This is the transcript of an episode of our podcast, That Cancer Conversation. You can listen to the episode here

Sophie

You can’t beat cancer without scientists.  

Their ambition to produce world leading science and research can transform outcomes for people with cancer. 

But 62% of biomedical research in the UK relies on charities, like Cancer Research UK, funding them. 

And now our science industry is starting to feel the effects of a cost-of-living crisis. In fact, the UK ‘s competitiveness in life sciences is now falling behind compared to other similar countries.  

But that’s not the only problem. Our manifesto reports that there is a funding gap of over £1 billion for cancer research over the next decade. And that can jeopardise not only research, but cancer patients too.  

Hi, I’m Sophie Wedekind, and welcome the third episode of That Cancer Conversation Longer, better lives. A subseries which unpacks our manifesto for cancer research and care.  

In this episode, I spoke to Owen Jackson, director of policy at Cancer Research UK, to help answer why we have this funding gap and what we need to do about it. 

Sophie 

Welcome to the podcast Owen and thanks for joining me.  

So we’re discussing longer, better lives our manifesto for research and care. And in this episode, in particular, we’re talking about our mission to back research. So to start off, I want to ask, why is cancer research in the UK so important? 

Owen 

Well, thanks for having me, Sophie, and it’s great to be on my first ever podcast. So I’m really excited about this.  

Research in the UK is really important, because research fundamentally as a promise for a better tomorrow. And you can see that because of research that we were doing in the 1970s, funded by Cancer Research UK and others, means that today, twice as many people are surviving their cancer for 10 years or more. And we wouldn’t be there if it wasn’t for research that was done back in the 1970s.  

Now, that’s the positive side, you know, we can actually give people a better tomorrow by investing today. The challenge is, we know that nearly one in two of us will get cancer in our lifetimes, we know that by 2040, there’s going to be probably half a million more new cancer cases a year in the UK than there has been because of result of an ageing population and increasing risk factors. So that’s an increase of a fifth on today in terms of cancer numbers. So the challenge is growing. And we can’t continue to just grow the amount of money that we spend on it, you know, we’ve got to think about how we do this in a new way, in an innovative way, which is where the research comes in. That research that we’re doing today will mean that we’re able to treat people more effectively. So people who’ve got cancer, may be able to live happier, better lives with their cancer. We can stop people from getting cancer in the first place. You know, we know many hands are preventable, the more we research, the more we can help people prevent getting cancer in the first place. So it’s really important that we’re doing research. And it’s important that we do it in the UK. The UK is one of the leading countries in the world, when it comes to impactful research studies. If you look at citations for global research papers, the UK is a really, you know, we’re up there with the best. So we need to stay there. We’ve got some really cutting edge treatments being developed in the UK, probably not as many as we would like. And that’s a challenge as well as an opportunity. We know that for every pound spent on cancer and cancer research, we return two pounds 80 in economic benefit to the UK. So and the last point I want to make because it’s really popular, if you ask the public, we have nearly three quarters of the public wants us to spend more on cancer R&D, because people see the benefits, you know, people know that they’re themselves or their brothers or sisters, their mothers and fathers, their children or you know, if they’re in trials, they see the benefit. They understand that that promise for better tomorrow, that being part of research not only benefits those people today, but also benefits people in 10, 20, 30 years time. 

Sophie 

Yeah, and cancer affects so many people, like you said, nearly one in two. And so, you mentioned that there are some challenges that researchers facing what specifically are the challenges that biomedical researchers face? 

