I remind Members of the changes to normal practice to support the new call list system and ensure that social distancing can be respected. Before they use them, Members should sanitise their microphones using the cleaning materials provided, which they should dispose of as they leave the room. Members should respect the one-way system around the room.
Members may speak only from the horseshoe and only if they are on the call list. Even if debates are under-subscribed, Members cannot join the debate if they are not on the call list. They are not expected to remain for the winding-up speeches, and there is less expectation now that Members will stay for at least two speeches: once they have spoken, they may leave the room.
I beg to move,
That this House has considered recognising and preserving the value of charity-funded medical research in the 2020 Spending Review.
It is a pleasure to serve under your chairship, Miss McVey. I should like to record my thanks to the Backbench Business Committee and the Chairman of Ways and Means for granting time for this important debate before tomorrow’s spending review. I also thank the British Heart Foundation for its assistance with preparations for this debate.
The UK Government website states that
“our world-class research and researchers play a vital role in delivering local and national economic prosperity but we recognise that some of that research is at risk from a range of income losses as a result of Covid-19.”
I agree wholeheartedly with that statement and emphasise that we acknowledge the extremely valuable scientific and medical contributions that they make.
As I hope to set out, charity-funded medical research has lost a great deal as a result of covid-19. If its contribution to the UK and, indeed, to the world is to continue, the Government must consider further support, particularly ahead of tomorrow’s spending review.
Life sciences research and development is funded through a broad partnership between Government, universities, the private sector and charities. In 2019, charities funded £1.9 billion in UK research and development. This year, medical charities have seen the closure of their charity shops, the cancellation of fundraising events and a drop in public donations.
The true value of charity-funded medical research is often under-appreciated, and to understand the gravity of the situation in which the sector finds itself we must first acknowledge the contributions it has made to society in a normal year. A 2017 report published by the Association of Medical Research Charities found that 397 unique medical products and interventions were produced further to charitable awards, most of which were drugs and diagnostic tools but the list includes a gas delivery ventilator system to help to protect long-term brain function in babies starved of oxygen at birth and new immunotherapies for cancer. These are practical benefits of research that save lives immediately, but in the medium to long term the development and sharing of knowledge is key.
Medical research charities have produced hundreds of models and more than 26,000 unique publications that go on to inform research for years to come. The production of such publications is not straightforward or free: it is largely unseen work that is essential to developing practical solutions to healthcare challenges. This knowledge, which has improved our understanding of diseases such as Alzheimer’s dementia, has also been used to inform policy making.
Throughout this pandemic the Government have outlined that their policy decisions have been guided by the science. I fully support that approach and I know that it extends to all medical and healthcare policies. The Association of Medical Research Charities reports that in 2017 there were 166 citations in policy documents which referred to research linked to medical research charities and 536 examples of researchers directly providing advice to Government. From clinical reviews to participation in advisory committees, the combined knowledge of medical research charities and their staff has critical value.
It is important to note that practical healthcare solutions and knowledge development are not exclusive to the research of major diseases. Thousands of people in the UK live with rare diseases and in 2018 alone medical research charities invested £142 million in 640 rare disease projects. Without ongoing research conducted by well-funded specialists, we risk declining health outcomes for many who suffer from all conditions, but particularly those that are less common.
Further to the expansive scientific and practical value of charity-funded medical research, there is a significant economic element. Last year, in Wales alone, 53 charities funded 289 active grants worth £89.7 million benefiting research institutions such as universities and NHS organisations. More than one third of charities associated with the AMRC projects that are being carried out are in Wales. At pre-pandemic levels, more than 17,000 highly skilled jobs were supported directly in the sector throughout the UK. It is thanks to the tireless work of these experts and their support teams that, for every £1 spent on research by public and charitable funders, there is a return of 25p per year in perpetuity. The financial value of the charitable sector is perfectly demonstrated by the British Heart Foundation, which made an investment of £476 million last year, leading to researchers leveraging £1.27 billion.
Unfortunately, as has been seen across the board, covid-19 has been catastrophic for medical research, posing immediate challenges as well as medium and long-term charity-funded uncertainties. The AMRC estimates that such charities lost 38% of their fundraising income between March and May 2020, leading to an immediate shortfall of £310 million this year. Predictions go on to warn of a 41% fall in research spend in this financial year, and reports from the Institute for Public Policy Research expect a shortfall of up to £7.8 billion in UK research and development spending between now and 2027. The British Heart Foundation alone lost £10 million in revenue during each month of the spring lockdown, and current restrictions will cost another £7 million. Because of this, the organisation has already halved its research budget for next year—a reduction of £50 million. Likewise, Cancer Research UK has been forced to cut £44 million from its research spending. Unfortunately, this approach has been necessary among many other charities, too. The current trajectory shows that it will be at least half a decade until we return to pre-pandemic levels and without a change there will be significant implications for jobs and health outcomes.
I know that many charities are grateful for the support that they have received from the UK Government through schemes such as the coronavirus job retention scheme, which has been extended to March next year, but with the overall reduction in income and consequently fewer research projects, many of those positions may not be sustainable. A survey of more than 500 charity-funded early career researchers in the UK found that four in 10 are considering leaving research due to funding concerns arising from the covid-19 pandemic. In total, half of researchers say that their funding will expire by the end of 2021. Of those, two thirds have been unable to secure funding to take them to the next stage in their careers. Cancer Research UK worries that, without support, it could be forced to lose 1,500 researchers—more than one third of its research workforce. It is worth putting on record that such jobs are highly skilled positions that require extensive research infrastructure and if we lose them, they may never return. Muscular Dystrophy UK notes that it funds new PhD students at each grant round, so without financial support not only are we damaging the industry now but there will be worrying implications for British research.
Medical research charities have, sadly, been unable to access the £750 million of additional funding made available in April to support charities providing essential services. This is despite many charities pivoting their research to support the national covid-19 effort, including Cancer Research UK labs providing testing kits and Asthma UK providing an essential post-covid hub and helpline for people left with breathing difficulties.
The number of patients entering Welsh research studies fell by 23.8% between 2018-19 and 2019-20. At the UK level, at the height of the first lockdown, the AMRC reports that 73% of clinical studies and trials funded by charities were paused or delayed. This number remained at 43% even in September. The expectation of some in the industry is that, unfortunately, some of these trials will never restart. We must do all that we can to reverse this trend.
