London Calling – Part II

Having spent the past few days in London meeting with investors and entrepreneurs, it was impossible not to be drawn into the painfully tragic Syrian refugee debate, poignantly jarring as we struggled to look at the photo of the drowned little boy. Remarkably, in the aftermath of that photo, many European countries welcomed refugees – literally with open arms, in some cities hundreds of cars were driven to the Hungarian border to pick up as many Syrian families as they could carry.

Toward the end of my trip much of the narrative shifted to what the U.S. should be doing, what is our obligation, our responsibility? Many Londoners felt that the U.S. in a very real sense set in motion a chain of events last decade which resulted in the largest European refugee crisis since World War II. It is hard to refute that position.

Most notably though, was how (relatively) peaceful it was unfolding. Obviously the extraordinary hardships families suffered to get to Europe are unimaginable, but once in Europe, there were no large-scale riots, no reported lootings. Many of the commentators remarked that it is often the “best and the brightest” who are displaced and that no-one choses to put their families through such fateful journeys.

I was reminded of two things these past few days. One, while growing up in Hong Kong in the 1970’s, was the Vietnamese “boat people” crisis who were fleeing countries across Southeast Asia – often times capsizing in the South China Sea with horrifically similar outcomes. The other more pedestrian observation was that relatively easy actions – reasonable diet, clean water, basic healthcare – have outsized benefits. We all know that, of course, but to see 100,000’s of people without that drives home how privileged developed economies are with quality healthcare infrastructure.

Which brings me back to why I was there. Four years ago I visited Tech City UK, London’s concerted effort to build a vibrant tech ecosystem – “Silicon Roundabout.” The progress is impressive as it now supports 40,000 start-up’s across the UK with 74% of those companies outside of London (as one Sunday headline in The Independent proclaimed “The hipsters have gone national”). Of the 40 “unicorns” in Europe, 17 are in Britain with 13 of those in London. Impressively, the Government’s Seed Enterprise Investment Scheme has invested 280 million pounds in this initiative, which just year-to-date has attracted an additional 1 billion pounds of private capital – quite interesting leverage on government dollars.

In addition to the sheer breadth of new company formation, nearly as impressive was the scale that the break-out companies have been able to achieve. The “Tech Track 100” follows the fastest growing technology companies in the UK – in aggregate these companies employ over 13,000 people and had revenues of 2.4 billion pounds in 2014; 52 of them are in London. Most of these companies were in the e-commerce, media, telecom, IT consulting, gaming, travel and advertising sectors. While some of the entrepreneurs I met with talked about more complete, innovative end-to-end healthcare solutions, somewhat disappointing was to see the lack of healthcare companies on the list – there were only two. Coming in at #9 was Immunocore (cancer therapeutics) which actually had raised the most private capital (205 million pounds) of all the companies listed, and Exco InTouch at #73 which was developing a mobile platform to track clinical trial patients.

So where were all the hot healthcare tech companies? The lead editorial in Sunday’s Times was lauding the virtues of genetic engineering (“Smile! Genetic Engineering is Good For You”) so clearly there was plenty of awareness. Not to wade into the debate around socialized medicine, but it does appear that a more robust healthcare innovation ecosystem still needs to develop, notwithstanding some of the very pressing needs as evidenced by articles “ripped from the headlines” this past weekend….

  • Cancer Research UK published a report quite critical of the National Health System (NHS) lamenting the lack of adequate cancer testing, imaging and surveillance. Apparently there are only 9 CT and 7 MRI scanners per million Brits – Spain has twice as many.
  • The NHS has now proven that death rates in UK hospitals are at least 15% higher on the weekends, after studying 15 million hospital admissions in 2013-2014. This translated into 11,000 avoidable deaths in that time period. Evidently the best day to have an acute episode is on a Wednesday. The root cause of this seems to be that “senior doctors opt-out” of weekend work.
  • Somewhat in the face of this is the stated “ambitious” plan for round-the-clock care when the NHS is cutting 22 billion pounds of annual spending. This announcement generated a lot of negative press.
  • In line with that though, the Cancer Drugs Fund announced that it would stop reimbursing for 25 specific cancer treatments which will likely affect the 24,600 people who accessed cancer treatments through that program.
  • BUPA, one of the largest UK healthcare providers, announced that it was selling its homecare business which provides services to 30,000 people, generating nearly 400 million pounds in revenues (but it loses money). Clearly there is an opportunity for business model innovation to get that service to be profitable.
  • And with great excitement, researchers at King’s College in London announced the development of a new blood test for ageing that will predict dementia based on one’s “biological age.” Just do not go to the hospital over the weekend to take that test.
  • Lastly, researchers at Imperial College London announced a new mobile phone app that applies an electrical current to one’s head to reduce the nausea associated with sea sickness. Maybe this will be the third healthcare tech company to break the Tech Tracker 100. Better yet, maybe this app can alleviate the sickness experienced with extreme stock market volatility.

And that was just the lead stories in the last few days. Speaking of stock market volatility (and the crack down on Chinese corruption, the devalued Russian ruble, the precipitous decline in oil prices, regime changes in Africa, etc), high-end London real estate is now suffering; we learned this weekend that the number of transactions was down 23% last quarter over the same quarter in 2014.


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2 responses to “London Calling – Part II

  1. Hi Michael –

    I agree, the NHS provides great challenges and opportunities for entrepreneurs.

    You may recall that I sold my first company, Clinical Solutions in 2006 at a time when all 60 million UK citizens had could access our symptom-based triage algorithms via a toll-free number. The program was called NHSDirect. It ran for 14 years, during which time more than 140 million callers quickly got to the right level of care as a result.

    I’m now seeing traction with my new company, Wellcoin (in the US), just in the 6 weeks since we launched. I had briefed you about Wellcoin 2 years ago – we developed the World’s First Health Currency.

    Hopefully we can meet soon, so I can brief you our progress. Wellcoin certainly has the chance to be as big or bigger than Clinical Solutions, and had direct applications in both developed and developing economies.
    CEO, Wellcoin

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