By Nick Mays
The recent Department of Health report, ‘Innovation, Health and Wealth’* tells an intriguing story about the potential economic benefits of the NHS. It goes further than rehearsing how it helps to develop a healthy, productive and economically active population. The report also states that the NHS supports the life sciences industry. So far, so good. But more controversially, it contends that, ‘by exporting innovation, ideas and expertise’, the NHS provides new business opportunities abroad for UK-based companies.
This interesting argument for NHS innovation is on top of the report’s central case that innovation helps ‘deliver more health benefit for a given public resource’. The report engages directly with understandable concerns that commerce might overtake health considerations by stressing the importance of robust evaluations that do not bend to industry pressures. Indeed, it makes some sound proposals to strengthen the hand of NICE, whose rigour and independence are exemplary.
Nevertheless, I would sound a warning. Amid the talk of promoting UK plc, there remains a risk of getting carried away and heaping NHS praise on developments of dubious overall benefit – if only to help secure overseas markets. Such a step would not only be bad for the NHS, it could also damage UK business in the long-run.
How might this happen? Surprisingly easily. All of us in research are aware of how studies and evaluations, however robust, can quickly lose their nuanced, shaded complexities in the hands of eager advocates. A study full of doubts, caveats and question marks can, once passed to an enthusiastic PR department, suddenly be transformed into a panacea.
Both the NHS R&D community – and UK business – should bear in mind the example of the US Food and Drug Administration (FDA). Although FDA approval is often refused, that’s not necessarily bad for business: the FDA’s rigour – and willingness to say ‘no’ – means that anything bearing its kite mark will be acceptable for sale anywhere. We should, likewise, be careful to maintain the NHS as a globally trusted brand.
So we should be wary not just about ensuring robust evaluation. We should also keep a close eye on the way those evaluations are presented publicly and, in particular, to the media. It is easier to lose a reputation than it is to gain one. In the long-run, too much spin could seriously harm the Health Service’s valuable business spin-offs.
Nicholas Mays is Director of the Policy Research Unit in Policy Innovation Research (PIRU) and Professor of Health Policy at the London School of Hygiene and Tropical Medicine.
*To read ‘Innovation, Health and Wealth’ go to: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_131784.pdf