Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

I beg to move amendment 18, in clause 14, page 10, line 37, at end insert—

‘(za) work in any field relevant to the NHS;

(zb) work conducted by any individual, group(s) or organisation(s) employed by the NHS or affiliated to it’.

Robert Key (Salisbury, Conservative)

With this we may discuss the following: amendment 136, in clause 14, page 10, line 40, at end insert—

‘(c) work done promoting innovation.’.

Amendment 137, in clause 14, page 10, line 40, at end insert—

‘(2A) A prize may be paid in instalments relating to subsections (2)(a), (2)(b) and (2)(c) above.’.

Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

We now move away from direct payments into innovation, and in particular this one-clause provision in chapter 4 on innovation prizes. I welcome attempts to aid the spread of innovation in the NHS and recognise that this is not only an area in need of improvement but an area with a large amount of potential. Innovation in the NHS, if given the chance to flourish, can motivate and incentivise staff to drive forward improvements to services and it can also furnish British business and industry with opportunities to develop NHS innovations, many of which may have been inspired by the ideas of NHS staff. In that respect, I declare an interest as the parliamentary adviser to the Manufacturing Technologies Association, who manufacture some extraordinarily precise, very small instruments which are used as part of NHS innovations. Through amendments 18, 136 and 137, I want to address gaps in the legislation concerning the scope of the prizes. I will address my queries on the prizes themselves later on.

The amendments seek to ensure that the innovation prizes are open to all NHS employees and to any groups or organisations affiliated to that service. They broaden the scope of prizes to include the promotion of innovation, and enable them to be paid in instalments so that staff can develop a long-term strategy for the uptake of their ideas.

Amendment 18 addresses Lord Darzi’s clarification on the fourth day of the Lords Grand Committee, that the prizes could be awarded to

“people working in the health service but not necessarily employed by it.”—[Official Report, House of Lords, 5 March 2009; Vol. 708, c. 324.]

He said he was aware of

“many people with university appointments who do full clinical work in the health service on honorary contracts.”—[Official Report, House of Lords, 5 March 2009; Vol. 708, c. 324.]

I can confirm that in a non-remunerative position. I am the vice-chairman at the Liverpool School of Tropical Medicine. I also sit on the board of the Innovative Vector Control Consortium, a research organisation trying to find an alternative molecular structure to DDT. The research going on there will have a direct impact if there is success. The Liverpool School of Tropical Medicine is already having an impact on many things in the health service and there is a fantastic collaboration between it and the university hospitals in Liverpool.

Lord Darzi was right to cite these people as a potential source of innovations, but there is a danger that they could be discriminated against if it is not overtly stated in the Bill that prizes are open not only to NHS employees. The British Medical Association expressed its support when it said that amendment 18 would clarify that medical academics are eligible for the prizes.

I am also concerned that the challenge of an innovation prize decided on by the committee might limit the pool of applicants to a particular field of specialism, and in so doing, discriminate against other NHS staff. By emphasising the breadth of the prize in primary legislation through the amendment, I hope to guard against its application to a specific group of NHS employees or a particular field of expertise. The prize’s potential would, therefore, be maximised to inspire everyone in the NHS to innovate. Will the Minister give an assurance that the Committee will not limit the scope of applicants to the prizes by defining too stringently the discipline from which the innovation must originate?

By extending the remit of the prizes to award the promotion of innovation through amendment 137, NHS staff who play a significant role in generating uptake of innovative ideas, and encouraging others to innovate, may be rewarded through the prize. While promotional work will be harder to define, its inclusion in the prize will encourage not only potential innovators, but those with the potential to facilitate the spread of innovation across the organisation. In the next group of amendments, I hope to have the opportunity to discuss the idea that the problem facing the NHS is not so much the dearth of innovative ideas, but their uptake across the service. Promotional activities can greatly aid the spread of innovation, which is why I propose to include them in the scope of innovation prizes. In parenthesis, from my own experience in the manufacturing industry, there is a great concentration on the word “innovation”, but people readily forget that a lot of that comes through developments of existing technology and building on prior innovations. There is often a great problem in giving the developments the same weight as blue-sky thinking innovations. We need to recognise that often 90 per cent.—in most fields—of what is regarded as innovation is in fact a development of an existing practice or idea.

