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Select Committee on Science and Technology Appendices to the Minutes of Evidence


APPENDIX 3

Memorandum submitted by The Royal Academy of Engineering

  The Royal Academy of Engineering comprises the United Kingdom's most eminent engineers of all disciplines. The Academy's objectives may be summarised as the pursuit, encouragement and maintenance of excellence in the whole field of engineering to promote the advancement of the science, art and practice of engineering for the benefit of the public. The Academy aims to take advantage of the wealth of engineering knowledge and experience that its Fellows possess. The interdisciplinary character of The Academy's membership provides a unique breadth of expertise with which to further all forms of engineering.

  By promoting a multi-disciplinary approach, The Academy is able to overcome traditional barriers and to demonstrate the interdependence of different areas of expertise in the efficient use of modern technology and engineering. Emphasis is also placed on the importance of well-informed communication between engineers, Government, research establishments, industry, public services and academia.

  The evidence which follows represents a collation of personal views from Fellows of The Royal Academy of Engineering. It cannot reflect the views of all contributing Fellows nor those of The Academy as a whole.

1.  THE COSTS AND OUTPUTS OF THE EQUAL INITIATIVE

  In terms of the costs and outputs of the EQUAL initiative, Fellows note that there is a shortage of information, both on the internet and in more traditional communication media. It is suggested that a network might be created to increase awareness in the general population and specifically within the academic community.

2.  THE EFFECTIVENESS OF THE INITIATIVE IN CONFRONTING THE CHALLENGES OF AN AGEING POPULATION

  Fellows note that the aims of EQUAL are immense. It is debatable whether a topic of this size can be covered coherently within one initiative. To make the initiative more effective, Fellows suggest that relevant science policy outputs (such as those from the "Ageing Population" Foresight Panel) should be timed to feed into the launch or re-assessment of the EQUAL initiative.

3.  THE DEGREE OF SUCCESS OF THE INITIATIVE IN MEETING ITS AIMS

  The lack of information regarding EQUAL in the public domain makes it difficult for Fellows to comment on the degree of success of the initiative in meeting its aims. This appears to be an important area with significant room for improvement. The clarification of the aims and objectives of EQUAL is another.

4.  THE ROLE OF THE OFFICE OF SCIENCE AND TECHNOLOGY IN CO-ORDINATING THE INITIATIVE

  Fellows are largely supportive of the OST as a channel for co-ordinating this activity. It is suggested that such co-ordination should impact in a practical way, across the Research Councils once EQUAL has clear aims and objectives. In any event, Fellows see very little evidence that such co-ordination exists. It is felt that the relatively low profile of EQUAL and this lack of co-ordination is having a negative influence on the public perception of support for the elderly. If EQUAL aims not simply to increase access to health care for the elderly, but to create new types of health care and living environments for the ageing population, then it is important that academia and the public are made aware of this. Support for the OST is not universal; some Fellows point to the lack of specific funding for EQUAL and assert that without dedicated funding—and hence a new channel for the distribution of funding—the objectives of EQUAL will not be met.

5.  TO WHAT EXTENT HAS THE ROYAL ACADEMY OF ENGINEERING BEEN INVOLVED IN THE EQUAL INITIATIVE?

  The Royal Academy of Engineering is concerned about the EQUAL initiative and has been involved in work which has been supportive of its aims through its recent studies in the fields of Biomaterials and Biomedical Engineering.

  For example, The Royal Academy of Engineering report, "A Review of the UK Research Base in Biomaterials" (August 1998) recommended that research funds should be increased "to support a balanced portfolio of research. In recognition of its importance, it is recommended that about 15 per cent of biomaterials funding be allocated to basic, curiosity-driven research, the remainder being divided between short and medium term programmes, giving priority to those programmes which meet the recommended criteria and are in line with the objectives of the Government's EQUAL initiative."

  The report goes on to highlight the opportunities that arise with these challenges. "With the current trend towards an increasingly ageing population, there is the potential for a real consumer-orientated market in medical equipment for the elderly. Comprehensive designs are required to support the lifestyle of the ageing population, for example to improve mobility, avoid trauma and reduce dependence. Such designs will lead to a better quality of life and are directly relevant to the Government's EQUAL initiative."

  In addition, the recent report from The Academy's UK Focus for Biomedical Engineering, "Medical Engineering: A Field with Potential" (June 1998) identifies the following areas as ripe for research:

A.  HOME MONITORING

  Improved monitoring methods are required with a wider repertoire of characteristics so that a comprehensive range data can be effectively monitored remotely. Less obtrusive and more reliable sensors are required, particularly for use in wearable devices. Such developments are already taking place in the UK in the area of sensors which can be implanted beneath the skin to monitor blood-sugar levels to control diabetes, a condition which has been estimated to cost the NHS £2 billion a year. Provision for wide-scale development of such novel systems, from prototype to commercial product, must be available. Research into the processes and care systems that can be used to provide local continuous monitoring. Such work is essential to address the deterioration in the physical condition of elderly people living alone that is sometimes associated with the non-compliance with prescribed medication and treatment regimes.