So what action is required? It is vital that we fund research to better prevent, diagnose and treat illnesses, a view shared by my constituent Mandy Swift who sustained two heart attacks in her early 50s and spoke out recently about the need for women to better understand their risk of a heart attack and its symptoms. Preserving charity-funded medical research needs to be a priority for the Government. We now stand at a crossroads and decisions taken in the days and weeks ahead can influence the future of charity-funded medical research for the next decade. As we reach the end of the transition period and want to retain our status as a global leader in this sector, we must provide the support that is necessary.
The Government have already pledged money through the sustaining university research expertise—SURE—package. I am delighted that, by introducing this programme, the Government have publicly acknowledged the value of our unique research and development ecosystem. However, it is unclear how charities will be able to engage with this funding. The spending review and the Chancellor’s statement tomorrow is an ideal opportunity to bring forward the further support that is much needed. I know that the charity-funded medical research sector is one of the many sectors calling for a bespoke package of support and, indeed, I am sympathetic to calls from many other industries. However, the unique contribution of medical research to our health, wellbeing and economy is unmatched. Charities fund research in every region of the UK, contributing to regional growth and the Government’s levelling-up agenda. Ultimately, this research also leads to health improvements, particularly in areas of unmet health need and inequality.
Organisations, including the AMRC, the Royal College of Physicians, the British Heart Foundation, Cancer Research UK, Muscular Dystrophy UK and the Francis Crick Institute, have all been in touch with me in the run-up to this debate calling for a life sciences charity partnership fund. This proposal centres on the three-year settlement to provide a match-funding arrangement that would contribute £310 million in year one to protect and enhance our status as a science superpower. The parameters of such a scheme could be settled upon by the Treasury in consultation with the sector. The Royal College of Physicians specifically notes that funding should be targeted to support more research activity in rural areas, such as north Wales, that often carry the highest disease burden but the lowest research activity. Some 40% of those working in rural hospitals would like to be more involved in research, and that figure is 12% higher than for reported respondents in city hospitals.
The Royal College of Physicians has proposed that, in areas where research activity is low, a trial should be programmed whereby 20% of consultants have 20% of their time protected for research. Such potential approaches are important. As the AMRC points out, during the pandemic its members in Greater London have been twice as likely to have secured funding than those outside the capital, leading to a risk that a charity funding crisis may exacerbate regional divides. Without much-needed support, more than 50% of the AMRC’s members have indicated that the impact of covid-19 on their research portfolio will have implications for the UK’s ability to attract research talent and global research leadership.
As the Government publicly acknowledge, we have a world-class research system and researchers too but, as a result of covid-19, thousands of scientists and projects are at risk. That concerns me greatly as a GP. Charity-funded medical research has been an intrinsic part of our national R&D ecosystem for decades, contributing to major scientific breakthroughs, the advancement of knowledge and economic growth. Without action soon, we risk years of poor research outcomes and thousands of highly skilled jobs being lost. Although some support has thankfully been made available, I believe that the spending review provides the Government with the perfect opportunity to extend that, ideally through a life sciences charity fund. I hope that such a plan is already in the Chancellor’s mind. If not, I ask the Minister to make him aware of today’s debate.
As the UK Dementia Research Institute notes, charity-supported medical research has been prominent in national efforts to tackle the outbreak. As attention turns to long-term impacts, we must ensure that medical research is supported now and into the future.
It is a pleasure to serve with you in the Chair, Ms McVey. I congratulate the hon. Members for Vale of Clwyd (Dr Davies) and for Bolton West (Chris Green) on securing this important debate.
Most of us will have put dignity to one side and “worn it pink” for Breast Cancer Now, piling on feather boas, hats and Elton John-style pink specs. It is a bit of fun, but it has a serious point. More than 150 MPs took part in 2019, and the charities Breast Cancer Care and Breast Cancer Now say that the Wear it Pink campaign has raised over £33 million in the last 17 years to fund breast cancer research and support. It is just one of the many activities helping charities to raise essential funds to support the cancer research that is so desperately needed, and it is helping to improve cancer survival rates.
This year is different, though. Understandably, covid-19 has meant that Wear it Pink and so many other events cannot take place. Although we might wear pink at home, it is not quite the same. Of course, such parliamentary events are just the tip of the iceberg in raising funds. Our charities have been hard-hit by the effects of covid-19. Their fundraising activities right across the sector have been hugely hit by the restrictions on holding events. Charity retail shops have had to close, resulting in a huge loss of income. It has made it more difficult for them to meet and engage with people, and to raise the money on which they rely to carry out their activities and to fund the research that makes such a positive difference to our knowledge of, and treatment for, the conditions that they work on.
I mentioned Breast Cancer Now. Most of us have been affected by breast cancer at some time in our life. In my case, no fewer than four of my aunties have been treated for breast cancer—thankfully, all successfully. It was only two weeks ago that we heard in the main Chamber from the hon. Member for Chatham and Aylesford (Tracey Crouch), who is undergoing treatment for breast cancer. Breast Cancer Now, which has provided a very helpful brief for the debate, has pointed out that 55,000 women and 370 men are diagnosed with breast cancer each year, that one in seven women in the UK will develop breast cancer, and that 35,000 people are living with incurable secondary breast cancer. It remains the case that almost 1,000 women die from breast cancer each month in the UK, with 600,000 living with or beyond breast cancer.
Covid-19 has had a severe impact on clinical trials. Breast Cancer Now points out that recruitment to many clinical trials was paused, and that the virus stopped new and ongoing trials, as healthcare professionals were asked to prioritise frontline care. I hope the Minister can say what the Government will be doing to improve the rate at which clinical trials will be restarting recruitment.
Members of the Association of Medical Research Charities have together invested £14 billion in research since 2008, with £1.9 billion spent on UK research and development in 2019 alone. That is more than was spent by the Medical Research Council and the National Institute for Health Research. It is half of publicly funded medical research nationally, and 66% of total research spend on cancer. Members of the Association of Medical Research are planning for an average 41% decrease in research spend in 2020-21. Many other charities are also facing difficult problems. The hon. Member for Vale of Clwyd (Dr Davies) mentioned the British Heart Foundation; many of my constituents have been in touch to talk about the importance of ensuring that its research continues.
