Richard Barker and Steve Smith: health and wealth are partners

As we confront a growing gap between NHS needs and NHS funding, one question comes into sharp relief: national wealth and national health, are they friends or foes?

We know that investment in research contributes both to the quality of care and to the economy

The past mindset is clear: the demands of the health budget are a burden on the economy. We cut back on research, resist the use of new technologies and control every item of spending.

The direct consequence will be an NHS that continues to underperform against its global competitors.

First, the NHS fails to adopt more effective ways of working such as transformative technologies like laparoscopy. Second, and even more damaging, it fails to compete on the global stage at inventing therapeutics and diagnostics that benefit patients and generate wealth in our highest added value industrial sector.

At a recent National Institute for Health and Clinical Excellence conference an NHS audience was asked: “Do you regard the NHS as part of the UK’s economic engine?” Few did. There are pressing reasons to change our mindset.

The life sciences sector is one of the most promising of the UK’s 21st century industrial sectors, with potential global markets approaching a trillion dollars, but one in which the UK is losing ground, and jobs.

Britain will otherwise squander its £2bn annual bioscience investment. We are second only to the US in our share of research citations in biology, pre-clinical and clinical sciences, yet fall well behind in capitalising on our investment.

We will continue to lose profitable clinical research to overseas competitors. The number of UK patients in global trials fell from 6 per cent to 2 per cent over recent years, because of lack of incentives for trusts.

Yet new treatments return patients or carers to the workforce more quickly, boost their productivity and lengthen their productive lives.

Finally, we will lose the opportunity to use our “unique” NHS system as a living laboratory assessing medical advances.

Exceptional vision

The NHS and the life sciences industry should be seen as partners with potential to drive both UK health and UK wealth, not competitors for scarce public funds.

Our concept of the sector should embrace publicly funded research, the NHS and higher education establishments and research based private industry.

This will need exceptional vision. Much good thinking and action has come from the Office for Life Sciences, and several health leaders, including Sir David Nicholson, are beginning to talk about the NHS as part of Britain’s economic engine, but more needs to be done in the policies and practices of the Department of Health, NICE, the NHS and the professions.

The approach needs places where the agendas of health and wealth develop side by side. Imperial College London is one such exemplar, creating an academic health science centre, a powerhouse that is beginning to rival Harvard and Stanford.

As well as a centre of clinical excellence, treating a million people a year, Imperial is a huge enterprise, with an annual turnover of £850m. It is ranked third in Europe for research in life sciences and biomedicine, spending over £160m. It has integrated leadership and governance, through a single chief executive and close working relationships between the college and the NHS trust. Seven clinical programme groups ensure research and patient services align and manage the combined finances. Its successes include the largest community based preventive cardiology programme in the country.

Four other centres in England: University College London, King’s College London, Cambridge and Manchester, have been designated academic health science centres, and Scotland has created similar structures.

So we know investment and leadership in research contributes both to the quality of care and to economic growth. NHS and academic clinicians, clinician scientists and scientists can work with the private sector. This collaboration is the theme of the translational medicine “supercluster” being built under the Office for Strategic Coordination of Health Research and the Office for Life Sciences.

There is a unique opportunity for the UK to show a global lead in crafting a new synthesis between health and wealth policy. That is the challenge before the new government as it develops its strategy for UK life sciences.