One would have thought that perhaps NICE, the National Institute for Clinical Excellence, whose remit is to ensure that, to quote "Our recommendations help practitioners and commissioners get the best care to people, fast, while ensuring value for the taxpayer" would be taking a careful look at the costs of genome projects, AI etc
Sadly, the executive is full of praise for the 10 year plan and welcomes speeding up all sorts of treatment ideas etc
"We will work more closely with the MHRA to speed up evaluations and ensure patients get safe, effective treatments sooner. Through new enhanced collaboration we will streamline and simplify the approval journey through joint scientific advice and closely aligned timelines between teams across both organisations. This will help increase coordination and reduce duplication, ensuring MHRA and NICE decisions happen as close together as possible"
After reading TTE evidence of the harms due to rushed and inadequate checks/ trials/ safeguards of breast implants,vaginal mesh, influenza and avian flu vaccines let alone Wegovy, is what should be the LAST thing a body devoted to excellence should desire!
Did the 10 year plan mention anything about teeth? Wait for an NHS dentist where we are is now a year or longer, not many taking on. 250 mile round trip to see an emergency dentist. Mostly the solution to dental emergency seems to be to pull the offending tooth as quick and cheap.
We’re going to be a toothless bunch at this rate. Loads of other examples like that- vaginal prolapse, leg ulcers, varicose veins etc etc
Genomics of sod all use for those aspects of personalised health care. Talk about priorities!
Ugh, that's depressing. NICE has fallen for it as well?
"streamline and simplify the approval _journey_"
(OK, let's put aside the double-Ugh of the marketing neologism according to which everything is a "journey"...)
Where have I heard that "streamline and simplify" phrase before? Perhaps on these pages?...
But there's an _opportunity_ here. For £REDACTED, I can offer both MHRA and NICE a suite of "journey-streamlining and simplification Solutions". A rubber stamp for each, with "APPROVED" on it. And I'll even throw in a spare one each, in case they lose the first one.
In 2000 my MBA thesis discussed NHS REFORM driven by Blair government. Twenty Five Years later another Labour government has produced a new 10 year plan. In the intervening period nothing has been done to fix the fundamentals which underpin patient centric medical care. So this plan like all the others will fail. The NHS in its current form is unsustainable and needs complete restructuring. Patient care is disjointed, plagued by absent diagnostics, and driven towards symptoms. Information Technology should underpin patient care diagnostic and evidence instead it hinders. Bureaucrats with little understanding of process and the value of data rule the roost. Another paperwork exercise.
It seems that the plan is to have what we used to call 'community clinics' staffed by dental nurses and therapists, and to try to lock graduates in to NHS contracts for 3 years ( no details as to what that will involve though!). I recall that Which magazine caused a stir about 30 yrs ago when it costed out how much a filling cost the NHS to carry out at a community clinic - and it was around £200 at the time ( incl overheads, staff,materials) and someone quickly realised it was far cheaper to send people to a dental practice and pay them a tenner or whatever the magnificent sum was those days! So,we can expect a core service ( scalings,fluoride, fillings)for a minimum number of patients ,by ancillary staff, and the rest of the treatment will involve a huge wait to be allocated to a dentist somewhere/anywhere fora denture/ extraction etc.
Gone are the days ....the rot started when Blair brought in a new contract.
It's a real shame. With the current level of graduate debt and the cost of living/housing etc, I expect dentistry graduates may well see those locked-in 3 years as a transitionary period in their careers, before they can start earning a decent income.
I was surprised that Scotland still seemed to have a functional NHS dentistry service when I moved here, but it has sadly gone the way of England and is now too effectively two tier.
For General Practice I think the rot started with Lansley's 2012 HSCA. Many of us weren't paying close enough attention at the time.
or 'By 2030, the NHS will implement DNA testing for newborns to prevent fatal diseases'
(Who wouldn't want to save babies from deadly diseases?)
Given these uncritical press releases appear to be a misleading mash-up of projection and fantasy, one can only assume the BBC Disinformation Police are away on sabbatical. Where would we be without TTE and critical sociologists?