I want to look briefly at two charities at opposite ends of the scale. Muscular Dystrophy UK supports people with neuromuscular conditions and the research that produces new treatments for those conditions, dealing with quite a small group of people as a percentage of the population. The charity points out that covid-19 has produced a shortfall of £310 million in charity research investment, and that although the Government have provided £750 million of support to charities, none of that was for charity research. Muscular Dystrophy UK estimates that it will take over four years for its charity research fund to recover, but a decade to rebuild what would be lost in terms of capacity and capability.
Muscular Dystrophy UK’s research relates to rare or ultra-rare conditions, supporting research, infrastructure and capability, and sustaining a diversity of funding approaches, including those that are high-profile and high-risk. It involves people with lived experiences of neuromuscular conditions to set research priorities through its lay research panel and its medical research committee. It has also supported research into gene therapy for Duchenne muscular dystrophy, cell-based screening for myotonic dystrophy and exome sequencing—all projects that have produced important outcomes, have led to further potential treatments that will make such a difference to those with neuromuscular life-limiting conditions. So those are really important issues, and the pandemic is limiting what can be done.
At the other end of the scale of numbers is Alzheimer’s Research UK. It works on behalf of a much wider group of people, who live with the impact of Alzheimer’s and dementia, sadly, another condition that most of us will be touched by in the course of our life—either in people we know or ourselves. Alzheimer’s UK points out that covid-19 is not the only health crisis that the UK is facing, and says that dementia is the only condition, of the top 10 leading causes of death in the UK, for which there is no treatment to prevent, cure or slow its progression; and that it is predicted that 1 million people will have dementia by 2025. There is an urgent need for medical research into Alzheimer’s, and that is largely funded by medical research charities such as Alzheimer’s Research UK.
Covid-19 has hit people with dementia hard. A quarter of people who have died from covid-19 also had dementia. Research is urgently needed, but it is facing delay due to the pandemic. Funding opportunities have been reduced and social distancing has slowed the pace at which researchers can work. We know, too, that dementia has a huge impact on too many people. It is vital that we support research into the causes of dementia urgently, even in these difficult times.
The medical research charities have come together to propose a way to ensure that that vital research for both rare and widespread conditions can continue. They point out that the current Government support for charities and Sustaining University Research Expertise—the SURE fund—is not a long-term solution, so they are calling for the Government to create a life sciences charity partnership fund over the next three years, starting with £310 million in year one, to meet that shortfall.
Our medical research charities play a huge part in developing future treatments for so many conditions. If we are to maintain that progress in cancer research, rare conditions, dementia and so many other things, the Government must help, so I ask the Government to commit, in tomorrow’s statement, to supporting that vital work.
It is a pleasure to follow my hon. Friend the Member for Vale of Clwyd (Dr Davies) and the hon. Member for Blaydon (Liz Twist)—a couple of excellent speeches, capturing the key features of what we need to be thinking about in this debate, and what the Government ought to be redoubling their efforts to focus on. We only have a day before the spending review, so hopefully the Minister will be busy after the debate, pressing the case for that vital funding.
This debate on the importance of recognising and preserving the unique value of charity-funded medical research in the upcoming comprehensive spending review is incredibly timely and incredibly important. It represents an area that has not received much attention to date; covid and its associated lockdown have had an impact on so many other aspects of our society that this area has barely been looked at. However, the consequences of the impact on the sector are profound and will be realised over many years to come, not only in terms of what it does, what it achieves and the advances it creates, but also the people working in that sector and the treatments and medicines that come from it.
We should be cautious when the Government approach anything that has unforeseen consequences. They are pulling on strings, and we quickly realise how much is unravelling. We have seen other areas of society that are facing great difficulties get funding or other support. As the thread unravels further, we are coming to the charitable medical research sector.
We initially thought the national lockdown would be for three weeks, beginning in March. It seems that round every twist and turn of the road we see yet another deadline, yet another target being drawn out; the next target was expected to be November, and it has been pushed back to Easter. We will soon, after a fashion, be celebrating our first anniversary of national lockdown in one form or another, and the impact over that one-year period is profound.
We know that the direct impact, in terms of health, has already been about 5 million fewer hospital appointments, tens of millions fewer GP appointments and millions fewer cancer screenings. We know the impact on mental health as well. That is more cause for the charitable sector in medical research to redouble its efforts in terms of work and to gain the support it needs from the Government.
We have a sense of the economic impact, which is counted in the hundreds of billions of pounds. That is extraordinary—incomprehensible; but more locally it is affecting our high streets, of which charity shops are a key part. Many research charities gain a very significant amount of their income from high-street charity shops, as do many other charities, such as the hospice movement. So much of that income has been taken away.
We also see the terrible impact on education. Schoolchildren have lost about six months of the school experience. Many schools have done a great deal of good work to ensure that loss is not too great, but many others have not been able to do so. We know that those children have lost out significantly, and some children in my constituency—and I am sure those of other hon. Members—have already missed a couple of weeks, or perhaps two sets of missed weeks, of school when classes, or even year groups, have been sent home because of covid. Therefore many students have lost four weeks of education, and by Christmas it might be six weeks. This is going to carry on until Easter.
The impact on the university sector is enormous, disrupting education. Where will those children and young adults end up? Hopefully, many of them will end up as technicians, engineers or researchers in the charitable medical research sector. Their loss of education, of experience, will have an impact on that sector in the future, and it will have an impact on their ability to get those jobs—those skilled, brilliant jobs. Their ability to get such jobs will be hindered partly because the jobs will not exist if this situation continues, but also because they may not get the experience or qualifications they need.
We can see how this reverberates through our society. Yesterday, the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) led a debate on the closure of sport and gyms, and the impact that their absence will have on health. In normal times, if we are told to jog on, or take a hike, that is seen as quite negative—at least, it always has been when I have heard it. However, for the medical research charity sector, jogging on and taking a hike—or doing sponsored walks or marathons—are a major source of income. That has gone. The London marathon this year was for élite athletes, and the Bolton marathon, which was to have been run for the first time in many years, was cancelled. Those opportunities—the core ways in which the charitable sector receives much of its income—have been taken away. Who would have thought that that would happen, when we were deciding in March to go down the route we did? I dare say none of us had any anticipation of where things would end up today.
It is important to understand the scale of the sector, which is enormous. For example, in 2018 the Association of Medical Research Charities invested £142 million into 640 rare disease projects. That is investment on a colossal scale. Probably tens of thousands of people overall are involved in clinical trials—particularly in the charitable medical research sector—so there is an impact on recruitment for clinical research, and although 3,203 or 49% of commercial and non-commercial studies are open to recruitment, only 26 have recruited a participant since 1 June. That is a huge loss of recruitment to clinical trials.
