The UK government has published the first outcome of the Industrial Strategy “sector deals” announced in the spring’s Industrial Strategy Green Paper. The Life Sciences Industrial Strategy was headed by Sir John Bell; the area is of undoubted importance for the UK, and the document has some very sensible recommendations. But there’s a bigger problem here – the life sciences aren’t an industry, they’re a science area. You wouldn’t describe your policies for the aerospace industry as a Materials Science Industrial Strategy or a Fluid Dynamics Industrial Strategy – industry policy should be driven by and framed in terms of the demand for innovation, not by the science areas which contribute to it.
In its detailed policies, there is much to agree with in the Life Sciences Industrial Strategy. There’s no question that the UK has a strong base in the life sciences, that this is a source of comparative advantage, and that this capacity should be preserved and strengthened. New industrial clusters in medical technology should be developed (especially outside the existing concentration of biomedical life sciences between London, Oxford and Cambridge), and the data the health system generates is an enormously powerful resource that should be exploited more (but with great care and sensitivity). And who could disagree with the proposition that the Home Office should be suppressed (they’re too diplomatic to put it quite like that, of course). There are some less good ideas too, with demands for more distorting tax breaks. The proposal to widen the scope of the “patent box” to include other types of intellectual property is a particularly bad idea, which would take what’s already a very poor piece of public policy and make it worse.
The headline recommendation is politically opportunistic, potentially positive, but not completely thought through in its current form. This is for a “Health Advanced Research Program”, in analogy to the US defense research agency DARPA. It’s politically astute in that it appeals to the current bout of DARPA envy amongst British policy makers (and it’s got a good acronym). As I’ve discussed before, I’m not convinced that this enthusiasm is underpinned by enough understanding of the way DARPA actually operates and the way it sits as one relatively small part in the wider USA innovation system.
One key issue is the question of how to define the problems, and being clear about who owns those problems. Part of DARPA’s success comes from the close connection to the people who own the problems the agency is trying to solve, who in DARPA’s case, are in the USA’s military. This clarity is not yet present in the “HARP” proposal. For healthcare, the key owners of the problems are the NHS, and the local authorities responsible for social care. Industry is important, both as potential providers of solutions, and as beneficiaries of the new business opportunities that the innovations should give rise to, but they don’t own the problems.
The strategy does indeed suggest that the key USP of HARP should be the involvement of the NHS, who, it is envisaged, will provide patient data and opportunities for piloting the resulting technology. The difficulty this leaves unsolved is one that the strategy itself correctly identifies – “Evidence demonstrates that access to and diffusion of products in the NHS is often slower than in some comparable countries. This environment risks creating a negative impression in boardrooms around the world with trials being diverted to geographies deemed more likely to use products. Partnership with industry through this strategy and a subsequent sector deal will be challenging unless there are clear signals that innovation will be encouraged and rewarded, and the challenge of adoption of new innovation at pace and scale is resolved.” The NHS is, as currently configured, structurally inimical to innovation.
How could you frame an industrial strategy in this general area? You could define it in terms of conventional industry sectors. For healthcare, this would include those sectors which develop and supply products – including pharmaceuticals and biotechnology, and the broader area of medical technology, including tools and devices, diagnostics and digital healthcare. Equally, it should include those sectors that actually deliver health and social care, which after all form a large part of the economy, albeit one that remains in large part outside the market. These include social care – a very large sector, which has low productivity and is problematic in some other ways, as well as hospitals and primary care. The interests of these sectors don’t always point in the same direction, as one can see from the constant tussles between NICE and the NHS and pharmaceuticals companies about drug pricing and availability.
Although in reality the Life Sciences strategy does largely read as a sector strategy for the pharmaceuticals and biotechnology sector, calling it a Life Sciences strategy does frame it in terms of the underpinning science. And in this sense Life Sciences is not a great term, being at once too inclusive and not inclusive enough.
What the strategy means by “Life Sciences” is essentially the high status science of biomedical research. But life sciences – biology – doesn’t just include those bits of biology that are relevant to human disease. That would cover the cell biology and physiology of the human organism itself, together with the biology of those organisms that are studied as more experimentally tractable models for humans – whether that’s mice or zebra-fish. And it includes the biology of human parasites and pathogens. What is left out in this narrow definition of “Life Sciences” are those aspects of biology that have other applications – in agriculture, for plant science and animal health, in industrial biotechnology, in environmental science and ecology. And of course we should not be afraid to stress that we should study biology because it is fascinating in its own right and yields insights into some of the biggest outstanding scientific issues that there are – how life started, whether other types of life are possible.
But the focus in “Life Sciences” on high status biomedical research is also too exclusive. Other areas of science and technology are important for healthcare, and are underemphasised in academia. These include engineering and nano-science, data science and IT, and, perhaps above all, the social science of public health and health economics.
The issue, then, is that by calling itself a “Life Sciences” strategy, it gives primacy neither to the relevant industry sectors, nor to the fundamental problem of caring for sick people. I think the ultimate goal here is the big problem of providing affordable health and social care with dignity for the whole UK population, in the context of the changing age profile of the country. The key organisations here are the NHS and the deliverers of social care, and the priority needs to be on enabling those organisations to become more innovative. This will certainly generate opportunities for key industrial sectors like pharmaceuticals and medical technology; improving the connections between the research base, industry, and the clinic remains just as important. But framing the problem right will change some of our priorities.