One of Britain's best cards is medical science. Burnham should play it

A version of this article appears in the Health Service Journal.

If Andy Burnham’s 10-year plan gives us another welfare and skills package with a health chapter and a science chapter bolted on, it will fail. For the first time in perhaps two centuries, ill health is holding back growth and shrinking the economy. In the most deprived parts of Britain, a child born today can expect barely fifty years of good health and its opportunities work, independence, the ordinary business of getting on. The damage starts early. Six in ten young people have never held a job at all, compared with four in ten twenty years ago. This is not a jobs problem. These young people are likelier to be deemed inactive than unemployed.

A health workforce is better for the economy

Ill health is the largest driver of that inactivity. Alan Milburn laid this out starkly in his Young People and Work report  in May. Housing, schools, devolution and other socioeconomic determinants of health shape economic outcomes, which shape health outcomes in turn, in a loop that has been documented since long before Mr Burnham arrived in Downing Street. His predecessors’ long-term plans now litter the table, each with its neat chapters on health, its chapter on science, and its forward promising decisive action. And yet, here we still are.

The number of 16 to 24 year olds not in education, employment or training already exceeds a million and is forecast to reach 1.25 million within five years. That is not inevitable. Any serious plan to break the cycle has to start from a simple fact: whether the economy grows now depends on whether people are well enough to take part in it. Burnham has been dealt a strong hand. The question is whether he plays it predictably or strategically. 

The predictable path is the easy one. Most civil servants, by now, can produce a competent chapter working through the determinants of health one by one; inspired by Burnham’s instincts, they could write another one.

The more strategic path means leaning in to where Britain still holds an unusually strong hand. Medical science: one of the few sectors where the country remains genuinely world-class. Burnham inherits a research base that led the global pandemic response, a life sciences industry worth some £147 billion a year and employing 360,000 people, and a public research return of roughly 25p on every pound, indefinitely.

Few industrial policies can match that combination of growth, social benefit and better health. This rare virtuous circle is within reach. 

Rosalind Campion Chief Executive

But that hand is weaker than it looks, though not for the reason most people assume. China has moved from copying molecules to originating them and is now a leading source of new cancer drugs and cell therapies; the US still commands the capital. But global competition isn’t what’s making Britain’s hand falter. Scientific excellence alone no longer buys a country the investment, the talent or the trial it needs – and without those, it won’t buy the health and growth Burnham is after either. Three things would.

1. Know what health is worth and investing accordingly

Right now, the government has no settled way of valuing health. NICE’s medicines appraisals are respected worldwide and we’ve agreed that for medicines, £35,000 for a year of healthy life counts as good value. But most of what determines a healthy life – housing, prevention, social care – sits outside that framework, unassessed. So investment decisions get argued for in adjectives, not evidence.

AI will force the issue: it is changing the cost of discovery, diagnosis and delivery far faster than appraisal systems designed for slower, more expensive medical innovation can adapt. Britain will end up rewriting how it values health regardless. The only choice is whether to do it deliberately or in a scramble – a question the Academy of Medical Sciences is already working through, and one Burnham would do well to join.

2. Involve the whole population in medical science, not just the rhetoric of it

Research is currently spread as unevenly as health itself, even though hospitals that do research get better outcomes for all their patients, not just those enrolled in trials. It doesn’t have to be that way. During the pandemic, trials ran in district general hospitals as well as teaching centres, and machinery that had crawled for decades suddenly moved fast. It stopped when the priority did, not because it couldn’t be sustained.

Patients enrolled in trials get tomorrow’s treatment early; almost everyone else is shut out, and older people, women, minority communities and people living with multiple conditions are routinely excluded from studies designed around a single disease. Fixing this pays for itself, industry trials were worth £7.4 billion to the UK economy in 2022, including £1.2 billion to the NHS. Returning even to 2017 activity levels would add £3 billion and 26,000 jobs to the economy, on top of the benefit to patients. This is entirely within the Prime Minister’s gift.

3. Workforce problems

Two challenges. The first: clinical academics – the people who carry a discovery from laboratory to bedside – are ageing and shrinking in number, a known problem left unfixed for years. The opportunity is now. 
Less discussed is a newer one: the medicines of the 2030s will run on RNA therapeutics, cell and gene treatments and AI-driven diagnostics, and delivering it needs skills the traditional pipeline does not produce: bioprocessing and manufacturing specialists, genomic and regulatory scientists, data engineers, hospital teams able to handle live cellular products.

A country can lead the world in discovering a therapy and still be unable to make it or give it. The Academy of Medical Sciences' first annual assessment of the field, Measuring What Matters finds that Britain remains far better at invention than deployment. No single person owns that problem yet, though a new taskforce bringing together those who hold the relevant levers has just been formed at the Academy. Solving these problems could transform both health and economic opportunity.

A strong hand is not a strategy

What the Prime Minister decides now will determine which way health and the economy move together. He would do well to treat health policy, science policy and economic policy as one conversation – not three separate chapters, bound into a report and left on the table with all the others.