There is a good example of how promotional activities can be fundamental to the spread of innovation in my own constituency at Leighton hospital near Crewe—the Leighton exposition. Since 2004, Mid Cheshire Hospitals NHS Foundation Trust has used its research and development office to set up an effective information dissemination forum to provide opportunities for local clinicians and researchers to network with one another  and discuss their practices, ideas and collaborations. The event also showcases the work of local health care research and audit. I attended the last evaluation and am grateful to David Cade and Sasi Willmott, who always produce a brochure with everything set out and documented. There is a prize for the winning entry that is judged by three external, high-powered academic adjudicators. The 60 innovations that were exhibited at the 2008 event bear witness to the fact that innovative ideas are alive and kicking in the NHS. Events such as the Leighton exposition help innovators to promote those ideas among colleagues and, therefore, generate uptake.

The Leighton exposition also demonstrates that it is the clinicians and researchers who are best placed to identify the challenges across the NHS. Innovations at the exposition included identifying reasons for delays in in-patient ultrasound scans, improving access to community services for elderly people after discharge from hospital and an analysis of whether proposals from the National Institute for Health and Clinical Excellence are useful in clinical practice. All these topics originated from staff who identified independently an area of research or a problem in need of a solution. If innovative events such as these are going ahead in trusts such as Mid Cheshire, and if innovators are succeeding in identifying areas of the NHS that are in need of innovation, it questions why the Government are investing in costly prizes that might inadvertently rob innovators of their role. By identifying a challenge for innovators to tackle, the innovation prize committee may be meddling unnecessarily in the innovation process. I hope to seek an assurance from the Minister that the creation of a national prize for innovation will not detract from home-grown, grass-roots initiatives such as the example I have outlined from my constituency—at Leighton hospital, near Crewe.

Amendment 136 would enable the organisers of events such as the Leighton exposition to apply for innovation prizes as the promoters of innovation. I hope the Minister will acknowledge that the promotion of innovation at a local level can be as effective in aiding the spread of innovation as rewarding the innovators themselves. The example of Leighton raises questions over whether innovation prizes will really overcome the obstacles that inhibit innovation in the NHS. The Secretary of State identified the problem with NHS innovation on Second Reading. He said that

“the NHS is good at invention, but it can be slow to adopt new technologies and treatments, and the spread of new ideas is variable.”—[Official Report, 8 June 2009; Vol. 493, c. 542.]

I wholeheartedly agree with the diagnosis of the problem but I question the remedy. Prizes may reward innovation that has already taken place—which, if I understand it correctly, is the main legislative purpose of the Bill—but I fail to see how this change in the rules will encourage the spread of innovation. The problem is surely one of morale. The uptake of innovation is negligent because morale among staff is low. Too often staff have seen their ideas go nowhere, which is disheartening and dispiriting. A recent report by the NHS Confederation called “Future of leadership: Leading innovation” highlighted the lack of uptake of ideas as a source of low morale among staff. It pointed to the preponderance of risk-averse middle managers in the NHS whose work loads are orientated towards short-term targets, rather than encouraging and championing innovative ideas  among their staff. It also emphasised the overly bureaucratic mechanisms through which innovators must pass before they can generate uptake for their innovation. The requirement for the clinician to write a business case was seen as a significant obstacle: it is perceived by staff as a way of saying no to innovation rather than as a vehicle to secure funds and uptake.

Amendment 137 aims to aid staff in generating uptake of ideas by allowing prizes for innovative ideas to be paid in instalments. Each instalment could be dependent on a new stage of implementation, thereby encouraging staff to support an innovative idea and see it through to completion. The problem facing the NHS with regard to innovation runs much deeper than generating ideas. A prize is a great way of rewarding the few innovators who have made it through the gauntlet of securing the support of their colleagues and managers. Only a small number of people can successfully negotiate a heavy target-driven work load to find the time and resources to innovate. However, for the majority of NHS staff, an innovation prize in and of itself will not enable them to overcome these barriers.

I hope the Minister will mention in his response the newly established innovation funds held by the SHAs. He may well say that the prizes are designed to work in conjunction with these funds to spread innovation. I welcome that funding and I hope it will provide much-needed capital for those seeking to develop their innovations. I hope he will also take the opportunity to give an indication of how he intends to change the culture of resistance amongst managers and other NHS staff—a culture that, we would argue, is hampered through a somewhat target-centric NHS. This is an issue that runs much deeper than simply the cash that comes with the prize.

