In the news

In the Education and Debate section of the BMP, Fears et al argue that the NHS should embrace the opportunities for disease prevention that will come from advances in genetics, and should act as an "informed and innovative customer" providing a market pull for new products and services arising out of genetic research and development in both the public and the private sectors [Fears, R et al (2000) BMJ 320, 933-935]. They warn that unless the NHS takes on this challenge, a private marketplace for gene diagnostic testing may grow up that could bypass the NHS, whose current service provision and organisation could come to be seen as outdated and inadequate. A holistic approach to health economics is also needed, they claim, in order properly to evaluate the costs and benefits of new technologies. Furthermore, an organised effort is needed in education and training, to ensure that clinicians in all disciplines understand genetics, its applications and implications.

Comment: Few will argue with Fears et al that an overarching strategy is needed for the development of health services as genetic science advances. Their suggestion that  the NHS needs "an integrated service culture ... with less compartmentalisation and more flexible transfer of skills" may also meet with some agreement, though many clinicians - general practitioners in particular - are wary of the extra workload and responsibility that a more direct involvement in genetics could bring. However the most contentious aspect of Fears et al's paper will almost certainly be their assertion that a new "strategic public-private partnership" is the way forward for the NHS.