So it looks like all we really know is that the government plan to funnel finite healthcare resource towards financing an audacious DNA data-mining research exercise for the benefit of Palantir and their successors/investors. And we are being led to believe it is a done deal, with no mention of choice, consent, opting out etc.
I'm sure it will for the greater good of mankind and not at all lucrative for the Medical (Military) Industrial Complex.
This again is the Govt driven by the needs of the economy over the citizens/patient, as seen in Covid, AHSNs and others. They see a potential economic win - and if they need bodies then so be it, we have plenty. But, as always we will do the leg work and then the start up will fly off to US to reap the rewards. I see AstraZeneca is talking about moving its share listing to US from London - Britain's most valuable listed company according to the Guardian.
The only solution I can see is the extensive use of Informed Consent by individuals, but that will need significant effort to change passive attitudes, thereby restricting these 'innovations' . DHSC will never stand against it in the face of the Dept of Business and Innovation who will rule the roost around the Cabinet table..
In the US genetic screening may be helpful but not necessarily in the way that they they think. I would like to see the epigenetic changes brought about by chemical exposures, especially in cancer clusters. We have a lot of them so it would be of interest to see more of what we suspicioned or see only in limited studies.
Not that anything would be done about it, observing the historical record, but all the same......
One would have thought that perhaps NICE, the National Institute for Clinical Excellence, whose remit is to ensure that, to quote "Our recommendations help practitioners and commissioners get the best care to people, fast, while ensuring value for the taxpayer" would be taking a careful look at the costs of genome projects, AI etc
Sadly, the executive is full of praise for the 10 year plan and welcomes speeding up all sorts of treatment ideas etc
"We will work more closely with the MHRA to speed up evaluations and ensure patients get safe, effective treatments sooner. Through new enhanced collaboration we will streamline and simplify the approval journey through joint scientific advice and closely aligned timelines between teams across both organisations. This will help increase coordination and reduce duplication, ensuring MHRA and NICE decisions happen as close together as possible"
After reading TTE evidence of the harms due to rushed and inadequate checks/ trials/ safeguards of breast implants,vaginal mesh, influenza and avian flu vaccines let alone Wegovy, is what should be the LAST thing a body devoted to excellence should desire!
Did the 10 year plan mention anything about teeth? Wait for an NHS dentist where we are is now a year or longer, not many taking on. 250 mile round trip to see an emergency dentist. Mostly the solution to dental emergency seems to be to pull the offending tooth as quick and cheap.
We’re going to be a toothless bunch at this rate. Loads of other examples like that- vaginal prolapse, leg ulcers, varicose veins etc etc
Genomics of sod all use for those aspects of personalised health care. Talk about priorities!
Ugh, that's depressing. NICE has fallen for it as well?
"streamline and simplify the approval _journey_"
(OK, let's put aside the double-Ugh of the marketing neologism according to which everything is a "journey"...)
Where have I heard that "streamline and simplify" phrase before? Perhaps on these pages?...
But there's an _opportunity_ here. For £REDACTED, I can offer both MHRA and NICE a suite of "journey-streamlining and simplification Solutions". A rubber stamp for each, with "APPROVED" on it. And I'll even throw in a spare one each, in case they lose the first one.
This is very good; great to have an academic use critical thinking and clarity; no mention of climate change at all!! .. very refreshing
"the cycle of hype and hope"; wonderful phrase
"Mass genotyping is a technology in search of a purpose that it has failed to find."; great
"It has not taken off for three main reasons: it is scientifically illiterate, profoundly unethical and hopelessly uneconomic. " keep it coming
"It has long been a fundamental principle of public health ethics that mass screening is only justifiable when it gives a clear signal about risk,"
If only others could speak clearly like this; endless screening programmes; colon cancer screening where no change in all-cause mortality is seen;
"The day when the UK is a health service with a nation attached is brought ever closer. "
or as John McCabe might have paraphrased " a DysHealth service masquerading as a nation .."
many thanks for this excellent, incisive writing
1984
And the slowly, ever so slowly, boiling frog syndrome.