Sandra Gidley (Romsey, Liberal Democrat)

I welcome these amendments because they give us a chance to probe where some of this money may be going. Before I progress with my arguments I was a little concerned by the closing remark of the hon. Member for Eddisbury, who talked about a culture of resistance in the health service. My experience of a lot of workers in the health service is—

Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

It was managers.

Sandra Gidley (Romsey, Liberal Democrat)

And managers. My experience is that they are not averse to change, although the hon. Gentleman may have spoken to different people from me. There is a lot of innovation out there, but sadly it is not recognised by many people, including politicians, it would seem.

One of my concerns about the Bill relates to clause 14(1), which states:

“The Secretary of State may make payments as prizes to promote innovation in the provision of health services in England”,

but says nothing whatever about the NHS. I therefore welcome amendment 18, which makes it clear that the prize may relate to

“work in any field relevant to the NHS”.

However, it occurred to me that a team employed in the private sector could do work relevant to the NHS and apply for a prize. It would be a concern to many of us if public money could, as a result of the way in which the  Bill is drafted, be diverted to the private sector. I hope the Minister can reassure us on that. Where do independent sector treatment centres come into this? What would happen if a team was doing something in such a centre?

I have another concern. When we talk about the NHS, innovation and prizes, we focus almost exclusively on secondary care. If we are serious about moving care towards the primary sector, we need a mechanism to ensure that that happens. For example, optometrists or dentists could have good ideas for prizes or innovation. My concern is that worthy committees full of specialists in secondary care will be set up and will focus automatically on secondary care, biasing what is done. Innovation is not just about the flashy new procedures, and it is not necessarily about the research; sometimes, it is just about thinking outside the box and coming up with a new way of delivering services that is more convenient for patients and the public and which could probably reduce some of the strain on the secondary sector.

When the fine detail is worked out, I very much hope that the prizes will not just be a means of congratulating those who already have quite a number of areas in which to show off their expertise. I hope that they will truly embrace all the NHS.

Mike O'Brien (Minister of State (Health Services), Department of Health; North Warwickshire, Labour)

This has been a helpful debate, and the hon. Member for Romsey has made some thoughtful points, to which I will return in a moment.

The aim of the prizes is to reward breakthroughs in the provision of health services in England, so the provisions relate to the NHS. The challenges will be designed to tackle some of our major health issues and bring about not only radical breakthroughs in the prevention and treatment of lifestyle diseases, but changes in the way in which things are managed and delivered. That includes secondary and primary care.

I strongly take the point from the hon. Member for Eddisbury that innovation could mean the development to a new level of existing ideas—he is absolutely right about that. The nature of the process makes it difficult to assess the quality of what is being done and to draw attention to it.

We will have to handle the prizes properly, and to some extent the hon. Member for Romsey is right that there will be a committee of the great and the good—there always is in such things. We will have to make sure that we have the right distribution of responsibilities on that committee, so that it not only focuses on the obvious issue of developments in secondary care, but includes management and delivery.

I agree with the hon. Member for Eddisbury, although I would not quite put it in the way that he did, that there is a lack of reward and recognition in the NHS system. The prizes are a way to incentivise people and focus minds. They are a way to reward people and to recognise that some people are anxious to make changes.

Unlike the hon. Member for Romsey, I agree with the hon. Gentleman that sometimes in management there is a culture of resistance, inertia or lack of innovation about the way things are done. If we can provide incentives such as this to organisations to be more innovative, to show that we are prepared to put resources behind new ideas that can improve patient care, then we  will truly feed into that emphasis on quality that came out of the review by my noble Friend Lord Darzi. That review focuses on ways that we can improve the quality of the NHS and the quality of delivery and recognise that we have passed the stage where we just need to focus on raising minimum standards. This is not just about minimum standards; we have to have a continued focus on that, but we now need to move to a higher level and look at how we improve the quality of what the NHS delivers at the top—make the best better, make the mediocre the best and ensure that we improve quality throughout the NHS.

The scheme is primarily focused at ensuring that people working in the NHS are able to see the benefits and recognition for their work in making a breakthrough. This is not restricted to the NHS; it is available to those working in academia. We want to ensure that there is a regional focus. The £220 million regional innovation fund has been launched and we will target resources at helping front-line staff to develop, grow and spread new ideas, delivering real improvements in the quality of the care people receive. Academic health science centre status has been awarded to five partnerships following the process of peer review by an international panel of experts. Academic health science centres will bring together world-class research, teaching and health care delivery, so that developments in research can be more rapidly translated into improvements in patient care in the NHS and around the world.

