Time to think big when planning healthcare

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| The European | 7th August 2019
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Chronic diseases are the primary cause of death and morbidity in the developed world. Conditions such as depression and other mental disorders, some forms of cancer, and disabilities have joined diabetes, cardiovascular disease, and chronic obstructive pulmonary disease (COPD) on the traditional list of diseases that are responsible for 60% of all deaths worldwide.

When they affect people of working age, chronic conditions result in sickness, absence and worklessness, as well as higher welfare costs and reduced tax income. Meanwhile millions are forced to join the growing number of informal caregivers who provide 80% of all long-term care in Europe and who might otherwise be contributing financially to the economy. Perhaps the true, immeasurable cost on our society though, is the millions of people unable to enjoy a fulfilling and rewarding life as a result of their condition.

Increasing pressure on healthcare 

The United Nations reports that virtually every country in the world is experiencing growth in the number and proportion of older people in their populations, with implications across almost every aspect of society and the economy. Worldwide, governments are wrestling with the challenges that an older population presents. No more so than in healthcare, where the growing fiscal burden of chronic disease and ageing means difficult decisions need to be made about how healthcare is funded and what form it takes.

As a result, many publicly funded healthcare systems are attempting to identify cost savings. Studies by the Medical Technology Group (MTG) have revealed that in parts of the UK, proven treatments such as cataract removal and hernia repair are finding their way onto lists of procedures that are restricted in order to reduce spending. Meanwhile, wider debates raise the issue of private versus public healthcare support, with growing pressure to move towards a higher personal and corporate healthcare contributions.

However, this approach fails to address the fundamental issues facing healthcare systems – how to reduce the toll of disease, in particular chronic conditions which represent around three-quarters of all healthcare spending. Instead, keeping those affected by long-term conditions out of hospital and returning them to the community should be the number one priority for all governments.

The untapped potential of medical technology 

Better patient education, support for self-management, and preventative medicine are all part of the answer. One often overlooked solution, however, is proven medical technology – which ranges from treatments that have been in use for decades, such as artificial knees and hips, and stents, through to newer technologies and procedures such as implantable devices, and interventional radiology. In fact, there are over half a million technologies available today, many of which remove the need for long-term treatment, reduce expensive hospitalisation, and enable patients to lead a normal, fulfilling life.

The trouble is that medical technology is often wrongly perceived as a cost-driver. In an environment where cost-cutting and short-term budgeting are the priority, restricting or rationing procedures is, unfortunately, seen as a quick fix solution.

Governments overlook the potential of medical technology

Research conducted by the Medical Technology Group in association with the Work Foundation reveals that this short-term, myopic approach means that economies are missing out on the benefits that medical technology can deliver. Our 2017 report, ‘Keeping Britain Working’, examined just eight existing technologies, including sepsis diagnostics, insulin pumps, and coronary angioplasty. It concluded that these treatments could save the UK economy around €550m in reduced healthcare costs, lower welfare spending and increased tax revenues. The study also found that over a quarter of a million patients would benefit from better outcomes, including an improved quality of life.

In June 2018, the UK Government announced an additional cash injection of €23bn in healthcare funding, a welcome increase of 3.4% in real terms over the next five years, that narrows the gap between the country’s healthcare spending and those of other Western European economies. Just 5% of that additional funding – the proportion that is currently spent on medical technology – has the potential to generate significant savings for the wider economy.

A shift towards value-based healthcare

However, without a fundamental review of healthcare policy, national governments’ additional investment in healthcare is at risk of being wasted. Instead a radical review of how health services assess value in their purchasing and commissioning is required. A cheapest possible approach is the healthcare equivalent of a race to the bottom. More sensible is a policy that makes value-based healthcare the focus. Under this system, greater emphasis is placed on the impact of tangible patient outcomes, ensuring better value for the tax-paying public and a better return on investment for the wider economy.

A fundamental change in approach

This new way of evaluating healthcare spending requires a radical shift in culture, systems, and processes. With growing demographic pressure, a mounting toll of chronic disease, and ever-tightening public finances, the change is needed urgently though.

For enlightened governments, the potential benefits of delivering appropriate medical technology and the best treatment first time is enormous. Not just for patients, but for our society as a whole.

Further information

www.mtg.org.uk

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