Memorandum 38
Submission from the Academy of Medical
Sciences
SUMMARY
1. The Academy of Medical Sciences welcomes
the opportunity to respond to the House of Commons Innovation,
Universities, Science and Skills Committee inquiry "Putting
science and engineering at the heart of government policy".
The Academy's core mission is to promote advances in medical science
and to ensure these are translated as quickly as possible into
benefits for society. Our 912 Fellows represent the UK's
best medical researchers, drawn from hospitals, universities,
industry and the public sector. The Fellows are therefore key
elements in connecting science, government, policy and society.
Given the Academy's constituency, our response focuses on medical
research. We would be pleased to expand on any of the points made
in this submission.
2. From the discussion below, we emphasise the
need to:
— Use scientific approaches to assess
the success of policy interventions.
— Provide guidance to outside agencies
on the various structures within government that consider scientific
evidence and advice.
— Improve transparency around the teams
responsible for specific policy areas.
— Engage scientists at the earliest
stages of policy development.
— Defend the Haldane principle.
— Support younger scientists and clinicians—particularly
GPs—in public engagement activities.
— Develop a dedicated online strategy
for science and society.
3. This submission includes sections on:
— Government policy involving science.
— Government policy about science.
GOVERNMENT POLICY
INVOLVING SCIENCE
4. The Academy has long been active in promoting
the need for public policy-making to make use of the best available
scientific evidence. It is almost impossible to think of a significant
policy issue that does not require the use of scientific evidence.
We therefore believe that the views of the science and engineering
community should be central to the formulation of all government
policy. Furthermore, we urge consultation with the scientific
community at the earliest stages of policy development.
5. The first recommendation of our 2007 report
"Identifying the environmental causes of disease: how
should we decide what to believe and when to take action?"[152]
calls on the government to integrate science into policy-making
by:
— Embedding researchers into policy
teams.
— Providing senior civil servants with
scientific training.
— Seconding scientists into government.
— Building a cadre of "evidence-brokers"
within government who are trained in both science and policy.
6. The report also emphasises the importance
of a taking scientific approach to scrutinising the effectiveness
of policy interventions: "Government… should ensure
that there is a greater emphasis on pilot studies and rigorous
evaluations of the effects of [policy] interventions".
7. The government has done a great deal
to emphasise the role of science in policy-making in recent years,
particularly through the establishment of departmental chief scientific
advisers (CSAs), the Foresight programme and GO-Science. We particularly
welcome the decision to upgrade the role of science minister to
include attendance at Cabinet meetings and chairmanship of the
new Cabinet Sub-Committee on Science & Innovation. However,
there is still considerable variation between government departments
in their use of science, something we emphasised in our responses
to the departmental reviews conducted by the former Office for
Science & Innovation. It is vital that Parliament, particularly
through the House of Commons Committee on Innovation, Universities,
Science and Skills and the House of Lords Science and Technology
Committee, scrutinises the use of science by government departments,
and reviews the performance of the various governmental scientific
advisory bodies and structures.
8. There are numerous structures in government
charged with considering scientific advice and evidence: we counted
seven government-wide science groups, in addition to the various
Science Advisory Councils and the 75 Science Advisory Committees.
This can be daunting for outside agencies to navigate, and a centralised
resource that lists all relevant groups and committees (and their
constituent members and contact details) would be beneficial.
The Council for Science & Technology (CST), which reports
directly to the Prime Minister, is an important structure for
ensuring that scientists can engage with government at the highest
levels. CST has published several influential reports in recent
years, but there is potential for it to do more, particularly
in engaging the wider scientific community in identifying priority
issues to raise with Ministers.
9. Accessing specific policy-makers within
government can be difficult and haphazard. There is a feeling
amongst Academy Fellows that government departments are still
too insular and compartmentalised, and could do much more to engage
with the wider scientific community to access new research findings
and consult with experts. For example, government policy-makers
would benefit from a more visible presence at relevant scientific
and science policy symposia, and should avoid simply delivering
a presentation without hearing about wider developments and engaging
in debate. There is also scope for increased transparency around
the departmental teams who are responsible for particular policy
areas; e-mail addresses and telephone numbers are difficult to
find and it is often impossible to identify the right individual
to contact, even for initial inquiries.
10. Government policymakers and Parliamentarians
have stressed the value of the medical science community speaking
with "one voice" on important issues, and over the years
the Academy has formed effective collaborations with our peer
organisations (Association of Medical Research Charities, Medical
Research Council, Wellcome Trust, Royal Society, Cancer Research
UK etc.) on debates including the Human Tissue Bill, the Mental
Capacity Bill, the Human Fertilisation and Embryology Bill, the
EU Clinical Trials Directive and other legislation. We have also
recently initiated a cross-Academy policy group, including representation
from the Royal Society, British Academy and Royal Academy of Engineering.