We are not restricting the award of prizes to those in the NHS, but we are ensuring that there is a focus on NHS workers knowing that they are available to them, that a challenge is being set and that if the challenge is met internationally or in another sector, a prize may be awarded. That will happen only if the idea is demonstrated to be replicable in the NHS. On amendment 136 we would not expect to award a prize simply for the promotion of innovation in itself. There needs to be an actual breakthrough and it needs to be replicable in the NHS; promotion of a project is one element of that. We need to be able to show that this idea, wonderful breakthrough that it is, can produce a wider benefit, not only in the NHS but, we hope, in some cases beyond that and possibly around the world.

On amendment 137 we are not intending to make payments in instalments. The challenge prizes are not about giving money in the form of grants for work to be undertaken, which the amendment seems to suggest. This is about rewarding work that has been done—we have got an innovation, we award the prize and then that money can be used to replicate or extend the innovation or move it to the next stage. We are going to award prizes for what has been done.

The hon. Member for Eddisbury asked whether this is meddling in innovation. Innovation often happens anyway; this is an encouragement of innovation. In that encouraging innovation and the development of new ideas is meddling, yes it is. It is trying to provide a prize for those who excel and to reward excellence. That is something that we should be doing. We do not want to detract from those in the NHS pursuing innovation; on the contrary, we want to encourage it.

The hon. Member for Romsey in her thoughtful speech asked whether this money would go to the independent sector were it to provide an innovation or breakthrough that helps patients. It will, if it helps  patients and if it is replicable throughout the NHS. If we can take the innovation from a private sector organisation and transfer it to the NHS, or if we can find ways in which it will benefit patients in the NHS, it will go to a private sector organisation. It is to reward something from which the NHS will benefit.

I hope that I have dealt with most of the points that were raised by both the hon. Members and that the amendment will be withdrawn.

Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

I am grateful to the Minister for addressing the matter carefully. As he recognises, we are concerned about this area. There will be significant benefits from getting this right. It has been helpful that he has clarified that the intent that lies behind this, which flows from the Darzi report, is that it is intended to reward breakthrough and reputable innovations or innovations upon developments. It is a post facto reward, so the question will be whether that is a sufficient pull-through incentive and motivator to influence people to shoot for the prize and to make sure that this inculcates more of a culture of innovative activity.

The Minister’s last answer was helpful because it is the equivalent of reaching a commercialisable stage in the private sector but absolutely focused on the public sector ethos of the NHS. With that clarity, I can see that the amendments may not wholly fit with that intent. The debate has been helpful, however, and I dare say the Committee of the great and the good, as the Minister described it, may find our exchanges useful in setting their own terms of reference and the expectations that are going to be laid upon them. I beg to ask leave to withdraw the amendment.

Robert Key (Salisbury, Conservative)

It may be helpful to the Committee in the interests of progress if we do not to have a separate debate on clause stand-part because the amendments seem to cover fully the substance of the important clause 14. Although the clause is important, it is very short.

Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

I beg to move amendment 19, in clause 14, page 11, line 3, at end insert—

‘(4) The committee shall advise on—

(a) the selection of candidates for innovation prizes;

(b) the payment awarded to each prize winner.’.

Robert Key (Salisbury, Conservative)

With this it will be convenient to take amendment 20 in clause 14, page 11, line 3, at end insert—

‘(4) The Secretary of State and his appointed committee may not determine the field, discipline or sector in which candidates for innovation prizes must develop their innovations.’.

Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

Thank you, Mr. Key. These amendments cover the rest of the subject, so the absence of a stand part debate is not an issue.

Amendments 19 and 20 lead on from the issues that we have just discussed in the last group. There is a concern that, by allowing the Committee to identify challenges—a word that the Minister picked up in his last response—for innovators to tackle, the Government will be undermining the entire concept of innovation.  Amendments 19 and 20 aim to define more precisely the role of the Committee and to ensure that they do not determine the field, discipline or sector from which the innovation must come.

One example is the case raised by Lord Darzi himself as an example of NHS innovation—the introduction of drug eluting stents in angioplasty. This innovation came about directly as a result of the experiences of interventional cardiologists who were involved in angioplasty procedures on a daily basis and familiar with the use of stents and catheters in heart surgery. These clinicians identified a need for the innovation after witnessing first hand the cases of patients who would have benefited from a drug eluting stent in their artery. It was the clinicians as opposed to the authorities who identified the need for an innovation or the challenge that needed solving. If innovation is about finding solutions to the problems we encounter in our everyday experience, why should we have these problems defined for us by the powers that be? Surely the prerogative to innovate and decide where to innovate should lie with the NHS professionals and staff themselves, not with a small committee that will inevitably have a more limited capacity to understand the scope for innovation in every specialism in the NHS.

