House of Commons - DIUS's Departmental Report 2008 - Innovation, Universities, Science and Skills Committee

DIUS's Departmental Report 2008 - Innovation, Universities, Science and Skills Committee Contents

8 Science

We asked the Secretary of State whether responsibility for science was better in DIUS or, as previously, in DTI/BERR. He saw synergies in having science within DIUS. He pointed out that, first, separation of science from DIUS would mean for universities the division of education and teaching policy from research policy so "that no university could engage with one government department over the whole of its activities—in innovation, research and teaching".[236] He said that since DIUS was set up universities could do that so "we have a better fit".[237] Second, he considered that because science was "clearly located in a department which brings together many of the elements that we need for competitive and prosperous policies from research, from innovation to skills" there was "coherence and a join between them that was not there previously".[238] Professor John Beddington, Government Chief Scientific Adviser, considered that the movement of science from DTI/BERR into DIUS was "the appropriate one".[239] He pointed out that that he worked closely with the Director General of Science and Research at DIUS and he considered that "intimacy of working is really helpful".[240] He also said that it was "important to be able to link in with the directors general of the research councils and the chief executives of the research councils in an intimate way, and also to be able to link in essentially with the innovation agenda".[241]

Our predecessor committee, the Science and Technology Committee, recommended the relocation of the Government Chief Scientific Adviser's office to the Cabinet Office.[242] We asked Professor Beddington if reporting to both the Prime Minister as the Government Chief Scientific Adviser as well as the Secretary of State of DIUS caused problems or tensions in terms of the departmental responsibilities. He replied:

There is a potential tension but I do not think there is one in actual fact. Essentially, we use DIUS as our landlord. We have a floor within DIUS. The salaries and rations and so on are managed by the DIUS organisation, but my reporting line is completely clear; it is to the Prime Minister and Cabinet and at a personal level to the Cabinet Secretary. We have to have a clear degree of autonomy from DIUS; I have to have the ability to challenge the science that DIUS is actually doing. That autonomy is preserved by the current arrangements. Of course I talk to the Secretary of State and Lord Drayson [Minister of State for Science and Innovation …] on a regular basis but my reporting responsibilities are quite clear.[243]

We can appreciate that a significant part of Professor Beddington's work may require contact with bodies such as research councils for which DIUS has responsibility. But equally significant amounts concern other departments—for example, he told us that following up the Foresight report on obesity required working closely with the Department of Health.[244] As he also pointed out, DIUS acted as a "landlord", a function that does not, in our view, have to carried out by DIUS. We conclude that, while the links between the Government Chief Scientific Adviser and DIUS are useful, they are not such to lead us to revise the Science and Technology Committee's recommendation that the Government Chief Scientific Adviser should be based in the Cabinet Office.

Role of Government Chief Scientific Adviser

Professor Beddington became Government Chief Scientific Adviser in January 2008 and explained that the way in which the Government Office for Science (GO-Science) was operating was "slightly different" from the time his predecessor, Professor Sir David King, was in charge. He emphasised the collegiality and the fact that he had a team of chief scientific advisers across government who worked closely together. He considered that they were "working at a number of levels that is relatively new", citing the example of biofuels where the Department for Transport had commissioned a report, which the

team of chief scientific advisers that I led added peer review (it was a critical friend of that report) to develop it. That brought in chief scientific advisers from [the Department for International Development], Transport and from [the Department for Environment, Food and Rural Affairs] to work together in this team and interact with the Gallagher group to produce what I think was a reasonably good and improved document from our input.[245]

He added that he would be setting out the "aims of GO-Science, how we intend to operate, and that will be published […] before the end of the year.[246] The report had not been published by the time we completed our deliberations.

