In 30 years the Cost of Medicine will Fall

Today the NHS celebrates its 70th birthday. It is a wonderful, special and remarkable institution, but according to many working in the NHS, as well as external observers, it is in a perilous state. The problem is money. The government has agreed to increase its funding but there is never enough.

The general wisdom is that this is how it will always be. You have heard the argument. We are living longer and require more medical intervention and the increasing hi-tech interventions are much more expensive.

But is that right?

It is probably right over 20 to 30 years but beyond that, the technology may actually reduce the costs as we have seen developments that may buck the high costs trend.

For example, surgical techniques are changing. Have you heard of nano-surgery? These are tiny scalpels which could be injected into the body and then manipulated into position by the huge magnets of CT scanners. In position, they can remove whatever needs removing. If it sounds a little like science fiction, then I must tell you that it is here now.

In 2015 Kings Hospital in London announced it was using NanoKnives for the treatment of liver and pancreatic tumours. The needles are moved into position and then a large electric current is passed between them to kill a tumour. It requires less time in hospital, is far less invasive and overall cheaper.

And, on the topic of robots increasingly they are being used by surgeons who sit in the side of the operating theatre looking at a screen as if they are indolently playing a computer game. It won’t be long before they aren’t even in the same country.

But the biggest saver will be the use of big data linked with Artificial Intelligence (AI). The last time you might have heard of big data was with the Cambridge Analytica debacle a few months ago. Put all that to one side. This is a good use of the technology.

Let’s start with the diagnosis. There are many news stories about the diagnostic use of AI, such as the one below. This just happens to be the latest from the BBC website.

In the last week, it was reported that an artificial intelligence system recorded a 2-0 victory against elite physicians in two rounds of a competition in Beijing to diagnose brain tumours and predict the expansion of brain hematomas, or bruises.

BioMind, developed by researchers from the AI Research Centre for Neurological Disorders and Capital Medical University, made correct diagnoses in 87% of 225 cases in about 15 minutes. A team of 15 doctors from top hospitals across China achieved 66% accuracy in 30 minutes. The AI system also made correct predictions in 83% of brain hematoma expansion cases, outperforming the physicians, who had only 63% accuracy.

In the UK an AI system recently passed its doctor’s exams scoring a very good result at 87%

That’s the AI bit now add big data. Soon we will all wear devices which measure a range of vital functions. Think of a better and more comprehensive Fitbit. It may even be implanted soon after birth. This device will continually send our medical performance to a large database and AI machine. The state of the system we call our bodies will be monitored real-time, just like a mechanical system.

Aircraft engines are continually monitored so that they can be repaired before catastrophic failure. And, just like the engine soon, our physical state will also be measured constantly. When something untoward is seen the AI system will step in and tell us to see a physician. If we do need surgery it will be easier, not least because we have found the problem earlier.

And, if there is major system failure there are significant developments in personalised medication based on our genome which are more effective than generics. Failing that soon we will be saving cells as we are born so that we can grow new organs later in life. No more waiting for a donor for a deteriorating organ.

Doctors are always telling us that prevention is the best cure and that is exactly where we are heading. The focus of medicine will, at best, be prevention or at worst, early detection. We will never prevent all illnesses, but hospital visits will become more focused and the pressure on the NHS reduced.

I love the NHS and happy 70th birthday. Your future may be very different to all that the naysayers would have you believe.