Snedden Campbell February 2023 Newsletter

Introduction by the founder of Snedden Campbell

Snedden Campbell (SC) is a Callendar-based recruitment firm for the global medical technology sector. It was founded by me and my wife, Jennifer Snedden, in 2001 as a recruitment partner for medtech firms in Europe and beyond. We find senior, skilled people and we make board placements in companies that are involved in a range of areas, including life sciences, biomedical, diagnostics and medical devices.

Working directly with company management or engaged by external investors, we have placed skilled staff in companies in the UK, Spain, France and Denmark and we have attended meetings in Germany, the Netherlands, the Czech Republic and Dubai.

As a small company with a global audience, we are one of only a small number of recruiters with more than two decaces of experience in medtech recruitment and we have an enviable and hard won reputation for quality, effectiveness and dependability, which benefits from a large amount of repeat business.

We bring a specialist understanding of the medical technology industry to the business, plus a mix of experience, curiosity and creativity to help find the best possible candidates available for your company. We’ve also been told on many occasions that working with us is an enjoyable experience.

I have been in candidate search for more than 30 years. Prior to launching Snedden Campbell, I held senior roles for some of the UK’s biggest recruitment companies. Fed up with men in grey suits, pointless KPIs and sharp practice, I decided to launch a new kind of retained medical technology search consultancy that would bring

approachability to headhunting, where clients and candidates would be treated equally and where nobody ever said ‘touching base’. I now spend my time meeting clients and delivering on projects around the UK, Europe and worldwide. Regular business trips always include a visit to the nearest art gallery or cathedral.

Outside of work, I love exploring Scotland on foot and usually in the company of Ziggy, the office wonder dog. If the weather is bad, I’ll head to my bench where I’m making a 1:48 scale, air force in plastic.

Jennifer leads our market analysis and candidate search function, as well as providing operational support for Snedden Campbell. She has played an important role in making the company what it is today, primarily by not putting up with my madder ideas. Away from the office, Jennifer relaxes, by designing and making soft furnishings, especially lampshades.

Ivor Campbell CEO of Snedden Campbell

PRAYING FOR THE NHS WILL NOT BE ENOUGH TO SAVE IT

By Ivor Campbell

With budgets already stretched before the Covid pandemic, the additional cost pressures since heaped on health trusts across the country by double digit inflation has brought the NHS closer to breaking point than at any time in its history. Every passing day seems to bring bleaker news for the beleaguered service, with a seemingly endless rollcall of damning statistics and publication of official reports charting yet higher levels of institutional failure.

If anything, the relentless flow of anecdotes of patient betrayal, breathlessly reported in the pages of local press, is more shocking.

At the time of writing, we had just learned that four patients waited more than 20 hours in the back of ambulances outside Royal Shrewsbury Hospital; that GPs in Peterborough are now responsible for the care of more than 2,000 patients each; and that Stockport NHS Foundation Trust is offering food bank vouchers to hospital workers struggling to get by on poverty wages.

In the same week, a British Medical Association (BMA) survey found that 44% of senior doctors are planning to leave their roles “in some capacity” over the next 12 months, while the Care Quality Commission (CQC) reported 132,000 NHS and 165,000 social care vacancies, meaning a workforce the size of the population of Newcastle-Upon-Tyne is needed to fix the logjam. Meanwhile, the average wait for category two, 999 calls for an ambulance — including for chest pains and strokes — in England and Wales is now 60 minutes, compared with a target of 18 minutes. And in Scotland, throughout August, one in ten operations was cancelled due to lack of resources.

Of course, none of this is likely to lead to any significant change – at least not in the short-term. Traditionally, the response of politicians to complaints of a ‘crisis’ in the NHS has been to throw more money at it, and right now there’s no money to spare.

While both Conservative and Labour governments have previously toyed with reform, none has dared challenge the universally free, taxpayer-funded model upon which the health service was founded.

Towards the end of last year, it was reported that NHS chief executives in Scotland – one of four autonomous

health service areas in the UK – have discussed abandoning its founding principles by having wealthier patients pay for treatment.

The prospect of the first ‘two-tier’ health service in the UK since its founding in 1948 is raised in draft minutes of a meeting of NHS Scotland health board leaders in September. They also discussed the possibility of curtailing some free prescriptions.

