Select Committee on Science and Technology Minutes of Evidence

Examination of Witness (Questions 1 - 19)




  1. Dr Metz, welcome to the Science and Technology Select Committee to help us out on our inquiry into EQUAL. I wonder if you could, as we always ask our witnesses, introduce yourself; tell us a little bit about your organisation; and also perhaps if you could tell us a little bit about what you see as AgeNet's main achievements during its three years of existence.

  (Dr Metz) Thank you for the opportunity to give evidence to the Committee this afternoon. AgeNet is an initiative whose purpose is to stimulate multi-disciplinary research, which will lead to improvement of the health and quality of life of older people. I have been Director of AgeNet since it got under way three years ago. It is my experience, and that of the members of the network, which contributed to the memorandum of evidence that I submitted. I should perhaps stress that this evidence is not intended to reflect the views of the sponsors and funders of AgeNet, many of whom submitted their own evidence. The remit I had, as Director of AgeNet, was to stir up activity in a field which by its nature is multi-disciplinary and spreads from the biology of ageing processes at cellular level, all the way across to (let us say) the economics of pensions. These areas interact because clearly the progress we make in the area of basic biomedical science will affect, in due course, the health in older people; and it will also affect the cost of long-term care and public finances; so making these connections across these areas was the main aim. We have done it by arranging workshop meetings. We have run over 20 so far. The characteristic of an AgeNet workshop is to bring together people who would not normally meet. People tend to operate within their profession or scientific disciplines and our aim has been to mix them up and get cross-fertilisation. The purpose of that has been to encourage people to work together in new research partnerships, and to bid for funding to run new multi-disciplinary projects. In addition, we run an active website, an e-mail based discussion group, and we have built up a database of over a thousand researchers, users of research findings and people with a policy interest. So that is the basis for the evidence I have set before the Committee, and I would be very happy to answer your questions.

  2. The EQUAL initiative was announced in 1995. We might have expected it to have made some impact by now. How effective do you believe it has been in meeting its objectives?
  (Dr Metz) As you said, it was announced in 1995. It has manifested itself through three research programmes organised by the Research Councils. None of these have yet got to the point where the research generally has been completed, but in all cases this has got under way. It is quite hard to assess the impact of EQUAL in terms of the deliverables of new research findings, which might be employed in technology development or policy or service development. On the other hand, clearly what has happened is that there has been a stimulation within the broad area of ageing research and, to some extent, some attraction of new people into the field, and encouragement to those who had already committed themselves to it.

  3. Is there anything we can learn from other countries? Obviously this increasingly ageing population is a problem facing other countries as well. Are they tackling this better than we are?
  (Dr Metz) I think different countries manage their research in this area in different ways, reflecting the general way in which they organise research. In this country we have the Research Councils, which you will be familiar with, and it turns out that four of these Research Councils have active programmes in the area of ageing. Inherently there is a degree of fragmentation and that is unavoidable given the way we have organised our Research Councils. In contrast, one can think of the United States where they have the National Institutes of Health. Within that they have the National Institute on Aging. That National Institute is basically a funding body and encompasses all the kinds of research that the four United Kingdom Research Councils handle. So in the United States you have a more coherent structure, in my view, for funding, which can take a more strategic view. In the European Union we have under the Fifth Framework Programme, for the first time, a Key Action, as it is called, on the ageing population. Again, this has brought together the whole range of scientific approaches, so one has the contrast between the United Kingdom model, in which there is a degree of fragmentation of research funding, and other models in which it comes together.

Dr Gibson

  4. You say the States do it in a different way because they have a different structure. What is the added value which they have produced, which we have not, or Europe, in this area of endeavour?
  (Dr Metz) It is hard to make a comparison because of the sheer scale of the United States' effort, as you will be familiar with, particularly in the biomedical sciences. The sense I have, looking at their programme, is that they are able to take the broad view and look at the interconnections between the different areas of ageing research. It becomes the responsibility of a single person who is Head of the National Institute on Aging.

