A BBI

The UK government last month announced the establishment of a new task force bringing together representatives of the government and the healthcare industry to "work together to support the industry and maximize the benefits for patients."

The first initiative of its kind between the government and the healthcare sector, the Healthcare Industries Task Force (HITF) will operate for one year under the joint chairmanship of Health Minister Lord Warner and Sir Christopher O'Donnell, chief executive officer of Smith & Nephew (London). Other participants will include Science Minister Lord Sainsbury from the Department of Trade and Industry; Mike O'Brien, minister of state for trade, investment and foreign affairs, and senior executives from manufacturers of medical products.

The HITF has been charged with delivering recommendations which should benefit patients, encourage the best use of National Health Service (NHS) resources and stimulate science and industry in the UK to improve growth in manufacturing, investment, employment and exports.

In announcing the establishment of the task force, Warner said, "The healthcare industry is important to this country, both in terms of developing products to support better healthcare in the NHS, and as an important economic sector." He said the task force "will help us to gain a better understanding of how government and industry can work together for mutual benefit." Noting that "great advances are being made in medical technology," Warner said, "I want to ensure we harness this expertise and maximize the benefits for the NHS, patients, industry and the national economy."

O'Donnell termed the UK healthcare industry "one of Britain's most successful industrial sectors as well as making a major contribution to the health of the British people." However, he said, "there are further opportunities by partnership with the medical professions and healthcare providers to improve industry growth and to contribute to patient benefits." He called the establishment of the task force "an extremely positive step," one that shows the British government "has recognized these opportunities and established this task force to examine the issues and take action."

In particular, the task force will assess how to:

Increase healthcare professionals' and patients' access to "appropriate and innovative medical technology" across all healthcare services

Foster and facilitate an improved environment for product research, development, clinical evaluation and related manufacturing investment

Provide a clear framework of regulation and information that serves patients

Promote international trade in products in this sector.

Four Working Groups are planned, each with co-chairs from government and industry.

The Association of British Healthcare Industries (ABHI) is bringing industry interests together for the task force, working with several other trade associations, including the British In Vitro Diagnostics Association, the British Healthcare Trades Association, the Surgical Dressing Manufacturers Association, the British Association of Anesthetic & Respiratory Equipment Manufacturers Association, GAMBICA (representing the interests of companies in the instrumentation, control automation and laboratory technology industry), the Association of Healthcare Technology Providers for Imaging, Radiotherapy and Care Manufacturers, and regional organizations Medilink and Southern Medical Alliance.

Citing figures from the ABHI, the government said the healthcare industry in the UK is made up of about 1,800 companies that produce a wide range of medical equipment and devices, "ranging from syringes and aids for the disabled to diagnostic test kits, pacemakers and high-technology scanners." Total output by those companies, which the statement said includes both major international players and small organizations manufacturing niche products, is about 4 billion, including estimated sales of 2.2 billion to the NHS and exports of about 1.6 billion.

Effort urged on osteoporotic fractures

Osteoporosis experts last month urged the European Union (EU) and national health ministries to improve policies and support programs directed toward prevention of osteoporotic fractures. The European Union Osteoporosis Consultation Panel presented a report at the European Parliament in Brussels, Belgium, outlining what it said are the key steps necessary to prevent fragility fractures that result from osteoporosis.

"Osteoporosis in the European Community: Action Plan," said that osteoporosis is one of Europe's most common but least-recognized diseases. One in three women over age 50 will break a bone due to osteoporosis, the report said, as will one in eight men, imposing what the consultation panel termed "a huge social and financial burden on society." The report, which was financially supported by the European Commission, estimated the annual first-year direct cost of treating osteoporotic fractures in Europe at EUR 25 billion. Citing a study indicating that one person in the EU suffers an osteoporotic fracture every 30 seconds, the panel said that the expanding older population means the number of fractures and their costs will "at least double" in the next 50 years unless effective preventive strategies are developed.

Dr. Juliet Compston, chair of the EU Osteoporosis Consultation Panel and a board member of the International Osteoporosis Foundation (IOF), said, "If we are to avoid an epidemic of osteoporosis and a miserable future of fragility fractures among the elderly of Europe, there are three key steps that, with support from the EU, must be implemented in member and accession states."

Those steps include:

Development of evidence-based prevention guidelines in all member and accession states, with governmental endorsement and financial support.

Appropriate access to and reimbursement of diagnosis and therapy.

Coordinated collection of fracture data to include in the EU health information system so preventive strategies can be evaluated and the allocation of future healthcare resources be better planned.

Making prevention of osteoporotic fractures a healthcare priority in all member states was first outlined in the 1998 European Commission "Report on Osteoporosis in the European Community-Action for Prevention; European Commission 1998." A 2001 policy audit report prepared by the IOF indicated that little progress had been made in implementing the eight policy change recommendations detailed in the 1998 report.