I hope the Minister will take this opportunity to assure the Committee that the committee that is set up will be wide-ranging enough in its areas of expertise to identify sectors where innovation is required. On the subject of the committee’s composition, in its brief to me the BMA raised the interesting proposition of placing patients and members of the public on the panel. Not only would this create public interest in NHS innovation, it would also give an incentive to applicants to ensure that their innovations directly impact upon patient care. When I asked the Minister prior to the Bill for an evidence base for the use of innovation prizes, he gave the example of the X Prize—a $10 million award for innovation across the globe. The X Prize website states:

“Rather than awarding money to honor past achievements or directly funding research, an X Prize incites innovation by tapping into our competitive and entrepreneurial spirits.”

If the Minister is using this prize as his model for NHS innovation, I have to ask why he is proposing to award prizes retrospectively for research and other innovations. I hope that he has some evidence base for awarding prizes retrospectively, a point which was confirmed in the previous group of amendments.

I also question the need for legislation when the impact assessment states that the Secretary of State’s existing powers already allow him to backfill the costs of research. It also states that the first round of prizes will be launched in 2009, while the legislation itself will not come into play until 2010. I assume, therefore, that the Bill is not actually the source of the power that the Secretary of State needs in order to get this going.

Sandra Gidley (Romsey, Liberal Democrat)

I note your desire not to have a clause stand part debate, Mr Key, so I shall try to incorporate my extra comments into the points I am about to make. Amendment 19 mentions what the Committee shall advise on. We have some very vague criteria. It would be helpful if those criteria were pinned down a little more. One thing that concerned me was the setting up of yet another committee.

Mike O'Brien (Minister of State (Health Services), Department of Health; North Warwickshire, Labour)

I am sorry, I didn’t catch the point that the hon. Lady was making. Someone coughed and I did not hear it.

Sandra Gidley (Romsey, Liberal Democrat)

We are setting up yet another committee, but presumably an existing committee could advise on these prizes. Clause 14(3) says:

“The Secretary of State may establish a committee...and may pay remuneration”.

This also worried me slightly. It is fair enough to remunerate someone from an outside body, but I suspect that most people on this committee already work for the NHS in some capacity. I seek some reassurance that they will not receive extra payments for their work on this committee when, presumably, their time on the committee will be at the expense of their other work.

It would also be helpful if the Minister could clarify whether these payments are going to go to individuals, heading teams or other teams, or whether they will go to the trust that will be implementing the work. I am not entirely clear who will benefit from these prizes. I am comfortable with the concept of prizes, because it is always nice for the work of staff to be recognised, it gives people an impetus and a feel-good factor and NHS workers need some of that, but I am not entirely clear who will benefit from these payments.

Amendment 20 seems to want to ensure that the Secretary of State or the committee do not

“determine the field, discipline or sector in which candidates for innovation prizes must develop their innovations”.

I understand the thought behind this, but bearing in mind my earlier comments, there is another way to look at this problem. I raised concerns earlier that primary care may not receive its share of the prizes. Concerns were raised on Second Reading , including by the hon. Member for Eddisbury, that the right sort of research may not necessarily feature highly. Is there a case for ensuring that at least some of the money is allocated to each of these sectors? One would not wish to be too prescriptive, but this would help the committee to concentrate its thinking on ensuring a breadth of awards across primary and secondary care and embracing what is regarded as the more pure research arena. It would be helpful to know whether there is any thinking on that.

My final comment is, again, about money. Things will get very tight, so will this be a new pot of money, or will resources be diverted from an existing awards scheme?

Mike O'Brien (Minister of State (Health Services), Department of Health; North Warwickshire, Labour)

I am grateful to hon. Members for the way in which they have dealt with the issue. Let me deal with some of the questions that have been raised.

The idea is that the prize should be paid retrospectively. However, it could be paid after a successful outcome in a challenge that was set upfront. The committee of experts could receive applications from individuals or organisations that wished to pursue a particular idea. Those individuals or organisations would then, in effect, be approved for that challenge, but they would get the funding only if their work successfully delivered.