While Humza Yousaf, Scotland’s Health Secretary, sought to play down the reports – insisting NHS Scotland would stay publicly owned and operated and free at the point of delivery –the reports represent something of a watershed. Yousaf’s comments were only to be expected. If there is a single, immutable reality of British political life it is that the NHS is an untouchable shibboleth, and any party that says otherwise risks courting elec toral oblivion oblivion.

Yet, there is a dynamic to the latest spot in which the NHS finds itself, which appears different to

anything in the past. Again, you need only scroll through some of the local press articles to discover that waits are longer, levels of basic care poorer and patient experiences grimmer than ever before. Figures published by NHS Wales last week revealed more than 60,000 patients are waiting more than two years for treatment.

Ian Hembrow, 53, from Maesteg, in Bridgend was told the waiting list for his urgent hip operation was four-and-a -half-years. In Bonhill, West Dunbartonshire, 69-year-old grandmother Mary Travis has already lived in crippling pain for more than two years, waiting for a back operation to straighten her twisted spine.

Earlier this month she was told that, despite being at the top of a waiting list, she could face a further, two-year wait. The NHS has changed little from the model envisaged by its founder Aneurin Bevan because there is an almost spiritual belief in its universality. People of all classes and backgrounds accept the same level of treatment as a right and consequence of being British.

Those principals have survived because NHS care, as as well as being universal, was also universally excellent. That can no longer be said to be the case. The withholding of treatment for years is worse than receiving poor treatment and those who can afford to pay privately for a better service will inevitably opt to do so. The most compelling argument against privatising the NHS has always been that the provision of healthcare should not be left to the vagaries of market forces.

The irony of the current crisis is that those very mar ket forces may now compel its demise. No matter how strongly Britons support the NHS, few will be prepared to wait months or years to have an ingrowing toenail treated or a cyst removed if they can have it done privately the following week for a few hundred pounds. And while we may be happy and willing to pay European levels of taxes in return for a European-style health service, we’re unlikely to do the same for a US-style system. With the growing development of robotics and telemedicine, as well as an expansion of over-the-counter diagnostics, more people are now seeking remedies, for a greater range of treatments, from their local chemist or from a private therapist or

practitioner. By spending a small amount each month, they can have more-or-less unlimited telephone or video access to a private GP. More is being done online than was the case a few years ago. Much of it remains minor, but the direction of travel is such that, before long, more serious illnesses will be diagnosed remotely and by high street providers. If patients can be diagnosed with prostate or breast cancer sooner,

plaints, while accidents and serious illnesses are treated by a publicly funded service, similar to the NHS, which is free at the point of delivery.

It’s unlikely the NHS will ever be wholly privatised, but we could see – slowly and over time – some of its more routine functions being taken over by private companies. Even the most traditional religions are forced to adapt and evolve to remain relevant and the NHS is no different. How it responds to the current crisis will determine its role in treating the next generations of patients and whether they will hold it with the same reverence for another 70 years.

Ivor Campbell is Chief Executive of Callander-based Snedden Campbell

It’s often said the National Health Service is the closest thing the UK has to a unifying religion. If that is the case, then the faith of its population is being tested like never before.

HEALTH LESSONS: Ambulances queueing outside an A&E department and, left, a hospital ward from the 1940s. Inset left, Humza Yousaf, and inset below, Aneurin Bevan

WAIT AND SEE

Will NHS waiting times ever revert to a manageable level without radical change, asks IVOR CAMPBELL

aiting times, waiting times… oh how we’re all waiting for the time when waiting times improve and we can feel confident that the NHS is working again.

The reality is, however, that without meaningful change, waiting times are likely only to become longer – at least in the short term.

Even if they improved, would that necessarily mean we had a properly functioning health service, or that patients were receiving a better standard of care? What is beyond question is that waiting times have become the standard against which the performance of the NHS and social care service are measured. With the publication of every new set of statistics, so the fulmination of the commentariat becomes louder and more hectoring.

Most public angst is reserved for waiting times for A&E departments because they are the gateway through which most patients enter the system. A logjam there, can lead to knock-on delays for the ambulance service, primary care, community-based care, and social services.

At the end of last year, the NHS

Wrecorded some ofits highest ever waiting times for A&E admission, with more than one in three patients having to wait longer than the fourhour target. At the time of writing, we learned that four patients waited more than 20 hours in the back of ambulances outside Royal Shrewsbury Hospital, in England. The average wait for category two, 999 calls for an ambulance — including for chest pains and strokes — in England and Wales is now 60 minutes, compared with a target of 18 minutes. When Matt Hancock was Health Secretary, he became so frustrated at the amount of attention paid to the four-hour waiting target for A&E that he called for it to be scrapped because, he said, it was longer deemed to be ‘clinically appropriate.’