Owen 

So there’s a few, you know, as I say, we start from a position of strength. So you know, these are not things that we can’t fix. And frankly, they’re things that we’re already fixing. But if I was to pull out a couple. Firstly, we need to make sure that the research sector, and by the research sector, I mean, everything from universities doing basic research, innovators who turned basic research into this new small startup companies, those small startup companies turning into large companies, the big investment done by some of our big research intensive industries, whether it’s pharmaceuticals or, or new treatments, or new tests. You know, that whole sector needs to be sustainable over the long term. One thing I’ll point out is university funding right now is in a pretty tricky position. We know that universities are struggling at times to fund to continue to support that world leading research that we need. So I would point to universities as a really important part of that sustainable research sector. And we what we really want to see more from government in terms of how we’re going to support world leading research universities over the next 20, 30, 40 years. We’ve got some we’d love to have more. And we need to make sure the ones we’ve got survive. And then the second thing I pull out in terms of a challenge, though, is that global competition point, you know, we’re struggling partly because some of our competitors are, and I use competitors advisedly in this context, because science is not always about competition. But there are many countries out there for whom, if you’re if you’re world leading researcher, considering where do I want to go and spend my career where do I want to go and set on my family and take my family and spend 30, 40 years building up my professional life? You know, those people have choices. And if we want them to come to the UK, and we want them to come to UK universities or UK companies, we’ve got to make it compelling and interesting for them. So that’s partly about talent. How do we attract those really top level researchers, but everyone they bring with them, you know, a world leading research lab probably supports tens, if not hundreds of other jobs. So we want to attract those people, we want to keep them here. And often that’s about investment. So how do you how do you ensure that if you’re, if you’re a world leading researcher in a lab, or you’re coming here to start a company, how do we make sure that you’ve got that investment opportunity behind, you know, in the UK, to turn your ideas into new treatments.  

And another aspect of that, in terms of that global competition, is trials. Clinical trials are really important in terms of bringing those new treatments to patients today, but also to turn those ideas and those potential treatments into really, you know, widespread treatments for tomorrow. And those trials are jewels, you know, everybody wants them, we’ve got a huge opportunity to have them in the UK, but lots of other people want them to and if we look at the progress that Australia, Spain, other countries in the EU are making, we’ve got to make sure we’re making those strides, too. So that’s about global competition. And then the third challenge, I would say is, the NHS is, is a huge asset to the UK, both in terms of us as individuals in going everyone has interacted with the NHS and almost universally the experience, people love the NHS, they want it to stay they want it to be as good as it can be. Too often I think it’s in for the for the biomedical research sector, the NHS can be seen as a barrier. It’s seen as big, bureaucratic and hard to get into when you’re trying to develop and deploy new tests and treatments. That shouldn’t be the case, it’s a huge asset in and out very few countries have got the kind of richness of data about people, the opportunities to put treatments into large patient groups very quickly, and the kind of diversity that we have in the UK, in terms of people’s backgrounds. So all of those things should be assets. And we need to try and make sure that the NHS is seen as a platform and a huge opportunity rather than a barrier to those biomedical research companies.  

Sophie 

And, you know, we’re talking about this funding problem. And that’s now estimated to be a funding gap of over £1 billion. Is it just support that we need, like a financial support from the government? Or is there more to it than that? 

Owen 

So let me explain the 1 billion pound gap. So it’s something that we’ve talked about a lot since we published ‘Longer, better lives’. So the billion pound funding gap is, is the product of a couple of things. The UK is really unique in how much we rely on research charities to fund some of this cutting edge research. That’s particularly true for cancer. But it’s also true for some other areas like cardiovascular disease and British Heart Foundation. But for cancer, it’s really, really important. So when you put industry funding to one side and industry are still the biggest contributors to research and development spending on cancer in the UK. But if you put industry to one side, and what remains is governments and charities and philanthropy. The majority of what remains more than 50% is funded by charities. That’s really unique. So government fund less than half of non-industry spending on research and development on cancer.  

Now, that’s, again, you know, from one perspective, that’s a real strength. It shows how much the British population of the public who support charities like Cancer Research (UK) in the UK by donating to us by running for us by campaigning for us by leaving us legacies, it shows how much people care. But it also reveals the risks that we have. And during periods of high inflation like we’re in right now, where people feel they can’t donate as much of their own money because we’re living in a lower cost of living crisis. People can’t donate as much money as they might like to charities. And so that’s affecting our income. And then on the other end, funding research is getting more expensive because of inflation, scientific inflation is running probably higher than inflation across the rest of the economy. So that means paying scientists running research institutions and universities, running clinical trials, all of this is costing us more year on year. So the £1 billion gap is the gap between current level of spending and the commitments that charities can make and what we need to fill over the next decade. Because if we assume that charities can’t continue to raise that our contribution in line with inflation, that’s the gap is what remains. So charities funding remains, you know, we are committed to what we are committed to, but above that, because of inflation, we need to find an additional £1 billion if we want to stand still, in terms of the real terms amount that we spend today.  

