knee replacement by up to five years, thereby again saving the NHS huge sums of money.

My concern is that it is purely by chance that the private sector has not taken this work further. The current NHS process for capitalising on these innovations is not quick enough. There is limited access to NHS funding, and progress is inhibited by insufficient incentives and enabling mechanisms to encourage trusts to invest in such promising cost-saving technologies. Hospitals exploit these ideas elsewhere in the world and significant royalty streams accrue. They would make a recurring contribution to the much required efficiency savings that the chairman and chief executive of my hospital trust are desperately trying to find at present.

In conclusion, I believe that the NHS is a powerhouse of innovation, but that that is not being harnessed sufficiently to accrue the tens of millions that would be available to individual NHS trusts if a bolder approach were taken by Government. I urge the Minister to consider carefully the potential of the ideas in the NHS and to do all he can to ensure that the scope of the Carruthers review is broad enough to deliver recommendations that will allow the huge value that exists to be realised.