Tag Archives: Research

Life sciences in small states

There is a clutch of small states within the European Union. There are many more small states outside the EU.

TAMPA, FL - JULY 13:  John Winskas, a student ...

Small states? (Image credit: Getty Images via @daylife)

Much can be learned from them, as at least within the EU, some seem more robustly managed and economic productive than their larger debt-laden counterparts.

Healthcare systems are often seen as requiring some degree of economy of scale. This in part is a function of how prevalent diseases are, such that in some small countries they would have one case in 2 years, rather than one case per million of population. Healthcare technologies can be incredibly pricey; for instance, a proton therapy facility will run between €100 and €200 million to set up. Healthcare buildings and research infrastructure are expensive to build and run. Health professionals can be expensive to train and employ and are generally globally mobile.

Associated with investment in healthcare within the EU, we find that almost every region or member state has life sciences, in some form, in their top 5 or so areas of national priority. Life sciences is challenging and demanding, and requires high degrees of global visibility and connectivity to other researchers. Commercialisation of life sciences in Europe is generally appalling; the EU’s research budget focuses on research, not translation and there is precious little to help good ideas bridge the ‘valley of death’ where unfunded good ideas go to die. Financing for life sciences developments consume vast quantities of risk capital, some of which will be unlikely to return any value for a decade or more.

Many EU countries try to avoid downside risks of failure by punishing it, rather than creating opportunities to learn. Countries that encourage risk taking, and make it easy to start and close down companies, with associated flexible labour practices, will outstrip protectionist fearful countries. While many countries fear unemployment, they fail to encourage job creation, which is an economies way of moving work around. Life sciences is one such area that requires particular flexibility owing to the nature of the work.

I recently had the privilege of working with colleagues in one of the EU’s small states, to help develop a life science strategy. National excitement included the construction of a new bioscience research and commercialisation centre (partly funded by the EU, thanks for that). The University is active across its faculties in life sciences areans, and with the College are both keenly extensively in high quality training of health professionals. Local industry is building on past successes in life sciences. The country has a well-developed and well-financed healthcare system.

The main lesson to small countries building life science (or any research-based commercial capacity for that matter) is that setting priorities is more important the smaller you are, as you can’t do everything. That means that some people may be disappointed that they are not on the short list of first projects. It means, too, that infrastructure projects are precious, as they are enablers of future potential — the longer term vision must be sustainable, as getting it wrong can be expensive — research buildings don’t make very good hotels.

Some thoughts:

  1. build on what you already are doing well as that is evidence you have the expertise, networks and working practices in place
  2. keep in mind that life sciences is much, much more than drugs; progress may be quicker in other areas, such as informatics, telecommunications, engineering, materials science, physics, chemistry, agriculture, etc.
  3. you can’t sensibly do life sciences with a weak university, so this may entail some difficult and hard rethinking of priorities and some sensible review of research productivity
  4. you can’t sensibly do life sciences without a teaching hospital; the academic health science centres in the US account for over 80% of productive life sciences research, so think about reorganising your own infrastructure to enable closer collaborations and alignment between university and hospital; this may, by the way, raise real issues for government if the teaching hospital(s) is state run
  5. you can’t sensibly do life sciences without understanding the logic of ‘bench to bedside’; productive work lies in translational research and solving clinical problems; this can challenge academe, which rewards the production of papers and volume of research funding for career progression; in life sciences, solving problems is paramount; understand what the Grand Challenges in life sciences are and see which one(s) you can focus on
  6. you’ll need to consider the economic developments that come with building a life sciences sector as you’ll need to energise high net worth individuals as angel investors to help start and run the small businesses that you’ll create; I’d discourage too much public sector hiring as it disincentivises university graduates from pursuing entrepreneurial careers (there is good global evidence that this can be a problem, so don’t make that mistake); best role for government is ensuring a flexible corporate start-up environment, a non-punitive bankruptcy regime, sensible taxation of start-ups, and seed funding; it might also be a good idea to give away all that publicly owned intellectual property;
  7. finally, the good news is that size doesn’t matter for innovation; there is no correlation between the size of a country and the ability of the country to innovate; many very large countries have clumsy policies that disincentivise and frustrate.