Actually,  if you include the fact that more people are getting cancer, so I talked about that increasing cases, if you want it to maintain a kind of investment per case, it’s significantly more, more like two and a half billion pounds over a decade. So that’s the kind of quantum, that’s the kind of size of the challenge that we are flagging here. And that money can’t just come from one source, it can’t come from charities, it can’t just come from government. There are lots of people in this, in this in this research sector that I talked about government, charities, research intensive industry, pharmaceuticals, philanthropists, even the city and you know, long term investors, people like pension funds. We want to work together with government, with industry, with those other sources with those other players in the sector, to say, how do we build over the next decade, a more sustainable sector so that we don’t have this risk that when there are periods of high inflation? We are having to flag that we that, you know, there’s research that we are having to leave on the table. You know, we get bids from scientists across the UK, but also around the world that we have to say no to. And these are, these are bids that are really high quality science, developing the next generation, you know, I talked about that, that, that promise for a better tomorrow, we’re having to turn down research because we can’t just continue to we can’t raise our prices, we’re not a company that we can raise our prices to raise our income. So how do we work with others to fill that billion pound funding gap? So you asked, is it all about money? No, absolutely not. You know, some of these other things that we’re talking about today are also challenges and opportunities. But this is a particular one that we wanted to flag, if you want to continue to be globally competitive, and we want to see those tests and treatments, and we want to continue to see the progress that has been made in cancer survival, we need to make sure that we can fund that research that’s needed. 

Sophie 

And you were speaking about how we’re quite unique that the UK, a majority of cancer research is funded by charities. When you when we look at other countries, is it a fairly similar percentage? Or is it like quite different in how they fund cancer research? 

Owen 

It’s, it’s quite different. So the UK is unique in this in, in how much of our cancer research and in particular is funded by charities? The US government fund, I think, five times per capita more than the UK Government is does. Germany funds more than twice as much. So you know, it is unique. And as I say, that is you know, that’s not to say it’s wrong, or in any way, you know, the model is right or wrong. It’s just different. But it does mean that we have a challenge here in relation to inflation in relation to this sustainability challenge that others may not have. 

Sophie 

Okay, yeah.  

So we know that basic research is really important, the projects that start in labs, but we also know that it’s also really crucial for patients to start to see the results of that kind of research through clinical studies, and translating into treatment. Are there any ways that we can start to improve research translation in the UK? 

Owen 

Our manifesto for cancer research and care that we published, alongside our manifesto, I should say we published a programme for government. So this is a much more detailed, you know, manifesto is nice and short and simple. Our programme for government is designed to be that next level of detail. So more than I think there are 200 pages, 69 recommendations for governments. And we want it to be the blueprint that we can use to turn this opportunity, these ideas into practical changes that we can make. And our programme for government includes a chapter on translation. Because exactly as you say, how do you take science or ideas research being done in a lab or on a computer, how does that turn into a treatment? How does that turn into a new test? So if you want some more detail on this, you should go and read our programme for government. But I would pull out a couple of things that we talked about in in in our programme for government.  

Firstly, I’ve talked about research done in universities, there’s a there’s a really well worn track of academic researchers becoming entrepreneurs. These are the people who really understand the science, they really understand the detail of what they’re doing. And they are fabulous entrepreneurs when they aren’t given the right conditions and support to do so. So we want there to be more of a better support mechanism for academics who want to spin out companies and become entrepreneurs.  

More than 50% of spinouts in the UK, from universities come from just 10 universities and over half of those are in the South East of England. So we’re really good at this in pockets and we would love to see more of that being done, outside of the Golden Triangle, the Golden Triangle Cambridge, Oxford, London is a huge driver of biomedical research in the UK and is and is genuinely a world leader. You know, those golden triangle centres are world leaders in biomedical research, we want to build on that we want to say that if you’re an academic who wants to become an entrepreneur, wherever you’re studying in the UK, we want you to be able to have the same level of support and access to those kinds of mechanisms as academics in those in those centres. And we think that government and the funded research funders, including us can do more to incent support and incentivize those University, those academics who want to make that transition to being an entrepreneur. The second thing I would flag is trials. So trials we’ve talked about already. Trials deliver patient benefit, because they give people access to potentially treatments that they would not otherwise have access to. But the NHS benefits too.  

