Sir Richard Peto, Convocation 2015 Honorary Degree recipient

Sir Richard Peto, Convocation 2015 Honorary Degree recipient


Thanks very much. I think what I’ve done all
my life is just study the obvious, you know just study obvious things like smoking. And
it turns out if you study obvious things then you find out things that do change the world,
make things a bit better. But none of it is the work of genius. I think I’ve just been
lucky in the problems where I’ve studied. Actually Prabhat said that 99% of the world
is not British so I tried to do 99% of my work outside Britain. But remember 99.5% of
the world is not Canadian. So you lot, with all of your public health skills had better
actually go and do a lot of things in a lot of other countries as well. Canada has had
a tradition of doing a lot for the world and I hope that a lot of you will choose to continue
that tradition. Many more amazing statistics actually is that 95% of the world is not American. What I found, if you read about what’s happening
in the world, you read about the various epidemics, the various problems that are happening, then
we tend to read about all the bad things. But it’s extraordinary the extent to which
primitive death is disappearing, when reasonable aim for 2030 would be the wish we could finish
up halving under 50 mortality, if we took the 2010 risks of dying before you’re 50.
Well we could easily actually half that by 2030 just by keeping on the way we are. Death
rates are going down. We talk about an epidemic of non-communicable disease, but actually
death rates are going down. Death rates from heart attack, from cancer, from stroke, from
chronic lung disease, worldwide on average things are going down. There are some horrible
places where things are going up. But if you look over a period of decades we’ve never
actually had the longevity we’ve had before. Worldwide life expectancy is more than 70
years now. And it’s healthcare professionals like you that make differences. Also the Sanitary
Engineers of course. And it’s the people who try to reduce the number of wars. And sometimes
it succeeds, sometimes it doesn’t look at it.
But overall you can think that the 20th Century was the century of the dead. We had 200 million
dead in wars and famines caused by war. But actually it’s probably the century of life
in that you at the extraordinary changes in child mortality. It’s gone down since the
middle of the 20th century, just the risk that a child is going to die before they’re
5 has gone down from about 25% of all the kids in the world to 5%. Things are getting
better. So it’s a good job you’re graduating now while there’s still something to do. Some of you are going into research. Research
is fun. But I had lots of you guys who..looking after patients because I’m going to be a patient
sometime soon, and when I’m a patient I don’t want to be confronted with Epidemiologists,
I want to be confronted with competent nurses and doctors and things like that. I think overall I’ve been lucky in what I’ve
happened to work on and I think that it was because the university I was at, the University
of Oxford back 40 years ago, I was just given a job for life and told “okay you may want
to some big project in which case you’ve got to raise money, but you’ve got life-long security.”
I don’t whether this should be done. I really don’t know whether it should be done. When
the old Soviet academies were secure and just gave out money according to the whims of the
leaders it didn’t work. It was a bit sterile. But there ought to be some bits of academic
life, some bits of research which are in a way protected from always being evaluated,
evaluated, evaluated all the time. And so much time is wasted and so much dishonesty
is involved and hypocrisy in always pursuing grants that sometimes you just need the luck
of protecting some people. I don’t know how those people should be chosen, but I hope
the university system somehow does continue to have some people protected from eternally
being harassed by being evaluated and having to report on what they’re doing all the time.
Everything I’ve ever done that I think was worthwhile, as I said all I’ve done is studied
the obvious, would never have got through Review Committees. They’d have said” what’s
the point in this, you’re not going to learn anything new. We all know that smoking kills
people.” But actually we did get some new things. And we studied treatments that were
fairly obvious and just showed that you get moderate improvements. Well you get moderate
improvements in the treatment in millions of patients and that’s good. You finish up
avoiding tens of thousands of deaths. I don’t know, there needs to be some kind
of plurality in the way in which we fund things. And the other things I would like to make
a plea for, that I don’t think it’s exactly a plea to you new graduates, is that I think
that somehow we are overemphasizing privacy of records to the point where it’s very difficult
to do serious medical research. If somehow there was a sort of “BANG” and the ceiling
collapsed down and some kind of toxic chemical got released here, and we want to know what
happens to you all over the next few decades, are you going to get cancer or not…well,
with the present laws on privacy it could be very, very difficult to do it. Whereas
if the same accident happened in Oxford we could just send the names off and we’d find
out all the diseases that happened to you over the next few decades and if you want
to opt-out then you could opt-out. I think that we need medical records to be available
to medical researchers and then we will find things that matter. You’ll find sort of odd
cause-and-effect relationships. Anyway, I’d like the world to make it a bit easier for
medical researchers. You know, ethics is alright, I like ethics. But I think we should recognize
that you ever have an Ethics Committee, you should never have an Ethicist voting on it
because it’s a direct conflict of interest. No Ethicist ever made it big it life by saying
there’s no ethical problem. My brother said that all Ethicists are villains and should
be shot and that he was going to write a paper entitled “Ethical Cleansing,” but he was only
joking. I don’t know, just medical research is serious,
the consequences are serious. And it’s just ridiculous when you see things like the increasing
death rates from smoking in China. There was a million deaths in 2010, two million deaths
in 2030, three million deaths a year in 2050. Pravatt had this statistic wrong, he said
“that I predicted a million deaths from smoking this century, I’d actually predicted a billion.”
And that’s about what will happen if we keep on with the present uptake rates worldwide
because it’s fine in Canada, lots and lots of people who’ve stopped and lots people haven’t
even started, but worldwide…worldwide tobacco consumption is going up still, and there’s
a billion smokers. And it’s just silly when something like that kills half the people
who do it. Anyway, you lot, you’ll have something to
do with what happens. Just write and tell me what the death rates are in 2050. I’d like
to know. I would like to thank the University of Toronto
for this honour and I’d like to wish all you lot luck. And lastly, I think it’s actually
the parents who should actually get the degrees, not the kids, it’s the parents who do the
hard work, I’m telling you. Thank you very much indeed.

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