HC Deb 28 November 1969 vol 792 cc873-84

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Hamling.]

4.1 p.m.

Mr. John Fraser (Norwood)

We sometimes hear easy phrases about the lack of communication between people and Parliament. The subject of cancer research—a non-political subject—has been raised in my local Labour Party and it is a good thing to know that the channels of communication, in terms of Adjournment debates, are so direct. During the last few years the subject of cancer has been spoken about more easily than in the past, when it suffered from a veil of secrecy or shame, in the way that mental illness did. Perhaps not enough was done about it because people were not willing to speak about it easily.

My belief is that discussion and frankness about the disease of cancer—a major cause of death in these days—is to be welcomed, because discussion increases public awareness, and when the public is aware and informed pressures for research into the causes of cancer and its cure and care are likely to increase. When those pressures increase expenditure is likely to go with it.

I call to mind the names of people who have done a great deal to bring about this frankness and rather more open discussion, such as Sir Malcolm Sargent and Richard Dimbleby, who tragically died of the disease but posthumously have helped in the fight against it.

It will be readily agreed that the efforts of individuals and bodies, and the great campaigns, and what has followed in terms of fears about lung cancer arising from smoking and the pollution of the environment, coupled with this increasing degree of frankness, have increased the impetus of cancer research and treatment. But we must ask ourselves, first, whether the money being spent and so generously subscribed by the public is sufficient and, secondly—and not less important—whether the research being undertaken is being adequately co-ordinated, and whether the priorities that now exist between different fields of cancer research and different bodies undertaking cancer research are the correct ones.

It is not possible to specify all the sources of funds which now go into cancer research. I hope that I shall be forgiven if I omit many of the worthy causes. The main sources are, first, the Medical Research Council—a Government-sponsored body—to which I shall refer as "the council". Out of an annual budget of £17 million in 1969–70 it contributed £1.574 million to cancer research during the current year. The expenditure by that body has risen from £1.433 million in 1967–68 to £1.574 million in the current year. But the proportion of the budget of the Medical Research Council has fallen over the past three years and one would like to see it going back to the figure of at least 10 per cent. of the total budget—the figure for 1967–68.

The second body which provides money for cancer research is the British Empire Cancer Campaign, which I shall refer to as"the campaign". And the third is the Imperial Cancer Research Fund, which I shall refer to as "the fund".

The income and expenditure of these bodies is as follows. I have dealt with the Medical Research Council. The campaign last year collected £2,470,000. Out of that money, it spent £1,765,000 which it distributed to no fewer than 80 different research bodies. The largest bequest, of £245,000, was to the Institute of Cancer Research, better known, perhaps, as the Chester Beatty Institute. This institute is suffering at the moment an annual deficit of £200,000. The fund, in 1968, collected just a little more than the campaign, £2,530,000, and out of the money collected dispersed a good deal to its own research laboratories, which are in Lincoln's Inn Fields.

But out of the £2½½ million which it collected from the public, its expenditure on cancer research was only a third. Its surplus of unspent funds was £1,555,000. That is to say, the unspent surplus of the fund was equivalent to the whole of the grant from the Medical Research Council and was equivalent to eight times the deficit at present being run by the Chester Beatty Institute.

I do not want to say anything which would for a moment diminish the flow of funds to these public bodies. Indeed, I hope that anything said will increase this flow. We should pay tribute to the bodies which collect for cancer research and to the fact that only a tiny proportion of their income is spent on the administration and collection of money. The vast majority of the money, about 99 per cent., goes into research—

Mr. Speaker

Order. These two last funds are private charities, are they not? The hon. Gentleman must link them somehow with Government responsibility.

Mr. Fraser

The responsibility with which I want to deal is the link between the deficit suffered by the Chester Beatty Institute and the expenditure of Government money being devoted to cancer research by the council. The question is posed by a paragraph of an article in The Lancet on 5th July: Are members of the general public really satisfied when they learn that there is an unspent surplus of funds of £½million and the largest cancer research institute in the country is being starved to the point where it may have to lay off academic staff? But, since then, there have been redundancy notices sent out and I understand that the fund has had to eat away at reserves for new buildings. This, for a body which receives Government money, must be a very real concern.

