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Interview: Sir Robert Winston


As the Ebola outbreak continues to gather frightening momentum around the world Professor Robert Winston - or Lord Winston - is not immune from the implications.

From his small book-lined office at Imperial College, London, he has sage words for society on everything from science and politics to the NHS, reflecting the 74-year-old's long and varied career. He is probably best known for his stellar work in in-vitro fertilisation (IVF) research, but presently, his great passions are twofold - science education and his five grandchildren.

"You can't control the Ebola infection if the population at large doesn't understand why air travel, although advantageous in many ways, is a huge threat to our immunity. You can't possibly decide whether to have a nuclear power station in Cumbria unless you understand the science behind it. Similarly, you can't control global warming if you don't understand or believe it's happening. All science carries threats and dangers which, to have proper democratic control, need to be understood so we can take proper decisions about how to use science wisely," he says.

And that's at the heart of Lord Winston's Reach Out lab in the bowels of the University where an experiment in learning is taking place with the aim to better understand how to teach science to children aged six to 18. The lab has been running for five years and has about 7,500 children through its doors each year and has so far reached about 40,000 children from London and surrounds, a third of which are primary school students.

Lord Winston, founder and chair of fertility charity the Genesis Research Trust, also visits schools as part of the programme.

"We are researching what kind of teaching works best and the affect on our teachers and on the university - how it changes how we think about schools and education. "The need for broader science literacy is a given. It's widely shown that science education is not good enough and we are losing huge number of children by age 10-11 who don't see academic and scientific work as useful. We have a scientifically illiterate society and we need to do much more to promote science because in a society which is dependent on science we are very likely to make wrong decisions about how we use that science," he says.

The professor has also written about 12 books for children on science, including Science Experiments, which covers easy-to-do experiments including those involving balloon rockets and glow-in-the-dark jelly.

Along with his long-standing television career, Lord Winston is best known for his work in IVF where he has helped more than 10,000 women to have babies. He was already renowned for his work in microtubal surgery, where he operated on women's fallopian tubes, when he began work on IVF. He particularly pioneered methods which enabled the screening of preimplantation embryos to see if they were healthy or not. 

Of the countless families he helped does he have any standout moments?

"One of the most incredible times was with a woman from one of these male chauvinist countries. She had the most appalling medical history, multiple abdominal surgeries, and I said there was no chance. She came back two weeks later and then two weeks after that telling me there was a crisis, that her husband would divorce her if she didn't go back with something to show for her journey.

"In the end I gave her an open laparoscopy with great difficultly. I still have the photographs as she was in an unbelievable mess. I was lucky not to damage her. Despite warning of the dangers she kept on saying she wanted a sham laparoscopy - where's the ethics in that? Eventually I came to difficult decision I would take her in and do a laparotomy. I spent time not doing very much, demonstrated it was a hopeless procedure but at least she cold go back with a big scar and her husband can see she's tried.

“Fourteen months later my secretary informed me that an extra patient had just flown in to see me and she was very agitated. I said, 'look really she going to have to wait, I've really got to see the patents who are booked' so after several hours, at about 7pm in the evening, I saw this patient. I didn't recognise her but we found her notes so I remembered her case. She said, 'As you predicted I am now pregnant and I think I need to come into hospital for delivery.' In order to fly out of her Middle Eastern country she had donned a white flowing garment and boarded an aircraft in labour and waited in my clinic in the early stages of labour. We delivered her vaginally at about 1am the next morning. It just goes to show how predictions are pointless and how patients don't listen anyway.”

As two thirds of patients are not successful via IVF, Lord Winston is acutely aware that he "pedals in failure" and dealing with the grief of a patient who has to come to terms with the fact they will not have a child is something that he would constantly face.

"By the time I retired nine years ago I was beginning to understand how to listen to patients." He cites this as his Eureka moment - his ability to listen and see the patients in front of him - something he feels is being drained from the NHS at present.

"One of the issues [with care in the NHS] is that nurses are not set up to listen. The Health and Social Care Act is a shocking piece of legislation and I am surprised that doctors and nurses didn't fight that hard against it, we let our patients down.”

Lord Winston laments the fragmentation of the NHS and the expense involved in managing this new structure.

"There was a ludicrous symbolic acknowledgement of academic medicine, young doctors and nurses are not encouraged to do research. We have an NHS which is not costing out what it costs to do things. So there is the ridiculous situation where maternity care costs about £2.8billion and can only be afforded by the NHS overcharging for NHS IVF and abortions. How about that for a cruel irony? So infertile women and women undergoing terminations are actually paying for other women to have their delivery in hospitals.

"We have a totally disjointed unco-ordinated health service. We lay down and had our tummies tickled as we were told we'd be managing it but of course we're not, it's the GPs that are managing it and they are probably the least qualified and least invested to do it. The health act was not recognised, by the medical profession or the media, to be as damaging as it is. It's led to massive inequalities. It's not good for public health, it's disastrous in how it links up with social care, mental health is still greatly under-provisioned, and what is amazing is that the health service is still as good as it is.

 Lord Winston sits in the House of Lords and believes good care starts with nursing care."My next door neighbour is a retired teacher married to a man with Parkinson's disease... for the last three years he's been in care. My neighbour would talk to him while he was deeply unconscious. A nurse came up to her and said, 'Madam, I don't know why you're bothering to talk to him, he can't hear a word your saying'.

"That was a qualified nurse on the ward and that negates a very important neuroscientific principle that actually the last thing you lose is your sense of hearing and we do know that deeply unconscious people do hear and they do react.

"Later she went over to the nurses station and said very politely, he's not been washed or shaved in last five days and was told, 'it's not my job, see the ward orderly' who said, 'he's not exactly my first priority,' and walked away. That is the health service we've got and the key to that is standard of nursing.

"I'm not in practice so it's difficult for me to be critical, but certainly when I was in training and when I was a consultant I would always be accompanied by a nurse. Now most doctors don't have that notion of working in a team which includes a nurse," he says, lamenting the loss of the ward sister and matron.

When he's not visiting schools or standing up in the House of Lords, Professor Winston is involved in a 15-year-long project on transgenic technology which involves the modification of genes in animals to gain a better understanding of human disease and for human transplantation. He and his team modify the genes in the animals so that an organ transplanted from an animal would not be rejected by a human. It has the potential to save a huge number of lives around the world but it not without darker and more sci-fi sounding implications.

"One major concern is that someone will use the technology to modify the human genome. I think that's hugely dangerous. Firstly because it would be unpredictable but secondly because if it works out you'll have an enhanced human who might have a different view on the sanctity of human life."

Ultimately, after the myriad TV shows, the education, politics and science, what Lord Winston enjoys doing most is spending time playing with a self-engineered toy steam train in his garden in North West London with his six-year-old grandson Isaac.

"I am the fat controller. He is the thin controller and the train always ends up crashing."

A joy that he has no doubt enabled many families around the world to also delight in.