18 March 2015
The Science and Technology Committee of the House of Commons has questioned current arrangements for scientific advice to the Department of Health.
The Committee’s remit is to scrutinise the work of the Government Office for Science (GO-Science) and how that office informs the rest of Government. It has now released a new Legacy Report looking back over the last five years of Parliament since it was founded in 2010, ahead of today’s Budget.
The role of scientific advice in the Department of Health
In the Legacy Report itself, the Committee expresses particular concern over arrangements for scientific advice at the Department of Health where Ministers were reportedly unclear about how science should inform health policy decisions.
They note that the current Chief Medical Officer (CMO), Professor Dame Sally Davies, is doing an excellent job in bringing health-related science issues to public attention; however, they feel that her combining both the CMO and Chief Scientific Adviser (CSA) post is potentially problematic, as it could ‘blur the line between an advocate of policy and an independent adviser with a remit to challenge policy’. They call for actions to ensure that the current combination of CMO and CSA roles in one person ‘does not limit the potential challenge of policy through rigorous scientific advice’.
The Committee’s report also criticises the absence of a science advisory council or committee at the Department of Health; although the explanation for this is that there are so many different science advisory bodies to the Department of Health, they suggest that putting in place a science advisory council to coordinate these providers would be of value.
Having said this, the report emphasises that both the Department of Health and Department for Business, Innovation & Skills show a good use of scientific research and analysis in policymaking generally, in contrast to some other Governmental departments.
They also note that future Science and Technology Committee members may wish to look at how the President of the European Commission receives independent scientific advice with respect to EU legislation; the current President, to Jean-Claude Juncker, recently abolished the post of Chief Scientific Adviser to the EU.
Delivering scientific innovations to the National Health Service
Referring to their earlier criticisms on the poor application of scientific innovations by the NHS with respect to Creutzfeldt-Jakob Disease, the report notes that Life Sciences Minister George Freeman said that a new directorate of innovation, technology and growth has been created within the Department of Health with the specific mission to embrace the use of science and innovation in the delivery of 21st century health care. The recently announced Innovative Medicines and Medical Technology Review is apparently a result of this new prioritisation, focusing as it will on accelerating the uptake of innovations within the NHS.
The report is clear that ‘the role of the NHS in developing and utilising innovative technology is hugely important’, and calls for updates to the future Committee on the progress of the new directorate, the Innovative Medicines and MedTech Review and the Department of Health’s involvement in the Small Business Research Initiative within six months.
Supporting and surveying basic science
The report warns that ongoing investment in science is vital. Whilst lauding the current Government for recognising the value of science to underpin economic growth and generate valuable evidence for other forms of policy-making, but expresses concern over the absence of funding announcements in the science and innovation strategy released in December 2014, noting that basic science is often a target for governments making austerity-driven economies. The Department of Health is recommended to review how it currently allocates research funding, to ensure that it is aligned with ‘the most valuable science’ in the future.
In the report, the Committee also sharply criticises the Government’s Horizon Scanning Programme team for being much too slow and lacking in transparency and external representation. It also questions its separation from the Governmental Foresight Unit and recommends that they should be combined to one central source of what is termed futures analysis, supported by relocation of the GO-Science to the Cabinet Office.
Moving beyond research into practical implementation
The challenge for the Department of Health will be in ensuring that recommendations on uptake of innovation in the NHS are not too focused on supporting research in general, or on treatments in particular; too often in the past attempts to address the slow uptake of scientific innovations have concentrated on delivering new funding for research, whilst there remains a critical lack of resources to work with academic and commercial researchers, NHS scientists, health professionals, policy-makers and funders in identifying barriers to uptake and removing them. This is the sort of task that the PHG Foundation has so often funded and fulfilled in the past, generally working with desperately busy experts in different spheres who receive no funding or incentives for their vital contri butions.
George Freeman is quoted as having said that the aim of the Innovative Medicines and MedTech Review is to create a new landscape to create a ‘new model of research’ rooted in the NHS with coordinated support from the regulators, patient groups, charities and industry. Strong integration of ongoing medical research with the NHS itself is a desirable aim, and good news for clinician-researchers and their associated patient groups. However, there is a danger that it will continue to come at the expense of the modest resources needed to deliver robust, revised funding and regulatory arrangements, care pathways and clinical guidelines, and to deliver new tools for improved care into the hands of everyday health professionals, to benefit the widest number of patients in a fair and equitable fashion.