House of Lords - Science and Technology

Select Committee on Science and Technology Minutes of Evidence

Supplementary evidence by Help the Aged

EXTRACT FROM RESEARCH STRATEGY DOCUMENT

GOVERNMENT POLICY AND EXPENDITURE

Department of Trade and Industry

1. Apart from direct funding via the HEFCE, the Government exerts considerable influence on the Universities via the Research Councils, whose budget is controlled via the Office of Science and Technology (Department of Trade and Industry (DTI)). The aim of its research policy is to take the lead in providing new capital and enhanced research funding in order to restore, maintain and grow the infrastructure for research. The recommendations of the Government's Foresight Panel indicated that there were three primary areas into which funding should be channelled. These were Genomics, e-Science and the basic technologies. The science budget allocations for the three years 2001-02 to 2003-04 were announced in November 2000 (Spending Review 2000). The research vote was therefore transcribed into a funding formula to cover the period to the end of 2004 which added considerable extra spending to the baseline expenditure on research. These data are shown in Table 1.

Table 1

GOVERNMENT RESEARCH EXPENDITURE 2001-04 (OST Data)


(£M)	2001-02	2002-03	2003-04

Baseline	1,702	1,702	1,702
Additions	64	208	453

2. The Government's priorities for research expenditure are reflected in the structure of the funding within each of the research councils. For example, in the Medical Research Council (MRC) £65 million of the extra funding has been awarded for genomics research and £8 million for health informatics, bioformatics and e-science. An allocation of £41 million was allocated to the Engineering and Physical Sciences Research Council (EPSRC) to fund basic research into new and developing technologies. This was a cross-Council allocation, some of which was expected to feed across to areas relating to human health. A further £15 million cross-Council programme was established to tackle issues common to all Councils, eg IT provision such as SuperJANET. As part of the baseline expenditure, £675 million was provided for University research infrastructure (with an additional £225 million from the Wellcome Trust) as part of the Science Research Infrastructure Fund.

3. In the latest 2000 Spending Review, the Government has created a dedicated capital funding stream for the Universities amounting to a further £500 million per year by 2005-06. It has also doubled the OST budget for large families to £205 million per year by the same period.

Research Council Expenditure

4. There are four Research Councils who directly fund research into ageing issues. These Councils are the Medical Research Council (MRC), the Engineering and Physical Science Research Council (EPSRC), the Economic and Social Science Research Council (ESRC) and the Biology and Biotechnology Research Council (BBSRC). Their total levels of expenditure and their direct expenditure on research on ageing are shown in Table 2. The four councils are members of the Funders' Forum, a NCAR iniative to bring together all those bodies from the public and voluntary sectors who fund research on ageing. A preliminary analysis of the expenditure in Table 2 shows that only a small proportion of the total expenditure of the Research Councils is spent directly towards older people's issues. However, the inference that research into all issues relating to ageing is neglected may be fallcious, since a proportion of the work carried out in non-age specific areas may indirectly benefit older people. A good example would be research into those diseases which are associated with age but which do not exclusively affect older people, eg cancer. In any analysis of not only expenditure, but also the direction of research, the issue of identifying research related to ageing is problematic. For example, the Wellcome Trust does not categorise its research funding by age and is only able to approximate its expenditure on ageing research (vide Table 4).

Table 2

RESEARCH COUNCIL EXPENDITURE

DATA DRAWN FROM PUBLISHED SOURCES AS AT DECEMBER 2002


	Total Annual Budget (£m)		Older People's Programmes (£m)	Percentage of Total

BBSRC	213.9	SAGE	4.9	3.0%
		OTHER	11.9
EPSRC	436.2	EQUAL	9.0	0.7%
ESRC	74.4	GOP	3.5	3.5%
MRC	349.6	HoE	54.9	5.5%
Total	1,074.1		84.2	2.8%

(SAGE = Science of Ageing (now replaced by ERA (Experimental Research on Ageing));
(EQUAL = Extending Quality of Life; GOP - Growing Older Programme; HoE = Health of the Elderly).