The King’s Fund think tank has pointed out that even measuring the proportion of patients seen within four hours is problematic. Two separate departments could process the same proportion of patients within the timescale but have different average waiting times.

Besides, there are other metrics that may be more accurate in measuring quality of care, such as the time patients wait before

and our options are therefore to reduce the number of patients or to increase resources and the latter is not currently viable. Fewer patients would enter the system if more of them paid for their treatment privately or if those with less serious conditions avoided visiting their GP.

In the republic of Ireland, a GP appointment costs around €60 –with exemptions for pensioners, children under six and people on low incomes. Patients are also charged if they visit an emergency department without a GP’s referral. The Irish system may be unpopular among some, but at least it stops people turning up because they need a packet of paracetamol. Its advocates pointout that it prevents misuse of GPs’ time, allowing them to focus on those who are genuinely ill and that the service remains free to those who cannot afford to pay. Critics say such charges, if introduced in the UK, would undermine the founding principle of NHS, of care being free at the point of delivery to everyone, regardless of their means.

their treatment is completed; and the proportion of patients who return to A&E within seven days of their first attendance. Other measures, such as the time a patient waits to see a clinician, are also now recorded. Once patients are inside the system, governments continue to rely on waiting times as a key measure of clinical performance.

There’s a six-week target for the eight key diagnostic tests and investigations; a 12-week target wait for new outpatient appointments; a 12-week treatment time guarantee; and a waiting target of 18 weeks for an outpatient appointment, diagnostic test (if required) and treatment (if appropriate).

Again, we obsess over whether these times are being met and hand-wring over the deluge of statistics highlighting missed targets and, axiomatically, over further evidence of a broken system. Most people would agree that having to wait three years for an appointment, or to sit for more than 20 hours in an ambulance outside an emergency department, are failures of the system.

But is it necessarily the case that the speed with which a physician gets through appointments with patients should be the sole criterion upon which the success or failure of the system should be decided?

A doctor who spends more time with a patient and notices an underlying issue that has been overlooked by a colleague, who spends less time with each patient, is obviously doing his or her job more effectively, even if that means they are costing more in time and resources.

Waiting time statistics don’t show how often someone turnsup with a minor complaint that is masking something more serious and which is subsequently detected by a diligent clinician.

Diagnostics is increasingly focused on the personal side of healthcare. While newspaper headlines fixate about people sitting in ambulances or on trol lies outside of A&E departments, that is only a fraction of what hospitals do.

Acute, emergency care may be seen as the ‘sharp-end’ of the health service, but fewer people die from falling over when drunk or getting their head stuck in a saucepan than from heart disease, cancers, and strokes, which take more time to treat and rely on expensive and time-consuming, longterm testing. At the heart of the dilemma over how to fix the health service is the question of where best to distribute scarce resources.

We have too many patients with too few resources and our

We need to have a grown-up discussion about what would be acceptable and it may come down to cost. Would those of us who could afford to, be prepared to pay £20 to see a doctor? Possibly. Would they be prepared to pay £200? Probably not. Around 12% of healthcare treatment is already delivered privately. That used to be called privatisation by stealth but now it is accepted as being part of the system. People recognise that having the money and spending it on their health is worth potentially having an extra 10 years of living, pain free.

There are already anomalies of private healthcare existing within the system. Only the poorest people now receive free dental and ophthalmic care and private companies routinely provide services for the NHS. The system was devised in the late 1940s and, while it has been revised, many of us are still treated by a system that would be familiar to patients in the 1950s. How it will change in the next few years – if it changes at all –will depend upon public tolerance of a steadily worsening service. In the meantime, we will all have to wait and see.

Golden future for MedTech

Growth in the UK medical technology sector is gathering pace with three centres of excellence leading the push. Why is more not being made of this great British success story,

The UK is on course to become the world’s biggest innovator in medical technology outside of the United States. Only a few years ago, that statement may have seemed fanciful but a rise in investment in the sector since the Covid pandemic has put it on a path to unprecedented growth.

Collaboration between industry and leading UK universities in the so-called ‘golden triangle’ of London, Oxford, and Cambridge, has created a dynamic focus for creativity which could see the UK outstrip Germany and Japan as the world’s second biggest hub for MedTech development.

