John Crown (Independent)

I thank the Fine Gael Party and other colleagues for allowing me to break traditional order to speak. It was through no fault of anyone else that I failed to realise the Minister of State was coming before the House. It is important that I should be present and take this opportunity to have a chat with him. By coincidence, the conflicting demand on my time was the visit to the House this evening by the wonderful cancer researchers in the Gallery to discuss some new research projects with me.

I thank the Minister of State for his attention and welcome him to his new role. While he has been given a major task in what is clearly a very challenging time for the Government and State, he has also been given a great opportunity to the extent that if there is one bright spot on the horizon, one little glimmer of light in what sometimes appears to be a bleak future, it is research and development, technology, biomedicine, pharmaceuticals and the entire research and knowledge based sector. While a great deal of rather unknowledgeable cant is sometimes spoken about the knowledge economy, there are some real aspects of true knowledge on which the Minister of State will be able to capitalise.

Having thrown together a few points when I realised I would have the privilege of having a chat with the Minister of State, I ask him to forgive me if I ramble a little. I will focus on making a couple of core points, the first of which is the need for the Minister of State to realise, as he commences his job, that research and development is not some vanity project but is critical to the future of this country. Ireland exports €20 billion worth of pharmaceuticals and bio-pharmaceuticals per annum. To put this figure in some context and provide some perspective, we hear endless speeches from Ministers for Health and others about the need to curtail our expenditure on pharmaceuticals. The spend is €2 billion which is one tenth of the value of our pharmaceutical exports. Clearly there is an extraordinary balance of trade surplus. This is only one of many parts of our real economy that is thriving but which, sadly and for reasons which will be apparent to many, has been handicapped by having the millstone of a virtual financial economy based on bank debt cast around its neck. The real economy is not doing too badly and if we focus on the core areas of science, technology and manufacturing, we may be able to make up for mistakes we made when we thought we could get rich by selling each other houses. As a political entity which sponsors the science community, how are we responding to the situation? We should be very alarmed by figures which emerged in recent weeks showing that all our univeritsities have slipped in the world ranking tables. I regard this as being a very worrying trend which sends out a terrible signal at a time when we are trying to reinvigorate the country by reinvigorating the so-called knowledge economy.

I do not wish to be excessively sectarian by speaking only about medical and bio-medical research but these are areas in which I have some expertise. Many of the lessons to be learned from them are broadly applicable. We have six medical schools, which is more per head of population than any country in the world. My colleagues are probably bored listening to me make this point. Whereas we have one medical school per 750,000 population, the European average is one per 1.5 million of population and the North American average is one per 2.5 million of population.

There is something wrong there. Between them these six medical schools have fewer than 120 full-time consultant-level faculty members - I am trying to pin down the aggregate number. To put a perspective on this, many of us had the privilege of visiting the Harvard Cancer Centre in Boston last year where I rather provocatively asked how many full-time faculty members the centre had. The answer is 1,500, or one medical school with ten to 12 times as many as we have in our aggregate of six medical schools.

There is another set of problems in regard to medical practitioner numbers which needs to be addressed. However, in addressing the core problems of our health service and those in the Minister of State's remit which deal with research, we need to look at the structure of our universities, in particular that of our medical schools. I will try to put some perspective on what can be done. When I came back to this country in 1993, I was one of four medical oncologists in the country. I like to joke I was often in the elevator in Sloan-Kettering Hospital in New York with more Irish oncologists than there were in Ireland at the time. I was certainly often in Eamonn Doran's bar on Second Avenue with more Irish oncologists than there were in Ireland at the time. I came back with the ambition and desire to try to set up clinical research, namely, research that involved patients and gave them access to new cancer drugs, something which had very heroically but sporadically been done by leaders such as Ian Temperley and Shaun McCann in St. James's Hospital and by Professor Tom Hennessy in Trinity College and Professor Jim Fennelly in Temple Street. However, there was no national cohesive structure and most patients with the common cancers were not getting the opportunity to take part in research.

