Birmingham’s ICC was the venue when BQ held its Live Debate on the city’s fast-growing healthcare and life sciences economy. Ian Halstead covered the event.
Deliberation and debate are the ways to stir the soul of a democracy, according to the veteran American civil rights campaigner, Jesse Jackson. Not that he’s known for discussion, more for powerful flights of fanciful rhetoric, but there’s absolutely no doubt he would have enjoyed a tour-de-force by the Life Sciences Minister, George Freeman.
After a long day criss-crossing Birmingham - meeting a small army of people, and visiting an array of healthcare locations-the Mid-Norfolk MP would have been forgiven for dropping down a gear … or two. Instead, Freeman demonstrated not just an impressive mastery of his complex brief, from digital health to big data, and from genomics to pharma and beyond, but also presented his thoughts with such passion and purpose that the other panel members were visibly entranced.
Even one-time Labour Chief Whip, Jacqui Smith, could be seen nodding in accord, whilst others scribbled notes as future aide-memoires. “There’s no doubt that a genuine healthcare cluster has evolved in Birmingham, with tremendous examples of best practice,” began Freeman.
“I’m always keen to see conversations develop between the NHS, pharma, the public sector, academics, hospital trusts and clinical researchers, and it was clear that they are happening here. It’s very much the ‘big picture’ approach which is needed.”
It was clear that his affection for life sciences was deep and personal. “I worked in the life sciences industry in the late-90s, including four years as a venture capitalist, though I was very much a generalist surrounded by professors,” said Freeman. “I then worked in a start-up doing digital health, became very interested in stratified medicine and in how big data could take the sector forward. I’m an outspoken advocate of translational patient-centric medicine, involving scientists and universities, so was very pleased to see examples of this approach today.
“You see something incredibly powerful, when you have academics and healthcare specialists, with massive amounts of clinical data. You can create new pathways and drive innovation linked to advanced research.”
Freeman even paid tribute to the work of former Labour Health Secretary, Andy Burnham, although conceding that the political cycle didn’t dovetail easily with the needs of healthcare, because of the latter’s requirement for long-term investment. “Our challenge is to build on previous achievements, although now against a very different landscape,” he added. “The 20th century model of bio-pharma was deep science, with a lot of luck involved in terms of access to finance, and maybe 15 years and $1 billion required to bring a drug forward.
“That approach was based on the ‘blockbuster’ concept which appealed to the City, even though the record of discovery with regard to New Chemical Entities (NCEs) over the last 20 years was very poor.
“Now though pharma can’t afford to spend millions and wait 15 or 20 years for new drugs to come forward, and the NHS can’t afford to pay the costs which would be required at the end of that pipeline, or put up with a lower level of outcomes whilst it waits for those drugs.
“I recently went to Cambridge (Massachusetts) to see a £500m R&D centre right in the middle of a campus, and that is very much the model for the future, as can be seen here in Birmingham,” he said. “Now the sector is coming right back to patients, data and genomics, which is where it was in the golden age of pharma. There has been remarkable progress: 98% of women now survive breast cancer, for example, but the challenges of an ageing society require different approaches and different models.
“We should commit ourselves to this new landscape, and the NHS must better engage with the outside world. We are trying to unleash the power of our health system to take a lead in the new patient-centred model of health and life sciences research, in which devices, diagnostic, and digital must all converge.
“A very challenging technological landscape which will transform the way in which we regulate. Let’s leverage the power of our research, particularly in infomatics and genomics. It’s equally vital to have access to diverse and large population data, of which the West Midlands is an excellent example.”
Freeman paused to sip a glass of water, but his enthusiasm for the subject clearly wasn’t diluted. “We need big investment in genomics, so let’s be ambitious and be bold. Others are chasing us, but we have the momentum,” he said. “Unfortunately though, we are failing on the data and the infomatics. We’ve nearly got the infrastructure, but the interoperability is poor. We have created a railway line, but no-one has crossed it.
“Genomics and data are the technologies which will create the new landscape, but although I don’t see a funding gap, I do see an innovation barrier.
“The Academic Health Science Networks (AHSN) are a great concept, but lack procurement leaders and have funding problems. They are basically marriage brokers, but they need
”I’d like to see more, and bigger, partnerships in healthcare in our biggest cities, such as Birmingham, because you never know which pathways work, which might and which
Freeman had a healthy scepticism about what any government could achieve, seeing a future health economy driven by incentive-led and place-based integration. “Looking at Norfolk, £1.2 billion is spent on healthcare, but it all goes into different ‘silos’ and much isn’t best used,” he admitted. “I’d like to hear a compelling Heseltine-type plan for devolved healthcare, from council leaders, academics, the business community and others.
