Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, June 7, 2022

Official Report 947KB pdf

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Medical Charities’ Research (Economic Value)

The final item of business is a members’ business debate on motion S6M-04013, in the name of Sue Webber, on the economic value of medical charity research in Scotland. The debate will be concluded without any question being put.

Motion debated,

That the Parliament notes the publication of two reports by the Fraser of Allander Institute and British Heart Foundation Scotland about the role of medical research charities in Scotland’s medical research environment; welcomes the findings regarding the economic impact of medical research charity funding in Scotland, which, it understands, supported 7,475 jobs, £470 million in output and £320 million in Gross Value Added (GVA) in 2019; understands that funding from medical research charities is amongst the most effective of all sectors, reportedly supporting £1.33 million in GVA and 31 jobs for every £1 million invested; notes what it sees as the significant impact COVID-19 had on the ability of medical research charities to fund research, putting, it understands from the research, 575 jobs, £36 million in output and £25 million in GVA at risk in 2020 alone; understands that the British Heart Foundation currently invests almost £33 million on research in the Lothian region, and notes the call from British Heart Foundation Scotland for continued support for clinical research infrastructure and research careers to ensure the long-term health of the medical research environment and to amplify what it sees as the benefit of investment into medical research to the economy.

17:27  

I am pleased to have brought to the chamber my first members’ business debate, which is on such an important topic for Scotland. Cardiovascular health has always interested me, and it becomes more relevant when it relates to us personally.

In my pre-parliamentary career, I worked closely with medical and surgical professionals in university teaching hospitals across the United Kingdom. One of the first surgeries that I observed was open-heart surgery in the Western infirmary in Glasgow. The surgeon was Mr Alan Kirk—he was young and dynamic and was looking to adapt his practice to do beating-heart surgery rather than on-pump bypasses, with their associated risks.

Much has changed surgically since then—not least the closure of the Western infirmary and the establishment of the West of Scotland regional heart and lung centre at the Golden Jubilee hospital. Perhaps the canny among members in the chamber might recognise the surgeon’s name, as Mr Kirk was in Parliament last week. He is now, with his colleague John Butler, a pioneer of robotic thoracic surgery. We need clinicians such as them to adopt new and innovative techniques that benefit patients and improve outcomes.

My dad is one of those who benefited from innovation. When he was told that he needed cardiac surgery, I know that the look on my face told my mum and dad how serious things were. I silently wanted to know that he would get an off-pump bypass; I did not want his heart to stop beating. He did get an off-pump coronary artery bypass graft, which was successful. Nearly 10 years on, he has not looked back, so I thank the team at NHS Lothian.

Before all such work comes years of research and investment and the blood, sweat and tears of those who carry out the research. Funding for clinical research in Scotland through the chief scientist office has remained stagnant for several years. When investment in clinical research is compared between the UK and Scotland, investment in Scotland equates to £12.79 per capita, as opposed to the £20.55 per capita spend in England.

The British Heart Foundation believes that the Scottish Government should increase funding to the chief scientist office in line with the per capita funding of the National Institute for Health and Care Research by the UK Government. If the Scottish Government were to utilise Barnett consequentials and its own budget to match per capita the planned NIHR funding increase to £2 billion, it could transform clinical research in Scotland by securing Scotland again as a world leader in medical research and bringing new and improved treatments and care to Scotland first.

Research could generate as much as £257 million for the economy every year and support 6,000 jobs across Scotland. There are also indirect and direct benefits for the national health service. For example, troponin tests are used on an individual’s admission to accident and emergency to test whether they have had a heart attack. The high-sensitivity troponin in the evaluation of patients with acute coronary syndrome trial—led by Professor Nicholas Mills, who is a British Heart Foundation professor of cardiology at the centre for cardiovascular science at the University of Edinburgh—looked at the use of a higher-sensitivity troponin test than was previously used. The reduction in time in hospital and the 50 per cent increase in discharges as a result of the new sensitive test could create huge cost savings for the NHS and reduce bed demand at a time when the NHS is under significant pressure.

