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My Lords, I thank the Minister for introducing this debate and reminding your Lordships of the elements of the Queen’s Speech relating to healthcare provision and the science sector in our country. I remind noble Lords of my interests as professor of surgery at University College London and chairman of UCLPartners. It is a pleasure to follow the noble Baroness, Lady Walmsley.
I would like to pick up on some points made by my noble friend Lord Patel. I reiterate the tremendous regard and respect that all Members of this House, and I in particular, have for my noble friend Lady Emerton. She has made a remarkable contribution to your Lordships’ House and is one of its kindest and most thoughtful Members. It has been a great pleasure and privilege to come to know her since I was fortunate enough to join the House.
The Queen’s Speech rightly identified Her Majesty’s Government’s commitment to healthcare and the NHS. Clearly, safety is vital and the Government should be congratulated on introducing legislation to establish the health service safety investigations body. However, there are a number of potential concerns. A number of other organisations in the broad structure for the delivery of healthcare and other regulators already have a safety responsibility—NHS trusts, professional regulators, the Care Quality Commission, NHS Improvement and so on. All these bodies have statutory responsibilities. How will Her Majesty’s Government ensure that there is not regulatory overreach, which can have a detrimental effect on openness and transparency and impede the objective of ensuring that safety is at the heart of healthcare delivery? It is a very important question. Further regulation without consideration of what is already available could be very harmful.
There is also a clear commitment to ensuring that the additional funding already identified for the provision of healthcare in the NHS is appropriately applied. In this regard, are Her Majesty’s Government satisfied that the current landscape and the disposition of NHS England and NHS Improvement are appropriate, or do they present something of an impediment to the establishment of proper integrated care? This must ensure that the community base, rather than hospitals, is the focus for the management of chronic diseases, and that we have a system that facilitates the appropriate management of patients with established disease and ensures that prevention is at the heart of our ongoing healthcare strategy.
The adoption of innovation is also absolutely critical. The landscape, populated by many bodies, is particularly defined by the academic health science centres and health science networks. Are Her Majesty’s Government content that that structure is appropriate to facilitating the adoption of innovation at pace and scale, or is it necessary to look at those particular designations, and indeed other elements of the system, to ensure that they are better co-ordinated to deliver the adoption of innovation? Innovation will be critical to the sustainability of our NHS; we need innovation not only in novel therapies, medical devices and technologies but in how we develop the workforce to respond to the challenges of the next two decades.
We are also particularly privileged in our country to have a unique ecosystem defined by the National Health Service, our universities—we have four of the top 10 in the world for biosciences and life sciences—a remarkable pharma industry sector and, of course, a biotech and medtech sector. Those sectors commercially provide some £63.5 billion of turnover to the UK economy, employ more than 200,000 people and represent some 5,000 companies. That is of huge importance, not only for ensuring that innovation is established quickly, discovered and brought to bear to manage the diseases of our fellow citizens, but for its economic contribution. This has been well recognised by recent Governments, who have shown important commitments to this area.
However, in a report published in September, the Institute for Public Policy Research identified that whereas in 2011 our country enjoyed 10.5% of global spending on life sciences R&D, that figure fell to just 7% in 2016, despite an important commitment by the Government. The circumstances around Brexit have caused further uncertainty in the life sciences sector. It is a matter of deep regret that there might be further delay in delivering Brexit.
The implications of this are substantial for this important part of our economy, but they are also vital because if we fail to sustain the pace of innovation in life sciences, we will not deliver an NHS that can provide the most important benefits for our fellow citizens. That NHS will not be able to contribute to the growth of the economy and to increased wealth creation in our country because patients and individuals will be less healthy and less economically productive, and the broader benefits of this important sector will be lost to our country.