Aug 042015

The constant knee-jerk response to the NHS’ perennial financial tribulations – more here – usually takes the form of a politicised barrage of criticism about how ‘Dave and his cronies’ are deliberately starving the health care system of cash in order to somehow force it into being rescued by a cabal of privateers crouched slavering in the wings waiting to pounce and bleed dry what is patently not a cash cow. Empirically this makes no sense, but it’s worth having a look at just how ‘cash-starved’ the NHS really is. Figure 1 below from independent think tank The King’s Fund shows UK spend vs a number of developed countries, including some – often cited by the political left as examples of progressive health care utopias – who are ahead in terms of overall expenditure. Indeed, those countries (excluding the US for its obvious outlier status) spend a maximum of about 15% more overall on health (not the 40-50% trotted out by the usual suspects). Nevertheless, 15% (or an additional 1-2% of GDP) is a very significant amount and would undoubtedly dig the NHS out of a hole, but where is that money coming from? The figure clearly shows that almost without exception (the exception being Norway, which can reap the rewards of decades of prudent investment of its oil revenues) all of those countries have a higher private component of health care expenditure. Indeed, if all private components were removed it would look as if the UK spends no less of its public money on health (in fact possibly on the contrary it might even spend more) than other developed states.

Private-public health care spending in OECD

Figure 1. Private-Public Health Care Spending in OECD (The King’s Fund)

Data published by The World Bank (see summary in Figure 2, and original data at bottom of this post) would indeed seem to support this viewpoint. While the data for % GDP health, and by implication health care spend per capita are lower in the UK vs other high income OECD countries, UK public spending on health is clearly shown to be higher. What else can explain this gap other than the under contribution of the private sector hinted at in Figure 1?

Back to Figure 1, and another way of interpreting this chart is to look at those countries that spend overall less than the UK but almost invariably have a higher private component. Of course we are told nothing here about health outcomes but I doubt that the populations of Korea or Ireland are significantly more sick than Britons. So, this could well be an indicator that a higher increased private health care expenditure component is an efficient way of driving down overall costs with no detriment to outcomes. But why let reasonable questioning stand in the way of ignorant apoplexy and a rational debate on the future of the NHS?

Health Care Spend World Bank Data

Figure 2. Health Care Spend World Bank Data



Data from World Bank


Data from World Bank


Data from World Bank
Jul 092015

Fifty-five percent of millennials who live with diabetes stated they would trust a health app over a health professional for advice. The same number stated they are connecting with their doctors more frequently because of health apps. The index findings reflect a striking knowledge gap among both the general public and those living with diabetes about the causes, impact, costs and treatment options for one of America’s most prevalent chronic diseases. While nearly one in 10 Americans (29.1 million) suffer from the disease, 57 percent of the U.S. population isn’t aware that diabetes can cause other major health issues, including heart disease.

Jul 062015

Screen Shot 2015-07-29 at 3.02.32 pm

The Millennium Development Goals Report 2015 finds that dire poverty has dropped sharply, and just as many girls as boys are now enrolled in primary schools around the world. Simple measures like installing bed nets have prevented some six million deaths from malaria. But nearly one billion people still defecate in the open, endangering the health of many others.

In fact, though, how much of those gains can be attributed to the goals is unknown. The sharp reductions in extreme poverty are due largely to the economic strides made China alone. Likewise, some of the biggest shortfalls can be attributed to a handful of countries that remain very far behind, in particular India, where an estimated 600 million people defecate in the open, heightening the risk of serious disease, especially for children.

Reducing Child Mortality

Reducing Child Mortality

The New York Times has a good report here.

Given that health is a key component of the MDGs, what can healthcare communicators read into these findings? Having worked extensively in the region (albeit moreso in China than India) and having developed communications programs in both markets, it is clear that from an organisational level China is streets ahead. And, the long-termism so evident there is in large part absent in India. The way pharma engages with stakeholders in both markets is quite different, with Indian strategy much more focused on traditional channels and being less invested in digital and social engagement. It would surely make sense for India to revisit its policies that so restrict multinationals from investing in the country and consider embracing partnership from the pharma sector.

Jan 152014

To me the future challenge in healthcare is increasingly about value; about communicating the product’s place not just vs its peer set, but about understanding the patient pathway in the context of continual challenges to this pathway given evolving care and payer systems (market access). How we communicate product evidence is one thing (science-focussed medical communications); how we identify and use (and generate) additional evidence to be able to make it more persuasive moves us into the territory of social media, data and analytics… this is where we need to be finding the story and exploiting the earned and shared space in which to tell it (digitally). Creative and the owned space will diminish relative to the above – at least this is what I see happening. The old med comms rhetoric of creative+science = effective product story is all a bit generic as a standalone.

…which way?