Memorandum submitted by the Academy of
Medical Sciences (FC 58)
OVERVIEW
1. Spending cuts to the science base put
our economic recovery at risk by undermining the pipeline to,
and workforce of, our research intensive industries. In responding
to this consultation from the House of Commons Science and Technology
Committee we have drawn on our recent publication: Reaping
the rewards: a vision for UK medical science, which sets out
our priorities for the next Government (please find enclosed).[97]
The Academy of Medical Sciences is the independent body in the
UK representing the whole spectrum of medical science. Our mission
is to ensure better healthcare through the rapid application of
research to the practice of medicine. Our response focuses primarily
on the medical and biomedical sciences, but many of the points
that we make have relevance across other research disciplines.
PROTECTING THE
SCIENCE BASE
2. Cuts to science base funding must be
avoided. Our recent report: Reaping the rewards: a vision for
UK medical science outlines how medical research will create
new jobs, catalyse sustained economic growth and help to restore
public finances by improving health and making the NHS and public
services more cost-effective and productive. Our position is supported
by the recent economic analysis of the Life Science Sector, which
highlights the value and future potential of this sector and the
comparative advantage afforded by the UK's research base.[98]
3. This is not the time to undermine the
research base that underpins the economically valuable Life Sciences
sector, particularly when analysis commissioned by DIUS in 2009
highlights the challenge that the UK faces in maintaining its
international lead in certain fields without the additional investment
that meets the growing competition from the technologically specialist
research countries such as China, South Korea and Singapore.[99]
4. Medical science is a long-term endeavour.
Major reductions in funding will cause significant harm. Areas
of research that are cancelled before they can deliver represent
wasted investment. Moreover, subsequent loss of staff and expertise
mean that projects and research areas cannot easily be resumed
if funding subsequently becomes available.
5. Public investment in medical research
must be sustained if it is to continue to leverage many times
its value in funding from industry and charities. For example,
a recent report commissioned by the Alzheimer's Research Trust
found that every £1 of public or philanthropic spending on
basic research can lead to an increase of £8 in private investment
over the following eight years.[100]
The same report found that every £1 increase in public spending
on medical research stimulates investment of £2 to £5
in research by the pharmaceutical industry.
VALUING THE
RING FENCE
6. The science budget ring fence is vital
for maintaining confidence in the UK's commitment to research
both within and outside the UK.
7. We note the Committee's interest in whether
a ring fence should be established for departmental R&D budgets.
The ring fence around the health research budget has been very
successful. Previously, research within the NHS suffered through
the diversion of money intended for research and infrastructure
support into direct patient care. NHS managers are subject to
intense pressures to deliver immediate healthcare targets, and
therefore afford a low priority to research. As a result, the
NHS has often been perceived by the academic and commercial community
to be a challenging and inconsistent research partner.
8. Over the last four years, a number of
initiatives have sought to increase the standing of the NHS as
a partner in health research. The most significant improvements
have resulted from the establishment of the NHS National Institute
for Health Research (NIHR) with its ring fenced budget and the
associated formation of the Office for the Strategic Coordination
of Health Research (OSCHR), which has promoted coordination of
the strategies of the MRC and NIHR and driven greater coherence
across the spectrum of UK health research.
9. Ring fencing the R&D budgets in other
government departments will allow a long term strategy to be developed
for the use of this budget to underpin evidence-based policy making.
As in all areas of research, in spending departmental R&D
budgets, peer review should be used to assess the quality of proposals
and evaluate final reports.
MAINTAINING A
BALANCED RESEARCH
BASE IN
THE FACE
OF SPENDING
CUTS
10. In medical research it is more helpful
to consider an iterative cycle of ideas that should exist between
the laboratory, clinical and population sciences, rather than
the rather simplistic dichotomy between "basic" and
"applied" research. All parts of the cycle need to be
properly funded.
11. We are aware of discussions around possible
responses to budget cuts which include reducing funding to all
areas of research and institutions ("sharing the pain"),
or focusing limited funding on research areas judged to be of
highest priority or institutions regarded as the most productive.
Strategies that follow either course must address the associated
risks. Spreading cuts equally risks suboptimal funding in all
areas of research, while focusing cuts on a small number of areas
or institutions risks undermining the pinnacles of excellence
that exist outside the favoured institutions or research fields.
12. The UK needs to maintain a balance between
responsive mode and priorities-led research. Society-at-large
expresses its priorities though support for the medical charities,
which then take the lead in pursuing those research goals. However,
important areas of clinical need (eg mental health, respiratory
medicine, diseases of the digestive system, urinary incontinence)
receive very little charity money. Such areas must be considered
carefully by government funding agencies.
13. Too much emphasis on priorities-led
research brings the danger of sequestering money away from more
readily soluble research problems. For example a pressing medical
need may not be soluble at a given time with the given state of
knowledge and technology. Top-down identification of priorities
must be informed by knowledge of scientific tractability, and
accompanied by solicitation of innovative and challenging ideas
from the scientists and dialogue with the wider stakeholder community.
The UK's history of supporting responsive mode research over the
long-term has generated considerable, though often unanticipated,
health and economic rewards.
SAFEGUARDING THE
NEXT GENERATION
14. We are concerned by the recent announcement
of the £398 million cut to the budget of the Higher Education
Funding Council for England (HEFCE) that will impact on the funding
of teaching in English universities.[101]
There is a virtuous circle between teaching and research that
generates new knowledge and brings health and economic benefits.
