My wife and I are part of the problem. Last weekend we ran respectable 10 kilometre times although we are both in the latter half of our fifties and we will play energetic tennis twice in the week ahead. Both had life expectancies in the early seventies at birth and now our risk adjusted life expectancies are straddle ninety years. We are a triumph for modern lifestyles and medicine (both having had interventions for conditions which may well have been fatal one hundred years ago) yet healthcare is the political scourge of our times. The success of society in increasing healthy productive years is matched by the failure of that same society to plan for such success in the provision of pension, health and social care. Yes, we have a financial crisis which has followed the profligacy of a generation but this is a minor issue compared to the need to rebuild our economic models to accommodate the demographic changes which us ‘baby boomers’ are so central to.
Addressing the challenges of the huge social successes that longevity has delivered to me and countless millions of others is no small matter. Governments are still locked in the mindset that this is a crisis that will go away and we can all carry on as before. As far as health provision is concerned this is an illusion and requires a serious look at the whole way that care is provided to a population which, as it ages, will make more demands on the exchequer than previous generations. Fundamentally, we need a revolution in the way that care is provided to move it to a newer and lower cost point whilst maintaining or improving quality. This can be done and has been done in all walks of life but it will require a huge freeing up of the system and an openness to change which has so far not been a characteristic of health provision. Today, Eucomed launched a strategy for the industry which addresses the needs and opportunities for change. This coincides with the publication of an Economist Report entitled Future-proofing Western Europe’s healthcare: A study of five countries. Both are accessible at www.reforminghealthcare.eu.
The provision of care for masses of ageing people in Europe and elsewhere is just as susceptible to innovation as every other walk of life. We just have to see it and be prepared to change. My house is furnished with unimaginable technology that my parents could not have dreamed of. I communicate freely and widely with more people and receive 10% of the mail that dropped on my mat 10 years ago. Much of what needed to be delivered by skilled tradesmen is carried out by myself and my family. The world has changed dramatically in almost every respect and will continue so to do.
Changing healthcare to allow us to address the challenges ahead requires the same openness and readiness to innovate that we have seen in our domestic lives and in many of the industries that serve us. But health is much more complex and has more rigid social structures. Change in health will require stakeholders coming together in a spirit of optimism and readiness to learn from each other. Our strategy states this need very clearly and reflects a desire for change which is open about the potential impact of new ways of working on all participants. Change will not take place at the required rate if all players sit in their respective corners and defend their interests at the expense of the system as a whole.
We believe that technology is one of the keys that can open the door to a future filled with optimism but that industry must change from a model built almost solely around improving clinical outcomes to one that includes delivering those outcomes in a more cost efficient and economically sustainable way. I am very proud of what the medical technology industry has delivered to mankind over the past century and the way that we have already contributed to longer lives for our citizens and lower costs of delivering care (hospital stays have dropped by 50% in Europe in the last 20 years) but we must do much more in the way of delivering ‘value based innovation’, which is marrying cost-efficiency with health outcome needs of payers and policymakers.
But the job is not just for industry. It is for others to come to the table as well and be prepared to change their behaviour. All need incentives to invest time and effort in driving change. For some, change is threatening to their professional and economic interests but these challenges must be understood and addressed if the needed shifts in approach are to be made. Industry will not invest in newer, more effective and cost-effective technologies if the return on investment is eliminated. Doctors will resist new ways of treating patients if their skills are seen to become redundant and payers will not change their approach if they cannot see clear evidence of the way that these approaches will help them manage their budgets. Patients, also, will need to understand that going to see an expensive doctor in an expensive hospital does not necessarily equate to their receiving the best care. We all need to come together to work on new models and new systems or face being swamped by demand for care that cannot be delivered.
The European Commission’s Innovation Partnership on Active and Healthy Ageing is a welcome part of the equation and sets out the challenges very clearly. As a flagship this is encouraging but it will require all aspects of the system to evolve very rapidly at all levels if the challenge is to be addressed. National governments are panicking at the moment and making short-term moves which will not serve to solve the problem in the long-run. This is understandable given the economic crisis but we must move on. One member state seems to think that forcing its health system to buy ‘generic’ medical technologies (whatever they are?) will solve the problem. Others think that they can finance the system by not paying their bills. These will not solve the long-term challenge and are ill-conceived. Ultimately, innovation of the sort that has made domestic appliances widespread, and freed households from the tyranny of domestic chores, or motor vehicles widely available, to allow easy movement, is needed in healthcare. We need to care for people in the community because hospitals are expensive and we need to ensure that hospitals are more efficient and safer because acute illness will not disappear. But to do this we need a blooming of innovation. Technology itself delivers little but innovation will not be possible without embracing technology as the key to unlock the door to solving many of the challenges. That innovation must be valued and rewarded or it will not happen.
The European medical technology industry strategy is a step in the direction of aligning our sector with the needs of the future. Please read it and let us know what you think.
– John Wilkinson, Chief Executive, Eucomed