Reaching 60 is often associated with people slowing down and feeling their age. For example, Britons are entitled to a free bus pass.
But their universal health care system, the National Health Service (NHS), which celebrates its 60th birthday on July 5, is largely considered to be in better shape now than in its fifties – even though baby boomers are gray and new. Medicines are expensive. It would be unthinkable to eliminate it and switch to private systems.
Bashing the NHS has become Britain’s national pastime, and at one of the world’s five biggest employers, shortcomings are inevitable. But those who use the service regularly tend to rate it more positively than those who mainly talk about it. British newspapers are often full of reports of poor management, but a recent survey showed that 91% of 17 million hospitalized patients rated their care as good, very good or excellent.
And although the NHS sometimes does poorly in surveys that focus on how well specific diseases are treated, perhaps the most thorough assessment of late – equity, efficiency, quality, access, And long and productive patients live by the Independent Foundation. The Commonwealth Fund – ranked it atop the health care systems of Australia, Canada, Germany, New Zealand and the United States.
Scientific research has been a main goal of the NHS since its foundation – but one can be forgiven for not knowing it. Over the years, funding for research has been distributed within regional health care providers in a system that may have been designed to hinder collaboration between universities and pharmaceutical companies.
All credit, then, to the NHS’s Director General of Research and Development, Sally Davis. With the creation of the National Institute for Health Research (NIHR), a virtual body within the NHS, Davies has pulled funding into broad daylight. By 2011, these are expected to amount to approximately £1 billion (US$2 billion).
For researchers’ careers, networks and collaborations, and transparent indicators of achievement, Davis’ Best Research for Best Health program is helping to transform the research landscape.
Plans include virtual organizations to connect universities, hospitals and industry; The ten ‘academic health centers’ resemble American university hospitals, allowing researchers to study patients more easily; And somewhere between 15 and 50 ‘health innovation and educational clusters’, which the government hopes will spur procedural innovation, promise better funding for the academics involved. Meanwhile, the NIHR collaboration with the Medical Research Council, after a poor start, is starting to make progress.
Perhaps the most important step for biomedical science in the NHS lies in opening up the ocean of patient data that the organization has collected over decades.
Public consultations starting now, Favor Sounds says, will lead to ways by which researchers can more easily find suitable patients for research and clinical trials, and access data that Sources are unknown but subject to patient permission. In particular, the national extent and depth of those data will provide researchers in academia and industry with a globally unique resource for highly targeted studies and clinical trials – a key element of translational medicine.
Such an information system would create concerns about privacy. In the future, those concerns will become more sensitive as genetic testing becomes more predictively powerful. Yet, at the same time, as that era flourishes, it will bring forth the risk-pooling benefits of universal health-care.
Unless people are required to share genetic data with private insurance companies, as is the case in the United Kingdom until at least 2014, those suspected of ill health would do well to buy insurance cover. The genetically fortunate, meanwhile, can save money and rely on the state. This will squeeze private insurers, suggesting that the golden period of the NHS is yet to come.