Health and Social Care Bill

Lord Walton of Detchant Excerpts

Wednesday 9th November 2011 Lords Chamber

I hope that by the time we finish this preliminary skirmish about research we will be a little bit clearer. It would be extremely helpful if the Committee could have an organigram, or at least some diagrammatic form, of where the responsibilities will actually lie so that we know what the research landscape will be. That would help us to concentrate our minds on finding productive solutions. I beg to move.

[Lord Walton of Detchant]

My Lords, I warmly support this group of amendments, so ably proposed by the noble Lord, Lord Willis. The questions which he has posed to the Minister are of considerable importance. I do not propose to repeat them, but I look forward to hearing the answers.

In my professional lifetime, there is no doubt at all that research has transformed the practice of medicine. Research is the lifeblood of medicine. After all, antibiotics have been effective in depleting very many of the infectious diseases which I knew as a young doctor. Programmes of vaccination and inoculation have been successful in banishing smallpox from the world and, in the near future, it is probable that poliomyelitis will become a disease of yesterday as well—it is likely that there will be no such cases in the world in future. The conditions of childhood which so ravished children when I was a young doctor, such as diphtheria, scarlet fever and, to an extent, measles and German measles have been successfully controlled by vaccination. In particular, in relation to rubella or German measles, that programme has prevented the birth of children with many birth defects which resulted from infection with that virus in pregnant women.

There is no doubt, too, that the developments in diagnostic techniques, imaging, computerised tomography and other techniques, such as magnetic resonance imaging and so on, have transformed diagnosis. So, too, have many other techniques which have been introduced into medicine in the course of the last few years. Now, many painful and devastating operations have been prevented by interventional radiology, whereby under X-ray control, for example, in people with heart disease the passage of catheters into the coronary arteries can deal with that disease, even though in some cases there is a need for open-heart surgery. I could go on: there is hip replacement and joint replacement of all kinds, or the use of steroids in the management of autoimmune diseases. These have transformed the progress of medicine and, as the noble Lord, Lord Willis, said, today's discovery in basic medical science brings tomorrow's development in patient care. This is a lesson which we all have to recognise. That is called translational research; you translate the result of the basic research in the laboratory, or basic clinical research, into effective treatment of disease.

All of these things are happening all around us and, as the noble Lord, Lord Willis, said, the evidence is clear that when one looks at research citations and publications in learned journals, for instance, there are many more published in the United States but, if you translate those citations according to population this country, the United Kingdom, in its research productivity in the field of medicine, stands the highest in the world. Yet obstacles and problems which have been encountered over the years have to be overcome.

Fifteen years ago, on behalf of your Lordships’ Select Committee on Science and Technology, I chaired a sub-committee inquiry into research in the NHS. From its very beginning, the National Health Service provided limited funds for research purposes and there was a locally operated clinical research scheme. It was helpful in that it helped many young doctors and medical scientists to take their first steps in research by receiving small grants to help them to conduct such investigations, but the actual amount of money expended in that way and the results of this research were very limited.

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My reason for this amendment is to ask my noble friend the Minister what progress is being made to form a research integrity concordat. When do we actually expect that to be finalised? While there is evidence in Australia, Norway and the United States, where there are defined offices of research integrity, the Government have said that they do not want to go down that road; they actually want a concordat. For what it is worth, I support the Government on this; I think that that move is right. It is only right, however, if that concordat becomes a reality, so my real question to the Minister is about when it is going to become a reality. When can he assure the House that we do not need to have a different organisation in order to ensure that the duty of research—which is now going to be imposed on the Secretary of State—does not blow up in his face at some future date? I beg to move.

[Lord Walton of Detchant]

My Lords, I am glad that the noble Lord, Lord Willis, has raised this extremely important matter. Research misconduct is rare, but it happens. Several years ago, there were a number of quite cogent reports produced by Dr Frank Wells of the British Medical Association, Dr Stephen Lock, who was the editor of the British Medical Journal and his successor, Dr Richard Smith, which actually demonstrated that in a number of rare cases research results had been fabricated. This issue has been highlighted by a number of similar events in the United States and elsewhere. The universities, the research councils and a number of other bodies have looked at this matter and made a number of recommendations. I am not at all certain that this is the right place in this Bill for this issue to be raised, but the question needs further consideration by the Government—for instance, to decide whether this important issue should be in any way part of the remit of the proposed new medical research agency.

[Baroness Thornton]

The noble Lord raised a very interesting and important point, but I do not intend to delay the House by expanding on it.