Putting research at the heart of Ireland’s healthcare

Prof Helen Whelton believes in the power of research to improve people's lives and boost the economy. So much so, in fact, that she argues research in healthcare and innovation is a patient right.

But while Ireland is producing quality research, the country is better known to international medical tech and pharmaceutical companies as a place from which to export their products, rather than a place in which to research and develop them.

Prof Whelton took up the mantle of University College Cork’s Head of the College of Medicine and Health in October 2017. In this role, she is also chief academic officer to the HSE South/Southwest Hospital Group, which includes 1.2 million people. With a professional background in dentistry, she has a PhD in dental epidemiology and has run national surveys on children’s oral health for a number of years, and oral healthcare product trials.

Recently, Prof Whelton officially launched the €6 million Horizon 2020 project that she has been leading for the past four years. Entitled Advocate, the EU-wide project aims to add value to oral healthcare and encourage preventative oral care practices. For the study, Prof Whelton and her team spoke with dentists from eight different European countries and analysed their patient data to see how effective their systems are in creating and promoting oral health.

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Prof Whelton’s colleagues at the College of Medicine and Health are conducting a number of research projects that are having an impact in the areas of patient treatment, policy and society. The college houses a total of six schools, including that of nursing and midwifery, public health, medicine, dentistry, clinical therapies and pharmacy and, as such, research topics range from neonatology to immunology.

Small bandage

Dr Anne Moore and her team have developed an ImmuPatch, which provides immunisation in the form of a patch or small bandage. The ImmuPatch is much easier to transport over long distance and in hot climates than normal injections, and Dr Moore has been working with Médecins Sans Frontières and the WHO to develop policy and practice regarding this type of vaccine.

A multidisciplinary team at the Infant Research Centre has developed methods for diagnosing infants who are more likely than others to have seizures, so that these infants can receive care that can prevent seizures and any subsequent brain damage. The centre has also developed a test to predict pre-eclampsia, and a bio-bank of maternal and cord blood.

Meanwhile, Prof Denis O'Mahony in the school of medicine has developed a tool called Stopp-Start, designed to reduce the risk of adverse drug reactions among older people, while Prof Jonathan Drennan in the school of nursing and midwifery has recently looked at the issue of staffing, and what skills mix is needed where and when within the health service.

All this research is crucial because it leads to better patient outcomes, says Prof Whelton. “We’re working hard to develop this academic healthcare model because research active health services produce better patient outcomes,” she says. “And that’s a part of my passion for what I do, because in everything I do, I always go back to the patient and what’s good for patients in Ireland.”

We need to move away from the idea of research as an optional extra – it is a patient right

But not only is research crucial to patient outcomes – it is also beneficial to those working in the health service and to the country’s economy. “I see the three-legged stool of research, the health service and industry as a win-win-win,” says Prof Whelton. “It’s a win for patients because a research-intensive health service gives patients better outcomes, whether you’re participating in the research or not.

“It’s also really great for recruitment and retention of staff, because people really like that challenge of being involved in research and they find it brings a new dimension to their work and keeps everything fresh,” continues Prof Whelton who, prior to taking on her role at UCC, worked as Dean of Dentistry at the University of Leeds.

“And when you think of the size of the med tech/pharma industry here, it’s really good for the economy. So it’s a whole ecosystem, and it all adds up very nice.”

But despite research conducted at UCC – and other universities across the country – as well as ongoing collaborations with industry partners, Ireland is viewed by international med tech and pharma companies as an exporter of products, not a developer. For example, Ireland has about one-fifth the number of clinical trials that are run in Denmark.

"Ireland is one of the largest exporters of medical and pharmaceutical products," says Prof Whelton. "In terms of the world, it's seventh, and in terms of the EU, it's the third largest exporter, after Germany and Belgium. We export 17.5 billion medicinal and pharmaceutical products per annum.

“About 50 per cent of the biotech facilities here have R&D facilities, but we would like to increase that because we want to move Ireland up the value chain in terms of what we do. We don’t just want to be producing the products, although we’re delighted with that. But we have a very highly educated workforce, so given that I think it makes sense that we would try to bring more research to Ireland for these companies.”

Infrastructure

Prof Whelton says we must strengthen our infrastructure in order to convince international companies to research and develop their products here.

"We're looking at methods nationally to underpin research in Ireland, because what I described as the win-win-win situation – that's recognised by the IDA, by Enterprise Ireland, by the Department of Business, Innovation and Skills, by the DOH [Department of Health], everybody recognises it," she says.

“But we need to act collectively in this country to ensure that we have the infrastructure to support that influx that we’re looking for. It is about ensuring that we have the governance structures in place. As part of this, we’re currently developing a national ethics committee to ensure that we can be responsive in a very timely way to the needs a pharma and med tech to have their studies approved and properly governed.

“So it’s about investing in that infrastructure, ensuring tight governance of it and having a high quality ecosystem to draw people in. But that does require investment.”

For Prof Whelton, supporting research is not just something that’s good for academics – it is a patient right, and not just something to pay lip service to. And as part of this, she says, hospitals need scaling up.

“This maybe isn’t a great time to talk about scaling up hospitals but [it is needed],” she says. “For example, we have the biggest hospital in the country here in Cork and my clinical academics tell me that they could do twice the research they’re doing now, if they had more space. And so we have to decide at the coal face if we’re going to prioritise research – because it’s good for patients. Not because it’s good for academics, but because it’s good for patients.

“People have to pay more than lip service to that. They need to understand it. We need to move away from the idea of research as an optional extra – it is a patient right.

“I am very proud of what we have here in Cork and I think that the world should be coming to us. If we can get that foreign direct investment in, that will be helpful to invest back in the whole ecosystem. That will benefit our patients and support a productive workforce which will in turn help foreign direct investment even more. It really does all link up.”