The Action Plan presented last month aims to raise the priority of osteoporosis at government level, with particular emphasis on the development of effective strategies for the prevention of fragility fractures in high-risk individuals. "Since a first fracture is rapidly followed by more fractures, it is critical that healthcare policies promote the detection of osteoporosis before the first fracture occurs," Compston said. "The Action Plan reveals that, unfortunately, early detection is not perceived as a healthcare priority." She added that, while osteoporosis is one of the worst chronic diseases in Europe, "most people have no idea of their personal risk status."

Coalition pushes for more research support

The Swedish Research Council (Stockholm, Sweden) is spearheading a concerted campaign by all of Sweden's stakeholders in science and technology in an effort to convince government to increase support for public research by SEK7.5 billion ($950 million) or 37.5% by the end of the decade.

Public support for research and development in Sweden stands at around SEK20 billion a year, P r Omling, director general of the research council, said, but it is spread thin. "We have a nice red Ferrari when it comes to infrastructure, but we do not have enough gasoline to use the full potential of the system," he said. During the last 10 years the throughput of both undergraduate and postgraduate students has doubled, Omling said, and the number of institutes active in research has risen substantially. Yet funding has stagnated, and there is now evidence, he said, that Swedish research is losing its competitive standing.

Although Sweden's research output remains high in terms of numbers of papers, Omling said its quality, gauged by citation levels, is falling. Innovation, as measured in terms of use of patents obtained by Swedish researchers, also is suffering. "We are not able to transfer them into companies or commercial usefulness," he said. A talent exodus is another problem. "There is a drain of people over to the United States all the time." While the numbers might not be large, Sweden is losing some of its best people by that route, Omling added.

All of Sweden's stakeholders in research, including the Swedish Agency for Innovation Systems, the Royal Swedish Academy of Engineering Sciences, the Royal Swedish Academy of Sciences and the Association of Swedish Higher Education, which represents 39 universities and colleges, have signed up for the campaign. That in itself is unprecedented, Omling said. Historically, Sweden's universities have enjoyed high degrees of autonomy and have received funding directly from the government. But now they have accepted the principle that they might have to compete for funding based on performance measures.

The research council's submission to the government calls for an additional SEK3 billion to be made available annually to national research councils and a similar sum to be provided to universities and third-level colleges. It also has called for SEK1 billion for applied research and innovation, and another SEK 500 million for the same body to spend on incubators, seed funding for early stage companies and other technology transfer measures.

Reid salutes partnership with U.S., firm

Speaking at the "Learning from Kaiser Permanente" conference in London last month, UK Health Secretary John Reid blasted critics of a new National Health Service (NHS) partnership with the U.S. health maintenance provider. "Some people have a problem with conferences like this; they seem to be opposed to learning. We are asked to be so frightened of 'abroad' that we must not learn from them," Reid said. "I stand in a different position I believe that a preparedness to learn and improve is a sign of strength, not of weakness." He added, "We know that the NHS principles do not apply in the U.S. and the values and structures of the NHS are different. But that doesn't mean that we don't learn anything from a different way of working."

Reid said the lessons UK health officials can learn from the not-for-profit Kaiser Permanente (Oakland, California) organization include keeping patients out of the hospital, active management of patients, self-care and shared care, the use of information, "but most notably how to increase integration." Noting that Kaiser Permanente integrates prevention, diagnosis, treatment and care, he said doctors "have fast access to diagnostic services in the community," which helps to avoid stays in the hospital for such tests. "Their integration of inpatient and outpatient care enables patients to move easily between hospitals and the community," Reid said, adding: "Integrating care makes sense for the NHS."

He said NHS Primary Care Trusts "are in an ideal position to do this and develop stronger links between prevention, diagnosis and treatment." That could be done, for instance, "through employing medical specialists in asthma and diabetes to move away from a hospital-focused system."

Eight primary care trusts have been working in pilot programs with Kaiser Permanente, which provides healthcare for some 8 million persons in the U.S., with a focus on minimizing hospital stays through provision of a wider range of specialist medical services in the community and encouraging patients to get more involved in their own care. Kaiser uses around one-third of the number of bed days as the NHS for leading causes of hospital admission such as asthma, bronchitis and strokes among people over 65 years of age. The UK pilot program involves educating and encouraging patients to become more involved in their own care. Reid said last month that the UK government was "encouraged" by early indications from the pilot programs.

Professor Chris Ham, director of the Department of Health's strategy unit, said, "The main lesson from Kaiser is its ability to minimize the use of acute hospital beds through an integrated approach to service delivery. At the heart of this approach is a strong focus on the management of people with chronic diseases and the breaking down of barriers between secondary and primary care."

Siemens, November AG in agreement

November AG (Erlangen, Germany) agreed to work with Siemens Medical Solutions (also Erlangen) to develop technologies for blood diagnoses at patients' point of care. The products are intended to detect viruses, cancer cells and genetic risk factors.

The companies will jointly develop and produce lab chip products, aiming to bring them to market by the end of 2004. The companies declined to disclose the financial details of their contract, but November AG estimated the market for their products as about EUR 1 billion annually.