Just keep polishing your shiny new 4x4 (electric of course ) and dream of your next foreign holiday.
And all is well.
In 2000 my MBA thesis discussed NHS REFORM driven by Blair government. Twenty Five Years later another Labour government has produced a new 10 year plan. In the intervening period nothing has been done to fix the fundamentals which underpin patient centric medical care. So this plan like all the others will fail. The NHS in its current form is unsustainable and needs complete restructuring. Patient care is disjointed, plagued by absent diagnostics, and driven towards symptoms. Information Technology should underpin patient care diagnostic and evidence instead it hinders. Bureaucrats with little understanding of process and the value of data rule the roost. Another paperwork exercise.
It seems that the plan is to have what we used to call 'community clinics' staffed by dental nurses and therapists, and to try to lock graduates in to NHS contracts for 3 years ( no details as to what that will involve though!). I recall that Which magazine caused a stir about 30 yrs ago when it costed out how much a filling cost the NHS to carry out at a community clinic - and it was around £200 at the time ( incl overheads, staff,materials) and someone quickly realised it was far cheaper to send people to a dental practice and pay them a tenner or whatever the magnificent sum was those days! So,we can expect a core service ( scalings,fluoride, fillings)for a minimum number of patients ,by ancillary staff, and the rest of the treatment will involve a huge wait to be allocated to a dentist somewhere/anywhere fora denture/ extraction etc.
Gone are the days ....the rot started when Blair brought in a new contract.
It's a real shame. With the current level of graduate debt and the cost of living/housing etc, I expect dentistry graduates may well see those locked-in 3 years as a transitionary period in their careers, before they can start earning a decent income.
I was surprised that Scotland still seemed to have a functional NHS dentistry service when I moved here, but it has sadly gone the way of England and is now too effectively two tier.
For General Practice I think the rot started with Lansley's 2012 HSCA. Many of us weren't paying close enough attention at the time.
This is a really powerful guest post, thanks - I've only seen the planned NHS baby DNA genomics project being framed in a positive light in the media:
'Every newborn baby in England will have their DNA mapped to assess their risk of hundreds of diseases' (https://www.bbc.co.uk/news/articles/c1ljg7v0vmpo)
or 'By 2030, the NHS will implement DNA testing for newborns to prevent fatal diseases'
(Who wouldn't want to save babies from deadly diseases?)
Given these uncritical press releases appear to be a misleading mash-up of projection and fantasy, one can only assume the BBC Disinformation Police are away on sabbatical. Where would we be without TTE and critical sociologists?
So it looks like all we really know is that the government plan to funnel finite healthcare resource towards financing an audacious DNA data-mining research exercise for the benefit of Palantir and their successors/investors. And we are being led to believe it is a done deal, with no mention of choice, consent, opting out etc.
I'm sure it will for the greater good of mankind and not at all lucrative for the Medical (Military) Industrial Complex.
This again is the Govt driven by the needs of the economy over the citizens/patient, as seen in Covid, AHSNs and others. They see a potential economic win - and if they need bodies then so be it, we have plenty. But, as always we will do the leg work and then the start up will fly off to US to reap the rewards. I see AstraZeneca is talking about moving its share listing to US from London - Britain's most valuable listed company according to the Guardian.
The only solution I can see is the extensive use of Informed Consent by individuals, but that will need significant effort to change passive attitudes, thereby restricting these 'innovations' . DHSC will never stand against it in the face of the Dept of Business and Innovation who will rule the roost around the Cabinet table..
On the ID card issue watched Darkhorse podcast last evening The Truth about Real ID - 45mins https://www.youtube.com/watch?v=BUIbf5tFA4E&list=PLjQ2gC-5yHEug8_VK8ve0oDSJLoIU4b93&index=1
In the US genetic screening may be helpful but not necessarily in the way that they they think. I would like to see the epigenetic changes brought about by chemical exposures, especially in cancer clusters. We have a lot of them so it would be of interest to see more of what we suspicioned or see only in limited studies.
Not that anything would be done about it, observing the historical record, but all the same......