The UK medical equipment market is currently worth around $30billion-ayear, compared with £31.7billion in Japan and $35.8billion in Germany. All are dwarfed by the US sector, which generated $176.7bn in 2020.

While most of the focus in recent years has been on the growth of UK Biopharma – which has a turnover of £40.7bn – core MedTech is now primed to challenge it as the country’s leading life science sector.

The biggest driver of growth is undoubtedly the region between Oxford and Cambridge, which contributes £111bn in gross value added to the economy every year.

asks Ivor Campbell

According to a recent report by the local enterprise partnership, that could reach up to £274bn-a-year, with the support of an integrated housebuilding and transport programme.

A snapshot of the growing influence of the UK is seen in the work Snedden Campbell does in placing candidates with companies in the sector. Shortlists for senior executive positions globally are now dominated by British-based applicants. That wasn’t the case as recently as five years ago.

The growth in flexible and remote working, following the pandemic, has made geographical location of staff less relevant than in the past.

A decade ago, you would expect a UK shortlist for senior MedTech executive positions to have up to 30% non-UK based candidates. Now it’s invariably 100% UK-based.

With a worldwide remit – and we’re looking for a CEO at the moment –we can produce a decent selection of candidates from people who are entirely in the UK. Not necessarily Brits, but certainly people who are resident in the UK.

The golden triangle is home to four of the world’s 10 best universities for healthcare – Oxford, Cambridge, Imperial College London, and University College London (UCL) – and

in the Cambridge Biomedical Campus, Europe’s largest centre for medical research and health science in Europe.

Cambridge also houses AstraZeneca’s new global headquarters, which will house 2,000 workers it is completed, as well as the Wellcome Sanger Institute, the heart of Britain’s genomic-sequencing work.

The ‘Oxford cluster’, meanwhile, includes the Jenner Institute – which developed the Oxford-AstraZeneca vaccine – the Harwell science park, and gene-sequencing equipment manufacturer Oxford Nanopore, one of the largest firms to emerge from the UK’s life-sciences ecosystem.

Snedden Campbell now places more senior science professionals in Cambridge alone than it previously did in the whole of the UK, according to its chief executive.

Cambridge has come from almost nowhere in diagnostics, six or seven years ago, to being dominant in what we do.

The university, the local authority and national government have been able to put an infrastructure together. It’s easy to get to, it’s not a bad place to be and London is nearby.

With London doing the money and Oxford and Cambridge doing the science, we have the infrastructure for a globally dominant sector.

Having one of the business capitals of the world close to two major science bases, is getting close to the ideal. You get the symbiosis that Massachusetts gets being close to New York.”

British universities keep appearing in the world’s top 50 universities and they produce some very good people indeed, who go on to do Masters’ and PhDs in the UK. It’s certainly the case that the big UK science universities are producing the kind of people that everyone from early stage to big corporate scientific and engineering

organisations want to hire.

It’s particularly interesting the number of start-ups in Cambridge launched by people who have been to Cambridge University at some stage and hiring people who were also students there. While this isn’t America and we are still short of at least a zero on investment numbers, we do have a pretty strong base of people starting businesses up who have got a fighting chance of getting somewhere. Breakthrough drugs developed in the UK over the past year include lecanemab which slows the rate of decline in memory and thinking in people with early Alzheimer’s disease in what is being described as a “historic moment” for dementia treatment. The cognition of Alzheimer’s patients given the drug declined by 27% less than those on a placebo treatment after 18 months. This is a modest change in clinical outcome but it is the first time any drug has been clearly shown to alter the disease’s trajectory.

Ivor Campbell is Chief Executive of Callander-based Snedden Campbell, a specialist recruitment consultant for the medical technology industry

With London doing the Money and Oxford and Cambridge doing the science, we have the infrastructure for a globally dominant sector

WE NEED TO TALK ABOUT HEALTHCARE

Former health secretary Sajid Javid was pilloried for asking if free, universal healthcare has a future in the UK. The episode demonstrated clearly why we can’t even begin to consider reform of health provision, until radically rethinking the way in which the issue is discussed and debated, writes Ivor Campbell

The NHS has been likened to a 74-yearold patient who has not been taking good care of themselves.

Record waiting lists, full wards, blocked beds, ambulances queuing outside casualty departments, patients dying unnecessarily, nurses out on strike and public satisfaction in freefall – what a pitiful roll call of institutional ill health.