What does that mean? We have to think of the meaning and impact of those significant figures. It is about a treatment, in one form or another, that could and should be given to people for a clinical trial period. It might not be effective, but it might well be. A trial would give people hope of receiving treatment and support. That is particularly important in relation to rare diseases, where people often feel neglected because there is not the focus on those diseases that there is on higher-profile disease conditions. Medical trials give people hope that treatment for rare diseases is being focused on and supported and that, although it may take years, a treatment will arrive at some point. However, there is an impact on people and their families when clinical trials are closed down and that hope is taken away.
As the lockdown caused by covid rolls on, the period for restarting a clinical trial is pushed further and further back. That is not just because of the duration of the lockdown and difficulty in recruiting people to the trials, but because of funding. If there is no funding, the organisations cannot even start the process of clinical trials. The British Heart Foundation is funding more than 1,700 research staff, working on more than 800 research projects, and it also funds 440 early-career researchers. That is a huge number of people in the sector. The Francis Crick Institute in London has 1,500 scientists, students and support staff working across a variety of disciplines, and looking at illnesses such as cancer, heart disease, stroke, infections and neurodegenerative diseases.
Large organisations are often more resilient because they have better funding streams. Smaller organisations, perhaps more often looking at rare diseases, have less funding for what they are doing, so they are far less resilient. All of this, coming together, gives a clear and powerful reason why the Chancellor, the Minister and others need to act to ensure that this focus—this funding—is there on a sector of our society that is often neglected and not thought about but that, when our friends and our families are hit, is so highly valued and so highly prized.
I urge the Minister to ensure that life-saving medical research can continue throughout and beyond the pandemic lockdown. Government must establish a life sciences charity partnership fund commencing with a commitment in the spending review to an initial £310 million for 2021-22. That may have to continue into following years. It is estimated that, to recover, if Easter sees the end of the lockdown period, the challenge for the sector may carry on for another four years or more. The funding has to follow the sector for at least that period of time.
In conclusion, if we are—I do not like the phrase—to build back better and ensure value for money and the effectiveness of research, we must recognise that the north of England, and particularly Manchester and its surrounding areas, has great expertise in this area. When we are looking at value for money and cost-effectiveness, the golden triangle is magnificent in so many ways. However, when looking at investing in the future, the medical research sector and Government should be thinking about Manchester central, the city of Manchester and the wider area. I hope the hon. Member for Manchester Central (Lucy Powell) will press the Minister on that point as well.
It is a pleasure to speak in this debate with you in the Chair, Ms McVey. This is a timely debate ahead of tomorrow’s spending review. As the chair of the all-party parliamentary group for eating disorders, I will focus my short remarks today on eating disorders and research funding.
We have already heard that covid-19 has had a devastating effect on the charity sector more generally, with income from fundraising lost during lockdown. The value of the expertise of medical research charities has never been more stark, yet they were not included in the Government’s £750 million support package. The charities are a huge driver of medical research in the UK, and we have already heard some of the numbers, but they are worth repeating. Members of the Association of Medical Research Charities invested £1.9 billion in 2019 alone. That is 51% of publicly funded UK medical research. They face a shortfall of up to £7.8 billion between now and 2027, according to the Institute for Public Policy Research.
I want to draw some attention to the importance of charity-funded medical research to understanding and treating eating disorders. The impact of an eating disorder can be devastating, and there is a pressing need for more research. We have heard particularly about specialist and rare diseases, but eating disorders are widespread and have epidemic proportions in many ways. Eating disorders are especially prevalent among young women, affecting about 15% of that age group, but the truth is that eating disorders do not discriminate. That is an important factor. According to the charity Beat, up to 5% of the population will experience an eating disorder.
Eating disorders are all-consuming. They have an impact on social relationships, quality of life and physical health. Anorexia nervosa is one of the most common forms of eating disorders and has the highest mortality rate of any mental health condition. According to the Medical Research Foundation, up to half of people with an eating disorder have self-harmed. Despite all of that, there is still limited research focusing on the causes of eating disorders. There is a serious lack of investment for mental health research in general. In a study last year, the charity MQ: Transforming Mental Health found that eating disorders were among the mental health conditions that received the least research funding.
In recent years, medical research charities, including several members of the Association of Medical Research Charities, have played a hugely welcome role in funding and supporting eating disorder research. Often, the chances for early interventions for eating disorders are missed, and treatments may not always be effective, so many patients are admitted for expensive hospital treatments. Currently, less than half of individuals with an eating disorder reach full recovery. Again, that is an important statistic: half never reach full recovery. That means a large proportion of people in this country are affected by eating disorders.
Studies funded through medical research charities have included research into self-harm and eating disorders, as well as the treatment of adults with anorexia and autism. In February, the largest ever study of eating disorders, the Eating Disorder Genetics Initiative, was launched. This seeks to build on existing research, which shows that genetic factors are involved in eating disorders.
In conclusion, eating disorders are serious conditions and can be potentially life-threatening. These studies help us to understand more, about not just the treatment of eating disorders but the underlying causes and common risk factors; they may even prevent eating disorders from developing in the first place. It is crucial that these charities receive the financial support they need, so that they can continue to play this vital role.
I, too, add my voice to the many here today. Medical research funding is so important, and it needs support from the Government. I urge the Minister to make her voice heard in the spending review tomorrow.
It is pleasure to serve under you, Ms McVey. I congratulate the hon. Member for Vale of Clwyd (Dr Davies) on securing today’s timely debate and the Backbench Business Committee on granting such a debate.
“A statistic will never truly capture the devastating impact research cuts will have on all of us. Research is hope. Research is more time with your loved ones. Research is improved quality of life. Its value is immeasurable.”
Those are not my words, but those of Aisling Burnand, the chief executive of the Association of Medical Research Charities. We have heard much today about the investment the AMRC has put into lives of so many of our constituents. Some 151 charities, which have joined together with the public through their fundraising efforts, have spent £14 billion over the last decade in funding 17,000 research staff and driving 213 clinical trials, advancing the frontiers of medicine and enhancing lives as they go. As we have heard in today’s debate, they also bring resources back Not only does every £1 invested bring 25p back into the economy on a permanent basis, but charities save our NHS so much money through their early interventions and by advancing the frontiers of medicine.