We asked Professor Beddington about his profile in the media and whether it had been as high as that of his predecessor and whether or not that was a good thing. He considered that if

you are going to have an impact, you have to have an impact at a number of levels. Some things require a fairly high media profile. In one of the areas, particularly highlighting the issues of food security and the related issues to food security of energy security, water security and so on and the link with climate change, I think I have been relatively high profile. […] In other areas I think it is more effective to discuss with the appropriate members of government—appropriate Ministers or with Permanent Secretaries or scientific colleagues. I would expect in the future that issues will arise where I will seek to have a substantial media profile.[247]

When he gave us evidence previously, on 12 December 2007, Professor Beddington explained his role as ensuring that:

the Government gets the best possible scientific advice, that where there is uncertainty, that is characterised, where there is risk, that is characterised, but I see my job as really trying to ensure that, when a new policy is made, it is based on the best possible scientific advice that is available at the time. Now, at some stages, there may well be contradictions between scientific advice and other policy imperatives, and that is taken as understood, but I think my central role is to do that and that is what I will try to do.[248]

With this description of his role in mind, when he gave evidence in November 2008, we asked Professor Beddington about two matters: the Government's decision to reclassify cannabis; and the scientific evidence supporting homeopathic treatments.

Reclassification of cannabis

On the reclassification of cannabis from a Category C to Category B drug, Professor Beddington said that "science can provide advice […] but scientific evidence is just one part of the decision process. One should look at scientific evidence; one should assess it; and then you should also look at other factors, economic and social, in making that decision."[249] As he had not looked at the matter in detail at the time he followed-up with a written memorandum in which he said:

In reaching a decision on the classification of cannabis, I am satisfied that Ministers sought and considered sound scientific advice. The Government consulted the Advisory Council on the Misuse of Drugs (ACMD) which provides independent scientific advice on the harm to society and individuals posed by specific substances. In May the Council recognised that the most worrying individual harms are the effects on mental health, but recognised that evidence on this issue is confused. It found clearer evidence about the social harms (such as impaired driving skills) associated with cannabis, but little real evidence that cannabis is a significant cause of acquisitive crime or of anti-social behaviour. The majority of Council members, having weighed up the evidence available, took the view that cannabis should remain a Class C drug because its harmfulness more closely equates with other Class C drugs than with drugs in the Class B category. However, a minority were concerned about the effects of cannabis on the mental health of users and supported reclassification to Class B.

In the absence of factors other than the scientific advice it would have been appropriate for the Home Secretary to take the view that cannabis should remain in class C. However, scientific advice is not the only factor that Ministers take into account when reaching decisions. In this case, I understand the Home Secretary also considered evidence on wider issues including public perceptions and the needs and consequences for policing priorities. These are issues which the Advisory Council made clear it was not able legally to take into account in advising on the classification of substances.

The Government accepted the other 20 of the 21 recommendations made by the ACMD in relation to cannabis, including those on research to improve the evidence base available for policy making and treatment.

More generally, I recognise that there is a relatively limited evidence base to inform policies on drugs and associated issues such as mental health. The recent Foresight report on Mental Capital and Wellbeing and the report by the Academy of Medical Sciences on Brain Science, Addiction and Drugs provide some helpful suggestions on how to address this. I shall take a close interest in how they are taken forward.[250]

Homeopathic treatments

We asked Professor Beddington, in November 2008, whether he considered that the National Health Service should spend money on homeopathic treatments.[251] He replied:

It depends on the extent of the placebo effect[…] It is not just in terms of homeopathy, but, I suppose, less conventional medicines. There does seem to be some evidence that they are effective. In terms of homeopathy […] I see no evidence beyond the placebo effect that it works. […] I can make that point to government and say that there is no evidence that homeopathy works. The decision on whether you wish to fund homeopathy as part of the National Health Service has other factors which are beyond science.[252]

I think this is more policy than science[…] I am quite firm with this. I see no scientific evidence that homeopathy has an effect beyond the placebo effect. The question that […] is a reasonable one, but I think it is possibly better posed to the Department of Health rather than me.[253]

We found Professor Beddington's statements equivocal compared to those of this predecessor, Professor Sir David King, who stated in evidence to us in December 2007:

The issue of homeopathic medicine leaves me completely puzzled. How can you have homeopathic medicines labelled by a department which is driven by science? There is not one jot of evidence supporting the notion that homeopathic medicines are of any assistance whatsoever; therefore, I would say they are a risk to the population because people may take them expecting that they are dealing with a serious problem.[254]

After the evidence session in November 2008, we asked Professor Beddington for a note on the statements that the Department of Health (DH) had made on the adequacy of scientific evidence to support homeopathic products and the extent to which evidence based on such products had informed policy-making at DH. We set out the contents of the note[255] Professor Beddington supplied at some length:

The evidence base [for the provision of homeopathic treatments by the National Health Service] is sorely lacking, but this is [an] area where wider factors than science may be relevant. For example, there is considerable public interest in complementary therapies and it is estimated that in any year 11% of the adult population visit a complementary therapist for one of six named therapies including: acupuncture, osteopathy, chiropractice, herbal medicine, hypnotherapy and homeopathy.