It’s a million miles from the confidence of 1948 when the service was founded, as part of a radical government plan to rid the nation of ‘want…disease, ignorance, squalor and idleness’. The debate about where it goes from here has not been short of contributors – politicians, think tanks, NHS staff, journalists, and many more, have all had their say. It has even been suggested that a citizens’ assembly should be set up to determine the future of the health service.

With few exceptions, they talk about a lack of resources –hospitals need more beds, wards need more staff, staff need

higher wages – and, in the background, the Government is dealing with some of the most challenging economic conditions we have ever experienced as a country. Those who propose spending more money on the health service inevitably cite a ‘special case’ defence, when it’s pointed out there is no more money. They accept that budgets are tight, but surely extra can be found, because health is not like other government departments.

There’s an impenetrable, circular logic to public discussion of the NHS that makes criticism redundant, leaving sceptics craving a darkened room in which to lie down.

At its heart is the argument that any attempt to improve the health service by means other than additional public funding is secular heresy.

Last month Sajid Javid, the former secretary of state for health and social care, became the highest profile figure yet to question whether the NHS can survive in its current form, or whether we should now confront the option

of making some people pay for some provisions. Javid, who will stand down as a Tory MP at the next election, suggested the possible introduction of a fee being charged for certain appointments. Such charges exist in some other European countries, for example in Norway patients are required to pay around £20 required to visit their GP, while in Ireland the cost of attending a hospital A&E department is around £75. Leading the voices of condemnation against Javid was former Labour prime minister Gordon Brown who accused him of ‘testing the water for a different kind of NHS’. Efficiencies welcomed in other areas of public service like eliminating waste, merging duplicate provision, seeking cheaper alternatives, automating processes or – lord forbid –involving the private sector – are immediately denounced as equivalent to ‘profiting from sickness’.

The reality is however, that injecting extra money into healthcare provision, even if it was available, would do little to improve performance because – and even its staunchest supporters agree – the NHS is a bottomless pit. Don’t take my word for it, there’s a recent case study of what happens when ministers pile endless amounts of cash into the NHS.

At the start of his second term as prime minister, Tony Blair committed his New Labour government to matching European levels of spending on health, rising from seven per cent in 2000 to more than nine per cent by 2008.

To give you an idea of the scale of this financial outlay, it entailed, by 2003/04, spending £63.7billion on the NHS with, by far, the largest proportion going on staff wages. And the result? Writing in the Lancet in May 2007, Hannah Brown said: “Ten years of New Labour health reforms have injected badly needed funds into the UK’s National Health Service. But through repeated restructuring and micromanagement, Blair’s government seems also to have eroded clinicians’ flexibility to care for patients.”

To accompany his high spending, Blair’s reforms amounted to introducing an element of competition among different elements of the health service, but with the crucial proviso that outside competition from the public sector remained verboten. By 2015, Phil Whitaker, writing in the left-leaning New Statesman –in an article headlined ‘How Labour broke the NHS’ – concluded: “Labour finds itself in an embarrassing position: the party that began privatisation has to explain why that process – which has, after all, resulted in improvements in the elective-care arm of the service – is simultaneously incompatible with meeting the present-day challenges the NHS faces.”

Making decisions that appear sensible at the time but which later turn out to be foolhardy are not, of course, restricted to politicians. I recently unearthed an article from the British Medical Journal (BMJ) from 2008, where The BMA (British

Medical Association (BMA) had just voted, albeit marginally, not to increase the amount of medical training in the UK because, they thought, it would devalue the profession and suppress wages.

Scottish First Minister Nicola Sturgeon also cut the number of medical nursing places, believing that we had too many doctors and nurses and, if we needed more, we could always import them from overseas. Perhaps we shouldn’t expect our politicians – with all the resources of the civil service and their coteries of special advisers on tap – to be able to foresee changed circumstances a year or two down the line.

How we now deal with the current record shortage of NHS staff, appears to be anyone’s guess. With no-one available to fill them, the fact that there is no money to do so appears moot. Even if the funding was available, we can’t train new doctors in six months.

Meanwhile, significant changes to primary care appear to have crept up on an unsuspecting population without forewarning. As recently as a decade ago, patients were generally able to book a same-day appointment with their local GP. Those with slightly longer memories may remember when GPs visited you at home and when GP surgeries doubled as minor injuries clinics, where you could go to be treated for minor cuts and bruises.

Now GP surgeries have turned into little more than glorified triage services and the local hospital is effectively the first port of call for any patient suffering from anything more serious than a sore throat.