B.  REHABILITATION

  Rehabilitation of the elderly and others, such as children and other people affected by injury or disease is a wide field requiring research to:

    —  Provide a new generation of prosthetic devices. This requires the development of improved, compact energy storage systems.

    —  Improve orthoses. This is particularly relevant to those required after trauma, surgery or joint and neuromuscular disease.

    —  Help avoid the problems arising from immobility. Such problems include circulatory disorders or the formation of pressure sores. A great deal of work has already taken place in the university sector to model the effects of forces on the formation of pressure sores, so providing potential solutions to their formation.

    —  Produce novel techniques for assisting patients suffering from incontinence.

    —  Improve augmentation of impaired sensory function.

    —  Create robots and remote control systems. Such systems are required to assist people in their homes.

    —  Develop the application of electrical stimulation to improve function in neuromuscular disorders and in patients with spinal cord injuries. In the longer term, techniques providing direct access to sensory and motor nerves will remain a research objective.

6.  HAS THE EQUAL INITIATIVE IDENTIFIED AND SUPPORTED THE MOST APPROPRIATE RESEARCH AREAS FOR CONFRONTING THE CHALLENGES OF AN AGEING POPULATION?

  Fellows do not have sufficient information on EQUAL initiative outputs to be able to make judgements about the identification and support of EQUAL research areas. However, it has been suggested that it might have been appropriate to launch the EQUAL initiative with a smaller-scale, short-term project, to alert the community and prepare it for a larger scale programme in the future. The concentration of effort is believed to be a prerequisite for an effective programme, which is envisaged to encompass engineering research and "infrastructural" research into social systems and the experiences of the elderly. Aspects of the latter research elements could be addressed and prioritised by involving groups such as Age Concern (specifically, their "Debate of the Age").

7.  IS RESEARCH IN THIS AREA RECEIVING SUFFICIENT GOVERNMENT FUNDING?

  EQUAL is held to be a most important initiative. Current funding levels are seen to be inadequate to meet the immense research challenges of extending quality life. Fellows state that this funding shortfall needs to be addressed. It is suggested that the Government's commitment to taking up the challenges of the Ageing Population could be made much more explicit by identifying new money and targeting specific funds into this area. At present the Government is perceived to be following the practice of identifying an area as important and then passing on advice to the funding and decision-making bodies.

  It is suggested that without new and dedicated money, the aims and objectives of EQUAL will not be met, as it is extremely difficult for a peer-reviewed grants committee of a research council or other body to positively discriminate in favour of technology for the elderly disabled. Indeed, some Fellows reflect that the competition for funds from initiatives such as EQUAL and Foresight is a constraining factor in many research areas. It is therefore felt that the important philosophy of this initiative requires new mechanisms—and possibly new channels—to be put into place for the prioritisation and distribution of EQUAL funds. If decisions are made inside or outside of the Office of Science and Technology, they need to be taken by those without vested interests.

8.  TO WHAT EXTENT HAS EQUAL STIMULATED RESEARCH IN NEW AREAS?

  With the dearth of available information about EQUAL, Fellows of The Royal Academy of Engineering see little evidence that the initiative has stimulated research in new areas; rather, researchers have been encouraged to change the way that they present their research. It is noted that the presentation of a new `spin' on old activities is not what the EQUAL initiative was intended to achieve. Hence, although EQUAL might be high on the national agenda, EQUAL objectives are not receiving attention in a practical way. It is noted that it is possible that it is still too early to detect the influence of outputs from such an initiative.

9.  WHAT ARE, OR SHOULD BE, THE KEY AREAS OF RESEARCH FOR THE EQUAL PROGRAMME?

  The Royal Academy of Engineering has identified a number of key EQUAL research areas in the fields of Biomaterials and Biomedical Materials, which are described in the response to question 5. In addition, Fellows identify a number of other priority areas for research:

    —  Research projects to explore and address the issue of discrimination in NHS healthcare provision. It is noted that treatments that may dramatically improve the quality of life of the elderly (eg heart surgery, immediate physiology treatments after a stroke) are often withheld. A programme to change the attitudes of managers and clinicians within healthcare would therefore yield significant benefits.

    —  Activities that research and highlight the importance of preventative medicine for future generations of elderly.

    —  Research programmes to explore the social issues—as well as the health issues—which contribute to extend quality life for retirees (eg loneliness versus physical ailments). The interaction between health and social factors is well illustrated by the influence of housing type and quality for the elderly, which also requires research.

  This advice for the prioritising of research areas to address EQUAL objectives comes with one proviso; that engineers, scientists and social scientists are not restricted in their areas of research to those which have been specified by Government. Politicians should trust the scientific and engineering community and lead not by dictat but by encouragement.

January 2000


 
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