Five things that could save Healthcare
Summary
Things are bad but there is always reason to hope. In the UK, 3.3 million people are waiting longer than 18 weeks for elective treatment; over 400,000 are waiting more than 12 weeks for mental health services, 337,000 are waiting more than 12 weeks for community health services. That’s 4 million people poorly served by our health system - numbers large enough that you are probably close to someone who is represented by those numbers.
Every health system in the world is struggling with this challenge of rising need and scarce human and financial resources to meet that need. The traditional model of healthcare delivery doesn’t work any more and that we need some magic, if we are to save our healthcare systems.
Everyone has their own examples of the hope on the horizon - but these are my favourite five today. They aren’t the result of a careful scoring and curation - they are just some of the ones I carry about in my head. In a world full of negative narrative, they bring hope to me that maybe we’ll be ok. I hope they will for you too! Oh. And none of them are AI.
They are:
The decline in use of tobacco and alcohol
Hi1a - the extraordinary venom that will save lives
Using ultrasound to treat dementia
The long-term, total artificial heart
The improving science of weight and nutrition
1. Just say no: The decline of smoking, drinking and drugs
Don’t believe what your sweary uncle says on Facebook about the younger generation. People are drinking, smoking and using drugs a lot less. Statistica is reporting that the total value of alcohol and tobacco sales has dropped by 25% since 2005. And that’s despite a spike during Covid. Meanwhile use of other drugs has also been declining steadily since the late 90s, again despite a spike during Covid. This has got to be good for public health in the long run and should mean some improvements in levels of healthy life expectancy over time.
Find more statistics at Statista
Annual expenditure on alcoholic beverages and tobacco in the United Kingdom from 2005 to 2022, based on volume*
2. Hi1a: Spiders to the rescue!
Funnel Web venom - the paramedic's secret weapon - created with help from ChatGPT
Found in the venom of the Fraser Island Funnel Web spider, the molecule Hi1a was discovered by Professor Glenn King and is currently in trials as a treatment for heart attack and stroke. This molecule when administered by doctors (rather than spiders) in needle or pill form (rather than through fangs) stops the process of cascading cell death after a stroke or heart attack. This incredible treatment could therefore prevent the vast majority of the harm caused by stroke and heart attack. It is expected to be easily administered - possibly in an ambulance, allowing early intervention to limit as much damage as possible. It could even protect donor organs - allowing them to have a useful life which is measured in days, not hours. Read more here. Despite recent advances, cardiovascular disease is still responsible for 1 in 4 UK deaths. Treatments like this could turn a major heart attack or stroke into a scare. And that could give people a real chance to address their risk factors after a scare. That could reduce incidence and that would significantly reduce hospital bed days for attacks that do happen.
3. Ultrasound hope for dementia
There’s been a lot of attention (rightly) given to new immunotherapy drugs which break up amyloid plaque in the brain. This plaque is believed to damage brain cells and is found in the brains of alzheimer's patients. There is also an equally interesting parallel line of research looking at using ultrasound to break up that same plaque. Even more promising is the use of the two together, with ultrasound not only breaking up the plaque but disrupting the blood brain barrier to “let in” the immunotherapy drugs and increase their effectiveness. With dementia estimated to affect 850,000 people in the UK, breakthroughs in its treatment could make a huge difference, not just to the healthcare system but to the community and the economy.
4. Bionic hearts
Created with help from Chat GPT
Each year in the UK, there are about 200 heart transplants carried out. Against the huge volume of work done by the NHS, it’s not much - but it would likely be more if we were better able to find donor matches. So, while an alternative to donor hearts might not revolutionise the whole healthcare system, it will make a big difference to those at risk of heart failure. And for those people, the successful development of a working artificial heart is a big deal. But the fact that it was developed by a student engineer trying to save their father adds a lot to the story - and the abandonment of the previous received wisdom that a heart has to generate a pulse. As the linked article from the Sydney Morning Herald states: “Daniel’s heart is different,” said Monash University engineer Shaun Gregory. “It’s more like a fishtank pump than a heart ... It’s a revolution. It’s [the Wright brothers] inventing the plane to fly instead of trying to mimic birds’ wings flapping.”
5. Understanding the drivers of obesity
We’ve known for a long time that the rates of obesity and overweight have been rising steadily since the 70s and no amount of public health messaging, new diets or exercise programmes have really made a dent. We also increasingly understand that the individual’s ability to control their own weight is limited. But we are now beginning to see new links that may help explain and eventually help us to manage appetite and weight. Proper scrutiny is being given to Ultra Processed Food. The Protein Leverage Hypothesis also looks promising. Genetic mapping is helping us to understand the genetic variations in how different people perceive hunger. GLP-1 (Wegovy) is proving an effective, albeit expensive, treatment in reducing appetite and weight. Meanwhile large scale studies like PREDICT are bound to help us understand better what works in a hugely complicated field where genetics, the microbiome and the psychology of behaviour all interact. There will be no silver bullet - but indications are that more people will soon be helped more meaningfully, thanks to this research - and that will free up a lot of NHS resource.
