I’ve just spent a very interesting three days attending the Commonwealth Heads of Government Meeting (abbreviated to CHOGM) here in London, bringing together heads of state and a wide variety of interest groups, discussing a range of topics.
As the UK looks to re-establish ties beyond Europe with Brexit fast approaching, this CHOGM seemed to have special significance for all attending – a sense of reconnecting and perhaps rediscovering the relevance and role of the Commonwealth in the 21st century.
What was apparent in all sessions, was the clear divide between developed and developing Commonwealth nations in terms of challenges being faced, not least the huge demographic disparity between aging populations in developed nations, and the rising youth demographic in places such as Africa.
This year’s stated themes were sustainability, fairness, security and prosperity so I did find it surprising there wasn’t more of a focus on health, given that excellent healthcare, equitably available to all, is so central to achieving these aims and swallows the most significant proportion of national budgets for many member nations.
Thus, I attended the single session at CHOGM on health, New Models of Healthcare, with great anticipation. The session sought the answer to ‘What innovative products from across the Commonwealth can help deliver 21st healthcare?’
Chaired by the Rt Hon Professor the Lord Kakkar, he could not have shown more sensitivity and skill in running a forum of such a diverse group and wide topic.
Professor Agnes Binagwaho of Rwanda gave compelling examples of the issues faced in her country, highlighting for many of us what we take for granted. For instance, she highlighted the role the private sector could have on improving social and economic outcomes by lifting middle-aged people’s access to affordable prescription glasses. In Rwanda, as your sight deteriorates with age, without access to glasses it can mean losing your job as a teacher or factory worker.
Lord Kakkar allowed the conversation to run, but frequently came back to central themes of ‘what will we do over the next 2 years so we aren’t having this same conversation at the next CHOGM?’ Keeping it real, the points were clearly made that the issues in developed countries are ones of legacy processes and approaches, whereas developing countries face very different issues and, in some cases, more of a ‘blank canvas’ on which to build superb systems and services. He also stressed the need, if progress is to be fast and efficient, to leverage existing knowledge and organisation structures, rather than create new complexity or invest in new research.
The question was asked what Governments could do to enable the private sector to contribute more. This was very topical for Cemplicity, as we’ve received significant support on our journey from Government agencies. One of the most useful things Governments can do is to present a clear picture of their priorities and the types of products that will solve the biggest problems. For entrepreneurs, this is like a spotlight on opportunities that we can then take the risk of developing, knowing there will be Government sponsored demand if we do our job right.
I was reminded, when this question was asked, of the Ireland Government’s ex-Head of Digital Health, Richard Corbridge (who now works for an NHS Trust in Leeds). In Cemplicity’s early years working in Ireland we saw Richard engaging with the private sector on numerous occasions. One of the things Richard did exceptionally well was make it very clear to us what types of products the Government wanted and which diseases were causing the greatest burden. One thing private companies are good at is finding the money, so it isn’t the Government’s role to fund everything. However, this clear view of needs or problems to be solved is immensely helpful.
Despite all the discussion of digital disruption and the key role technology will have in future, there was no mention of the critical backbone that is a single electronic health record. Governments must set the national framework even if this allows some local procurement flexibility. They must also dictate the need for the interoperability of all products coming into the system. (Hats off to Professor Binagwaho as the only person who mentioned the ‘I’ word!). Establishing this clear framework will go a long way to ensuring future, well-integrated health systems, and we need look no further than Estonia to see the great benefits that result for patients, service providers and sector funders. (https://e-estonia.com/solutions/healthcare)
Of course, Cemplicity isn’t in the business of e-health records or disease management apps. While I listened to the diverse group grappling with issues from villages with the most basic infrastructure, to mortality in childbirth 300% higher than Singapore, it was clear that each health system must be designed around the needs of patients, their families and communities. The ability to capture the patients’ voice and bring this effectively into planning and decision making is critical. I left with a renewed sense of purpose and excitement about the contribution we can make to this challenging journey, to transform health systems so they work better for patients and funders.