It is fair to say in reply that the campaign cannot spend all its surplus, because it is undertaking a large expansion programme and needs to set aside money for new buildings and for the employment of staff over a long period. There are arguments on both sides, but to the ordinary man in the street it must seem incredible that one research institute should be facing redundancies and having to cut into its building funds.

In July, the following appeared in the Sunday Times: A top scientist at Chester Beatty confirmed that the staff were worried. It seemed to him not only serious but stupid. He said, 'It looks as though we shall have to lay off staff in a massive way in the next couple of years. We have virtually stood still for the past three years and we have used up our reserves. We dare not undertake any expansion'. Therefore, the ordinary man in the street wonders why one has a surplus and one has a deficit and whether perhaps there is adequate co-ordination in cancer research. That is one worry which the public and Parliament must have.

The second worry is that there are, financed through the Government-spon- sored council and by the private organisations, an enormous number of research projects. The Lancet tells us that many people are now worried that there is not adequate co-ordination of effort. Perhaps there is insufficient exchange of information, and, possibly, the priorities may not be right. I am a layman and I do not know the answers to these questions, but they should, I think, be answered.

I come now to the questions which, I consider, should be put to the Minister who has responsibility for research. First, what help is being given by the Medical Research Council or by any other means to the Chester Beatty Institute to continue its research work and to avert redundancies among the staff and a curtailment of its hoped-for building programme? What is being done to prevent this state of affairs continuing and to give hope and reassurance to the directors of the institute and the staff who apply themselves to the work of cancer research there?

Secondly, what consideration is being given to getting the fund out of the dilemma which it faces? As far as I know, it receives no money from the Medical Research Council and, therefore, apparently it has to put aside two-thirds of its income to finance future building and to have sufficient in reserve to guarantee stability of employment for its 400 employees.

Surely, if the Government were prepared not necessarily to give money but to underwrite staff and maintenance costs in the future, this might make it easier for the fund to dip its hand into its pocket and not have to accumulate large reserves because it has no other sources of income. If a source of underwriting could be made available through the Medical Research Council or some other Government-sponsored means, this might make it easier to distribute for immediate use the money available to the private funds.

Thirdly, what progress is being made in co-ordinating cancer research? In 1968 a British Cancer Council was set up to co-ordinate research work but, unfortunately, at that time both the fund and the campaign, the two biggest providers of money, refused to join. It was believed by many commentators to be singularly unfortunate that the two largest bodies should not have joined in. Can my hon. Friend the Minister tell me whether they have now joined in or whether the Government themselves, through the agency of the Medical Research Council, are making a real effort not only to co-ordinate the efforts and the many research projects which are being undertaken by institutes, research bodies and individually in cancer research, but to work out a system of priorities as to whether, for example, basic research into the nature of the cancer cell or other research into the early diagnosis of cancer symptoms is important?

I appreciate that in these matters the Government certainly are not responsible for the conduct of private funds, and that should be so, but the Government have an influence through the Medical Research Council in directing the order of priorities and the way in which, at least, public money is spent.

Another question which I should like to put to my hon. Friend the Minister is whether he is satisfied that the Medical Research Council is not financing projects which are really the responsibility of the Science Research Council. I am thinking in particular of molecular biology and biophysics, matters which might be the responsibility of the Science Research Council. It does not matter who undertakes them but it would be wrong if these subjects, which might be pure science subjects, were taking away funds which might otherwise be available for cancer research.

I should like to know, finally, whether the Minister is satisfied that sufficient money is being spent by the Government in cancer research and whether they might not be willing to match private contributions for cancer research. When one considers the deaths from cancer, the suffering, the disablement and the loss of work and of talent which it causes, is not the amount which is being spent by the Government through the Medical Research Council—about£1½ million a year—ludicrously small?

I know all the arguments about public-expenditure. The House has been discussing them indirectly all day. But we might look at the way in which things like industrial training boards and the redundancy fund are financed, not from public expenditure and taxation, but from industry's own funds. Is it not possible to organise matters so that private industry finances cancer research? For instance, if only 1 per cent. of the cost of cigarettes were devoted to the cause of cancer research—rather less than 1d. on a packet of 20 cigarettes—I believe that it would bring in about £5 million a year, and double the present expenditure on research into cancer.

When we consider other cancers caused by chemical agents or the fumes from motor cars, is it not possible so to organise matters that industry has its own levy made available for research?

