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We've already been talking about the issue rationing and the fact that the
decision-making is coming down more locally.
It's happening at hospitals here, it's happened at GP level in the UK.
It is a trend which is happening incredibly fast. In my country, it's happening for one
really big reason,
which is the only way, politically, to enable hospitals to close and health
cuts to happen,
is to get doctors, who are as local as possible,
to make those decisions so they'd get assassinated instead of you. And that's
what's happened.
So, a friend of mine is in the business of closing a big local hospital
in my town. He has hate mail, he's had
5 or 6 thousand people out on the streets, shouting his name.
They are determined the hospital should not close.
But he is a general practitioner,
he's a local family doctor, and the local family doctors in the UK have been given
the power, over almost the entire health budget of the UK.
It's the massive revolution, and a different version of it i think, is
happening here,
in terms of much more local based decision making in hospitals,
but in many countries this is going to happen. And it's all about community
and patients, and being closer to those
that make the decisions, and allowing families to have a voice and all that kind of
stuff.
But it has profound implications, for just about every aspect of this competition.
And one thing we want to say about Medtech is that the competition is getting
complicated.
Because in the age of austerity, I mean I think my friends in Greece right now,
in the age of austerity we have rationing, not just between
a modality of treatment, for say, cancer reconstruction of
breast surgery, but we're dealing with a quarrels between
breast surgeons and cardiovascular surgeons for budget. We're dealing with
quarrels
between Education and Health for budget. Between Health
and Defense for budget. Between prevention of
of infectious disease in children
vs. care of the elderly, joint replacement and dementia research.
These are huge, hugely important debates,
which will cloud every decision about Medtech for the next 15 years or more.
20 years, 30 years, rationing has always been with us, but now,
it's been formally acknowledged, right out because of the
austerity issue. And rationing,
rationing is
being influenced irrationally. Irrational rationing.
Because of course, it's emotion which is driving a lot of this. Patient campaigns,
what they read on Google.
We have legal and IT-related decisions which aren't necessarily in the
best interest of patients.
We have financial incentives which we've talked about, whether it's the surgeon
jointly financed with the hospital and so on.
Many of these things are changing. Patient experience, local skills and
experience.
Whether there's the local infrastructure to take advantage of it and so on.