5. In the recent 2002 Spending Review, the Government has granted an additional £120 million per year to the Research Councils to contribute to the indirect costs of research. There is also a new investment of £100 million per year from 2002-03 to 2005-06 to provide increased stipends to PhD students and postdoctoral fellowship salaries.

Spending by other Government departments

6. In addition to research expenditure via the Research Councils, several Government departments have research budgets which are dedicated to older people's issues. Some of these departments are shown in Table 3. "Current projects" includes work that may have been proceeding for some time, eg longitudinal studies. An interesting feature again is the relatively small amount of funding which is dedicated purely toward ageing research. For example, in the year 2002-03 the total R&D budget for the NHS was £540 million; direct expenditure on ageing research was ca £5 million.

Table 3

RESEARCH EXPENDITURE—GOVERNMENT DEPARTMENTS

DATA DRAWN FROM PUBLISHED SOURCES AS AT DECEMBER 2002


	Current Projects (£m)	Annual (£m) 2002-03

Department of Health (Older Peoples Services)	14.83 (n=64)	2.50
Department of Health (NHS)	5.62 (n=34)	2.30
Department of Work and Pensions	3.57 (n=18)	1.23

Research spending by charities

7. The figures for research expenditure by other charities are shown in Table 4. The charities listed are all members of the Funder's Forum. It has not been possible to access all the required data from publicly available sources and even the Charities themselves could not provide some of these data accurately. For example, the Wellcome Trust does not categorise its research according to an age criterion, making expenditure estimates difficult. Therefore only a partial representation has been possible.

Table 4

RESEARCH EXPENDITURE ON AGEING—CHARITIES WITHIN THE FUNDER'S FORUM


Charity	Current Projects (£m)	Annual (£m)	(Total) £

Alzheimers Society	2.3	0.1	(0.1)
Anchor	NA	NA
British Heart Foundation	1.4	NA	(40.4)
Joseph Rowntree Foundation	1.25	NA
Nuffield	0.29	0.29	(5.22)
Research into Ageing	5.04	2.45	(2.45)
Stroke Association	5.98	NA	(0.44)
Wellcome Trust	108.00	NA
Total	124.26	NA

Figures in brackets represent total research expenditure per year. Data abstracted from published figures as at December 2002. "NA"—data "Not Available".

Gross domestic expenditure on research

8. The latest data on the UKs' gross domestic expenditure for R&D show the figures for 2001 and were released in March 2003. The data shown an annual increase of 5 per cent in real terms from 2000, to a figure of £18.8 billion. The Office of National Statistics (ONS) differentiates between "sectors carrying out R&D" and "sources of funding". Expenditure by "sector of funding" for 2001, in real terms, was as follows:

Business Enterprise	46%	(£8,691 million)
Overseas Funding	18%	(£3,386 million)
Government	15%	(£2,841 million)
HE Funding Councils	8%	(£1,474 million)
Research Councils	7%	(£1,359 million)
Private Non-profit	5%	(£889 million)
Higher Education	1%	(£177 million)
	100%	£18,817 million

9. Therefore the OST expenditure for R&D in 2001 (at £1,766 million) represents 9.39 per cent of the total UK spend. It is likely that from the figures available, that only circa £200 million per year is spent directly on ageing research, making it a very small component of research expenditure nationally (ca 1 per cent).

The National Collaboration on Ageing Research

10. The National Collaboration on Ageing Research was launched in November 2001 following two national initiatives—the EQUAL initiative set up by the OST and a three year project—Age Net—developed by the Research Councils (funded through the OST's Foresight Challenge Competition). Its Director is Professor Alan Walker of the University of Sheffield.

11. The NCAR was launched in response to the driving factors of demographic change and the deficiencies of the UK research base. These deficiencies include a lack of multi-disciplinary research, poor collaboration and consultation between research funders and a lack of co-ordination between researchers and key end-user groups, not least of all older people themselves. The inclusion and empowerment of older people is an issue of increasing importance, exemplified by the notion of the "new politics of older age" and by the many models of older people's involvement which have been produced in recent years.

12. Therefore the main aims of the NCAR are set out as follows:

(a) To act as a link between initiatives and key research groups.