Mr. Speaker

Order. The hon. Gentleman's last two proposals would involve legislation.

Mr. Fraser

I shall end my questions at that point, Mr. Speaker.

Cancer research must be a matter of vital importance and interest to the community. I praise the Government for the way in which they have increased expenditure on it over the past three years, but I urge them to continue to increase that expenditure, and I hope that the public can be satisfied that it is being spent in the right way and that there is adequate co-ordination.

4.16 p.m.

The Minister of State, Department of Education and Science (Mr. Gerry Fowler)

I am grateful to my hon. Friend the Member for Norwood (Mr. John Fraser) for raising a matter of such vital importance. Clearly, finding a cure to the dreadful scourge of cancer is a matter near to the hearts of us all. But despite what one reads from time to time, the dramatic break-through is, unhappily, not a characteristic of medical research. The problems that arise rarely lend themselves to the simple solution. This is particularly so with cancer, that parody of normal life processes.

Research now embraces a range of work, extending from the clinical treatment of patients through a host of scientific disciplines to the most fundamental and generalised studies which may be relevant not only to cancer, but the whole spectrum of diseases.

Therefore, it is difficult and probably pointless to try to determine where cancer research begins and ends, and it is equally difficult to say precisely how much financial support is being given to that research. According to the best estimates of the £60 million or so in a year being spent in this country from all sources on medical research of all kinds about £5 million, or one-twelfth, is devoted to research directly concerned with cancer.

Of this sum the Exchequer via the Medical Research Council and also, I must stress, the National Health Service and the universities—my hon. Friend neglected the contribution made from public funds through agencies other than the M.R.C.—provides about £2 million. So the total is rather more from public funds than my hon. Friend allowed. The remainder, as he said, is contributed by the great voluntary bodies, and I pay tribute to the British Empire Cancer Campaign and the Imperial Cancer Research Fund.

I know of the enormous work done at local level in raising funds. In my constituency every year there is an enormous effort to raise funds for the British Empire Cancer Campaign, which I find extremely impressive. We must all be grateful as a community to those who toil so selflessly to help us in our efforts to find a cure for this dreadful disease.

It is often suggested that we should spend more on cancer research, and my hon. Friend asked whether we should. In an ideal world it may well be true that we should spend more, but it is impossible to say exactly how much should be spent on research into this or any of the other major scourges that still afflict us. We must remember that advances in medicine and many other fields of knowledge are not a direct function of the amount of money invested. I wish they were. They cannot be bought, They depend on the emergence of new ideas and of new techniques. The main requirement is that we should be ready to recognise and support such developments when they appear.

I should like to refer now to the way in which the Medical Research Council divides up its expenditure. The largest single item on cancer research is for maintaining its own establishments, of which there are 23 directly connected with cancer, and second on the list of priorities is cancer research. The Department, as agent for the Government as a whole, gives the Medical Research Council a lump of money, and what the council spends it on is a matter for its own scientific judgment. This is the whole basis of the research council system. We rely on the research council to exercise its scientific judgment in the establishment of priorities or, to put it a little more directly, one does not keep a dog and bark oneself. We do not try to bring to bear any undue influence on the Medical Research Council to establish a different order of priorities.

My hon. Friend asked whether or not we had a coherent policy and whether there was sufficient co-ordination of the various bodies which are concerned in cancer research. Monolithic organisation for its own sake offers few advantages. The Government welcome the existence of voluntary organisations. As my hon. Friend knows, experts have been known to differ as to what is the most profitable line of research to pursue, and official organisations do not, and I am happy to confess it, possess a monopoly of wisdom. The independent bodies with independent funds, able to exercise independent judgment, form a necessary counterbalace. Among other things, they are in a position to support projects which have, perhaps, only a very long chance of success and for which public money can be provided only sparingly.

This is not to say that there is no co-ordination between these elements. The M.R.C. has always worked in close consultation with both the British Empire Cancer Campaign and the Imperial Cancer Research Fund, through M.R.C. representation on scientific advisory committees of the two organisations, and the council has recently been discussing the possibility of a joint co-ordinating committee to facilitate the exchange of views.