Undertaking such clinical studies in Scotland is crucial to improving patient care and reducing inequalities in care. Investment in such research has the potential to support the Scottish budget through reducing overall costs in the NHS.

Other charities are raising similar concerns, as well as pointing out the benefits of increased investment. Stroke is Scotland’s leading cause of disability. About 10,000 people every year have a stroke, and 128,000 people in Scotland are living with the effects of a stroke. The Stroke Association is the only funder in Scotland of exclusively stroke research, with a current portfolio of £3.5 million. Investing in stroke research can generate savings for health and social care, as well as improving quality of life for stroke survivors and their families. In the UK, research investment per stroke patient is only £48 per year, in comparison with £241 per cancer patient and £118 per dementia patient. Given that stroke generates such a sizeable economic burden in Scotland, it requires greater priority in research funding and support.

Cancer Research UK is the largest independent funder of cancer research in the world. In 2020-21, it spent £421 million on new and on-going research in the UK into prevention, diagnosis and treatment. It has supported research into more than 200 types of cancer, with long-term investment to help to create a thriving network of research in 90 laboratories and institutions across the UK and to support the work of more than 4,000 scientists, doctors and nurses. Cancer Research UK has spent more than £188 million on research funding in Scotland over the past five years across seven universities, and it currently funds 100 PhD students, among other things.

It is not just direct health benefits that come from medical research; there are also benefits to the Scottish economy and to every individual who is impacted by the research. Not every project will result in a miracle cure, a wonder drug or a new approach, but I think that we can all agree that research saves lives.

I call Paul McLennan, who has up to four minutes.

17:33  

Thank you, Presiding Officer. I mention that I have to chair a cross-party group meeting at half past 6, so I may have to leave before the minister sums up.

I thank Sue Webber for bringing forward the debate. She and I, along with others, visited the British Heart Foundation research centre near Edinburgh royal infirmary a few months ago. We were shown around the facility and shown the research that goes on, which she touched on. In the institution, we spoke to medical students and doctors who benefit from the funding. It was absolutely fascinating and made us all aware of the amazing unseen work that is carried out by the British Heart Foundation and other charities day in, day out.

In East Lothian, about 11,000 people are living with heart and circulatory diseases, about 12,000 people have been diagnosed with high blood pressure, about 27 per cent of adults have obesity and 16 per cent of adults smoke. In Scotland, 30 babies a month are diagnosed with a congenital heart defect and about 700,000 people are living with heart and circulatory diseases. The most frightening statistic is that, every 50 minutes in Scotland, someone is admitted to hospital because of a heart attack, so we can see the benefits of the research. Heart and circulatory diseases kill three in 10 people in Scotland.

When I recently visited the British Heart Foundation shop in North Berwick, I was warmly welcomed and was impressed by the set-up. The BHF is the largest charity retailer in Scotland and the UK. It is an important contributor to the circular economy and to a sustainable Scotland. It has the support of 1,400 volunteers, who allow its 75 shops across Scotland to raise money for life-saving research.

The BHF supports the Scottish Government’s proposal to ban the destruction of unsold goods. It believes in reducing waste as much as possible by recycling the donations that it cannot sell, and it is working towards a goal of zero avoidable waste by 2030. It sells an average of 1,500 tonnes of what it calls pre-loved clothes across its 75 charity shops and it resells 18,000 sofas every year. It funds £60 million of life-saving research in Scotland, and that is largely from the sale of donated goods.

That research funding creates additional benefits for the economy in Scotland. Research by the Fraser of Allander Institute at the University of Strathclyde on the value of medical charity research funding in Scotland has suggested that funding from the British Heart Foundation creates £80 million in gross value added and supports 1,860 jobs across the country. In February, the institute published analysis on the contribution of medical research funding by charities to the Scottish economy. Its modelling found that research funding by charities in 2019 supported 7,500 jobs, £470 million in output and £320 million in gross value added in Scotland. Charity retailers also provide more than 25,500 jobs in the UK, alongside 233,000 volunteering opportunities.