However, covid-19 has disrupted the incredible story of how charities play a central role in advancing science and the UK’s global excellence in this field. That partnership really makes its mark in advances in medicine.
The hon. Lady is making some excellent points. Does she share the view that there is immense collaboration with the private sector, universities and research institutes, as well as the charity sector, and that that ecosystem, which is so often talked about, is key to our position in the world and our contribution to the world?
I thank the hon. Gentleman for that intervention. The interdependence of the various sectors in coming together really puts the UK in a unique position in the way it advances so much medicine. Over recent months, in response to covid-19, we have also seen the incredible work of all the sectors, which have come together to try to beat this virus. Charities play that crucial role, and they are playing it today as they try to support individuals through this difficult time.
We know that a £310 million shortfall in funding will have significant consequences. Cuts always do. As we heard, it will take about four and a half years to recover from the downturn. Tragically, that will all be too late for some. This year alone, it is predicted that we will see a 41% decline in research spending. Many PhDs, fellowships and other opportunities will be denied, cutting vital skills in medical research. If postgraduate researchers do not have the opportunity to apply their skills and knowledge, we will be at risk of losing a generation of medical research. That is why significant investment is needed to save the sector.
With 34% of staff furloughed, clinical trials have been paused and delayed to protect research in the longer term. Without additional funding, there is little hope that those trials will restart. That means that families, such as that of a constituent who came to me, will never see the opportunity to extend their lives and to have a quality life for longer.
The sector is rightly calling for a life science charity partnership fund to fund the research part of its work. That would be built on a match funding principle and would start with a three-year programme of investment into research. The Medical Research Council is seeking a commitment of £310 million in its first year to match the funding it has lost this year due to the lack of funding resource. Not only will that research-driven approach help with economic recovery in the wider field and reduce unemployment, but it help us to continue to lead advances in medicine.
Like all charities, medical research charities have not been served well during this crisis. In fact, that has been a major oversight on the part of the Government. Medical research charities provide not just research but crucial support to their beneficiaries. Over the last six months, I have met many research charities, which have told me about the work they are undertaking, and that work has expanded during the pandemic.
Many organisations provide support services to the people and families who depend on them. The NHS is less accessible, so people have turned to the charities they know and trust for additional advice and support. Regular therapeutic interventions have often not been available on the NHS because of its focus on covid-19—we all understand that—and appointments have been cancelled. People have turned to the charities they know and the relationships they have to seek advice on issues such as where to get food, shielding, what protections they have for their health, and how to support relatives and family members at such a delicate time.
Other organisations, which would normally provide psychological support or respite support or perhaps fund parents to stay near their child as they receive treatment, have also been under great strain. Many of these organisations have described demand for their helpline more than doubling as people turn to them for support. However, they have not received additional support from the Government in response to covid.
Yes, the Government did provide £750 million to all charities, although we must remember that 168,000 charities have had to share that money. However, I must stress that that money was for additional support directly relating to covid-19. Of that money, £2 million went straight to the hospice movement, and rightly so, although that money is now spent, and more is needed. The rest is being divided between the larger charities, and there is a pot for smaller organisations. However, the majority of charities have not received anything over this time, and we have heard today that medical research charities certainly have not had their share.
This was all a direct response to covid, and we have seen more demands being placed on charities, as I have set out. That has also meant that more investment is needed by those organisations. Charities themselves may have direct funding for funded spend, but they are really struggling with their core costs. If their core costs are not met, the charities cannot deliver the specific outcomes we all know so much about from our constituents. It is vital, therefore, that the Government step up tomorrow with a package to address those core costs. Charities have already lost £10 billion in the last six months, and they predict they will lose 60,000 staff. Some 20% of charities will not be there if the Government do not make that investment. They say they value charities, but charities need valuing with resources, and without those resources, they will not continue.
We know that fundraising opportunities have all but dried up. We know that retail, which has been successful since its return, has now been locked down yet again, and therefore the income of organisations is in a perilous situation. That is why the Government need to step up at this point. Many charities did not qualify for the grants that were available, and of course have struggled and still have bills to pay. As the charity sector says itself, rightly and proudly, it has never been more needed, but I would add that it has never been more in need. That is why it is vital that, after today’s debate, the Minister goes back to the Treasury one more time to make the case for research charities and all charities, to make sure they have the research support, funding and investment they need.
Charities are not an optional extra. We know that because, as we have heard during today’s debate, the outcomes they deliver—in not only research but care support and civil society—transform people’s lives. Some 7 million people every year generously donate to medical research charities, often as the result of personal experience or the loss of a loved one. The paucity of the response compared with the public contribution needs to be addressed. Charities stretch their pound further than any other sector, and they provide the highest standards in research and care. They are essential, yet in just a few months’ time, they may no longer be there. We need a robust response from the Minister today, and we need a financial response from the Chancellor tomorrow.
Thank you for chairing this debate, Ms McVey; it is a pleasure to speak in it. I thank the hon. Member for Vale of Clwyd (Dr Davies) for securing it and for his lucid and compelling presentation of his arguments.
For most of my career in the NHS, I was involved in the delivery and management of clinical trials, from surgical interventions, radiotherapy and chemotherapy to nursing and allied health professional research. This activity was conducted in the pursuit of improving cancer treatment and outcomes, but clinical trials are also essential in developing effective treatments for multiple sclerosis, myalgic encephalomyelitis, Alzheimer’s disease, arthritis, Parkinson’s disease, heart and lung disease, and many others. While we may all hope that we will not rely on this research at some point in the future, the progress that is so regularly made reassures us that we are often at the vanguard of effective treatments and care.
However, clinical trials do not appear out of thin air. They are underpinned by groundbreaking scientific discoveries that must translate from bench to bedside, where research initiated in the laboratory is safely developed for clinical use to provide direct benefits to patients. Such translational research evolves from basic experiments in the laboratory—at the bench—to pre-clinical research, before commencing study design, protocol development, and then starting the process of phased clinical trials.
I intend to focus my remarks on childhood cancer, but before I do, it is really important to me—I pay tribute to the words that have already been said on this topic—to mention other vital charities that have made enormous advances in care, but that have yet to receive any meaningful support during the pandemic. The worthiness of these charities—CLIC Sargent, Teenage Cancer Trust and of course Macmillan Cancer Support, to name but a few—is beyond question. Their specialised support is a lifeline to so many. Many other disease-specific charities are in a similar boat, so we must not forget them either.
