Written evidence submitted by the British Heart Foundation (TSB0015)

The British Heart Foundation (BHF) is the nation's leading heart charity. We are working to achieve our vision of a world in which people do not die prematurely or suffer from cardiovascular disease. In the fight for every heartbeat we fund ground breaking medical research, provide support and care to people living with cardiovascular disease and advocate for change.

The BHF is the largest independent funder of cardiovascular research and the third largest charitable funder of medical research in the UK. Each year, thanks to the generosity of our supporters, we are able to fund around £100 million of new research across the UK and in all four nations. Our funding portfolio extends from laboratory science to clinical trials and population studies.  We fund people from PhDs to professors as well as investing in large programme and project grants.

A well supported science sector is vital for medical research charities, such as the BHF. Ongoing Government investment in science will allow UK researchers to continue with their world-leading research, maintaining the UK’s global position in life sciences, stimulating the economy and providing continuing improvements in public health. Conversely, cuts would have a profoundly damaging, long term effect. They would disincentivise investment from other sources, such as industry; reduce the amount of research which charities can fund; and damage the UK’s ability to retain and attract talent to research.

That is why we are calling on the Chancellor to maintain the science budget in real terms beyond 2016 and protect research that saves lives.

Current science budget allocations

1.       Scientific research and its translation into new technologies and treatments is a long-term process and as such, needs stable, long-term investment. It is estimated that the lag between investment in cardiovascular research and its eventual impact on patients is around 17 years[1]. Previous long-term investment in research across the public and private sector has transformed the lives of patients across the UK. Within cardiovascular disease, we now see more people surviving heart attacks, better diagnosis and treatment of inherited conditions, and more babies born with heart defects growing up to live healthy, productive lives. Continued long-term commitment from the UK Government is vital in order to support the sector and ensure that research today results in benefits in the future. 

2.       A productive research environment depends on Government investment in both science capital and resource. Whilst large-scale projects provide an exciting opportunity for research, support must also be given to existing projects so that institutions and facilities are well-maintained and the research within them continues to thrive.

3.       Since 2010, the resource allocation for science and research has been protected in cash terms at £4.6 billion per annum. The maintenance of this ring-fence over the past five years has provided much-needed stability to the research community and allowed the sector to focus on generating world-class research that adds to the knowledge base, delivers health benefits to patients and contributes to the UK economy.  More recently, the Government has also made a commitment of £1.1 billion per year for capital infrastructure funding, protected in real terms up to 2021.

4.       We recognise the Government’s commitment to protect science at a time which has required significant cuts to a number of Government departments. However, maintenance of the science resource budget in flat-cash terms equates to a reduction in real terms. As a result, since the science budget was ring-fenced, its value has gradually been eroded as a result of inflation. According to analysis from the Campaign for Science and Engineering, the resource budget accumulated a real-terms shortfall of £1 billion over the course of the last Parliament. If the flat-cash ring-fence is continued, this is expected to increase to over £3.1 billion by 2020[2].

5.       We therefore believe that the Government should commit to maintain the science budget in real terms at the Comprehensive Spending Review.

Budget distributions

6.       Government funding for research within higher education institutions (HEIs) is currently allocated through the dual-support system, whereby funds are allocated both through block funding from Funding Councils and research grants from the UK Research Councils. This system enables HEIs to maintain a solid research base at the institutional level whilst allowing individuals the flexibility to apply for project-specific funding to pursue the most promising avenues of their research. The system enables funding to be provided on the basis of proven and potential excellence, ensuring that research is conducted by the best possible people, wherever that may be. The dual-support system should therefore be maintained in future budget distributions.

7.       In order to address many of the biggest challenges facing society and to capitalise fully on new technologies, collaboration across scientific disciplines is increasingly important. Some of the most exciting and ambitious projects often emerge when different disciplines come together to address an issue. At the BHF Centre for Research Excellence in Cambridge[3], for example, interdisciplinary working has led to exciting research to develop 3D scaffolds for heart repair. It is vital that all seven UK Research Councils are well-supported, as a lack of funding in one area would impact on progress across other areas.

The impact of adjustments to Government expenditure

8.       Science and research is one of the UK’s biggest assets. The sector performs extremely well when compared internationally, ranking 2nd in the world for the quality of its scientific research institutions[4]. While the UK represents less than 1% of the world’s population, it produces 16% of top quality published research findings[5].

9.       The strength of our science base enables us to attract and retain the very best researchers to the UK and leverage further investment for world-class research. Its continued success relies on a network of different funders across the public and private sectors, each of whom have an important role to play in supporting the UK research environment. This interdependency means that any adjustment to Government expenditure would affect the ability of each of these funders to support research, limiting our opportunity to improve the lives of patients and boost the UK economy.