Not only is the quality of tomorrow's research dependent on the
quality of today's teaching but today's researchers benefit from
the insights that come from teaching students—particularly
about new or unfamiliar areas. Cuts to teaching therefore threaten
current and future generations of researchers.
15. The UK's reputation for research-led
teaching attracts students from across the globe. However, even
before the recent HEFCE cuts, the Academy had become concerned
that this reputation is being eroded. The report of the Academy's
working group on the role of teaching in academic careers will
be published in the Spring and will make recommendations to redress
the balance between teaching and research.[102]
16. We are particularly concerned that reducing
the number of PhD students may be seen as an "easy option"
in response to expected cuts in Research Council budgets. This
risks producing a gap in trained researchers who will be available
in the future when funding is increased. The UK's international
share of PhD students in the natural sciences is falling (although
those in the medical sciences have increased slightly) and the
ratio of UK researchers to total population has declined while
that of our competitors has risen.[103],
[104]
MEASURING IMPACT
17. Medical research produces a wide range
of socio-economic benefits, but systematic evaluation of research
outcomes is difficult and both national and international research
funders continue to grapple with the methodological and organisational
challenges involved. Such evaluation must take account of: the
international nature of the research enterprise; the value of
negative research findings; non-incremental developments in knowledge;
the importance of blue-skies research; and the long interval between
scientific advance and tangible clinical and/or commercial benefit.
18. A 2008 report commissioned by the Academy
of Medical Sciences, Wellcome Trust and MRC demonstrated some
of the ways in which impact can be quantified.[105]
It showed for example that every £1.00 invested in public
or charitable research into cardiovascular diseases in the UK
between 1975 and 1992 produced a stream of health and economic
benefits equivalent to earning £0.39 per year in perpetuity.
19. In terms of evaluating the impact of
past research we have expressed some reservations about the proposals
by HEFCE to include a measure of impact in its new Research Excellence
Framework (REF).[106]
20. Time lags: measuring impacts over 10-15
years may not be long enough. For example it can take up to 17
years to see the impacts of cardiovascular disease research.[107]
21. Attribution: impacts usually emerge
from several pieces of work, so cannot easily be attributed to
only one or two departments, particularly for in the case of researchers
that were involved in the earliest stages of research.
22. Weighting of Impact: as this is a new,
as yet untested area, it may be prudent to attribute a lower weighting
to impact in REF.
23. We support efforts to encourage researchers
to think about the potential impact of their research when developing
their grant proposals, both to maximise the value of this public
investment and because such consideration can lead them to consider
different approaches and possible collaborations. Much biomedical
research involves the use of animal or human subjects and is already
subject to an additional level of review that assesses whether
the expected impact of the work justifies the use of animal or
human subjects. Consideration of direct or indirect economic impact
must not prevent excellent, speculative research proposals being
supported in response mode funding. Some targeted funded programmes
will have a specific impact in mind. In these cases it is important
that peer reviewers and peer review panels are competent to assess
them.
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 2010
97 Academy of Medical Sciences (2010). Reaping the
rewards: a vision for UK medical science http://www.acmedsci.ac.uk/index.php?pid=99&puid=172 Back
98
BIS (2010). Life Sciences in the UK-economic analysis and evidence
for "Life Sciences 2010: Delivering the Blueprint".
BIS Economics Paper no.2URN 09/1072 http://www.berr.gov.uk/files/file54303.pdf Back
99
DIUS (2009). International comparative performance of the UK
research base. Report by Evidence for DIUS. http://www.dius.gov.uk/science/science_funding/science_budget/¥/media/publications/I/ICPRUK09v1_4 Back
100
Alzheimer's Research Trust (2009). Forward together. Complementarity
of public and charitable research with respect to private spending.
http://www.alzheimers-research.org.uk/assets/docs/20090917162138ForwardTogetherSep2009.pdf Back
101
Mandelson P (2009) Higher education funding 2010-11. http://www.hefce.ac.uk/news/hefce/2009/grant1011/letter.htm Back
102
For further details about this study please see: http://www.acmedsci.ac.uk/p47prid59.html Back
103
DIUS (2009). International comparative performance of the UK
research base. Report by Evidence for DIUS. http://www.dius.gov.uk/science/science_funding/science_budget/¥/media/publications/I/ICPRUK09v1_4 Back
104
BIS (2010). Life Sciences in the UK-economic analysis and evidence
for "Life Sciences 2010: Delivering the Blueprint".
BIS Economics Paper no 2 URN 09/1072 http://www.berr.gov.uk/files/file54303.pdf Back
105
Health Economics Research Group, Office of Health Economics, RAND
Europe (2008). Medical Research: What's it worth? Estimating
the economic benefits from medical research in the UK. London:
UK Evaluation Forum. http://www.acmedsci.ac.uk/p99puid137.html Back
106
Academy of Medical Sciences (2009). Response to the Higher Education
Funding Council for England's consultation: the Research Excellence
Framework http://www.acmedsci.ac.uk/p100puid170.html Back
107
Health Economics Research Group, Office of Health Economics, RAND
Europe (2008). Medical Research: What's it worth? Estimating
the economic benefits from medical research in the UK. London:
UK Evaluation Forum. http://www.acmedsci.ac.uk/p99puid137.html Back
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