Every single day across these islands, 12 families get the heartbreaking news that their child has cancer. Although I have participated in the breaking of such distressing news more times than I care to recall, as a parent I still cannot imagine how such news must feel. Despite the fact that much of my clinical and academic work focused on teenage cancer care, I still find the statistics shocking. About 4,500 children and young people are diagnosed with cancer each year, and although significant progress has been made in recent years in developing treatments—for leukaemia, for example—due to the often rare nature of cancer diagnoses at that age, it is still the most common cause of death in under-15s across the UK.
Covid-19 is having an unimaginable impact on charity fundraising—the lifeblood of the research process—and is putting vital treatment developments at risk. Medical research, development and innovation are an integral and vital part of the NHS and Scotland’s health strategy. Charities’ funding has been hit hard during the pandemic at a time when many of the causes they exist to support have come under additional pressures. It is therefore incumbent on the UK Government to ensure that the comprehensive spending review is not wasted on warfare but rewards the life sciences, which have been the only effective weapon in our armoury against covid. That must include supporting charity-funded medical research.
I recently spoke to Mark Brider, chief executive officer of Children with Cancer UK, an organisation that has raised more than £250 million since its creation in 1987 to support families and improve childhood cancer survival rates. The groundbreaking research it funds has led to the development of kinder, more effective treatments with fewer debilitating toxic effects. Childhood cancer survival rates for some cancers have subsequently increased from 64% in 1990 to 84% in 2017.
Children with Cancer UK has warned that it faces an income loss of about 40% as a result of the covid pandemic. It warns that, without additional support, much of its planned medical research will be cancelled, setting cancer research back by many years. It is not alone. A study this year revealed that charities in the UK are facing a £10 billion shortfall, and that as many as 10% face bankruptcy.
Members of the Association of Medical Research Charities are calling on the Government to commit to a life sciences charity partnership fund—a co-investment scheme that would provide a level of match funding from the Government for future research. AMRC charities play a vital and unique role in the UK’s research sector, funding 17,000 researchers’ salaries across universities, the NHS and other bodies. They invested £1.9 billion in medical research in the UK last year.
The covid-19 pandemic had an immediate impact of those charities, with a reported 38% loss in fundraising income, 34% of staff furloughed and 18% of spend on research in universities cut or cancelled as a result of the initial lockdown period. The long-term impact of covid-19 on AMRC charities looks to be just as devastating, with an estimated £310 million shortfall in UK medical research spend. It will take four and a half years to recover to pre-pandemic levels. Medical research charities did not benefit from the Government’s earlier package of support for charities, as medical research was considered outwith the remit of funding frontline services. It is vital that support for their work is included in the comprehensive spending review.
Charities have predicted that the shortfall could have a range of impacts, from preventing them from funding clinical trials and studies, to causing them to defer upcoming grant rounds and withdraw future funding. The British Heart Foundation has already announced that it has cut spending on new research awards by half this year, from £100 million to £50 million. Cancer Research UK has also reported cuts of £44 million in its research funding, and it says that 40% of charity-funded early-career scientists are considering leaving research as a result of funding concerns caused by covid. Without that support, CRUK could be forced to lose 1,500 researchers—more than a third of its research workforce. Already, 61% of charities have had to cut or cancel support for early-career researchers and skilled research roles.
Such a reduction in charity-funded research will have a major impact on the future skills pipeline of research and put early-career positions at serious risk. This means that the UK faces the creation of a lost generation of researchers and experts. Scotland and the other UK nations are world-renowned for research quality. Yet if medical research charities do not receive further financial help, the damage could be significant and, in concert with a hard Brexit, could cause irreparable damage to the sector.
Last month I wrote to the Treasury, supporting AMRC’s calls for the establishment of a life sciences charity partnership fund to support medical research charities. A total of 51 cross-party parliamentarians co-signed my letter, setting out the long-term consequences for the future of medical research and development without this urgent financial support.
We have called on the Government to provide at least £310 million in funding in the financial year 2021 to a life sciences charity partnership fund, to secure medical research for the next three years, thus preserving research charities’ vital and unique contribution to society and to the economy. That would be matched by funding from charities to secure the continuity of their research.
Establishing such a fund would not only safeguard medical research funding at this vital time, but ensure that the research institutions can continue to invest in talent and skills at a time when they are sorely needed. The fund would help contribute to a shared ambition to invest unprecedented levels in research and development across the four nations of the UK, and form a global hub for life sciences. Today’s medical research is tomorrow’s curative treatment. Collectively, medical research charities have saved millions of lives. Thanks to research, cancer survival in the UK has doubled since the 1970s, so that today two in four people survive their cancer.
In the pursuit of addressing the covid health crisis, we must be mindful that, in not delivering support in the form of the life sciences charity partnership fund, we inadvertently create a health crisis caused by stalling, or otherwise compromising, life-saving research from the bench to the bedside.
It is, as always, a pleasure to serve under your chairmanship, Ms McVey. I congratulate the hon. Members for Vale of Clwyd (Dr Davies) and for Bolton West (Chris Green), my near neighbour, on securing this extremely important and well-timed debate. We have heard some good and compelling speeches from across the board, from my hon. Friends the Members for Blaydon (Liz Twist) and for York Central (Rachael Maskell), and the hon. Members for Bath (Wera Hobhouse) and for Kirkcaldy and Cowdenbeath (Neale Hanvey). We are all making similar arguments.
By way of opening, we have heard many debates over recent weeks, both here and in the main Chamber, about the sectors and parts of our society that have been drastically hit by the consequences of the covid-19 crisis. I congratulate the hon. Member for Vale of Clwyd on bringing forward the debate because it is an area that has had a lot less attention than some others.
As others have said, as we are all making similar arguments, medical research charities carry out vital work that helps us to understand diseases and find new ways to treat, manage and prevent conditions. They provide that hope and support for many that would otherwise not be there. As the hon. Member for Vale of Clwyd clearly outlined, we have a world-class sector in the UK. From state-of-the-art brain imaging, which helps us learn more about the earlier stages in diseases such as Alzheimer’s, to the development of novel techniques to help revive and repair donor kidneys before transplantation, and to the study of data to help speed up cancer diagnosis, medical research is changing lives, especially with some of the rare diseases that we have discussed today.
