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Milburn challenges NHS to exploit genetics revolution

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7293.1018 (Published 28 April 2001) Cite this as: BMJ 2001;322:1018
  1. Judy Jones
  1. London

    A £30m ($42m) package of measures to help bring the genetics revolution into everyday medical practice has been unveiled by Alan Milburn, the health secretary. “The human genome project has already crossed a new frontier in scientific knowledge,” he told scientists at the International Centre for Life in Newcastle upon Tyne. “The question now is whether we can harness that knowledge to cross a new frontier in medicine.”

    Under the government plan, the number of consultants specialising in genetics will nearly double to 140 by 2006. Support staff and genetic counsellors will also double in number to about 450. The numbers of patients being seen by specialist genetic services will increase by about 80% to 120000 a year, and the wait to see a specialist is set to fall from about a year to three months.

    In his first speech on the subject, Mr Milburn gave a largely upbeat assessment of the impact of genetic science. The effect of such changes on people's lives in this century could be even more profound than those exerted by computer technology in the last, he said. “Developments in genetics should allow us to eradicate much of the trial and error common in medical practice… The NHS of the future should increasingly allow us to predict and prevent the common diseases of life.”

    To ensure that the potential benefits to patients of this revolution were fully exploited, hospitals might do less invasive surgery and more gene therapy. “Overall the NHS will need to gear itself increasingly to prevention and not just treatment,” he told his audience. “The pattern of care will alter, as new services take the place of existing ones: more genetic screening alongside more specialist genetic counselling; more regular check ups; more exercise on prescription alongside drugs on prescription, tailored to the individual's personal genetic profile.”

    Responding to public concerns about some developments, Mr Milburn promised a green paper on the subject and announced that Britain would become the first country to bring in a legal ban on human reproductive cloning. He also signalled the government's willingness to outlaw the use of genetic tests by insurance companies if such a step were recommended by the Human Genetics Commission.

    The NHS was Britain's best defence against the nightmare vision of a “brave new world” of two tier health care: a “genetic superclass” of the well and insurable and a “genetic underclass” of the unwell and uninsurable, unable to pay the premiums for medical care.

    The health secretary indicated that the genetics revolution could help safeguard the future of the NHS. “Genetic advances lay bare the fallacy that private health insurance is the way forward for our country. Genetics strengthens rather than weakens the case for Britain's NHS.”

    Yet still the subject often evoked strong public scepticism and confusion about “where the science of genetics ends and the nightmare of eugenics begins.” Unless public concerns were addressed and allayed, no government could gain public consent to realise the full benefits of genetic science. Although human cloning is already banned in practice—the Human Fertilisation and Embryology Authority will not license it—the government's plans for legislation will make the prohibition explicit.


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    Alan Milburn pledged support for a genetics revolution