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Reflector asks if the UK's newly announced post-Brexit life sciences strategy report is worth a look as a springboard to addressing future EU ties in healthcare, or just more bluster?
The unveiling of the UK government’s Life Sciences Industrial Strategy at the end of August was greeted with almost universal acclaim as a credible plan for the British healthcare industry to become a global powerhouse after Brexit. So it seems almost churlish to rain on the parade. But credibility is something currently in seriously short supply with the UK government. And the merits of the government’s pronouncements, and still more its commitments–on healthcare as on many other issues-are consequently open to question. The report itself looks good, of course. It talks eloquently of the need for support for discovery and translational science, National Health Service (NHS) collaboration, manufacturing, and skills. It lists objectives in “moonshot programs,” clinical trials excellence, conducive tax arrangements, and the growth of clusters. What’s not to like? And government ministers enthusiastically led the cheers as the report was presented. “The government is committed to helping the sector go from strength to strength,” said business secretary Greg Clark. Health secretary Jeremy Hunt said “Britain is well-placed to be a world leader in the life sciences industry after Brexit.” Alongside the publication of the strategy, the government also announced a new $16.8 million funding competition for a medicines manufacturing center, a $85.3 million investment in a vaccines development and manufacturing center, a $38.8 million investment in cell and gene therapy treatment centers, a $15.5 million cell and gene therapy investment in Stevenage, and $32.3 million to support small and medium-sized enterprises and boost innovation. The plaudits quickly followed. Former life sciences minister George Freeman greeted the “flagship announcement” as “a groundbreaking moment in the development of the 21st century UK economy.” The UK BioIndustry Association welcomed the report. Association of the British Pharmaceutical Industry (ABPI) CEO Mike Thompson said the “impressive report” is welcomed by leaders in the sector. Phil Thomson, president of global affairs at GlaxoSmithKline, said “GSK welcomes the vision.” So, too, did the Sanger Institute and the UK’s innovation organization, the Knowledge Transfer Network.
But it is one thing to put money into research. It is quite another to find the right people to conduct the research. The report does concede that “The potential disruption associated with Brexit could lead to some loss of talent from the sector; as such, creating an opportunity to bring very high-level talent into the country over the next five years is important.” So it blithely requests the setting up of a migration system “that allows us to recruit the best international talent”-without any mention of the UK’s ongoing travails to identify, and still less to negotiate, any such system. The Institute of Cancer Research (ICR) dared to highlight the point in its comments when the report was published: “For the UK, and global institutions like the ICR, to remain competitive, we need to be able to attract and retain the brightest and the best. We look forward to hearing more about the government’s plans for ensuring the UK continues to be a beacon for skilled scientists from within the EU and beyond.” But the UK is currently teetering on the brink of locking out most of the best brains in Europe, with the government’s imprecisions over Brexit generating uncertainty over EU citizens’ access to the EU, and threatening to push the country into a barren no-man’s land on everything from trade to data, and from research to regulatory affairs.
Bizarrely, the report makes hardly any explicit reference to the UK’s impending rift with the rest of Europe-although it insists repeatedly on the need for a view that extends across the next five years. It urges the UK to “work with industry and regulators to establish a working group to evaluate the use of digital healthcare data and health systems and to evaluate the safety and efficacy of new interventions”-without any acknowledgement of the fact that currently this is precisely what is taking place within the European Medicines Agency (EMA), that is about to be booted out of the UK as one of the many unintended consequences of the rush to Brexit. Similarly, the report recommends creating “a forum for early engagement between industry, NHS, and arms-length bodies (e.g., National Institute for Health and Care Excellence, Medicines and Healthcare products Regulatory Agency) to agree to commercial access agreements,” ignoring ongoing EU efforts-that the UK is still involved in-in early dialogue and health technology assessment. A few other incidental references to Brexit acknowledge potential challenges in continuity of regulation and of import/export regimes-but without any extended attempt to answer them. The introduction opens with the observation that “As the UK plans its future outside the European Union, identifying and supporting specific sectors of the economy to grow and expand quickly becomes a clear priority.” The report does note that “the future of regulation in the life sciences will need to be considered in light of the UK leaving the European Union”- but merely suggests that “the focus should be on alignment.”
This vagueness is characteristic of the UK government’s current approach to its strategic future, so it is perhaps unsurprising that this commissioned report displays the same insouciance. It is this air of happy optimism that is provoking such dismay on the other side of the English Channel, and prompting comments that are far from complimentary about the way the UK is addressing some of its most pressing issues. A senior EU diplomat described London’s proposed customs solution as sounding “like a fairy tale.” The UK government continues to act as if it is in denial over what Brexit really means. The improbable incumbent of the foreign office, Boris Johnson, hardly the government’s most able strategist, has had to recognize that his earlier dismissive remarks that the EU can “go whistle” for any UK money were ridiculous, and he now openly admits that Britain has a duty to pay what it owes when it leaves the EU. Those UK red lines-so triumphantly declared only months ago-on removing all influence of the European court and abruptly ending free movement continue to suffer drip-drip erosion in the face of dawning realities that Britain will need European workers, and judicial guarantees for trade with the EU or its own citizens living there, even after 2019. The poverty of the UK government’s current stance is emphasized when senior figures in and around the government are reduced to invective as their chief response to criticism of its failings. Backbencher Jacob Rees-Mogg, admirable for his sharp intellect and his wit, could find no better comeback to Jean-Claude Juncker’s comment that the UK’s position papers are unsatisfactory than to accuse the Commission president of being “a pound shop Bismarck, arrogant and bullying but without the charm.”
This dysfunction at the heart of the UK government calls into question any promise it makes. It remains to be seen what the-normally prudent and independent-House of Lords Science and Technology Committee makes of the life sciences strategy; it has just announced an inquiry into it, and is inviting contributions. But there was a small sign of what may be to come even in the eulogistic pre-prepared statement of support from healthcare industry organizations that the government included in its own press release on the life sciences strategy. This incorporated-almost incidentally-a certain reservation, in that it described the report as a “springboard,” and pointed out that it would be vital “that the recommendations set out in this strategy are fully implemented.”