The Life Sciences Delusion
More investment in life sciences is tackling the wrong problem. Helping the NHS means fixing the delivery mechanisms. That is where we need innovation and investment.
I also run an AI focused business consultancy called Sunstone. This post is a little experiment. I am cross posting it in my Sunstone substack because the example is directly relevant to AI and innovation.
I spotted something that really pissed me off last week. This is a lobbying cry from the supporters of the life sciences industry ahead of the UK Budget on 30 October.
On the face of it, surely a good thing. Invest in research into life savings drugs, support an industry where the UK is a world leader, guarantee high paying jobs and so on.
Horse****
This is a great example of a damaging trend in public life. Well meaning people using power, influence and clickbait "good causes" to secure a flood of money into solving the wrong problems.
Health is one of the prime examples. There is nothing wrong with finding new drugs or developing new treatments. But that is nowhere near to being our biggest problem. I call this the life sciences delusion.
Looking in the wrong direction
In the UK, our new government describes the NHS as broken. I don't agree with this - frankly it is a politically motivated insult to the 1.5 million people who work in the NHS.
Nonetheless, across the rich world our healthcare systems are under severe strain and showing signs of crumbling at the edges. This applies in every developed country, whatever funding arrangements are in place. There are two core problems:
Over regulation and over interference by governments. This stuff is big and complex. Governments don't know how to do it well.
Much more significant, demographics. An ageing population means more sick people with a more complex range of health problems AND fewer people around to treat them.
Basically, our future health depends on addressing this problem. The mechanism for delivering healthcare matters more than the treatments it is designed to deliver.
This problem is magnified in the rest of the world. In the poorest countries, the mechanism for delivering healthcare barely exists. People cannot get access to basic antibiotics. In some places, paracetamol is hard to find.
If we don't invest in fixing these things, we will have the science to cure everything in 10 years time. But health and life expectancy will be worse than it is today.
Why is this happening?
Most obviously because we misuse resources.
There are huge amounts of investment in healthcare - the chart shows VC dollars, a fraction of what goes into the healthcare system.
Almost all of this goes into drug discovery, medical devices and other treatment focused tech. Meantime, there is almost no support for tools and methods to help staff that actually deliver healthcare.
This is seen as unfashionable and unsexy. The Health Foundation released a great report earlier this year on what staff in the NHS actually want from technology. The answer was:
"Maximising opportunities to free up time in the NHS will require focusing on technologies that can help with administrative and operational tasks and inter-professional communication as well as clinical tasks."
Fed by a political and popular desire to focus on the wrong things, we also end up with bad policy. A simple example can be found in the programme announced by the new Health Secretary, Wes Streeting:
"We will make Britain a powerhouse for life sciences and medical technology."
The wider focus is on cutting waiting lists and boosting economic growth. These are achievable outcomes if we make real improvements in our NHS. They won't happen if we think being a life sciences powerhouse is the right way to achieve change.
This delusion is reinforced by earlier government announcements. The NHS will shift "from analogue to digital" apparently. 5 mins in a hospital will show you that the NHS is already digital. Staff are struggling under the legacy of badly designed, centrally driven IT programmes Adding some more based on nothing more than "build and the problem is fixed" theory is not going to help.
If you are still doubtful that these fine sounding ambitions can cause harm, consider recent coverage of an actual new class of drugs.
The Economist says GLP-1s "have all the makings of one of the most successful classes of drugs in history."
The best known brand of these new miracle drugs is Ozempic. They have been in use to treat type 2 Diabetes for 6 years. They have known effects on obesity and are emerging as potential treatments to reduce heart attacks and strokes, tackle chronic kidney disease, maybe slow Alzheimer's and even help with sleep apnoea.
Where are we in the UK? The drugs are only approved for treatment of diabetes. The BBC news last week ran a scare story about the risks of taking the drug when not prescribed. Presumably because people are acting on their own and seeking it out to help them lose weight. Heaven forbid that we would improve our own health in a way that doctors have not yet decided is allowed.
Earlier in October, the very same Wes Streeting suggested that the drugs could be given to unemployed people. Losing weight would then improve their chances of finding work. Not surprisingly, this attracted howls of protest. Mainly because it's clearly nonsense.
It's also a good example of top down control. The cost of GLP-1s is growing exponentially in the US. The NHS cannot afford the levels of expenditure and probably could not secure enough drugs to meet the demand.
We are controlling the supply because our delivery mechanism is not up to the job.
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