I wrote a paper looking more generally at healthcare systems of small countries (which includes a few remarks on life sciences). Paper on Overview of Small Health Systems

If these issues stir you to think more about life sciences and / or the challenges of smaller states, do make a comment.

Appointments in Quangoland

Photograph of Brittania statue, taken 13th Jun...

What would she do?

One of the great mysteries of the modern world is how to get appointed to the board of a quango.

I have also wondered whether the concerns about the effectiveness or not of quangos may lie in the criteria used to identify the types of people to run or govern quangos. To that end, would the public and political perceptions be different if there were greater confidence that quangos were both purposeful AND engaged the right people to sit on their boards and lead their management teams.

When I was doing work on revalidation of doctors (in the UK), following the tragic baby deaths scandal at an NHS hospital, I observed to medical colleagues that if they didn’t get their medical house in order they would be seen as unable to govern their profession and would lose their autonomy and control of the GMC: in which case, the chair of the General Medical Council would be lay chair, and they would be outnumbered by lay members. I observed that I might be the chair of the GMC since I knew a fair bit about what doctors do, which put the issue quite starkly.

The real issue is whether the criteria used to select candidates for quangos by appointing bodies fully engages the widest possible talent pool, or does it favour certain types of people, who in the end want to work with people like themselves, presumably in some respect professional quango-ites. Part of the challenge is that in many cases quangos should actually be putting themselves out of business. Other quangos should be driving reform and change. But the characteristics of people who get to sit on quango boards have to a great degree established their legitimacy, not as reformers, but as a ‘safe pair of hands’.  Radical, reforming, challenging individuals will never fit as quangos exude stability and bureaucratic purpose, not the instability that comes from reform and general disruption of the status quo.

Quangos could even be seen as evidence that the status quo is alive and well!  A quango focused on innovation should itself be innovative, it might instead suffer from the usual pressures to deliver performance metrics on attendees at workshops on innovation rather than evidence of innovative outcomes.  A quango on research would be disinclined to consider speculative more risky research proposals, as they must prove the value of taxpayers’ money. Quangos that invest in early stage high technology research spin-offs from research labs would need to demonstrate in some budgetary cycle that their investments were creating jobs, for instance, despite evidence that such start-ups might take 5 years before they would have any impact.  And so it goes.

In the meantime, taxpayers’ money is spent on people whose careers are simply to sit on quangos. And when do we have a discussion about whether the very criteria for public appointments to quangos are themselves part of the problem? Perhaps there’s a quango for that?

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Review of European Research Council: more like a midwife?

A midwife measures the height of the mother's ...

Midwife at work: certainly not taking credit for the pregnancy

The review of the European Research Council paints at times an ugly picture of a bureaucratic mess.  In search of simpler solutions of state run/owned type bodies, bureaucratic distance might be the best thing.  Otherwise known as autonomy, the ERC could still act in the interests of the European Union, but without all that bureaucratic overhead, and chummy photo-ops.

Make the ERC a charitable foundation, give it a bag of money, and tell it to get on with the business of supporting research.  Give it sufficient guidance to ensure alignment with sensible research goals, and from time to time, top up its funding, so that in time it operates with financial security.  Let it in effect be owned by everyone.

Staffed with world-class scientists, committed to a process of transparency and funding excellence, there is no reason to assume that it would fail to achieve any founding objectives associated with creating a uniquely European research funding organisation.

And if the Commission wanted the ERC, as a foundation, to pursue specific objectives, then these would above-board and clearly defined.

With this autonomy would come different forms of public accountability, indeed it would be accountable to more than the Commission, but to the wider standards of research excellence that it should be seeking in the public interest.

Let us, in the end, be clear. The ERC is not an innovative organisation, despite the words in the evaluation report.  It is simply a research funding body that seeks to link pots of money, specific research objectives and researchers, though some process of peer-review, assessment and analysis.  In the end, its success is measured not in money dispensed, or programmes in existence, but the results of research funded.  The ERC should think of itself more like a ‘midwife’, who can take little credit for the resulting offspring, but they can be assured that they did help.