In this way, we hope that policymakers can assess the weight,
as well as the breadth, of scientific opinion around particular
policy options; a crucial component of any successful consultation.
11. The recent Human Fertilisation &
Embryology (HFE) Bill/Act provided a good case study for the use
of science in government policy-making. Whilst government could
have engaged scientists more fully at the very earliest stages
of policy development (particularly in the development of the
initial Command Paper), subsequent dialogue with the scientific,
medical and patient communities was very constructive. Credit
should be given to the expertise and diligence of officials in
the Bill Team within the Department of Health, as well as to the
scientists who provided evidence and advice. The HFE Act also
showcased how the Academy of Medical Sciences can provide expert,
authoritative input into policy debates: after publication of
our initial report "Inter-species embryos"[153]
we worked with colleagues in the Medical Research Council (MRC)
and Wellcome Trust to produce ten separate written briefings and
three Parliamentary seminars, as well as numerous e-mails, telephone
conversations and meetings with individual MPs, Peers, government
officials and media representatives.
12. From our particular perspective, we
believe government could make much more use of the Academy of
Medical Sciences, as well as other national academies and Learned
Societies, which provide expert, and most importantly independent,
advice and input. This point was emphasised in the 2007 CST
report "How academia and government can work together":
"CST also believes that Government should make greater
use of bodies such as the Learned Societies, Research Councils
and the independent bodies such as the CST, all of which have
strong academic links and provide another valuable source of external
academic capacity."[154]
13. The Fellows of the Academy are an expert
national resource—representing the breadth of basic and
clinical medical research—on which policymakers in government
and allied agencies can draw. The Academy responds to specific
requests for input from government and others, and makes submissions
to governmental, Parliamentary and other public consultations.
We also have a strong proactive mission to raise important and
timely policy issues, to horizon-scan future topics, to promote
debate, to challenge existing policies and to identify future
opportunities for UK health and medical science. Through our reports,
such as "Pandemic influenza"[155]
and "Systems biology",[156]
the Academy provides authoritative, evidence-based analysis and
recommendations for action. We also invest considerable time and
effort into follow-up work, ensuring that our reports, for instance
on the use of patient data in research[157]
or on non-human primates,[158]
really do catalyse action in government and beyond.
14. We emphasise that the Academy's policy
and other activities are resource intensive and require ongoing
support from government (amongst other funders). The Academy of
Medical Sciences currently receives a small grant-in-aid from
the Department of Health, which will provide £415,000 in
2009-10; £425,000 in 2010-11; £435,00 in 2011-12;
and £450,000 in 2012-13. Despite requests, the Academy
receives no financial support from the Department for Innovation,
Universities and Skills (DIUS). This situation contrasts starkly
with the other national academies, which all receive Parliamentary
grants-in-aid from DIUS (see table below). In the 10 years
since the Academy of Medical Sciences' inception, we have accomplished
a great deal with only modest resources. However, securing financial
support from DIUS would provide the opportunity for us to reach
our full potential.
|
| Royal Society
| British Academy |
Royal Academy of
Engineering
| Academy of
Medical Sciences
|
|
DIUS Parliamentary grant-in-aid
2007-08
| £44.9 million |
£21.3 million | £9.8 million
| £0 |
|
GOVERNMENT POLICY
ABOUT SCIENCE
15. The Academy firmly believes that science in general,
and medical research in particular, brings significant social
and economic benefits. Indeed, a recent report commissioned by
the Academy, MRC and Wellcome Trust estimates that the socio-economic
benefits from public and charitable investment in medical research
are very substantial.[159]
A thriving science base contributes to UK prosperity, promotes
the health and well-being of our citizens and prepares us for
future national and international challenges. Establishing a UK
economy that is built on knowledge and innovation is the only
way to address growing global economic and industrial competition,
particularly from China, India and South Korea. While it is appropriate
for one government department to lead on science (and disappointing
that the UK government currently lacks a department with "science"
explicitly in its title), we emphasise that full utilisation of
science and research should pervade all departments.
16. From the medical science perspective, the UK's current
research environment is strong, especially following the establishment
of the National Institute for Health Research (NIHR) and the Office
for the Strategic Coordination of Health Research (OSCHR). The
recent emphasis on quality and innovation in Lord Darzi's NHS
Next Stage Review also puts science at the forefront of the health
service: the proposed Health Education and Innovation Clusters
(HEICs) and Academic Health Science Centres will provide opportunities
to establish regional policies around health science which both
harness regional expertise and address local needs.
17. While such support for medical science is to be commended,
we emphasise that OSCHR, NIHR and MRC (and indeed all research
councils and science funders) must defend the Haldane principle
to protect the independence of the research agenda from short-term
political pressures. The balance of funding for different research
areas will vary over time and should be influenced by societal
need and determined by scientific opportunity—creative ideas,
talented researchers, and advances in technology. We stress the
need for continued basic research to fuel the pipeline for translational
exploitation.
