The UK is on the cusp of what we hope will be the greatest surge in investment in science and innovation for a generation. The launch of UK Research and Innovation (UKRI) presents a huge opportunity to do things better, and not just to remake the existing system on a grander scale. How can we ensure the UK research and innovation system is not only more productive, but also fairly geared towards addressing the priorities of the people within it?

There have been important discussions about the need to shape the direction as well as speed of economic growth through investments in science and innovation - for instance about ‘mission driven’ and ‘inclusive’ innovation policy. Yet we are still early in implementing the bold shifts in policy thinking and practical organisation required, and in understanding how to deal with the complex trade-offs.

The ‘biomedical bubble’ is the ideal lens through which to consider these difficult balances between excellence and equity. The authors show it is a field the UK excels in, and one that has benefited disproportionately from public funding as a result. But as funding has grown, the productivity of that investment has declined. The authors question not only a broken R&D model, but an endemic bias in public support for R&D which still hugely prioritises manufacturing over services, decades after the UK economy shifted. They also question a system in which the health benefits of research and innovation spending do not spread in a way that is fast or fair enough.

Around half of all health issues are rooted in environmental and behavioural factors, however only 5 per cent of health research funding is spent on researching ways of preventing poor health. The authors also demonstrate the concentration of health research funding in three cities - London, Oxford and Cambridge - despite variations in life expectancies of up to eight years across the country.

The authors are not arguing against vital medical research or discovery-led biological research. Far from it. They are champions of UK science investment. But they are arguing for a review and reassessment of spending priorities, and a more sophisticated way to get the balance right in the future.

So far this concentration on biomedical life sciences has not been challenged or debated. For the first time, this report sets out the evidence, facts and analysis we need to have that debate. Who should benefit? Who should participate? Who should decide? This report raises important and challenging questions, and also offers practical ways to capitalise on the opportunity of UKRI for the UK’s future.

We look forward to the ideas and conversations it generates, and to working with UKRI and the wider community to shape an innovation system that powers a thriving future economy and society. Get in touch with [email protected] to get involved.