An open letter to Matt Hancock

Janssen's investigational CAR-T therapy granted PRIME designation by European Medicines Agency

Claudia Rubin pens an open letter to Matt Hancock MP urging him to celebrate science and support its central and complex role in shaping health policy.

 

Dear Secretary of State,

What a shambles.

Brexit-day, 29 March, has been and gone and though Britain may not have literally fallen off a cliff or the economy crashed entirely, Brexit has changed irrevocably the landscape of UK politics in many ways. Great leadership must now be shown to reset relationships, re-state our priorities and define where we are to go from here.

Certainly, we have let problems grow by being distracted from any domestic agenda by Brexit. You know all too well the troubles that the NHS finds itself in after a decade of austerity compounded by Brexit. Official NHS statistics show waits at A&E departments in England have hit their worst levels since records began. Public satisfaction with the NHS has fallen to its lowest level since 2007, according to analysis of the 2018 British Social Attitudes survey, published recently by The King’s Fund and the Nuffield Trust.

But one of the more pernicious effects of Brexit is perhaps the subversion of science, the rejection of evidence, and the de-prioritisation of UK industry as a key driver of decision-making. For had the opinions of scientists, economists and the industries – of manufacturing, pharmaceutical and many others – been truly valued, we would never have found ourselves at this precipice.

It was indeed one of the most memorable exchanges of the Brexit campaign when Michael Gove MP, Justice Secretary at the time, claimed that the British people had had enough of experts.

“The repercussions of the ‘abuse’ of science and scientists in recent years will be felt across healthcare”

The CBI cautioned repeatedly, and to no avail, that your government’s handling of Brexit was harming their members’ businesses. The Association of the British Pharmaceutical Industry has been vocal too, warning recently that the UK is in danger of losing its world-leading research and development status owing to Brexit fallout.

Scientists could not have been clearer. A survey of over 1000 staff at the Francis Crick Institute, the UK’s biggest biomedical research laboratory, revealed that 97% of scientists there believed a hard Brexit would be bad for UK science.

Given the hard, anti-science, anti-business Brexit path pursued by the Conservative Government, it is important to reflect on the impression this leaves, of the subversion of rigour, science and expertise, and how it may pervade into society at every level.

You will recall Sir Paul Nurse, in his role as past Chair of the Royal Society, warning in response to Mr Gove that: “The fact that experts have been derided in this way does have an effect in undermining science and scientific evidence”.

Like a pebble hitting the water, the repercussions of the ‘abuse’ of science and scientists in recent years will be felt across healthcare.

Take one of your key priorities for example, prevention medicine. This area of medicine is heavily reliant on public trust in the science of screening and policies supporting it, but the signs here are not good.

The NHS screening programme has reported the lowest levels for over a decade of women taking up breast screening. Last year, only 70.5% of eligible women responded to a breast screening invitation, meaning more than 750,000 women went unchecked.

Public Health England is currently running a cervical screening awareness campaign to address the 20-year low point in take-up by women, which in some areas is down to 50%.
The vaccine programme too, is at risk from good science giving way to myth and rumour.

The MMR vaccine rate has fallen again in 2017-18, with coverage now at 91.2% in England, (the World Health Organization target is 95%) and with London at the lowest rate, at 85.1%.

You have stated that you do not want to give any “credence” to the “anti-vaxxers”, who spread junk science about immunisation, and this is welcome, but will you go further? Debunking vaccine myths is important – Simon Stevens recently announced that NHS England is considering what action it could take to help stop the spread of anti-vaccine messages. This might benefit from an injection of some urgency from your office.

When and how will you articulate the vital and highly-complex role of science in underpinning all healthcare decision-making processes? What steps might you take this year to see that this is put into practice, in order to regain some of the enormous ground lost over the past three years?

Last year, you penned the foreword to the second Life Sciences Sector Deal, aimed at deepening the Government’s partnership with industry, universities and charities, and demonstrating how the NHS is pivotal as a delivery partner. We now need to see commitment, drive and determination from you and every level of your leadership team, for its delivery.

Progress made by the Life Sciences Council, the inaugural meeting of which was held at Downing Street and co-chaired by your predecessor in May 2018, could be a helpful guide as to the efforts being taken to repair scientific standing in the UK. What might we expect from this group under your leadership?

This year, the new voluntary pricing agreement has come into force. It commits the Government and the NHS to work together with industry to support innovation, so that people across the UK will see better and faster access to the most effective new medicines and vaccines. Are you confident in the ability of existing mechanisms to support this? What role will you play, for example, in the oversight of the methodologies review at the National Institute for Health and Care Excellence into its health technology appraisal process?

Without meaningful change in process, as well as in tone and culture, scientists and those around them who seek to translate their discoveries into real-life healthcare advances, will continue to wonder about their long-term UK prospects and the conceptual damage caused by Brexit may yet be underestimated.

 

Read the full magazine here: April Pf Magazine