PUBLIC ENGAGEMENT
AND DIALOGUE
18. Methods of public dialogue have advanced considerably
over the years and the DIUS Sciencewise-ERC programme and others
have done much to establish and disseminate good practice. Policy
development in important areas such as GM technology or embryo
research could not now be contemplated without integrated public
dialogue.
19. We emphasise that there is no "them and us"
when it comes to scientists and the public: scientists are themselves
part of society. This was demonstrated during the Academy's recent
study into "Brain science, addiction and drugs",
in which participants in the public meetings and workshops raised
the same concerns, voiced the same hopes, and identified the same
challenges and opportunities as the experts.[160]
Nevertheless, the report emphasised that: "in a liberal
democracy, an intelligent and appropriate approach to the regulation
of recreational drug use presupposes a prior deliberative and
inclusive community debate… Government should therefore continue
to engage in a sustained conversation with the public to develop
a position that commands real support". This point can
be generalised to many other areas of public policy.
20. There is now an expectation upon top scientists that
they will take their work into public forums. The Fellows of the
Academy typify this new breed of scientist: of the 215 Fellows
who responded to our 2007 communications survey, 98% had
engaged with the media about their work and 83% had given a public
lecture.[161] Reward
and recognition of scientists who take on science communication
as part of their work are important, and national academies, including
our own, have a role to play in acknowledging excellence in this
sphere. Research funders and higher education institutions routinely
include expectations around public engagement in grant application
forms and job specifications. However, there is still scope for
recognition of public engagement work in future versions of the
Research Assessment Exercise.
21. It does appear that participation in public engagement
work is more common amongst senior scientists, perhaps because
they have reached a level where they have more control over their
time. It is important to ensure that researchers at all stages
of the career pathway are encouraged to participate in public
engagement activities, particular younger researchers who might
be better able to connect with children and teenagers. There is
a case for a specific, dedicated grants scheme to enable early-career
researchers to undertake public engagement work. It would also
be helpful to gather information about the experiences of younger
scientists who combine flourishing research careers with significant
profiles as science communicators, and to gain the views of science
festival coordinators and media representatives about what makes
a good communicator and how scientists with a talent for public
dialogue can be identified and nurtured.
22. We stress that many medical scientists are also practicing
clinicians who engage with many different publics on a daily basis.
This interaction is often not included in discussions about public
engagement, yet is one of the most common and most important aspects
of the public's involvement with science. GPs in particular could
play a significant role in engaging individuals, families and
communities in medical science, and will almost certainly have
to respond to an increasing number of scientific inquiries from
their internet-using patients. There was broad consensus that
this issue merits further consideration at a recent Academy symposium
on "GPs and research".[162]
23. Finally, given that the public are increasingly accessing
scientific information from the internet, we believe that, to
date, public engagement strategies have not taken sufficient account
of the growth in online media. We therefore make a strong call
for the development of a dedicated UK "online strategy for
science". This strategy should include evaluation of current
and previous online initiatives: what has worked and what has
not? Whilst technical advances encourage the use of ever more
dynamic and interactive approaches, which tools are actually effective
in generating public engagement around science?
THE ACADEMY
OF MEDICAL
SCIENCES
The Academy of Medical Sciences promotes advances in medical
science and campaigns to ensure these are converted into healthcare
benefits for society. Our Fellows are the UK's leading medical
scientists from hospitals and general practice, academia, industry
and the public service.
The Academy seeks to play a pivotal role in determining the future
of medical science in the UK, and the benefits that society will
enjoy in years to come. We champion the UK's strengths in medical
science, promote careers and capacity building, encourage the
implementation of new ideas and solutions—often through
novel partnerships—and help to remove barriers to progress.
January 2009
152
A full copy of the report can be downloaded from http://www.acmedsci.ac.uk/p99puid115.html Back
153
To access the report go to: http://www.acmedsci.ac.uk/p99puid105.html
Back
154
CST (2007). How academia and government can work together.
http://www.dius.gov.uk/policy/documents/academia_gov_work_together_131008.pdf
Back
155
To access the report go to: http://www.acmedsci.ac.uk/p99puid89.html
Back
156
To access the report go to: http://www.acmedsci.ac.uk/p99puid97.html
Back
157
To access the report go to: http://www.acmedsci.ac.uk/p99puid62.html Back
158
To access the report go to: http://www.acmedsci.ac.uk/p99puid83.html Back
159
For more information see: http://www.wellcome.ac.uk/News/Media-office/Press-releases/2007/WTX038680.htm
Back
160
To access Brain science, addiction and drugs report, go to: http://www.acmedsci.ac.uk/p99puid126.html
Back
161
To access the Fellows Communications Survey, go to: http://www.acmedsci.ac.uk/p101puid124.html
Back
162
For further details see-http://www.acmedsci.ac.uk/p43evid102.html
Back
| 
