Medicine and Science from The BMJ

It has been a tumultuous time in UK health politics. UK Health Minister ,Wes Streeting, has freshly resigned. What does this mean for his newly introduced NHS Modernization Bill as it heads through Parliament?

Together with Hugh Alderwick, Director of Policy and Research at the Health Foundation, we unpack the bill's sweeping centralization of power, the abolition of NHS England, and the contentious role for US tech firm Palantir in the new NHS.

And, we explore a major milestone for women's healthcare. A condition affecting an estimated 170 million women globally has officially been renamed from Polycystic Ovary Syndrome (PCOS) to Polyendocrine Metabolic Ovarian Syndrome (PMOS). Rachel Morman, Chair of the PMOS charity Verity, joins us to explain why dropping "cysts" from the name is a vital step toward recognizing this as a complex, multi-system condition, and how this co-designed change will fundamentally reshape diagnosis, treatment, and future research.

Further reading:

Health Bill brings NHS management back into government

PMOS: What's in a name? Everything

PCOS name change to PMOS must be managed to avoid confusing patients, says expert

Twitter was launched 20 years ago, followed quickly by the iPhone and Instagram. Today, nearly 60% of the world’s population uses social media. Medical experts are sounding the alarm on the potential for these platforms to cause systemic harm. This past year has seen large events in the legal and public health battle against tech giants, with millions of dollars awarded in damages to child victims. Why has pinning down these companies proven difficult? And, what are the parallels between the social media industry and the historical tactics of "Big Tobacco"?

Guests:

Matthew Bergman is a practicing attorney and the founder of the Social Media Victims Law Center, as well as a professor at Lewis & Clark Law School in Portland, Oregon.

Ilona Kickbusch is an editorial board member of the BMJ and a visiting professor at the Digital Transformations for Health Lab at the University of Geneva, specializing in the commercial determinants of health.

Further reading:

From tobacco to TikTok: what public health litigation history tells us about holding social media accountable

What is the evidence for social media addiction?

The BMA has released their long awaited review of the Cass report. The original report looked at the provision of NHS gender identity services for children and young people, and involved a review of the science underpinning those services. It also set out a plan to improve care for gender diverse young people. 

We talk with David Strain of the BMA’s board of science to discuss their findings, and hear why they were critical of the Secretary of State, Wes Streeting's response to Cass’s review.

And, we hear about new research published with The BMJ that aims to help children with autism. The researchers used a non-invasive magnetic stimulation technique to target specific regions of the brain, with the goal of promoting sociality. We discuss the benefits, and how this technique might translate to treatment plans for patients.

Guests:

David Strain is an associate professor in cardio-metabolic health at the University of Exeter and Chair of the BMA’s Board of Science.

Benjamin Becker is a professor of psychology and neuroscience at the University of Hong Kong, specializing in brain-based interventions for mental disorders.

Further reading:

Puberty blockers: BMA critique vindicates Cass review but questions government “overreach”

Accelerated non-invasive brain stimulation in childhood autism

The new trade deal struck between the UK and US came into force in April. 

The deal will

double the amount that the NHS spends on new medicines, by the end of 2036 (from 0.6 - 0.6% of GDP).

 increase the threshold that the National Institute for Health and Care Excellence (NICE) sets for drug approvals - which will allow more to be approved, but will also allow companies to charge more for their pharmaceuticals,

 include a change to the rebate the NHS receives, to ensure that the extra drug spend occurs.

Cumulatively this will increase our drug spend by £56 billion in the next 10 years, which will have to come out of current healthcare spending - which experts are calling a catastrophe for the NHS.

Joining Kamran Abbasi to discuss are Sally Gainsbury, a senior policy analyst Nuffield Trust and Karl Claxton, professor of economics at the University of York. We also hear from Francis Ruiz, policy analyst at the London School of Hygiene and Tropical Medicine.

Reading list

The UK government must publish a detailed impact assessment of the costs and benefits of the US-UK medicines partnership

A budget apart: the case for ringfencing medicines in the UK

A blockbuster MS drug undergoes FDA re-evaluation. We explore the story of Ocrelizumab, a treatment for primary progressive multiple sclerosis, following a patient petition that highlighted internal disagreements among agency reviewers regarding its efficacy.

We look to Sweden, where new research involving sibling pairs separated by adoption investigates how early-life environments shape long-term health and social outcomes.

Finally, we revisit the dominant medical narrative on Alzheimer’s disease. Why is it so difficult to move towards comprehensive treatments? Has the focus on amyloid plaques hindered our understanding of other critical factors like vascular health and social inequality?

Peter Doshi is a senior editor at The BMJ and an associate professor of pharmaceutical health services research at the University of Maryland.

Erik Peterson is an associate professor at the Karolinska Institute in Stockholm, specializing in psychiatric epidemiology and adoption studies.

Carol Brayne is a professor emerita of public health medicine at the University of Cambridge and a leading expert in the epidemiology of dementia.

Reading List:

Multiple sclerosis: Could Roche's bestselling drug Ocrevus be doing more harm than good in women with primary progressive MS?

Home environment conditions during childhood and psychosocial outcomes across three generations in Sweden: population based adoption-discordant sibling comparison study