No-one voted for these changes and

yet we are now paying higher taxes for a service that used to be significantly better. And if anyone complains, they are accused of ‘talking down’ the NHS. Working taxpayers are now forking-out the equivalent of a fairly expensive private healthcare plan, in return for a rudimentary accident and emergency service. If you see a doctor at all now, you now need to be really quite ill. Before we can have a mature discussion about what to do about the health service, as a nation we need to agree to radically reframe the terms of debate.

First to be addressed should be commonly peddled conspiracy theories that any politician who is seriously intent on reform, must be trying to line the pockets of his, or her, mates, running medical supply companies. While this had undoubtedly happened in the past – and I can think of at least one current, high profile example – it is far from being rife and any politician on the make could surely find many more efficient ways of making large sums of money quickly. Another straw man that needs confronted is the notion that any attempt to make the health service more efficient, is ‘privatisation by the back door’. The NHS is a hugely inefficient bureaucracy that haemorrhages money and the only people madder than anyone willing to sell it, would be those willing to buy it.

Reframing the debate around the NHS and introducing reforms are both necessary and more urgent than many people believe. The staffing crisis will only deepen as medics trained in the 1980s are

Wherever you look, people are testing themselves for conditions that, a year-ortwo ago, they had never heard of. In the blink of an eye, it seems that self-diagnostics is the new yoga and wearable technology the new jewellery. There’s a certain irony in the fact that the global health crisis caused by the Covid-19 pandemic appears to have sparked the biggest healthcare revolution in a generation, with a massive growth in self-testing.

Until recently, there was a handful of tests available at your local high street pharmacy, most commonly to find out if you were pregnant or if you had a urinary tract infection. Other than for that, the only people routinely testing themselves were those with specific conditions such as diabetes or HIV.

Now, it seems, that whatever you want to test for, there’s a diagnostic kit that can be bought online or at a chemist’s store. Samples taken can either be processed at home, or sent to a laboratory for screening, diagnosis, monitoring, or to provide information about the risk of a disease.

now starting to retire and not being replaced. There are unsupportable stresses on the system that can only get worse.

There are some encouraging signs, including in the medical technology sector, where advances are helping to automate expensive, manually done tasks. Telemedicine, artificial intelligence, gene-editing technologies and synthetic biology will all have a role to play as health service providers look for more efficient ways of treating higher numbers of patients with fewer resources. Rather than throwing endless amounts of good money after bad, governments should use some of the NHS budget to offer tax incentives and prize money to health innovation and medical technologies companies. Why is there no current equivalent in medical technology of the Longitude Prize, where funds are offered to graduates and start-up businesses that can help to solve particular clinical problems?

The NHS is currently in the intensive care ward. The length of time it takes, before it can be moved back into a general ward and, ultimately, discharged, will depend on how quickly we change the nature of discussion around it.

Ivor Campbell is Chief Executive of Callander-based Snedden Campbell, a specialist recruitment consultant for the medical technology industry

Among the various things you can now test for at home are blood, iron, testosterone, diabetes HbA1c) thyroid func- tion, vitamins B9 & B12 and D, choles- terol, liver function and Omega-3. You can screen for glucose, gluten and lactose intolerance, digestive problems, anaemia, and stomach ulcers, muscle type or fat DNA (to find out if you have a predisposition to obesity) and you can also check your skin, foot, and nail fungus DNA.

If you have a spare £6,742.80 lying around, you could even invest in a Portable Point of Care Testing Device which uses ‘cathodic electrochemiluminescence technology’ to test for a complete range of potential conditions.

What some people – mainly those selling the tests – are calling the ‘democratisation of healthcare,’ is seen by others as the opening-up of a whole new market in hypochondria, or what is now called ‘illness anxiety disorder.’ As a general principle, having more information is better than having less, but I’m sure we can all think of at least one person who doesn’t need any more encouragement to look for more things that might be wrong with them. An inevitable consequence of the growth of home testing is a corresponding increase in primary care consultations. For self-testing provides only a starting point for people to use the information they have gained to then seek professional advice and treatment.

Those who might, in the past, have struggled on regardless with an ache here or a grumble there, now have a data set to justify their complaints. Where before we lived in blissful ignorance that we had an abnormal reading in our levels of vitamin B9, B12 or Omega-3, now we have a test kit with lines and markers to justify our conviction that we reside in the land of the unwell.

As we test the patience of GPs, where will it end, asks Ivor Campbell