Stem Cell Research

My Lords, I, too, congratulate the noble Lord, Lord Patel, on initiating this debate and on attracting an eminent group of speakers, such that I arise with a great deal of diffidence to make a few comments based on my background of having been involved in health service management for 20 years and in policy-making as a civil servant for the past nine of those. I had better declare the interestsof having been chief executive of the NHS and Permanent Secretary at the Department of Health. I think that those perspectives will allow me to make three points: one about services, one about research and one about public trust. There has already been a great deal of talk about the potential benefits of stem cell research to individuals, patients and all of us—perhaps to whole services—and there has been some discussionabout the cost to health services. As a health service manager, I want to hear more about how the development of stem cell research will make far more generic products available to a wide group of patients than is the case now. The noble Lord, Lord Patel, said clearly at the beginning that early research on adult stem cells has been very patient-specific and that the great goal in embryo research—I am looking at my notes to check that I have the science roughly right—is the ability to produce more generic products, which may then have an effect on a much wider group of patients. That must be the goal for which those of us who have been involved in managing health services will be looking from this research. However, the issue goes slightly wider than that. This is part of a much broader and longer-term trend in health services. To put it very simply, it is about the importance of early intervention. Health costs are growing rapidly in every country, whether they are developing or developed countries, and, before we reach the sort of situation in America in which perhaps 20 per cent of costs go on healthcare, we need to reorient health services much more towards early intervention; the slogan needs to concentrate far more on early health than on late disease. This research has the potential to contribute greatly to that sort of development and to reduce costs both in health services and in the wider community, as the noble Lord said. My second point, which goes hand in hand with the first, is the importance of research going hand in hand with clinical application. Having run a teaching hospital, I know how crucial it is that our services are constantly informed by the latest knowledge and that our knowledge is constantly informed by service reality. There needs to be as rapid a transition as possible from the laboratory to the bedside and learning from the bedside to the laboratory. However, the issue here—a point raised by my noble friend Lady Greenfield—is that we are talking about a substantial change in the way that medicine is conceived and therefore the way in which services will be delivered in the future. Therefore, alongside the science go important areas of research, which are about service delivery, sociology and economics. It is not enough for stem cell research to be purely at the scientific level. Science alone will not have the impact on services that we need; it needs to be accompanied by a wider range of research. Those first two points are variations on the theme of why stem cell research is important, and they come from the perspective of the manager or the person involved in healthcare delivery. But all that is valueless if stem cell research is unethical, immoral or, for that matter, hugely opposed by the public. That leads me to the issue of public trust, on which I want to make two short points. One is that, as a former policy-maker, I saw things very much from the decision-maker’s point of view. It is interesting that individuals may find it very easy to make a decision on this issue, as is the case with many other things that face people in government. They may, for a priori reasons, either see very clearly that it is inappropriate to do anything with human embryos, or equally see that, as a way of helping people who are crying out for help, it would be unethical not to do so. Many individuals will make those decisions easily but, for policy-makers, the issue is finely balanced. I urge the Government to be very clear about the messages that they give out in their forthcoming legislation, documentation and policy. The Government have been good in setting the right environment for stem cell research but it is important that a clear lead is given here. The Government must show that they have listened, understood and decided, and that they have a clear position on the ethical issues and on what will be allowed. They must not sit on the fence on this matter and give misleading signals to researchers or funders in this country. My final point on public trust has already been made much better by the noble Baroness, Lady Kennedy, and others. On most topics, I am not convinced by surveys that show that 70 per cent of people have answered a question in a particular way. There is a deep need here for appropriate members of the public to be involved in the decision-making process. Prior to this debate, I carried out a short straw poll of a number of people whom I know to find out what they knew about stem cell research. I was happy to learn that they knew even less than I do. I, too, have gone through a process of learning over the past few days. We cannot hope to get people up to the level where they can debate this issue in the way that many people in this Chamber can; nevertheless, having what I think the noble Baroness, Lady Kennedy, called the nuanced involvement of the public in this debate is absolutely essential.