The council's estimated direct expenditure on cancer research this financial year exceeds £1½ million. Much of this goes to its own very efficient units. But the council also provides nearly half the income of the Institute of Cancer Research, a body upon which my hon. Friend concentrated, by a block grant of nearly million. This grant will be maintained in real terms—and I stress that it will be in real terms—until 1972, and will have an annual increment of 3 per cent. in respect of development.

In addition to this, the council pays over £35,000 to the Beatson Institute for Cancer Research in Glasgow, and £84,000 to the Christie Hospital and the Holt Radium Institute in Manchester as well; as well as grants to individual workers and groups of workers in university departments and other centres.

I think that my hon. Friend would like me to concentrate for a moment, upon the Chester Beatty Institute. Unlike the other institutes of the British Postgraduate Medical Federation, and as a result, primarily, of its small teaching component, the Institute of Cancer Research receives no support from the U.G.C. funds. Nearly half of its income comes from the M.R.C. Several major areas of effort are grants made on an annual basis from the British Empire Cancer Campaign—£¼ million—and similar sums from legacies and other sources.

Recent references in the Press to the finances of the institute have clearly stimulated parliamentary interest. Several Parliamentary Questions have been asked recently. The Press reports centred on dissatisfaction on the institute over certain proposals to close down some of the work which has diverged to some extent from the field of cancer research or which seems to be no longer of sufficient promise. I must stress that at this stage the matter is entirely one for the institute itself. It is giving independent consideration to the future of its research programme and to the closely related problems of its administrative organisation and financing arrangements.

It would be quite inappropriate if I were to seek to give guidance or to intervene in the lucubrations taking place in the institute as to its internal affairs. The M.R.C. has confirmed its willingness to provide major support. Negotiations over the final form of the council's future grant are proceeding and it would be improper to seek to influence the course of those negotiations. The institute's object is to ensure that its resources are used in the most effective way by concentrating on what appears to be the most promising fields of research.

It follows that there may be times when certain research teams have to be disbanded. There is nothing odd about this. The first question I always ask whenever I go into an institute of research is not, "What new work have you started?", but, "What work have you stopped this year?" It is most important that all engaged in research should realise that because funds are not unlimited success with research depends on stopping unpromising work in order to begin more promising work.

I understand that at present the institute finds it necessary to discontinue certain lines of work so as to free resources for research projects which now have higher priority. In planning its revised research priorities, the institute has taken into account the views of a committee which visited the institute earlier this year to consider the programmes then in progress. My hon. Friend will be happy to know that there is very close collaboration and co-ordination in respect of a particular research programme.

My hon. Friend asked a series of other questions. One was whether the M.R.C. might be willing to underwrite the staff and maintenance costs at the institute. The answer must be, "No". The M.R.C, as do all science research councils, operates on the basis of supporting particular research projects which seem to the council to be promising scientifically.

Mr. John Fraser

I hope that my hon. Friend did not misunderstand me. I was talking about the funds of the laboratories in Lincoln's Inn, not the institute's.

Mr. Fowler

I am making the point that the M.R.C. cannot underwrite costs in this way. It must limit its support to particular research projects.

My hon. Friend also asked whether I was satisfied that there was adequate coordination between the M.R.C. and the S.R.C. in such fields as molecular biology. I am satisfied that there is close liaison between the councils. The Council for Scientific Policy exists to give general advice and in this case to co-ordinate effort. My hon. Friend asked whether there was any possibility of private industry financing research as a result of a levy. You, Mr. Speaker, suggested that that might call for legislation. It would also call for hard thinking by my right hon. Friend the Chancellor of the Exchequer, but I will bring it to his notice. I can undertake to do no more than that today.

I am sure that we are united as a House in hoping that research done at Chester Beatty and elsewhere will in the fullness of time lead to a cure for this dreadful disease. I am satisfied that not only is adequate effort in a competitive situation—other areas of medical research are equally deserving and competing for funds—going into sponsorship of research on cancer, but the Chester Beatty Institute must be left to get on with its own job and to decide its own research programme. It will have every guidance it requires and all the advice it asks for from the M.R.C. More than that one cannot offer.

Despite all the immense effort going into this research I cannot hold out any prospect of quick success, but if the extent of human endeavour is any measure a solution to this, one of the great remaining mysteries, will eventually be found. We all hope that it will be soon.

Question put and agreed to.

Adjourned accordingly at half-past Four o'clock.