The funding ecosystem

10. The strength of our current position is dependent on combined commitment from Government, charity and industry. Complementary investment from all sources provides the full support needed to drive forward world-class research and build on the UK’s current position. If Government expenditure on science and research were reduced from current levels, charity and industry would be unable to increase their investment to compensate.
11. Medical research charities pay for the direct costs of research, but they are dependent on Government investment to cover indirect costs such as heating and lighting, through the Charity Research Support Fund. This investment, which is provided as part of the quality-related research (QR) funding by Funding Councils, is crucial to ensure that donors’ money is only spent directly on research. Charities would be unable to step in to cover these costs if Government funding were reduced.
12. Government, charity and industry frequently fund in partnership in order to cover the costs of larger research projects. Joint funding between the BHF and the UK Government has made real progress in our understanding of why heart disease occurs, and how to prevent and treat it. We fund in partnership with the Medical Research Council (MRC), as well as benefitting from investment by the National Institute for Health Research (NIHR) when funding clinical studies in the NHS. Between 2008 and 2014, 51% of publications arising from BHF-funded research cited a contribution from a UK government-funded agency such as the MRC and the NIHR[6].
13. Two of our recent projects, made possible through joint Government funding, are helping to establish the best course of treatment for heart attack patients and for individuals with high blood pressure.

14. Complementary investment from Government, charities and industry is also vital in the translation of research into new technologies and treatments. Whilst industry support is often required in order to conduct large-scale clinical trials and take a product to market, Government and charities play an important role in ‘de-risking’ these projects at an earlier stage so that they are more likely to attract industry investment. This early support is crucial, as it prevents new drugs, diagnostics and other technologies with real potential from falling by the wayside and never making it to the patients that could benefit most. 
15. In October 2014, the BHF launched a new award that aims to support exactly this type of project. The BHF Translational Award supports pre-clinical development of innovative medicines and technologies so that they are more attractive for onward investment by larger charitable funders or industry. Our first award, outlined below, looks at a test that could improve the diagnosis of heart attacks.

16. Government funding not only complements but leverages funding for research across other organisations. Recent analysis commissioned by the Department for Business, Innovation and Skills suggests that an extra £1 of public funding will give rise to an increase in private funding of between £1.13 and £1.60[8].

The benefit to patients

17. Medical research underpins the vast improvements we have seen in human health and wellbeing in recent years. Increasingly we understand better why disease occurs, how we can prevent it and how we can treat it. Across different conditions and diseases, people are now living longer, healthier lives thanks to investment in science.
18. In cardiova­­­­scular disease in particular, over the last fifty years the outlook for patients has completely transformed. There are people living healthy, productive lives today who would have died in childhood in the past. Others have been prevented from ever having heart attacks which would previously have been unavoidable.

19. Our achievements have only been possible with the input of the Government, other charitable funders and industry. Scientific progress is not achieved by the investment of one organisation, but by a system of investors complementing each other’s work. With continued support from Government, charitable funders and industry, research can and will continue to make exciting progress to the way that we live and work.

The UK economy

20. Through the creation of employment opportunities, development and commercialisation of innovative technologies, and collaboration between business and academia, science and research strengthen the UK’s competitiveness and drive economic growth and productivity.
21. Investment in science and research generates substantial economic returns. The UK life sciences industry generates an estimated annual turnover of £56 billion. For every £1 spent by the government on R&D, private sector R&D output rises by 20p every year[9].
22. Talented people are our most valuable asset – without them, progress towards exciting new treatments and technologies would grind to a halt. The UK life sciences sector directly employs around 183,000 people[10]. In the last financial year, the BHF alone spent over £40 million on salaries through our research grants[11], to support cardiovascular researchers across the country. Our researchers are based at more than 50 locations across the UK, conducting lifesaving research across the four nations, including cities within the Northern Powerhouse.
23. If we are to continue to retain and attract talented people and maintain the UK’s global competitiveness, it is vital that funding is available for researchers at all stages of their career. Investment is needed to nurture future talent, support those at the forefront of their field, and ensure there is flexibility for the most talented researchers to return to academia after time away. One way in which the BHF does this is through the Career Re-entry Research Fellowship:

24. Scientific research also contributes to the productivity of the UK workforce by developing treatments and technologies that enable people to live longer, healthier lives. Thousands of lives are now saved every year, thanks to research developments in the prevention and treatment of heart attack. As a result of studies funded by the BHF and the MRC, statins are estimated to save around 7,000 lives a year in England alone by reducing risk of heart attack, heart disease and stroke. Of those that do suffer a heart attack, 70% now survive, due to modern treatments built on BHF-funded discovery. 

August 2105