Interview: Morning Wire talks to Mark Britnell, chairman of global health at KPMG

As chairman of KPMG’s global health practice, Mark Britnell understands the changing face of healthcare better than almost anyone.

With over 20 years' experience in healthcare, Britnell has overseen the largest new hospital build in British history, established the Royal Centre for Defence Medicine and worked as director general of the NHS (2007-2009). His book ‘In Search of the Perfect Health System’ serves as an antidote to recent stories of the NHS’ financial collapse, in large part because it is a story of how even the poorest countries can overcome the biggest health challenges – financial or otherwise. 

We need a more efficient NHS 

Last week, figures showed that NHS trusts have racked up a £930m deficit in the first three months of 2015 – twice as much as this time last year. Yet Britnell is optimistic saying he 'rejects the voices that say the NHS is completely unsustainable.’

Among those voices was David Bennett, the outgoing chief executive of NHS regulator, Monitor, who summed up the situation bluntly: ‘The NHS simply can no longer afford operationally and financially to operate in the way it has been’. 

So why is Britnell so positive? The answer, oddly, is waste. He argues that so much NHS money is wasted on unnecessary procurement systems that the NHS could easily be made more efficient and save cash using 'sensible improvement efficiencies'.

These include better training and more cost-effective IT services. This would mean more opportunities for tech companies offering Britain's ailing public health system better value for money.

The NHS has, according to Britnell, been 'littered with a trail of failed IT procurements' and he believes we need to take this much more seriously. 

Arguing that we need to 'strengthen our competitive spirit’ when it comes to procuring NHS goods and services, Britnell says there is more we can do to make doctors more productive too. But not necessarily by extending their working hours. Instead he claims that we need more technology to make their jobs easier and more efficient. 

He points to the example of Israel where 57 per cent of doctors’ consultations with children are by smartphone. And he throws in some healthy statistics. Although Israel spends almost 2 per cent less of its GDP (7.3%) on healthcare, it has a life expectancy of 83 years old – two years longer than the UK. 

A healthy state of affairs

But having worked in state-run and free market countries, Britnell is no fan of health systems entirely dominated by markets.

Arguing that health systems run by governments provide 'better care and value', he claims that free markets actually escalate costs due to asymmetries between hospital providers, health insurers and patients.

As evidence, he points to France and Germany whose health systems are market-based and which cost two percentage points more.

He adds that in the 'fragmented marketplace' of the United States, the costs are the highest in the world.

Referring to U.S. drug manufacturer Turing Pharmaceuticals, who recently raised the price on a drug used by cancer patients by over 4,000 per cent, he calls such profits ‘excessive’ and is in favour of Hilary Clinton's plans to reform laws around drug companies to prevent 'unaffordable' price rises. 

‘The big life sciences companies do need to make a profit. But when you get super profiteering, it damages trust between the life science industry and governments – and more importantly, patients.’ 

Arguing for more transparency around drug pricing, his slogan for life science firms is: 'You can run but you can’t hide.’

And what about the future?

Britnell predicts a bright future for life science firms as ‘we’re all getting older and ill-er'. 

When asked whether this high demand will mean paying for our NHS services, Britnell pauses.

‘I don’t see the UK fundamentally changing its policies on the way the health system is financed – over the next five to ten years.’ 

Instead, he hopes the government will spend more on healthcare as the economy grows. He claims that each year countries generally spend one per cent more on health care due to people living longer and costing health providers more.

Overall, he is optimistic and believes the NHS can look forward to a 'healthy if slightly bumpy' longterm future. 

And, he says, London is well placed to capitalise. 

‘Because of the convergence of big data and healthcare, London’s tech hubs make it a very exciting place to be right now.’