  5. What have they done for the ageing population? What advantages have there been in that? It is very important if we ask for national institutions to develop things. What have they actually done? They have had this experience for several years. Everyone still goes to Florida, you know!
  (Dr Metz) I think it is hard to put one's figure on it and say, "This is what they have achieved and we have not." But, of course, one is mainly looking to the future. The need to enhance effort on research in this area is one which is increasingly being perceived, given the demographic trends over the next half century. So I would say that the United States has got off to a good start. We are more at the starting line but have a lot of potential. The European Union has also made a start. It is what one is going to achieve which is important rather than what one has achieved thus far.

Mr Jackson

  6. A comment on that last discussion. The contrast between the fragmentation of the British system and the more organised structures in other parts of the world: the argument for the fragmentation has traditionally been that there has been more bottom-up initiative diversity, and that depends on maintaining a lively university sector, which I think we will be able to continue to do. I just wondered if you could say a little bit about—because we all have an interest in this question—what are the main areas, the main subjects, the main topics, which you think AgeNet will be exploring?
  (Dr Metz) AgeNet is a time-limited project, which will shortly come to an end in terms of what we are going to do. Perhaps that is not the main point this afternoon.

Dr Jones

  7. I think we are talking about EQUAL rather than AgeNet
  (Dr Metz) Yes. I set out in my memorandum what I saw to be the main structure for organising research. To think in these terms: in the area of the basic biology of ageing there is a lot of exciting work going on, which I would be confident in due course will have an impact on human health, although the gestation period will be quite long. We have to think about the timescale quite a lot. We have to think about the doubling of those, say, over the age of 75 over the next fifty years. All of those who will be 75 in 2050 are alive already. We really do have a long timescale. Within that timescale I would be confident that advances within the area of basic biology of the kinds supported by the BBSRC would actually make an impact. In the area of the age-associated diseases the paradigm is the work going on on Alzheimer's disease in the United States, Britain and Europe, and going on in industry as well as academia. My judgment is that the momentum here is that there will be real pay-offs. There are Nobel Prizes to be won. There are blockbuster drugs that can be developed, given the scale of old age dementia. In contrast, there are other areas of age-associated disease which receive rather little attention. AgeNet has run workshops on osteo-arthritis and age-related macular degeneration, loss of vision in old age. It is my judgment that these are relatively under-supported areas which would benefit from more input. Then there is a group of conditions one puts under the heading of "frailty", the more complex conditions of old age which are less amenable to a disease orientated approach, yet there is a real need on the part of the geriatricians, the nurses, and the therapists, to improve practice through evidence-based approaches; and to generate the evidence one needs research programmes of the right kind. There are methodological problems here. There are problems of getting financial support in an area where we need to do more. Then there is the notion of healthy ageing. The fact that many people live to an old age in good health, at least until close to death, and we need to understand much more about the determinants of healthy ageing. We can, through public health type approaches, encourage more general health in old age. Again, that is an important area which is under-researched. We know about some things. We know, for example, about the importance of physical exercise as a means of improving health in old age. We think that mental exercise would improve mental health but we are much less clear about how to do it and what impact we might expect. In terms of delivery of health care—health services research relevant to the needs of older people, where the needs are increasingly for treatment of chronic conditions as opposed to acute conditions and how the health service should handle this—this again is an important area of research where interest is beginning to grow but from quite a small base. Then we have the ways in which we can modify the environment, both the physical environment through new technology, and the social environment through a whole variety of interventions. I am just skating across the whole field very quickly. What I would stress is the enormous range of professional and scientific disciplines that have to be brought to bear, and the clear importance of inter-disciplinary, multi-disciplinary work. One of my anxieties about the fragmentation of research funding is that this fragmentation tends to create barriers to multi-disciplinary research which I think would be a pity.