Homeopathy has been funded by the NHS since its inception 60 years ago. It is used by patients for a wide range of acute and chronic physical and emotional illnesses, and to provide palliative care where a condition is beyond the scope of the body's normal self-repair mechanisms. Until very recently, there were five NHS hospitals specialising in homeopathic treatments, although one has recently closed.

In my evidence, I said that I knew of no scientific evidence that homeopathy has an effect, beyond the placebo effect. I have since learned of some qualitative evidence that suggests that homeopathy may be effective in treating certain conditions, such as asthma,[256]rhinitis and hayfever.[257]There is also evidence of effectiveness in the treatment of influenza.[258] However, the scientific basis of homeopathy remains highly questionable.

Complementary or alternative medicine (CAM) consultations tend to be more thorough and detailed than conventional medical consultations, focussing on the whole of the patient's life rather than their physical health alone. Such factors may well contribute to high levels of patient satisfaction with CAM treatments where they occur.

There is also the placebo effect. Studies have shown that patient expectations concerning a treatment, the patient's experience of the treatment and their attitude towards the healthcare provider can all affect the impact of a treatment. Despite a lack of understanding of the exact mechanisms through which the placebo effect may operate, research clearly shows that the effect exists and can have a significant impact on health. If a homeopathic treatment makes people feel better, whether that be through treatment specific effects or the placebo effect, then it could be considered as being worthwhile.

The GO-Science Review of the Department of Health did consider the evidence base for the efficacy of homeopathic medicines. It was the subject of a peer review by the independent Steering Panel, carried out to inform and test the broad recommendations in the main report. The study concluded that the scientific basis for homeopathy remained highly questionable and recommended the key components of a programme of research to develop a stronger evidence base. Paragraph 3.16 of Annex 1 to the Review states-

"Homeopathic medicine was part of the NHS, so the scientific evidence for its effectiveness was clearly important. While the reviews of the published evidence were useful, the scientific basis of homeopathy remained highly questionable. A programme for a stronger evidence base would necessitate agreement between practitioners, patients and researchers on what should be evaluated, and on relevant endpoints. Flagship trials should be run in the most promising areas, chosen on plausibility, and patient demand. These should be well planned, including pre-defined agreement on what constitutes a minimally important clinical effect, and adequate resource, so that the results were clear-cut. Innovative methods may be needed, for example, if there was a waiting list, then randomisation is as fair a way as any of deciding who gets treatment. The difficulties in setting up such a programme robustly cannot be underestimated. The Health Technology Assessment Programme provided a framework that should be as applicable to research on homeopathy as to any other therapy."

This supports the findings of the House of Lords Select Committee on Science and Technology Enquiry on complementary and alternative medicine in 2000, which recommended that money should be ring-fenced to develop the infrastructure for research into the effectiveness of homeopathy.

On the issue of DH statements on homeopathy and the evidence base supporting its use. I understand the Government does not maintain a position on any complementary or alternative treatment. Decisions on what type of treatments to commission and fund are the responsibility of the National Health Service with front line service providers judging the best treatment for an individual's circumstances, taking into account factors such as safety, clinical and cost effectiveness and the availability of suitably qualified / regulated practitioners.

CONCLUSIONS

First, this Report is not an appropriate vehicle to examine either issue in detail but we put on record our surprise at the evidence that Professor Beddington cited in respect of homeopathy, which is reproduced at footnotes 256 to 258 in our Report. We were surprised that Professor Beddington chose to offer a selection of papers purporting to provide evidence that homeopathy may be effective. This included an information pack for primary care groups, rather than the scientific papers on which the pack was based. He also cited the Vickers & Smith (2006) Cochrane Review on homeopathic efficacy in the treatment of influenza, when it concluded that it might "shorten the illness, but more research is needed", which appears a questionable reinterpretation of that review's results. If it was Professor Beddington's intention to correct his statement that "there is no evidence that homeopathy works" we accept that it would be possible to find supportive pieces of evidence to support an opposite view. We are concerned that on homeopathy Professor Beddington did not take the opportunity to restate the importance of the scientific process and to state that what was important was the balance of scientific evidence, which in the case of homeopathy, does not provide strong evidence that it has an effect, beyond the placebo effect. In both the case of cannabis reclassification and homeopathic treatments we are concerned that the Government Chief Scientific Adviser has not chosen to challenge departments where no evidence was produced.