“Birmingham is poised in a very exciting place, and although there are rival clusters, in Scotland and the North, not just along the traditional London-Cambridge-Oxford axis, the closeness of integration is creating something very powerful, and the Birmingham story must be told; again and again and again.
“The new Institute of Translational Medicine is the poster-child for what I am talking about, with regards to access. It is quite extraordinary what it can achieve in terms of delivering drugs, attracting philanthropy and securing investment.
“If I am right about the future landscape, then nowhere is doing it better than here, not even Belfast because they haven’t quite got the clarity of leadership on translational medicine. You will be right in the sweet-spot.
“I also like the regional links between telematics, healthcare and manufacturing. The idea of making devices here in a connected city is powerful, and I think an investment prospectus would work, as being able to track, trace, and then cost diseases will be critical.”
By now, Freeman wasn’t so much warming to his theme, as almost melting, so he gave way to allow the panel members to respond.
Graham Silk, who chairs the investment vehicle Hampson Holdings, agreed that greater focus was needed on creating infrastructure, and suggested the appeal of the city’s healthcare economy could see a return to Birmingham’s great Victorian era of philanthropy.
“We do need to drive our reputation globally, but at the same time, there must be focus on our changing demographics,” he added.
Mike Carr, programme delivery director for the Greater Birmingham and Solihull LEP, said his experience from the medical devices sector suggested that the timing of a new and integrated health strategy was critical, and he hoped to see more effective and more centralised local leadership.
The quality and strength of leadership in the NHS was the issue for Richard Devereaux Phillips, the director of healthcare policy for the Association of British Healthcare Industries.
“I like the idea of using big data to standardise systems and deliver better outcomes, but we mustn’t forget that although the pharma sector varies enormously in scale its players require the same essentials,” he added.
“Switzerland, for example, isn’t an immediately obvious location for big pharma because of cost, but it makes entrants very welcome, not least through very efficient processes.”
Peter Dines, the investment director and head of life sciences for Mercia Technologies, suggested that the NHS needed to develop better procurement structures and systems, and although a morsel of food prevented Freeman from replying, his nod sufficed.
Continuing the welcome mood of accord, Tony Davis - commercial director for the West Midlands AHSN agreed that the network needed more tools, especially for procurement and incentives, and that different organisational structures should indeed be considered.
Jacqui Smith, who chairs Birmingham’s two major NHS Foundation Trusts, accepted that the central challenge was for the city to become more effective at telling its own story. “It’s also crucial to focus on how the NHS accumulates and collates patient data. I do wonder if the correct incentives are in place,” she added - a point which also gained Freeman’s approval. “Equally, although collaboration at all levels is fine, at some point decisions have to be taken. At the moment, there are several parallel agendas on the future of Birmingham’s healthcare economy, and they need to be unified.”
There was another cautionary note from Simon Phillips, the planning, development and regeneration director with Bilfinger GVA, who is working with the city council and the NHS on the new Life Sciences Campus. “There’s been a great deal of talking in recent years, but now the city needs to move into a genuine delivery phase,” he said.
“The right land and the right kind-of space has to be available, particularly grow-on space, or potential occupiers will look elsewhere. The sector also does need to raise its profile to make wider audiences aware of what is happening here.”
However, the debate was very much Freeman’s show, and his positive mindset was again seen when he summed up what he believes Birmingham should do next. “I like Graham’s idea of philanthropic investment in healthcare, particularly the idea of using locally-backed Birmingham Bonds to attract new revenue streams to the sector, which reminds me of the great era of civic achievement which this city enjoyed under Joseph Chamberlain,” he said.
“Investment into healthcare from companies, organisations and individuals would really develop a shared sense of community spirit.
“I’d also like to see Birmingham create a new form of partnership, getting people to commit to a signed contract. It would need someone inspiring, bold and visionary to chair this body. That individual might be the new Metro Mayor, or might not, but must be someone with real drive and commitment.
“To me, there also should be a civic goal. Not rewriting existing strategies, but aiming, say, to make Birmingham the healthiest city in the country and tackling inequality and lack of provision. Health and wealth together would be a very powerful force.”
And then he was gone, whisked away at speed to ensure that the London train didn’t leave without him. Leaving just one observer to add the perfect footnote ...”He just didn’t seem like a politician.”