Medicine, of course, is truly international. New discoveries contributing to improvements in patient care have resulted from international collaborative research and development programmes.
It gives me immense pleasure to speak to you on the first day of your conference. When in 1982 I chided the BMA for its emphasis on technology it was largely because medicine seemed to be neglecting the human factor. I believe there are signs that this is changing. As an increasingly ageing ex-President of the British Medical Association, I was delighted that it had been decided to mount a Millennium Festival of Medicine to celebrate the achievements of British medicine during the last century and to look at the prospects for major developments in medicine and healthcare in the coming years. Throughout this millennium year, a major series of events for healthcare professionals and the public has been organised throughout the United Kingdom in association with the Millennium Festival of Medicine. This Keynote Conference, with its wide-ranging topics, is the culmination of that stimulating and fruitful programme.
Medicine, of course, is truly international. New discoveries contributing to improvements in patient care have resulted from international collaborative research and development programmes. In all of this, the United Kingdom has an outstanding record of achievement in medical science, of which we can be justly proud. The discovery by Sir Alexander Fleming of penicillin bred several generations of antibiotics, which have been effective in dramatically combating many infectious disorders which previously claimed untold numbers of lives. But now the development of antibiotic resistance presents a major challenge to both doctors and patients in enforcing the kind of restraint in their use which has been lacking in the past.
The lesson here, I suspect, is that with each new advance, medicine and the society it aims to serve need to become constantly better at understanding fully, coming to terms with and managing any unforeseen consequences - before it is ever too late. But that may be too tall an order... There is no doubt that we live in an age of unprecedented - and sometimes terrifying! - technological advance where the speed of advance so often outstrips the necessary ethical considerations. However, the British invention of the CT scanner has spawned massive developments in the imaging of the human body and provides much new diagnostic information which could not be achieved by older methods of study except at the cost of considerable suffering and potential risk to patients.
As important as these extraordinary scientific and technological advances, I believe, will be the rediscovery of the healing relationship with the deeply felt need for better support systems to enable healthcare professionals to maintain and nurture their capacity to communicate and care. There are still many diseases that elude cure. But all patients need care and support to improve their well-being. New approaches to care involving specialised rehabilitation and well designed, easy to use technical gadgetry and domestic adaptations have enormously benefited the lives of many disabled, ill and infirm individuals. But we need to do ever more to ensure that today's developments in laboratory and medical science bring tomorrow's practical developments in patient care, comfort and convenience.
It is the education of tomorrow's doctors and all other healthcare professionals that will determine how people are treated and cared for in the coming century, developing the relationship between professionals and patients into a real and creative partnership. I know that Sir Kenneth Calman is chairing today's theme on "Trends in medical education and practice", which covers topics as diverse as the education of doctors, the information explosion, improvements in the quality of care, delivery of service in the hospital and community, and the issue of testing and treating healthy people. The theme concludes with a forward look at medical education at a time when the country is very short of doctors and when the Government is committed to increasing the medical student intake by 1,000 a year.
I fervently hope that the human skills and intuitive abilities that are possessed by new medical students will be valued and nurtured by the latest training programmes so that their vision and commitment to caring can be harnessed alongside their ever-increasing scientific knowledge and technical expertise. The reinforcement of the values of public service (although made more complicated in today's increasingly litigious environment) will, I hope, continue to be an integral part of the culture of the medical profession as it develops in the new millennium. The ever advancing skill of the surgeon is just one example of such expertise and Sir Miles Irving will be speaking about "Accomplishments and challenges in surgical practice", including such issues as transplantation, imaging, key hole surgery, clinical effectiveness and even the wonders of telesurgery.
I can imagine that views differ considerably in such a gathering as this, but the human genome project fascinates and alarms us in equal combinations. Its development, achieved through international collaboration, promises new techniques in identifying and treating diseases with a genetic component and, potentially, in tailoring drugs to the individual. However, the project also raises important issues of bioethics. All such radical developments impact on society as a whole and the values that society both seeks to protect and, ideally, nurture. I very much welcome the leading role that the BMA is taking in this area and can only urge that great care and detailed consideration be given to these challenges before it is too late to reverse any unseen or unwelcome consequences of this, I acknowledge, important work.
I am very glad to see included in the programme the subject of "Interrelationships in health care" with Rabbi Julia Neuberger from the King's Fund. There are issues here that deeply concern all of us and that are surely as critical; the continuing inequalities of health, the importance of the involvement of patients as real partners in the healthcare process, mental health and care in the community, how to live with long-term chronic health problems and, even, the way in which we die and deal with death.
Another session will consider integrated and complementary therapies and will highlight the growing interest in shared practice between orthodox and complementary practitioners in helping patients to manage their disease and, on occasion, to cope with the rigours of some orthodox interventions. As you know by now, this is an area to which I attach the greatest importance and where I have tried to make a particular contribution. The role played by my Foundation for Integrated Medicine will - I hope! - be highlighted and doubtless reference made to the forthcoming report of the House of Lords Select Committee on Science and Technology, which has been carrying out an in-depth examination of complementary and alternative medicine over the last year. I know that the vitally important question of partnership will be considered.
Increasingly, I have no doubt, doctors and other healthcare professions will need to work ever more closely with their patients to explore which treatment the patient believes best meets their needs. I believe that the potentially powerful role of complementary therapies will need to be increasingly recognised and incorporated into an individual's healthcare. There is a good deal of work still to do in this area - not least of all in respect of securing research funding to determine the efficacy of such therapies, in better regulation and in educating more orthodox doctors in how to respond to what I predict will be an increase in patient demand for complementary medicine as a support - and sometimes an alternative - to more orthodox approaches. These are all areas where my Foundation for Integrated Medicine will be increasingly active in the next year.
The final session of your conference will look at new and emerging epidemics, which have replaced some of the old threats from infectious disease. Successful vaccination and immunisation programmes have slashed the terrible harvest of infant deaths and childhood disability that resulted formerly from the common infections of early life. Energetic world-wide programmes have vanquished the scourges of smallpox and polio. The world - not least those developing countries blighted by the tragedy of AIDS - waits impatiently for similar success in the race to develop immunisation against complex viruses. Meanwhile, for those already infected in developing countries, combinations of new antiretroviral agents have brought outstanding hope, though for most sufferers worldwide even the simplest symptomatic treatment remains, depressingly, an unattainable dream.
As it did in the 19th century, medicine will once again have to consider the impact of pestilence and famine on human health. A new danger is the transfer of infective organisms between the animal kingdom and man and the terrifying potential of environmental changes with their serious effects on health. Some recent occurrences - such as the BSE disaster and even perhaps - dare I mention it! - the present severe weather conditions in our country - are, I have no doubt, to a certain extent the consequences of mankind's arrogant disregard of the delicate balance of Nature. Somehow we have to find a way of ensuring that our remarkable - and seemingly beneficial - advances in technology do not just become the agents of our own destruction.
It would be nice to think that the discussions at this conference will play a part in considering these crucial matters. Whatever the case, the achievements of British biomedical science and medicine have certainly been remarkable, but human health now faces unprecedented threats and I very much suspect that our problems as a species are only partly soluble by medical science. What matters for patients is the daily work of the doctors, nurses and other health professionals who continue to facilitate their survival and well-being, both as individuals and as members of their communities.
Constraints of time, resources and facilities have always posed problems to the health professions. Rising patient expectations are now putting enormous pressure on all health systems. The constant developments in healthcare continue to increase demands and costs. All these issues, I know, will be looked at during this fascinating conference which has produced a programme that I can only commend to you as inclusive, comprehensive and forward looking. I wish you well...