(b) To engage in a new Cross-council Approach.

(d) To provide a link to the major research centres in the EU.

13. There has been criticism that these laudable aims are yet to be fully achieved, and that there is no explicit aim to integrate older people into the research process. However, it must be said that the Collaboration would require more than its present level of staffing and financial resources to enable its full potential to be reached and that it has only been operating for 18 months.

Funders' Forum

14. The Funders' Forum is made up of the following bodies:

Research Councils—BBSRC, EPSRC, ESRC and MRC;

Voluntary Sector—Alzheimer's Society, British Heart Foundation, Help the Aged, Joseph Rowntree Foundation, Nuffield, Wellcome Trust;

Public Sector—Department of Health.

A summary of the research portfolios of the members is found in Annex B.

15. The Forum was intended to provide a platform to identify areas where joint working can make a greater impact and where the greatest gaps in research are. Its overall aim is to stimulate and facilitate multi-disciplinary working and develop research activities across the boundaries between research funders.

16. The Funders' Forum has been perceived as lacking leadership, coherence and unified and purposeful effort. Recently, discussions in the Forum have centred on the appointment of a National Institute of Ageing; integration of research in the NHS and the inclusion or representation of older people in the Forum.

17. The Research Councils are at an advantage in so far that they already have cross Council mechanisms for communication and strategy building (the Cross-council Co-ordination Committee, led by the MRC). The Charities in the Forum at present do not share such a mechanism and it is difficult to make an appreciation of what, if any, their shared position might be.

18. There also does not appear to be any integrated concentration of research direction emanating from the Forum, despite the members' position as leading funders of research. This situation does not compare well with the strategic direction found in The United States, where the National Institute of Ageing delivers a very sophisticated and informed leadership role, with an impressive budget and research portfolio.

19. Possible solutions to some of these problems include a proposition to fund a national centre of excellence of ageing research, either real (eg based on a University) or virtual; collaborations between the major University institutes of ageing in order to secure large European funding; a campaign for increased Government expenditure on ageing research; widening the collaboration of the Forum to include professional bodies, such as the British Geriatrics Society and the British Society of Gerontology.

Research on ageing in the UK

20. Consideration of the direction and extent of academic research on ageing (both pure and applied) is fundamental to the synthesis of an informed and correctly positioned research strategy. It appears that there is no centrally held information database on current research activity on ageing in the UK universities. A review of the current University research effort on ageing is clearly beyond the scope of this document. Indeed it is not clear if such a review has been carried out. However, the following synopsis of research activity has been derived from a search of the individual University websites based largely on the membership of Universities UK.

Universities UK—121 Members

Institutes of Ageing 7

Bristol, Cambridge, King's, Liverpool, Newcastle, Oxford, Sheffield

Research Groups or Centres 15

Aberdeen, Queens Belfast, Birmingham, Edinburgh, Keele, LSE, LUT, Manchester, Nottingham, Open, Reading, Stirling, Surrey, UNN

Research Programmes 12

Brighton, Brunel, Bath, Cardiff, Dundee, Imperial, Kent, Lancashire, Leeds, Leicester, LSHTM, Southampton, Teesside

21. From formal meetings with a number of University Vice-Chancellors, it appears that not only is there no centrally compiled record of current research on ageing in the UK but that often there is no accurate record of the on-going research within individual Universities. The NHS Strategic Reivew of Ageing (1999) was unable to compile a comprehensive complete and accurate record of ageing research in the UK. A database of current research on ageing would therefore appear to be a valuable asset to the development of a national strategic direction for research.

22. Research on ageing in the UK, within all areas including the Universities, the public sector and the private corporate sector appears to be fragmented and to lack strategic direction. This has been implicity recognised by the formation of the NCAR and the Funders' Forum and explicity by the NHS Strategic Review on Ageing and Age Associated Disease and Disability. Among the recommendations of the Review (1999) were:

(a) A directed strategy relevant to the health and social needs of the ageing population was necessary.

(b) A National Research Advisory Group should be set up to foster comprehensive research relevant to the health and wellbeing of older people, including a review of research priorities.

