THE FUTURE OF HEALTH 2009
As the fervor over health reform ratchets it is hard not to perceive it as a storm in a teacup where at worst the teaspoon gets damp or a few drops hit the tablecloth. Because this great debate about what is best for UK health hinges on a belief that another major shake up of the NHS is not only needed but capable of unlocking massive savings; sufficient, it is hoped, to offset the cost hike of an ageing population. After a career of practical engagement with the NHS I say this is a dream and not reality. No pot of gold is likely to be unearthed by another radical restructuring of the NHS, it will just produce confusion, disarray and disaffection and take a decade to bed down with little meaningful savings.
NEED FOR RADICAL CHANGE
Yet nobody denies healthcare needs radical change, just not the type that entails throwing the currently functioning NHS structures up in the air and thinking that where they land is new so it must be better. Indeed a game change is required if we are to retain the bones of the NHS but nothing this current coalition is championing meets that brief.
A GAME CHANGER
Instead I will outline a game changing health idea. This is a well developed concept that I have paraded in front of senior health figures for some years without takers. That is not to say senior health individuals don't 'get it', but such is the fixation of their paymasters on tinkering with the existing NHS structures that they are currently blind to more radical approaches.
I summarise this 'big idea' in three simple steps;
step 1: keep people well, so obvious because it means we need worry less about the cost of treating the ill. The one factor we can all agree on is that what we eat and what we do affects our health. So to improve the health of our nation we need a better understanding of what we all eat and do and how it affects us generally and individually. To do that we need to collect mass data on health and habit that are acceptable to the public. Suitable technologies are emerging right now.
step 2: use the new gold - data. Data can be collected by providing everyone we can, starting with at-risk groups, with the means to tell how fit and active we are. It allows us to balance what we eat is putting into us and what we do takes out. For the individual this data will be used to encourage appropriate physical activity and generate the behaviour changes needed to make it sustainable. Such data makes it feasible to highlight activities local to each person that they might enjoy and that should fit into their lifestyle. Also by linking this data to employers it is possible to structure packages the employer uses to assess the health and well being of their workforce and to address issues like mental and physical stress in a formal way.
But it clearly not possible nor acceptable to try and force the collection of this data. The key is being able to offer the individual something they value and want. The more you engage with the individual the more personalised this information becomes, increasing the likelihood we respond positively over longer periods. Having done that we can then extract the more valuable data that enables step 3.
step 3: collect this data into structured packages for sale to policy makers, academic and private buyers interested in its ability to illustrate fundamental patterns of health that currently elude us. It will identify and make it possible to rapidly target geographical health challenges, show how social or environmental factors affect health and could produce almost instantaneous feedback on which health practices, activities and foodstuffs are more effective, plus a great deal more besides.
If it sounds awfully expensive then I should add that we intend to offer this service to individuals for free using the structure of a social enterprise, a 21st century form of business able to make fat profits but without the imperative to distribute it to shareholders. So how can it all be paid for?
To answer that we need to consider the value of fine grained health data. If Google currently makes £6bn a year profit just from the data on what we each search for on our computers then let us consider what value might attach to health data? This is a far stronger business plan than the one Google began with because we now understand better how to value data. The business aim is to collate mass health data and market it for sale. Without the need to distribute profits to investors we can plough them back to supporting the causes of the business.
And lastly if you are concerned that people will be resistant to having their health data used in this way you need look no further than Google. They look at what we search for and target advertising based on it. They look into your googlemail emails and target advertising based on what you write. Yet we happily allow it because we get their browser for free. The phrase best used here is 'anonymised data', data that has all the richness we require to build complex pictures of health but that does not include any information that leads back to the iindividual.
It has some resonance with current government policy in that it takes a Big Society view of health. In the UK we all jointly contribute to the cost of health, so the behaviour of my neighbour affects me. As Finland has shown, it can become socially unacceptable to be obese, to drink too much or smoke, a principle that works best in a collectively funded health system such as the UK.
Now for the killer blow! Few have really explored this opportunity to date meaning that we have been able to write a US patent application covering the use of health data, collected by these means, as a basis on which to make local or national decisions on health matters. This is a very fundamental patent, as fundamental as patenting the use of Internet search data as a means to work out what people are interested in. We envisage that Google will one day appreciate the opportunity only to realise we have restricted their freedom to operate.
CREATING THE NEXT MILLENIUM NHS
Yet this is not just a new form of business, it also addresses a new market with new products and new services using a new form of business structure, one that can't reward investors in the traditional way. Hence unsurprisingly politicians and entrenched health professionals struggle to grasp the potential of this idea and those in control of investment funding shun us.
But can there be a more pure embodiment of the NHS values and remit? The 21st Century NHS extending its scope to include wellness, or in other words healthcare activities that keep people well rather than treating them when ill. Run as a social enterprise out of the UK but licensing data to governments and companies globally yet generating huge profits that are used to support the NHS whilst at the same time reducing the costs it faces.
YOUR NHS NEEDS YOU!
This is where I want your help. Unless that patent is supported the opportunity cannot be reserved for a UK based social enterprise and the profits won't go back into supporting the NHS.
Right now I want your letters of support. With them I can make funders and health professionals take notice.
If you like the idea send a link to someone influential.
Later I will set up a subscription system to begin funding the idea on a collective basis. But for now we need sufficient critical mass to get the health mandarins to stop arguing about wasteful reorganisation and take a look at this far more radical idea.
If you want to discuss this with me I am very happy to do so, I will send business plans and copies of the patent as needed and can be called on 07713327210 or emailled on mike@pmuk.com and you can look at www.pmuk.com to see something of my past.
Over to you.
If you like the idea send a link to a friend or your MP?
PS Its called H4S which stands Health For my Self
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