Mr Beard

  8. I understand what you have been saying but what I am not clear about is what AgeNet or EQUAL have brought to this. Many of the things you have been talking about, in terms of Alzheimer's disease and arthritis research and healthy ageing, those issues have been talked about for an awful long time. What exactly has EQUAL and AgeNet brought to this scene in the period you have been in existence?
  (Dr Metz) EQUAL has brought some additional funding through the Research Councils—not a lot but some.

Dr Jones

  9. Because they have given it a higher priority?
  (Dr Metz) Yes. That is right. What AgeNet has done is to try and bring together people from different professional backgrounds, different disciplinary backgrounds, to make progress in the 20-odd areas of workshops that we have run. I would not argue that the impact of either EQUAL or AgeNet in the years these have been going has been particularly great, but a start has been made on what is a long-term and increasingly important problem.

Mr Jackson

  10. May I pick up here. When I launched EQUAL in 1995, the name that I was using was Extending the Quality of Active Life. I think there is a temptation to focus it on the purely medical side. As my colleague Nigel Beard is saying, obviously there has been research into Alzheimer's for as long as we have realised that Alzheimer's is an identifiable problem, if not necessarily an understandable problem in terms of how we deal with it. To what extent do you think the stress on the ability to be active in life when one is ageing has come across to a wider research audience?
  (Dr Metz) I think the Engineering and Physical Sciences Research Council's programme is particularly relevant here because they have not gone much into the medical side. For example, we and they ran a workshop meeting, together with the Design Council, on design for old age, with a particular focus on the notion of inclusive design. The notion that one can design the world in a way that allows people with developing disabilities to be more active. For example, the design of the bottle top of this kind of bottle (indicating) is an important consideration. You want to design it in a way that people with developing arthritis and limited ability to exercise torque can actually open it, as opposed to designing it for the average younger man which in the past is what has happened. As a result of this workshop, the EPSRC had a core of proposals on the topic of Design for Old Age, Design for All. I was pleased at the number of people who attended the workshop, who actually succeeded in winning funding. We shall see what comes from this programme. So that is one area where the notion of activity in old age is particularly relevant. I would not say that would be true for the Biotechnology and Biological Sciences Research Council's programme, which is on the science of ageing, the science at cellular and molecular level. It probably will be relevant to the Economic and Social Research Council's programme Growing Older, which is currently getting under way, and looking down the list of 30-odd projects most of these are of practical application to the issue of an active old age.

Dr Turner

  11. What has EQUAL done which could not have been done in any other way? Can you point to any other research which has been produced, which has been specifically generated as a result of having EQUAL instead of leaving the Research Councils to get on with the age-related work that they are doing already?
  (Dr Metz) The best example of work which has been done, which would not have been done, is in the area of the Engineering and Physical Sciences Research Council's EQUAL programme, because that Research Council would not naturally be in the area of ageing in the way that the MRC or the ESRC or the BBSRC would be. Indeed, the EPSRC's programme, in The Built Environment, and in Design for Rehabilitation, is funding work that would have been difficult to get funded through their normal grant mechanisms. This is because to the panels concerned with the award of grants, work of this kind would have seemed a bit non-central, a bit non-core to the work of that Research Council. By setting up a specific programme you give some protection, particularly to multi-disciplinary proposals. Some of the best proposals involve engineers working with gerontologists. That would seem a bit odd to a regular panel of the Engineering and Physical Sciences Research Council, but not to the panel that the Council set up to manage the grants under the EQUAL programme.

  12. Do you think that EQUAL has been able to unlock the resources that otherwise would not have been available?
  (Dr Metz) My judgment is that the scale of resources is quite modest and was found by the Research Councils within the normal ebb and flow of funding decisions. So I would see EQUAL as no more than a start, a move in the right direction, but one which I think ought to be built upon.