We found Professor Beddington's responses on the questions of the reclassification of cannabis and, to a greater extent, on the scientific evidence to support homeopathy showed a sharp contrast in approach to his job to that of his predecessor, Professor Sir David King, and to be out of step with the view he expressed before he took up his job in December 2007 that Government should get the "best possible scientific advice that is available at the time". Professor Beddington is the Government Chief Scientific Adviser and we are surprised that rather than champion evidence-based science within government he appears to see his role as defending government policy or, in the case of homeopathy, explaining why there is no clear government policy. This is an issue we expect to return to in our inquiry "Putting science and engineering at the heart of government policy".

USE OF METRICS

We also asked Professor Beddington about the metrics employed for evaluating the usefulness of the work done by the Government Chief Scientific Adviser. He considered that that was a matter which the Council for Science and Technology[259] might consider and he undertook to pursue it.[260] We recommend that in responding to this Report the Government Chief Scientific Adviser explain what follow-up action has been taken by the Council for Science and Technology on the use of metrics for evaluating work done by the Government Chief Scientific Adviser.

Government Office for Science annual report

The DIUS Departmental Report does not cover the Government Office for Science. Professor Beddington explained that the Government Office for Science was a "lodger" and that while "we work alongside DIUS […] we are not part of the family".[261] He considered it would be "inappropriate" for the Government Office for Science to be "a substantial portion of [DIUS's] annual report".[262] He added that the Office would be producing a GO-Science report by the end of the year and that he would be "very keen to discuss that here with this committee […] once that report is published."[263]

We assume that professor Beddington was not referring to the annual report 2008 on the Science and Innovation Investment Framework which was published in December 2008[264]and that there will be a separate report on the activities of the Government Office for Science published shortly. We agree with the Government Chief Scientific Adviser that it would not be appropriate for the Government Office for Science annual report to be included within the DIUS Departmental Report. We welcome that the Government Office for Science is producing a report on its activities. We recommend that Government Office for Science report annually on science across government.

SCIENCE REVIEW PROGRAMME

We raised with Professor Beddington the time that Science Reviews were taking. The Science Review Programme involves:

reviewing existing departmental systems for assuring the quality, management and use of science;

a close examination of the extent to which science and scientific advice consistently and effectively feeds into a department's strategy and policymaking; and

identifying and disseminating examples of good practice from within the UK and abroad.[265]

Professor Beddington said that the time the reviews took was "ludicrous".[266] He had taken part in the Review of the Department for Environment, Food and Rural Affairs and "it seemed to be going on forever."[267] We note that the review of DEFRA was carried out between January 2005 to July 2006.[268] He explained that soon after taking up his post he had

commissioned a review of reviews in co-operation with the Heads of Analysis Group and [had] commissioned a consultant […] to come forward with recommendations on what was good and what was bad about the previous practice and to make recommendations about the future. The answer is that he has come forward with proposals which the Heads of Analysis Group have accepted and which I accept, too. The new reviews will be significantly shorter, maximum three months; they will be conducted in a completely different way from other reviews. They will be jointly owned by the Permanent Secretary of the department concerned and myself, and they will be driven at a very high level. There will be an immediate going in to look and see what are the key issue and if some things worry us, then we would start to look at those in more detail. […] The pattern of reviews which we would then plan to start early in 2009 should mean that we will be able to get a lot more done; we will be using consultants to help us and we will be using a much higher level of professional input into these reviews.[269]

We welcome the Government Chief Scientific Adviser's proposals to speed up and streamline the Science Review Programme.

Haldane principle

The Haldane principle arises out of the Haldane Report, published in 1918, that examined the structure and function of the UK government science. The central thrust was that general research should be administered at arm's length from government departments. The creation of the UK's Research Councils has been seen as the embodiment of the Haldane principle.

