One of Britain's foremost physicians says that the UK’s healthcare system is costing more than anywhere else in the world outside the USA yet fails to focus its efforts in areas where it can do most good.

In a presentation to Scotland's health research and innovation conference, Professor Sir John Bell argued that, for all its achievements, the failure of the NHS to adopt technology is a core reason that its productivity is reducing year-on-year instead of increasing.

Professor Bell is Regius Professor of Medicine at the University of Oxford, a past President of The Academy of Medical Sciences and a founding director of three biotechnology start-ups.

He told the audience at the event marking the 50th anniversary of the creation of the Chief Scientist Office that there needs to be a change in the paradigm of the NHS which, since its inception, has focused on late-stage symptomatic disease and has been resistant to change.

Professor Bell was one of the authors of the UK Life Sciences Vision in 2021 which set out health missions to address the rise in chronic diseases and in the number of people with co-morbidities – several conditions at the same time.

The focus of the NHS, the Vision proposed, needs to be on obesity, cardiovascular disease, cancer, dementia, respiratory illnesses, mental health, ageing and prevention.

However, Professor Bell says only cancer has any form of credible provision for prevention or early intervention.

"We've always thought about healthcare as being about health economics – what's the impact of this disease on the cost of providing healthcare within a healthcare system.

“In fact, there's a whole other domain to this and that is what is the cost of illness or chronic illness when it takes people out of the workforce. It causes a drag on productivity and economic growth because you've got so many people who are in trouble."

Professor Bell pointed to data showing that the NHS in Britain is ‘averse to’ technology and spending on medicines and medical equipment, and, while its overall costs are second per head only to those of the USA, its patients outcomes are amongst some of the worst.

He suggested that lack of resources makes the NHS a difficult place for people to work productively:

"It's not because of a lack of staff because the staff numbers have gone up and the patients waiting for NHS treatment has really jumped and that's a reflection of the productivity of the system.

“We train more doctors and productivity goes down, it doesn't go up."

Professor Bell says the biggest increase in workforce has been hospitals, while it should have been in primary care.

In a wide-ranging keynote speech, Professor Bell presented a vision of community-based prevention and early diagnosis of chronic conditions with integrated digital systems to support patients and health teams made up of many different disciplines.

He says that while the increase in life expectancy due to modern medicine brings an increased need for health, it is a huge achievement:

“It means is that you're all going to have 15 more years with your grandchildren than you would have otherwise… I would argue that is probably one of the great achievements of modern science, and I don't think we as a medical profession talks very loudly about this. But the truth is that there was a massive achievement when you sum them together.

“That’s a great success but it has also created problems. And that is a lot of people living older, and not necessarily living well into their older life.”

Read more from the CSO Conference: Scotland’s first chief scientist; 50 years ‘just the beginning’ says Chief Scientist

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