WHEB Commentary

Libby Stanley

The future of healthcare

Health is one of the two largest themes that the FP WHEB Sustainability Fund invests in. We currently have nearly 23% of the fund invested in healthcare companies and structurally the fund is always likely to have a 20-30% exposure to this sector, due to the make-up of our sustainable investment universe. As an impact investor, it is also an area where our investments can make a significant positive impact on society.

Healthcare is a vast and diverse industry, but WHEB tends to invest in companies working on the delivery of healthcare rather than companies that develop drugs and devices to cure diseases, for example we invest in stocks like Tivity, Cerner and Centene.

With an increasing global population, the pressure on healthcare systems across the world is becoming ever more apparent. For the UK, the struggles of the NHS are reported on an almost daily basis in the press.

It’s not just the increase in population that is burdening healthcare systems, but also the fact that longevity is increasing globally. By 2030, 1.4 billion people will be over 60 years of age which is 16% of the world’s total population and by 2050 it will be 2.1 billion which would be 21%. Compare that to 1980 when it was only 9% at 0.4 billion. [1]

In fact, global healthcare systems have been victims of their own success as they keep people healthier and living longer. It’s a fantastic achievement but it presents its own problems. In previous generations, communicable diseases were the big killer and the big drain on healthcare resources. In our new longer-lived, safer world, it is chronic diseases which dominate (diseases which last longer than three months and are not passed from person to person), for example: obesity, cardiovascular disease, cancer, diabetes, osteoporosis and arthritis. Living with these diseases can be debilitating, severely affecting a person’s quality of life for very long periods of time as we all live longer.

So, with all this in mind, what is the future of healthcare? This was the question addressed by a panel of experts at WHEB’s June Annual Investor Conference.

Population health management

An essential feature is likely to involve population health management. Dr. Shaun O’Hanlon, Chief Medical Officer at Emis Group, said “our genetic make-up can’t cope with what we put in our bodies these days and we need to drive lifestyle change. Population health management is about keeping us healthy rather than reacting to illnesses”.

But how can the health service encourage people to eat more healthily and exercise more regularly? According to Dr. O’Hanlon, a healthy diet and an active lifestyle would have a more positive impact on the healthcare system and help people not just live longer but also have a better quality of life in older age rather than taking medication.

Big data and AI

Dr. O’Hanlon believes that data and technology could be the solution that will “effect change in people’s behaviour”. He thinks the growing pool of health data can be used to personalise a person’s experience of healthcare enabling them to make more effective changes to their lifestyle for themselves.

Dr. Joanne Medhurst, Medical Director at the Central London Community Healthcare NHS Trust, thinks there is a “tsunami of technology” approaching the healthcare industry and “it’s time GPs get with the program” because artificial intelligence will be incredibly useful as a basic screening tool. For example, IBM’s Watson is being primed to give healthcare treatment. “Watson can deal with knee pain, you don’t need to see a doctor” she said.

Dr. O’Hanlon agrees that much of the interaction in a GP’s surgery could be done with augmented technology like AI. “This could free up clinicians to do the more complex, more empathetic work and the more physical work of examining patients where there is more need to have that one to one interaction. Strangely, one of the areas where this is taking off is mental health. There is a real problem, especially in men, in having an honest interaction with a doctor. There is evidence that some men will open up more to an app than a real person, they will be more honest and be more receptive to app-based therapy. In some areas, technology can make the experience better.”

Dr. Medhurst hopes that technology will give GPs more time to be compassionate to patients who are suffering pain, distress or grief, and also care for those who are at higher risk but might not know they are ill. “It would free us up to focus on the ‘unworried ill’ rather than the ‘worried well’. “We need to embrace it, it’s a win-win for everyone”.

This commentary is taken from the ‘The future of healthcare’ panel at WHEB’s Annual Investor Conference on 21st June 2018, moderated by Ted Franks, Partner & Fund Manager at WHEB. To listen to Ted’s short presentation on health and the panel discussion, please click here.

[1] Source: UN Department of Social and Economic Affairs: World Population Ageing 2017

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