The British Heart Foundation has welcomed the increase in NIHR funding from the Scottish Government to £78.4 million. In the 2021 autumn statement, the UK Government committed to increasing the NIHR budget to £2 billion by 2024-25. The BHF is asking the Scottish Government to commit to ring fencing any consequential funding to Scotland from the UK Government’s NIHR funding uplift to £2 billion by 2024-25.

Government funding of medical research follows similar patterns to that of medical research charities; much of the funding supports work in universities and the NHS, which we have talked about. Such funding supports the creation of highly skilled professionals who are significant economic contributors in their region. If the Scottish Government were to make the commitment on the NIHR funding uplift, that could generate £56.4 million for the Scottish economy every year and support more than 1,100 jobs.

With continuing investment, Scotland can attract more talented researchers and create greater stability for those who seek to build a clinical research career in Scotland. The pandemic reduced funding from charities and other funders that have traditionally supported clinical research careers. Career funding is crucial in allowing healthcare professionals to develop the skills to undertake research in the NHS. We can attract such highly skilled professionals to Scotland, who can bring their research skills and increase NHS Scotland’s clinical capacity.

17:38  

As volunteers week 2022 comes to an end, I would like to thank my colleague Sue Webber for securing the time for this afternoon’s debate. The value of medical charity research is an important topic, and the debate is a fitting tribute to the fundraising efforts of thousands of volunteers in the north-east and across Scotland who help to raise money for potentially life-saving medical research.

The funding contribution that charities make to medical research is startling. The Fraser of Allander Institute estimates that, without it, the Government would need to increase direct funding by 73 per cent to cover the shortfall. The work of such organisations and others like them has brought hope to thousands of people who face life-limiting conditions and illnesses.

Cancer Research UK supports pioneering research into more than 200 types of cancer. Its contribution to the medical research base should not be underestimated. Over the past 40 years, cancer survival has doubled in the UK. Meanwhile, the British Heart Foundation has invested £50 million in more than 100 projects in Scotland to research heart and circulatory disease.

In my region, the BHF funds two PhD studentships and 10 other research staff at the University of Aberdeen. Led by Professor Dana Dawson, researchers in the granite city are carrying out the first national study into broken heart syndrome, a potentially fatal heart condition that is experienced by thousands of people the length and breadth of the UK. At the University of Dundee, where the BHF supports seven research staff, researchers have been running a treatment trial into high blood pressure.

However, the reality is that those organisations, like so many others, have been hit by the Covid-19 pandemic. At the height of the pandemic, medical research expenditure by charities fell by around 44 per cent as retail trading came to a halt and household budgets faced significant uncertainty. While the UK has largely returned to business as usual as Covid-19 restrictions have been lifted, concerns remain about future investments in medical research. There has already been a significant reduction in research spend from the Association of Medical Research Charities for 2021-22, amounting to around £150 million. The BHF reports that it will take three or more years before charity research spend returns to pre-pandemic levels.

That has implications not just for Scotland’s health research and development but for our economy. As well as helping to improve health outcomes for the population, third sector medical research contributes to job creation, technological innovation and national infrastructure, and it helps to develop Scotland’s skills pipeline. Moreover, the Fraser of Allander Institute found that a pound spent on medical research funding by charities has a significantly larger impact than the average pound spent in Scotland.

As the Scottish Government looks at the levers that it can pull to build a strong economy, I urge it to think holistically about the value that third sector medical research can add to the Scottish economy and society.

17:42  

I welcome the debate and thank Sue Webber for bringing it to the chamber. I also thank the British Heart Foundation for commissioning the research from the Fraser of Allander Institute.

The conclusions of that research on the economic impact of medical research in Scotland—in particular, that which is funded by charities—have been partly rehearsed already. Indeed, they been rehearsed over many years in Scotland in a variety of publications. That research stresses how important the medical and broader scientific research that is done in our universities and institutes is to our communities and to our country’s future. No picture that is drawn of a successful future Scotland does not have research excellence right at its centre.