(c) A Network of Trusts should be set up with responsibility for carrying out commissioned tests of new interventions and services.

In relation to specific subject areas, further recommendations included:

(a) A review of the research priorities relevant to the health and wellbeing of older people.

(b) A regular review of assistive technology.

To date, it appears that few, if any, of the above recommendations have been actioned.

International developments

23. There is an international consensus on the agenda for ageing research. The document, entitled "The Research Agenda on Ageing for the 21st Century" was published following the Valencia Forum, which preceded the 2nd World Assembly in Madrid in June 2002. Developed by UN Programme on Ageing, with the support of the International Association of Gerontology, the Agenda was designed to support the implementation of the International Plan for Ageing. It identifies six major priorities for research and 10 critical research arenas. Specific research agendas for the UN Regions of the World are under development and will be published by the end of 2003.

24. The International strategy for Help the Aged was written in 2002 ("Older People Everywhere") and is currently under implementation. Its principal objectives are:

(a) Building a strong network of capable organisations through support to strengthening age-interested organisations world-wide;

(b) Supporting the most vulnerable groups through carefully targeted programmes;

(c) Raising awareness and commitment within the UK within critical audiences of policy makers, public and donors in the UK; and

(d) Delivering concrete results through new partnerships and collaboration with other organisations interested in similar issues, where there are opportunities for encouraging mutual learning and making an impact.

In implementing this programme there is an implicit concept of building the evidence base for informing HtA's activities, in partnership with Help Age International.

CONCLUSIONS

25. It is therefore suggested that the following conclusions may be drawn:

(a) Direct expenditure on research on ageing appears to be a small fraction of Government funded research expenditure and even smaller in relation to the total UK spend on R&D.

(b) The apparently low direct expenditure on ageing research is to some extent offset by the research on medical conditions which are associated with ageing.

(d) The principal areas of biomedical expenditure appear to be age-related cardiovascular conditions (eg heart disease and stroke); biology of ageing and mental function.

(e) In the social sciences, the main areas appear to be quality of life issues; family, kinship and support networks and healthy productive ageing.

(f) Some notable research "gaps" appear to be:

(i) modifiable risk factors for well-being and health (eg environmental factors, diet, stress, exercise, social participation, leisure, life style and recreation;

(ii) the economics of older age, including economic activity and ageing;

(iii) technology and the older user.

The research base on ageing in the UK is fragmented, lacks co-ordination and strategic direction.

INTERNATIONAL COMPARISONS

26. Government Science Investment Framework (2004-14) aims to increase R&D expenditure from 1.9 per cent to 2.5 per cent over the 10-year period. Average annual rate of R&D funding increases aimed at 5.8 per cent 2004-08. Over the 10-year period, average annual rate ALL SECTORS must be 5.75 per cent—a significant challenge. The following date compare the total R&D investment of Japan, the EU and the USA. These data should be compared to the figures for investment in science as a percentage of R&D, given previously in Table 4, for the UK only (maximum level—ca 0.4 per cent GDP).

Table 9

COMPARISON OF INVESTMENT IN R&D AS A PERCENTAGE OF GDP 2001


Source	GDP ( bn)	R&D %GDP	GBAORD %GDP	GBAORD ( bn)	% Private Sector of R&D

Japan	5,145	2.91	0.64	20.58	74
EU	8,524	1.92	0.73	62.22	66
USA	9,327	2.62	0.81	75.54	78

(Eurostate, 2003)

GBAORD—Government Appropriations or Outlay on R&D

Table 10

INVESTMENT IN R&D AS A PERCENTAGE OF GDP 2002 (HM TREASURY, 2004)


% of GDP	UK	France	Germany	USA

Business	1.24	1.37	1.73	1.87
Public Sector	0.62	0.83	0.78	0.80
TOTAL	1.86	2.20	2.51	2.67

USA—National Institute on Ageing (NIA)

27. Research programs supported by NIA (part of the National Institute of Health—NiH), include studies on the mechanisms of ageing, the processes of ageing, ageing and the nervous system, and ageing in relation to health and disease. NIA supports four extramural research programs:

Biology of Ageing

Behavioral and Social Research

Neuroscience and Neuropsychology of Ageing

Geriatrics and Clinical Gerontology

The Institute also has Intramural Programs with laboratory and clinical research conducted at the Gerontology Research Center and at NIA facilities in Bethesda, MD. It supports conferences, workshops and meetings plus funding and training of new investigators.