I will outline some of the spin-offs of research. Research does not only give good knowledge - it is good medicine and good science and gives better care to patients. People who undergo clinical trials have reproducibly better outcomes than patients who get the same treatment off trials because of the increased vigour and discipline associated with the oversight of their trials by an increased number of medical professionals. In addition, research can bring huge amounts of free medication and drugs into a health system. Although there were only four of us, we decided 12 years ago we would set up the Irish Co-operative Oncology Research Group. I am happy that Mr. Brian Moulton, currently the chief executive of the organisation, is present in the Chamber today. He made a big investment of his then still young future in coming on board with us.

I will give the Minister of State some facts I believe to be relevant. This organisation, in a country that has never had a national cancer clinical trials group, recently put its 7,000th patient on a trial. We recently conducted our 200th clinical trial. We are getting 1,250 queries per month on our website from patients asking whether there is a trial open for their cancer. We have the allegiance and membership of every cancer-treating physician in the country. Recently we did a little audit on how we have done in terms of publications. The leading medical journal in the world, the New England Journal of Medicine, this month published two papers that carry the Irish Co-operative Oncology Research Group name. This is invaluable branding and is a great tribute to the country and its reputation in the largest circulation medical journal in the world. We have extensive connections with the industry. We reckon we have brought in €16 million worth of free drugs to the cancer services of this country in the past four years alone, moneys which otherwise would have had to be spent buying the drugs. In addition, many drugs became available to Irish cancer patients before they were available internationally. ICORG is seen as a beacon of a small country punching way above its weight.

The US National Cancer Institute has as its long-term goal that 3% of American cancer patients will be offered clinical trials. We are heading towards 10%. There were occasions some years when 40% of breast cancer patients in this country were on clinical trials. No other country can do that. We have every clinician on board and we have a new system through the leadership of my colleague, Professor Arnold Hill from the Royal College of Surgeons of Ireland, in co-operation with ICORG. We are putting in place a system which will collect a specimen of cancer tissue from every breast cancer patient in this country. It is a treasure trove for scientists and researchers to have the tissue and the clinical follow-up on the patients who are treated in a finite number of centres, in many cases on clinical trials. This is a competitive advantage we can offer which nobody else can. That advantage is needed because already, if I may paraphrase Ross Perot, in some parts of the world the sucking sound is being heard, not of industries fleeing south of the American-Mexican border but of clinical research fleeing east to Asia and Russia, to countries that are setting themselves up as able to do this work cheaper than the US and most western European countries. However, we can do things they cannot because of our concentration, the high penetration we have into the community and because we are collecting tissue from every patient.

We have too many universities - I say this provocatively - none of which I believe has reached the standards of excellence we would like them to achieve in spite of the presence of many excellent individual laboratories. We have set up Molecular Therapeutics for Cancer Ireland. This has brought together UCD, TCD, DCU and the RCSI, while we are making overtures to the universities in Cork, Galway and Limerick to come on board and have a truly national laboratory-based focus.

There are some problems the Minister of State needs to examine. Some parts of the bureaucracy in the interface between the Government and the research system work very well but some parts do not. I wish to single out Science Foundation Ireland for particular praise. The fact that it has a history of being led by science professionals, people who actually understand the problem, has been extremely important. It has made the foundation innovative and bold and has given it a number of wonderful advantages.

There is a halo effect. When that company in New Jersey is wondering where it will build its plant, I do not believe that the fact that others in the company are reading research reports that have a heavy Irish input is unimportant. In the case of at least one drug, for which I had the privilege of making the presentation to the FDA, a particular drug licence was granted. That drug turned into a multi-million dollar drug for the company. I cannot believe that sort of thing does not have an influence when a company is deciding where to put the factory. There are real tangible benefits from the halo effect of good research. I know the Minister of State will take my advice to heart if I tell him the right way for Government to deal with the research world is to lead, follow or get out of the way. I strongly believe that, as I believe the Minister of State will be a leader. We are very anxious to work with him in an attempt to develop this for the benefit of all our citizens. I thank him for his attention and am grateful to my colleagues for allowing me to speak out of turn.