The conclusions of the report that we are discussing tonight only add to the wealth of data and policy documents dating back to the start of devolution that come to the same conclusion. The importance of university research and innovation to my home city of Dundee cannot be overstated. I note that the performance of the University of Dundee school of life sciences is of truly global significance. In the research excellence framework that was published only in the past few weeks, Dundee came out as the top university in the whole of the UK for biological sciences, bar none.

I wish that I could say that the debate was timely. It makes calls on the Government that perhaps would have been better heard prior to the recent resource spending review, which, it turns out, was neither a real spending review, nor—as we have heard continuously—a budget. The result seems to me to be little more than an appetiser for Andrew Wilson’s growth commission austerity.

If the resource spending review is anything, it is an expression of priorities, and I am afraid that education and the research that we are talking about tonight are not among them. That is confusing for some of us, because education used to be the sacred cause. It was once the defining mission and, only a matter of weeks ago, it was central to the supposed economic transformation strategy. Instead, we have real-terms cuts of 8 per cent for higher education and a globally competitive sector that has to work to attract talent, external investment, partnerships and student recruitment, which is suffering badly as a result of a lack of leadership and prioritisation by the Scottish Government.

Specifically in relation to research, we have an outstanding set of REF results in Scotland, in which improved performance against the previous comparator seven years ago has been rewarded by cuts to budgets. The University of Aberdeen in my region has had a £2 million cut in the research excellence grant. That is a 10 per cent cut—the absolute cap on what was permitted—and more cuts are expected to come in 2023-24. That is not investing for the future—it is punishing the successes of the past.

The motion before us makes a request to Government to step in when the unexpected happens. When the pandemic hit, the resource from charity shops and donations dried up, as other members have highlighted. That is what Government should do: it should be there when the rain falls; it should help to bridge an unexpected gap.

What is unforgivable is when Government not only sees the trends but actually creates them. There is no doubt that our research leadership in the UK is slipping—that has been happening for years and years. Just a few weeks ago, the REF results that I mentioned showed that eight of our top 10 performers improved at a slower rate than comparator universities in the rest of the UK.

On the same day that the Scottish Government published its resource spending review, UK Research and Innovation, which is the UK-wide research council, published figures on multiyear research funding for universities in England. Research funding for English universities will go up by 31.7 per cent over the three-year period from 2022-23 to 2024-25. That is the direct local competition that our universities must meet. Scottish and English universities use their core funding to compete for research grants. The playing field is deeply uneven, and we can only predict that Scotland’s share of competitively won research funding from UKRI will continue to slide. A few years ago, it was at 15.4 per cent, now it is at 12.9 per cent and it will go down further in the years to come.

The question that we face is one of leadership and choices—the choices that leaders make. The British Heart Foundation is right to highlight what our strengths are, while reminding us how precarious that position is if Government chooses to ignore the realities that I have outlined.

Thank you, Mr Marra. I now call Stephanie Callaghan, who will be the last speaker before the minister responds to the debate.

17:46  

Thank you, Presiding Officer. I, too, thank Sue Webber for bringing this topical debate to the chamber.

The pandemic has certainly brought the importance of medical research for our health and wellbeing to our attention. In Scotland, the life sciences community mobilised and responded rapidly to the challenges that arose from Covid-19. From research, drug discovery and manufacturing to clinical trials for our vaccines, Scotland is considered a world leader in medical research and we must maintain this proud legacy across the private, public and charity sectors. The health benefits are clear. Medical research continues to develop and make life-changing differences to patients. Importantly, for so many people who are living with long-term conditions, research provides hope for the future that there will be less pain, that they will get better treatments and that they will have a little bit more control over their lives.

The focus of today’s motion is research charities, which are in a unique position to leverage the power of grass-roots movements. Generous public donations and specialist expertise from the industry can be complementary, and drawing on the lived experience of patients and families is key to that.