  13. In addition to encouraging multi-disciplinary research and collaboration, have you been successful in involving the private sector? Can you give some examples where you have done that?
  (Dr Metz) It is never easy to involve the private sector at the best of times. There are certainly examples within the Medical Research Council's LINK programme, called Integrated Approaches to Healthy Ageing, which involved pharmaceutical companies and academic researches. But, of course, pharmaceutical companies are well practised at working with academics; and it is not entirely clear whether that particular research programme, although it is relevant to ageing, in fact has resulted in work that would not otherwise have been done. In the area of engineering, of medical engineering and bio-engineering, we attempted to get the involvement of industry. We ran a workshop to try and bring in industry to get funding under this LINK programme. Although it was reasonably well attended, I have to say that following up the outcome we could not identify any new projects which were funded. One of the problems is the small size of the companies involved in this sector. Again, a problem of fragmentation.

  14. What about the future? Can you think of targets that it would be useful to set for EQUAL in the future and how would you wish to see those assessed?
  (Dr Metz) I am not sure about targets. I would favour a more strategic approach on the part of Government and the public sector research funders to the needs of an ageing population. I would favour it because, as I have indicated, the timescale is quite long and the breadth of disciplines is wide. In that situation it is hard to rely on the normal processes carried out within individual Research Councils, or individual Government Departments, to be sure that in aggregate these will come out to be about the right thing for the United Kingdom in scale and balance and in priority. So while targets could come out of the strategy exercise, my feeling is that that kind of exercise would be desirable, whether or not you identify particular targets at the end of the day.

  15. What about the end-users of EQUAL's work? How do you think they feel about it and how much have they been involved?
  (Dr Metz) One nice thing about the Engineering and Physical Sciences Research Council programme was a specific requirement to involve users in each project. I thought that was a good feature. Apart from that, it is hard to put one's finger on the involvement of users. One class of users which is important is Government Departments, because in the era of an ageing population many Government Departments ought to be interested in the implications of population ageing for their policies and functions and ought, therefore, to be interested in research that would generate the knowledge which would help them form those proposals. I would not say, as yet, that Government Departments have really got on board this initiative but hopefully in the future they will do so.

Dr Gibson

  16. In terms of the balance of research that goes on into ageing and so on, the molecular biologists are going to win out, are they not? You mentioned the Nobel laureates. That is where it is going to happen. All that kind of research is the sexy area. So how are you going to balance in this? You are going to lose, are you not? The European Commission has the same trouble. Molecular biologists are omnipotent. All the other things just do not matter. Forget the arts block. It is irrelevant.
  (Dr Metz) Within the Fifth Framework Programme Key Action, the managers of that programme have said that they have struggled to keep that balance by, in a sense, protecting the less obviously scientifically attractive areas. That would be part of developing the strategic view. One would attempt to assess the burden on society of an ageing population and what might be done through research-led innovation to counter that. While the attractive parts of molecular biology of ageing would need to be funded because there might be very big pay-offs there, one would also want to see work on rehabilitation, on the built environment and such matters receive a reasonable amount of money. One would want a process of evaluation that attempts (albeit comparing apples and oranges) to say something about the benefits. I myself am a believer in some kind of cost benefit analysis when it comes to assessing applied research. The benefits are the benefits to society that arise from implementing research findings on a wide scale.

  17. Is that happening?
  (Dr Metz) No.

  18. Why not? How would you redress the balance in this country?
  (Dr Metz) I would encourage the Office of Science and Technology to continue with the EQUAL initiative but to develop it into a more coherent, more strategic view of research cost and benefits, as seen from a public sector perspective. It would encompass the work of Research Councils—and the Office of Science and Technology is the purseholder for them—but it could cover the interests of other Government Departments, both as funders of research and users of research findings. In particular, it should include the National Health Service because the National Health Service is a major funder of research and has been reviewing its programme on age-related research; and, of course, it is the major user of research findings. I believe one ought to try and bring all that together and reach a broad view.

  19. It is a challenge.
  (Dr Metz) Yes, it is a challenge.

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