The Fiscal Year 2004 budget request for the NIA is $994,441,000 including AIDS, an increase of $36,785,000 and 3.8 per cent over the FY 2003 amended President's Budget Request.

NIH's highest priority is the funding of medical research through research projects grants (RPGs). Support for RPGs allows NIH to sustain the scientific momentum of investigator-initiated research while providing new research opportunities. In FY 2004, NIA will provide an aggregate average cost increase of 2.6 per cent for Research Project Grants. Also in FY 2004, NIA will fully fund 13 grants. NIA continues to support funding of AREA awards. Promises for advancement in medical research are dependent on maintaining the supply of new investigators with new ideas. In the Fiscal Year 2004 request, NIA will support 571 pre- and post-doctoral trainees in full-time training positions, the same number as in FY 2003. Stipend levels for NRSA trainees will increase by 4 per cent over Fiscal Year 2003 levels for predoctoral fellows, and from 4-1 per cent, based on years of experience, for post-doctoral fellows.

The Fiscal Year 2004 request includes funding for 67 research centres, 213 other research grants, including 181 clinical career awards, and 101 R&D contracts. Intramural Research receives a 3 per cent increase and Research Management and Support receive a 1.8 per cent increase over FY 2003.

EU—Research Programmes

28. The main, though not exclusive vehicle for EU spending on research has been through the Framework programmes. Figures for the levels of spending are as follows:

— Fourth Framework (FP4) 13.25 billion.

— Fifth Framework (FP5) 14.96 billion.

— Sixth Framework (FP6) 17.5 billion.

EU RESEARCH ON AGEING EXPENDITURE

29. Estimates for the proportion of these Framework programmes which have been spent on ageing research are as follows:

— Fourth Framework Programme 1994-98 ( 13.25 billion);

Biomedicine and health 157 million.

— Fifth Framework Programme 1998-2002 ( 14.96 billion);

Key Action 1 ("QoL") and Key Action 6 ("Ageing and Disability") 190 million.

— Sixth Framework Programme 2002-06 ( 17.5 billion);

Combating major diseases 1,155 million.

30. Assumptions have to be made that ageing related research areas are subsumed within the "biomedicine and health" and "major disease" categories (the data source (Eurostat) does not give these details).

CONCLUSIONS

31. International comparisons of research expenditure on ageing are difficult to make because of the absence of detailed data available from public sources and secondly because the data that are available are not or cannot be differentiated according to an age criterion. However the following conclusions can be made.

(a) Of the three economies under consideration (USA, EU, UK), the USA spends the most on ageing research in a highly strategic and well directed programme, via the NiA. For example, using data from 2001:

— Government Expenditure on R&D: ca 76,000 million.

— Government Research Expenditure on Ageing: ca 632 million.

In 2005-06 the NiA budget will increase substantially to an expenditure total of $1 billion per annum ( 769 million).

(b) The UK's apparent spend on ageing research is far less than the USA, on a percentage GDP basis, or as a proportion of gross research expenditure, as the following 2001 data show:

— Government Expenditure on R&D: ca 3,000 million.

— Government Research Expenditure on Ageing: ca 300 million.

( 300 million = ca £200; estimates includes Research Councils ca £151 million; Government spending departments £6 million.)

— EU Gross Expenditure on R&D: ca 164,000 million.

— EU Expenditure on R&D: ca 62,000 million.

— EU Research Expenditure on Ageing: ca 200 million.

32. It is arguable that it is the gross expenditure that is the crucial factor, since one scientific breakthrough yielding a research outcome of substance (eg a new drug, therapy, intervention or finding which effectively alters practice or policy) benefits all members of society equally.

October 2003