During the covid crisis, charity funding has plummeted, which has had a stark and immediate knock-on impact on medical research, as we have heard. Charities are projecting that it will take more than four years for spend to return to pre-crisis levels. With a big chunk of around half of all medical research coming from charities, we must not underestimate the impact that will have and continue to have on the health and wellbeing of our country for many years to come.
The UK sector is facing an existential crisis, yet, like so many other sectors, it has unfortunately so far been excluded from specific Government support. Medical research charities predict a shortfall in spend over the next year of at least £310 million. Research by the IPPR reveals that medical research charities expect this year to lose 38% of fundraising income, and over 25% next year. The thinktank estimates that there will be a cumulative £7.8 billion shortfall in health research and development investment between now and 2027, or 10% of all UK health R&D.
What does that mean in practical terms? As we have heard in the debate, there is, first, the immediate impact on medical trials and research and on patients and all those affected by disease. Almost three quarters of clinical trials and studies funded by AMRC charities were either scrapped or mothballed during the first lockdown, and although some have been picked since, many have not. Medical studies to be cancelled or stalled include those tackling the UK’s biggest killers—dementia, coronary heart disease and cancer—which could have long-term consequences. The Stroke Association states that three quarters of its funded research projects have been suspended because of the pandemic.
In the long term, less money for medical research means fewer trials and studies and fewer patients able to participate in this life-changing work. Last year, 213,000 people took part in 1,200 clinical trials or studies funded by medical research charities. Medical research charities have played a key role in breakthroughs over the past century, and we heard about some of them today.
The second impact is on researchers and the skilled workforce. Medical research investment is used to fund PhD students, fellowships and other early career researchers. Last year, 17,000 researcher salaries were funded by AMRC charities. Less money simply means fewer of them; fewer of them means losing out on their skills and talents, and on the important scientific progress that they could make in the years ahead. It will also further accelerate the unemployment crisis we face. Sadly, a recent AMRC study found that four in 10 are considering leaving research altogether, owing to funding concerns. The same survey found that 61% of charities have had to cut or cancel support for early career researchers and the skilled research roles.
The third impact is on health R&D funding and the wider economy. Nosediving research and development will affect the whole economy. As we have heard, every £1 invested in medical research delivers a return equivalent to roughly an extra 25p on that investment.
Charity research funding stimulates investment from the private sector, as we have heard, and from universities, further boosting our economy and research sector. It is an ecosystem and it relies on all the system being able to play its part. As my hon. Friend the Member for Bolton West (Chris Green) said, it can and does play a key role in reducing some regional inequalities and, with more than half of medical research coming from charities outside London and the south-east, in the so-called levelling up agenda by contributing to regional economic growth. Charities have a better record in this respect than Government research funding, under which about 80% goes to the golden triangle. There is definitely an opportunity to switch that balance.
Despite the importance of medical research charities to scientific progress and to people’s lives, and despite the significant role they play in our economy, unfortunately the Government have not given them the support they needed during this difficult time. I understand that there are many pressures on the Government’s finances and many calls for help, but only 3% of the country’s medical research charities were eligible for the Government’s charity support package—just five out of the 152 medical research charities. More than 150 were ineligible, and that included those researching conditions such as motor neurone disease, Parkinson’s, breast cancer, hearing loss, bone cancer, liver disease, meningitis, Crohn’s, diabetes, multiple sclerosis and many more. This is a huge blow to patients who rely on breakthroughs in those treatments.
Fortunately, given the well-timed nature of this debate and where we are today, there is an opportunity tomorrow for the Government to rectify that. The Opposition hope that, in the spending review, the Government will consider the proposal for the life sciences charity partnership to help plug the funding gap. This is now critical and urgent, and in the week when the Oxford vaccine for coronavirus has made such brilliant progress, what better way to support the life sciences in this country and recognise their contribution than to support this partnership fund? It would be a partnership arrangement and there would be matched funding. In the grand scheme of things, £310 million would be an investment well made. It is not a huge amount of money.
I am grateful for the powerful points that my hon. Friend is making. In the light of the amount that has been spent on covid-19 and the fact that people have not been able to access regular services in the NHS, does it not bring into scale how £310 million could make a significant difference?
It really does, and my hon. Friend makes a powerful point. I urge the Government to see it, not as day-to-day spend, but as an investment in the future health, resilience, wellbeing and economic viability of the country. I look forward to the Minister’s response and hope that we hear some good news from her today.
It is a pleasure to serve under your chairmanship, Ms McVey, and I congratulate my hon. Friend the Member for Vale of Clwyd (James Davies) on securing this important debate and raising the issues currently affecting medical research charities. I thank all hon. Members for the quality of their contributions to the debate. My hon. Friend the Member for Vale of Clwyd spoke of how the work of the medical charities is invaluable—he mentioned the British Heart Foundation and Cancer Research UK—and of the practical benefits that those charities bring.
The hon. Member for Blaydon (Liz Twist)—who I am sure would look very dignified in a pink boa, as have I, in my time—commented on the work of life sciences charities, specifically in relation to breast cancer. We recognise that work, which affects so many lives. The Government’s research and delivery parties are committed to trying to get the clinical trials started as soon as we can. My hon. Friend the Member for Bolton West (Chris Green) talked about the varied work that is being done, and mentioned the marathon elite runners. I have run the marathon twice, although I am sad to say that this year I was not invited to join the elite runners. The work is incredibly important, and this medical research is constantly on my mind.
The hon. Member for York Central (Rachael Maskell) mentioned the work of the AMRC, also acknowledging what the charities do in giving advice. It is very important that we get that advice and I am sure that it has been welcomed.
The hon. Member for Kirkcaldy and Cowdenbeath (Neale Hanvey) mentioned the work of the Teenage Cancer Trust. We have been able to retain the research that is needed, and we absolutely acknowledge the vital work that it does. We have indicated in our R&D road map that we acknowledge the work of these charities.
The hon. Member for Manchester Central (Lucy Powell) mentioned the work of life science charities and their key role in medical breakthroughs, as well as the many medical research charities that are involved. I would like to acknowledge the work that is carried out by the thousands of charities, including medical research charities, across the UK. The people who work and volunteer for them demonstrate huge passion and a commitment to the incredibly important causes. I saw the passion at first hand during the time I was working at Help the Aged, which is now known as Age UK. I have also seen it in my time as a science Minister when working with the medical research charities over the last year. The research that they collectively support has a huge impact and improves our health and wellbeing, and the Government have been working with them over the past few months to see how the research can be best supported.