So Lord O’Shaughnessy public was asked by government to do a review of commercial trials in the UK last year. And in his report, he identified around a billion pounds of lost value to the NHS, because our number of the number of people in commercial trials in the UK has halved over five years. So the NHS actually benefits from these trials, too, because it’s, it’s access to drugs that the NHS don’t have to pay for, that are paid for by companies. It’s a lot of the other costs associated with those trials are met by the industry. So these are things that are really valuable to the NHS as well, we can really do with that billion pound of missed money. So one of the things on trials that we would love to see government and regulators work together on is how do we speed up the approvals and signup processes for those trials to be to get underway in the UK and I talked about global competitiveness. This is something that for instance, Spain have made a really big push on is how do we get those trials up and running as fast as possible. That doesn’t mean fast does not mean unsafe. These trials are still being required to run at the exact same level of credibility and rigour as any other trial. But we can do it faster in the UK, others are showing that it can be done faster. And we’ve made some real progress on that in the intervening years since the Lord Shaughnessy published his review, but we can do more particularly on the issue of single sign off process for trials. So rather than having to go to lots of individual trusts, to get approval to run your trial, we would love for there to be a single process that you can go through to get one, one sign off process done. So you can run your trial everywhere in the UK.  

And then the third area I’d flag in terms of in terms of translation is time for research. So in our NHS, we have doctors and nurses and allied health professionals who spend part of their time or they would love to spend more of their time doing research being part of research studies, being part of trials, running trials. And when we ask clinicians, a couple of things come out, they don’t feel they have the time that they need to do their research. Even those who are actually part of their contractors to do clinical research don’t always feel they have the time to. But actually one of the challenges the NHS has at the moment is retaining those work, you know, the doctors and nurses when they have so many other options. So retention of staff in the NHS is an issue. And again, when you ask clinical regular doctors and nurses who are involved in research, they really talk about research as being a huge part of why they like working for the NHS. So if we can get more time for research for some of those people working in the health service, we’re probably more likely to keep them in our service.  

So make it easy for academics to become entrepreneurs, make it easier for those trials to get up and running as fast as possible, and make it easier for our clinicians and our nurses to spend more of their time being part of research studies because it benefits patients and it benefits the NHS. 

Sophie 

When you were talking about how faster doesn’t always mean unsafe. I kind of went back thinking about you know, COVID-19 and the how quickly we got a vaccine during that time and that it wasn’t unsafe, it was just the pressure was there. And they needed that as soon as possible. But they still went through all the checks and balances. So it’s kind of we’re seeing real life examples where we can, you know, if we have the right funding, if we have the right talent, you know, we can get the treatments faster and not in an unsafe way either. And in terms of, you know, for someone who may not have read the manifesto, what would be your take home key messages for that person? 

Owen 

So, as you can probably tell I like threes, threes are always nice. So I would say I would give you three take home messages, we need to fill that £1 billion funding gap over the next decade, we have, but we have, we have an opportunity to do so. And we set out some of our ideas about how we might start to do that in the manifesto in the programme of government. And at Cancer Research UK, we’re working more on those ideas this year. So we are working with government and with industry well, from now on, really to try and work out what some of those models might be.  

My second message would be better research equals better care. So being able to run trials, being able to get onto trials, being able to be part of research for clinicians, and nurses, all of that actually, it’s not this isn’t a nice to have in research, is not a nice to have, it’s a necessary part of a good health service. So we need more research because it leads to better care both today and in the future.  

And my third, my final message, and really what I would hope people will take away from this is we’re in a real position of strength. And the UK is a world leader in biomedical research and in cancer research. And what we want to do through the manifesto, through working with government, through working with the rest of the sector, is to make the most of that position of strength, to build on it and to say, well, actually, in 20 years time the UK is still going to be there, not because we rested on our laurels. But because we took the opportunity to double down on the things we do really well. And to focus on putting more of our effort into the things that will deliver better care for patients, and mean that we can end cancer sooner. 

Sophie 

My conversation with Owen highlighted a lot of things. So I’m going to take a leaf out of his book and summarise it in three. One, that we need more than money to fix our funding gap. Two, we have the talent and drive to deliver more research. And three, when we have the right systems in place to support our scientists it supports everyone in return.  

Our mission, asking politicians to back research should be a no brainer. But that intention needs to be followed by action. And if you want to show your support you can sign our open letter in the show notes calling for our policy makers to do so.  

Because more research means beating cancer sooner. 

I’d like to thank Owen for joining me today and if you’d like to be updated on when new episodes drop, you can subscribe to That Cancer Conversation on all podcast platforms.  

Thanks for listening and talk to you next time.