Paul McLennan talked about how the British Heart Foundation has raised so much in funds through its stores. It brought to mind a wee meeting that I had with a young man called Mohamad, who won an award for his volunteering. He came to this country as a refugee and decided to volunteer at the British Heart Foundation, and he was hoping to become a doctor in the future. That was a couple of years ago now. He had so much warmth and dedication, and volunteering helped him to learn the language. There are lots of little ripples that come out from these charities. They make a real difference to our communities.

The economic value of medical charity research in Scotland is clear, but it is not without its challenges. As the motion highlights, medical charity research in Scotland supports a lot of local jobs and generates wider investment, with direct employment at universities and in medical industries but also that spillover effect that supports a wide variety of jobs right across Scotland, too. Many of those jobs are highly skilled and well-paid positions within world-leading institutions. The medical research sector is one of the most effective in Scotland in driving economic growth and employment and it has attracted talent from all over the globe.

However, research charities face quite serious issues in 2022. The pandemic has put enormous financial pressure on individuals and organisations; that is not going away any time soon given that the current cost of living crisis looks set to worsen. Medical research funding by charities is estimated at around 46 per cent of all third sector and public funding, making this income integral to Scotland’s medical research industry. The long-term consequences of charity funding reductions in Scotland are likely to include shortages of highly skilled medical researchers and stagnation in treatment development. It also has the potential to negatively impact on Scotland’s reputation as a world leader in research.

In response, some charities have called on the Scottish Government to increase investment in third-sector medical research by a further £37 million. However, Scotland does not have the same borrowing powers as Westminster. Making a comparison between the UK Government’s spending per head of population of England with that of Scotland seems to be a wee bit unfair, given that the Scottish Government’s hands are tied, fiscally speaking.

Where would that additional investment come from? The Scottish Government is already doing so much to mitigate some of the damaging policies, including the bedroom tax, that have come out of Westminster, and is looking to increase child support. While we do not have the freedom to borrow and make long-term investments in our people’s health and wellbeing, our economic options remain limited.

We need to listen to charities to understand the challenges that they are facing and make sure that we are doing everything that we can to support their ambitious work, thereby ensuring that Scotland remains a world leader in research and development. Within its budget, the Scottish Government has already demonstrated its commitment to ensuring that researchers have access to the infrastructure, training and career development opportunities that they need to succeed and to work with partners. The work to create an attractive environment for students to carry out their research is on-going. I agree that we must, moving forward, work collaboratively with the medical research charity sector.

In reality, only with the power of independence will Scotland be able to properly address the challenges ahead. We need that to happen in order to enhance our economy and improve our nation’s health.

17:51  

I congratulate Sue Webber on having secured this members’ debate and I thank members who contributed to discussion of this very important topic.

The Scottish Government recognises the important impact that the medical research charity sector has on the wider economy, particularly across the life sciences sector. By investing in growing our own company base and attracting new companies, we are building a community. We want Scotland to grow as a place for true innovation and for the research that is undertaken here to make a real difference to our own and global health challenges.

Scotland has a thriving life sciences community that is recognised for the distinctive capabilities of its business base and research institutions, its international reputation and its potential for significant growth and creation of high-value jobs. In 2019, turnover in the sector stood at £7.4 billion, with gross value added at £3.1 billion, and the sector employs nearly 42,000 people in over 700 enterprises and higher education institutions. The health and life sciences sector in Scotland is supported by a highly skilled workforce operating in a diverse range of functions, including research and development roles in a range of research operations. We continue to invest in our future workforce, recognising the critical role of the development of scientific and commercial skills in sustaining our economic recovery and contributing to future growth.

In terms of boosting innovation, we will be updating the Scottish Government’s innovation strategy this year. That will provide an opportunity to build on the national strategy for economic transformation and other recent work, such as the Muscatelli report, the Enterprise and Skills Strategic Board report on innovation and the UK Government’s innovation strategy.

The Scottish health and industry partnership is working in collaboration with AstraZeneca, Roche and the Digital Health and Care Innovation Centre to develop a heart failure service, drawing on the Opera research study. This aims to create a streamlined digital service that can effectively address diagnosis backlogs and reduce waiting times for echocardiograms in the Glasgow area, while demonstrating the use of new artificial intelligence technology in the heart failure diagnosis pathway. Heart failure accounts for 1 to 2 per cent of healthcare spending in developed countries and 52 per cent of patients die within five years of diagnosis. Heart failure prevalence is predicted to rise by 46 per cent over the next eight years.