In a speech on 29 April 2008 to the Royal Academy of Engineering the Secretary of State considered that the three fundamental elements of Haldane, as he enumerated them, remained entirely valid:

that researchers are best placed to determine detailed priorities;

that the Government's role is to set the over-arching strategy; and

that the research councils are "guardians of the independence of science".

He said that "these should be the basis for Haldane today, and over the decades to come, and I am happy to re-state them".[270]

There has been criticism of the manner in which the Government has interpreted the principle. It has allowed the Government to have its cake and eat it: to let the Research Councils take criticism for difficult decisions, while the Government can exercise direction on spending decisions. In our report on the Science Budget Allocations published on 23 April 2008 we had "reservations about the influence Government appears to have on the use of the budget and the extent to which the Haldane Principle has been upheld".[271]We concluded that large "parts of the budget are tied to cross-council programmes that largely follow a Government agenda" and that, while it was acceptable for the Government to set priorities for UK research, it was not "for it to micromanage individual Research Council budgets".[272] We recommended that the Government "make clear its role in regional science policy and how this fits with the Haldane Principle".[273] It also seemed to us to be a "breach of the Haldane Principle that the Government should direct a Research Council to switch funding from postgraduate awards to programme funding merely on the basis of it being out of step with other research councils, or indeed for any other reason".[274] In its response Government rejected our points and drew attention to Mr Denham's speech of 29 April.[275]

In view of this exchange we returned to the Haldane principle, when the Secretary of State gave evidence on 29 October. We pointed out that the Government set up three new major institutes for research—the Office for Strategic Co-ordination of Health Research (OSCHR), the Technology Strategy Board (TSB) and the Energy Technologies Institute—which would set the direction on spending decisions. At the same time it appeared that the Government outlined six themes where research money should be dedicated[276] and there had been a significant shift of research money in the Research Councils from responsive mode to programme research as a result of that.

In response, the Secretary of State referred back to his speech to the Royal Academy of Engineering when he has been "happy to restate the core principles of the Haldane Principle, but I pointed out three areas where I think inevitably in the modern world ministers will have a greater degree of engagement.

The first was in major projects; so, for example, the Camden Medical Research Centre would not happen if you just said to the [Medical Research Council] it is up to you to make it happen or not. You had to have engagement with ministers across government.

The second area is that I think it is legitimate for ministers to say, "Look, there are some very, very big questions in our society that we need research to help us answer: for example, climate change; the implications of an aging society and the other cross-cutting areas." I think that is one of those areas where, provided ministers are open about it and upfront about it, that is a reasonable contribution for us to make.

The third thing I think we were right to do […] was that if you have an overall responsibility for science policy there are times when you will need to raise questions and initiate things. So, for example, […] my decision to get the Wakeham Inquiry underway, which was taken before there had been any public criticism of the [Science and Technology Facilities Council] at all, it was just me looking at what they were proposing and saying, "This is going to raise lots of questions about the state of physics." So it was not for me to step in and say, "You cannot do this, STFC" it was my job to say, "This is going to kick off a debate about the state of physics," and we then found the mechanism for Bill to come in and do his report. […]

So Haldane, I think we are respecting, but I am being very honest that in practical government terms in those areas of big projects of strategic priorities we have an input to make.[277]

We do not propose in this Report to reopen the debate about science budget allocations and we put on record that we do not necessarily share the Secretary of State's definition of the Haldane principle. We accept, however, that it is entirely reasonable for the Secretary of State to raise, and to suggest refinement, to the application of the Haldane principle 90 years after it was formulated. We hope that there is a debate on the application of the Haldane principle to scientific research in the 21st century and we expect that this is an issue we will return to in our inquiry "Putting science and engineering at the heart of government policy".

236 Q 200 Back

237 As above Back

238 As above Back

239 Q 228 Back

240 As above Back

241 As above Back

242 Seventh Report of the Science and Technology Committee, Session 2005-06, Scientific Advice, Risk and Evidence Based Policy Making, HC 900, para 25 Back

243 Q 229 Back

244 Q 274 Back

245 Q 232 Back

246 As above Back

247 Q 227 Back