Research conducted as part of the NHS next stage review demonstrated that challenge prizes in other sectors have led to investments of up to 10 to 16 times the cash value of a prize in relevant research to meet the objectives. In a sense, therefore, there is a kudos to the prize—there is a recognition that organisations, groups, teams and  individuals strive for. The prize gets excellence out of those who might otherwise feel that they would not be recognised if they work really hard. We want the team of experts to stimulate innovation and excellence and to ensure that we have the best delivery.

We want a broadly based expert panel that includes leading medical scientists, hospital staff, managers, academics and others and which will look broadly at the way in which the NHS operates. As the hon. Member for Romsey said, a number of committees already exist. Indeed, there are several important awards recognising innovation and outstanding performance by health care practitioners and organisations, such as the health and social care awards awarded by the NHS Institute for Innovation and Improvement. However, we want to go beyond the performance achievement recognised by current prizes and to award cash prizes that are linked to predefined challenges and which will have a significant impact on the population’s future health.

Professor Sir John Bell, the president of the Academy of Medical Sciences, has been appointed as the expert panel’s interim chairman, and there will be a call via the NHS Appointments Commission, for expressions of interest in membership of the panel. That is the way in which we intend to go about this.

Whether payments will be made to individuals or teams depends on the nature of the challenge that has been set. A challenge may be set for an individual or a team. The challenge may for a PCT to develop a new way of delivering health care. There will therefore be a degree of flexibility in terms of the response to the challenge. The committee of experts will be given the flexibility to determine that.

Will particular sectors be identified? Yes, groups or individuals will be able to write in to say, “We wish our research to be considered for a challenge prize.” The committee of experts will then examine the application together with others and take a view, on the basis of the resources available to it, as to which could really benefit the NHS and be replicated throughout it.

The hon. Member for Romsey hinted that there are all sorts of innovations and new ideas, but it will not be possible easily to replicate some of them. They might be good for the private sector, but not the public sector, and they might have just a limited, narrow objective that will not have large-scale applicability. The committee will therefore need to examine whether something will benefit the NHS as a whole—that is the objective. It will have the criteria, and it may say, “This is such an important area that we need to award a challenge prize, even though only a very small number of patients will benefit from a breakthrough in this narrow area. However, the aim is that the NHS would be able to benefit more broadly from an innovation.

The panel of experts has a fair degree of flexibility in its response. We hope that it will be able to frame a challenge and incentivise a solution in such a way that efforts and funds are multiplied by teams striving to compete and win a prize. The innovation challenge prizes’ purpose is to focus minds by putting significant challenges into the system. They are a first for the NHS and we continue to work with a range of stakeholders to make sure we get this right. Once the panel has been appointed, these conversations would really have a starting point. Challenges could be laid down to innovators from across the country to tackle issues such as childhood  obesity, Alzheimer’s, dementia, addiction, or chronic obstructive pulmonary disease. The prizes would reward only those ideas that could be replicated and diffused quickly across the NHS, accelerating the time it takes for ideas to move from, in effect, the bench to the bedside. We want to move excellence forward as quickly as possible. I hope with those reassurances the amendment will be withdrawn.

Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)

I think that the Minister has done extraordinarily well to get as far as this point in our proceedings before coming out with the first big soundbite: “from the bench to the bedside.”

We have had a helpful debate. Lying behind this innovation and prize process is clearly a model of being focused against an identified challenge. This is an inelegant analogy but, within the NHS, we have an equivalent to the Manhattan Project. On the prize, I can see that the Minister hopes that the leverage through the kudos will excite people to apply the research capacity to come up with a successful solution. It will be important that we retain the idea of this committee or panel of experts—although in recent days, the news coming out of Iran about the Council of Experts has been very unhelpful, not least as it involves the only thing that can put any constraints on the Supreme Leader. That said, the nub of this will be how the panel calls for ideas for challenges, from which it will, after a sifting process, come up with what will be put out there.

For what it is worth, arising from my work on malaria, I draw the Minister’s attention to the fact that there is already a model that might be effective for the new committee: the Medicines for Malaria Venture, which is based in Geneva and partly funded by Bill and Melinda Gates. It works well by taking ideas from various sources that might be able to come up with innovative solutions to combat malaria. It has done a tremendous job and, through the sift, has identified where the effort needs to be made. That model is probably worth looking at.

Following a discussion that is useful to have on record, especially as the committee sets about its work, I am happy to beg to ask leave to withdraw the amendment.