Science, research and innovation are central to the Government’s ambitions. As I have mentioned, we published our R&D road map in July to ensure the UK is the best place in the world for scientists, researchers and entrepreneurs to live and work. Although we recognise the challenging economic and fiscal climate, the Prime Minister only this month re-emphasised the importance of science and innovation to our future prosperity and our ambition to move towards investing 2.4% of GDP in research and development. The UK is a world-leading research base and has global expertise across a wide range of disciplines—not least in medical research, where we boast a vibrant ecosystem that brings together researchers in some of the world’s top universities to work collaboratively with their counterparts in leading pharmaceutical companies, clinical researchers in the NHS and those supported by medical research charities.
Charity-funded research has been a distinct part of the UK research system, and I am proud to say that the UK is home to many globally recognised medical research charities, which are an integral part of the world-leading life sciences sector. The health and wellbeing of millions of people in the UK and around the world depends on the medical advances that have come from research funded by charities. I want to take the opportunity to give thanks for the contributions made by research charities, both to the important areas of research that they fund and to the many brilliant researchers they support.
Additionally, the Government have provided significant support to research charities through investments in research infrastructure, such as Manchester Cancer Research Centre and the Institute for Cancer Research in London, which provided the facilities and expertise needed by Cancer Research UK to carry out its incredible work, and through collaborations such as the UK Age Research Forum, where UK Research and Innovation works with a range of charities, including the British Heart Foundation, Versus Arthritis and Alzheimer’s Research UK, to support research that makes a difference to the lives of older people. Through direct funding, Research England is providing £204 million this year to support charity-funded research in universities in England. Through the tax system, over £1.3 billion in tax relief on donations was received in 2018-19 through gift aid, benefiting all charities, including those carrying out vital medical research.
All that shows that we as a Government are committed to supporting research into diseases and conditions that affect so many people around the UK. I know the pandemic has been a challenging time for charities, and that all parts of society and the economy have been affected by the covid pandemic—medical research charities and the research that they support are no exception. We have heard during the debate that they have suffered a series of blows to their income. Many charity shops around the country have been unable to remain open. Fundraising events, which are so important for raising money for research and for raising the profile of these causes, have been cancelled or postponed. The impact of the loss of income has had an impact on the research programmes that charities are currently supporting; as we have heard, it will affect their plans for future research.
In response to the challenges, the Government have provided significant support both across the economy and to charities more specifically. The coronavirus job retention scheme has enabled charities to avoid making staff redundant and to continue their vital work. During these unprecedented times, however, the Government have depended on the expertise of our research base to respond to the enormous challenges we have faced. Our scientists and medics, including those supported by charity funding, have had a key role in taking forward our response to the pandemic. We established a vaccine taskforce to co-ordinate all the work going on across Government, academia and industry, and we accelerated the development and manufacture of covid-19 vaccines. Through the university research sustainability taskforce, we quickly gained a fuller understanding of the impact of covid-19 on research in universities, including that supported by charities.
Many hon. Members mentioned the SURE fund. As a result of the university research sustainability taskforce, we put in place the sustaining university research expertise fund to support university research that has been impacted by the pandemic and to secure researchers’ jobs in universities. The fund has now gone live, with expressions of interest from universities expected this week. Universities are required to pay particular attention to the medical research that charities have traditionally supported when allocating the funding. In addition, we have provided £60 million to support PhD students whose research has been affected or delayed by the pandemic, to give them the time they need to complete their work. We have also supported UKRI to commit more than £95 million to research to tackle covid-19 and we have repurposed research grants with a total value of £80 million to address the effects of the pandemic.
All of that sits alongside the road map we published in July, which sets out the Government’s long-term plan to bolster the UK’s world-class credentials in research and development and to deliver economic growth and societal benefits across the UK for decades to come.
For long-term research projects that take a great while to get off the ground and perhaps recruit people for clinical trials—including people studying at university at the moment—a £320 million commitment tomorrow would give a great deal of reassurance. Obviously the Minister cannot commit to that here and now, but will she reassure us that that is on her mind and that she will make her best endeavours with the Chancellor?
I thank my hon. Friend for that point, which I will refer to in my remarks.
The Government’s goal is to further strengthen science research and innovation across the UK to ignite the UK’s economic recovery, boosting productivity, creating new jobs and improving people’s quality of life. Within that, we also have a commitment to the levelling up agenda. The road map sets out our wish to build on the UK’s strengths in the life sciences sector. I look forward to continuing that work with the medical research charities as we develop a more detailed plan for delivering the road map’s ambitions.
Medical research charities are an important part of the UK research landscape. As I have set out, the Government recognise that and already provide significant support through the tax system, the research funding system and the many measures introduced to counter the impacts of the pandemic. While it would not be appropriate to respond in detail at this stage about the spending review, I assure hon. Members that the issues they have raised have been noted and in the coming weeks we will continue to work with the Association of Medical Research Charities on how they can be addressed, how we can support this vital research and how we can maintain the UK’s excellent capabilities in medical research while recognising the challenging fiscal circumstances we face.
I thank the Minister very much for her response and colleagues in the Chamber for their contributions. We have heard powerfully from everyone about the challenges facing the sector. Numerous vaccines are on the way and we very much hope that by Easter we will have some return to normality. Even so, we have heard how the sector will struggle for many years to come, even in that apparently good scenario.
I thank the hon. Member for Blaydon (Liz Twist) for emphasising the good charitably-funded work she is aware of on breast cancer and muscular dystrophy and by the Alzheimer’s Society. My hon. Friend the Member for Bolton West (Chris Green) certainly took the opportunity to highlight the pandemic’s impact and the importance of supporting research in the north of the country. The hon. Member for Bath (Wera Hobhouse) referred to eating disorders and the hon. Member for York Central (Rachael Maskell) emphasised the difficulties that charities are under, in some cases because of their core costs. I also thank the Front Benchers for all their warm words in that regard.
The Minister kindly outlined some of the support already available to the sector. I know she has listened to the debate and will take back the comments she heard. In particular, regarding the SURE fund, I ask the Minister to take good note of feedback from the charity sector, because I know it has great concerns about how the fund will relate to it. Finally, I ask the Minister to go back to the Chancellor and emphasise the need for this sector to receive assistance, whether through a life sciences charity partnership fund or other means.
Question put and agreed to.
That this House has considered recognising and preserving the value of charity-funded medical research in the 2020 Spending Review.