Scotland’s world-class university research and its key outputs of new knowledge and insights are fundamental to economic recovery and growth. The baseline grant for university research and innovation from the Scottish Government via the Scottish Funding Council was increased by £4.7 million to almost £200 million in 2022-23 in order to maintain and strengthen Scotland’s excellent research base. The impact of research outputs from Scotland’s universities is being maximised through increasing linkages to the wider innovation ecosystem, including partnerships with businesses, charities and NHS Scotland.

Does the minister not recognise that the allocation from the Scottish Funding Council is resulting in cash cuts to the amount of funding for universities, many of which have improved their performance over the last seven years? Successes are being rewarded with cuts from the Scottish Government. Is the 31.7 per cent increase in UK research that is done in England not a wake-up call to the Scottish Government about what it must do to make our sector competitive?

The sector in Scotland is hugely competitive. We attract far more than our share of research spending across our universities. Even our charity spending is significantly higher than spending across the rest of the UK. The Scottish Government continues to recognise that and to support the research base and the sector.

As well as addressing national challenges and creating a highly educated society, our investment in research is helping us to reach the economic, societal and environmental aims of Scotland’s national performance framework and the sustainable development goals. Over the past two years, health research has been in the news like never before, so I want to take this opportunity to pay tribute to all those who have contributed to Scotland’s research response to Covid-19, including colleagues from the third sector, universities and the NHS.

I would also like to thank the people of Scotland for their extraordinary level of involvement. In 2021, over 20,000 people were recruited into Covid-19 clinical studies in Scotland. The studies include the SARS-CoV-2 immunity and reinfection evaluation study—SIREN—that provided key early data on whether prior infection with Covid-19 protected against future infection, and the genetics of susceptibility and mortality in critical care study that is generating data on the genes that influence people’s susceptibility to particular infections. Scotland has also been fully involved in clinical trials of Covid-19 vaccines—globally, the first patient in the Janssen vaccine trial was recruited in Dundee.

As part of the research response to the pandemic, we also launched two Covid-19 research funding calls through the chief scientist office. The rapid research in Covid-19 programme saw 56 individual projects funded, with a total investment of £5 million. As awareness of the longer-term effects of Covid-19 infection began to emerge, a second call was launched for research on key aspects of long Covid and nine projects were funded from that call.

The research funded through those calls has continued to inform the clinically relevant knowledge base around Covid-19. An example is the cardiac imaging in SARS coronavirus disease—CISCO-19—study led by Professor Colin Berry from the University of Glasgow and funded as part of the rapid research in Covid-19 programme. That study follows patients in real time after hospitalisation with Covid-19, and uses a number of medical assessments to understand more about patients’ health, including scans of the heart, kidneys and lungs, blood tests to measure inflammation and blood clotting over the short and medium terms, and a series of questionnaires on quality of life. The first round of results from the study were published recently in the prestigious journal, Nature Medicine.

The CSO recently announced the outcome of its precision medicine alliance Scotland funding call. This sees almost £10 million invested in four NHS-led research projects that will accelerate the development and delivery of precision medicine-based approaches to tackling health conditions of major importance in Scotland, including diseases that disproportionately impact people who are at risk of socioeconomic disadvantage. That investment adds to the strong precision medicine ecosystem in Scotland that includes the Precision Medicine Scotland Innovation Centre and the Glasgow precision medicine living laboratory.

To finish, I would like to congratulate both the British Heart Foundation Scotland and the Fraser of Allander Institute on the publication of their respective reports. The Scottish Government looks forward to continuing to work with third sector organisations, including the British Heart Foundation Scotland, to build on our strong research and innovation base for the benefit of the people of Scotland.

Thank you, minister. That concludes the debate and I close this meeting of Parliament.

Meeting closed at 17:58.