These articles in the Britain section are published in the UK printed edition only, and are published here for the benefit of readers of non-UK editions.
Medical science
COMPANIES that announce breakthroughs in medical science usually get a hero's welcome. But whereas surgeons applauded when Health Care International (HCI), a private hospital, announced this month that one of its doctors had invented an anaesthetic machine which means people feel much less sick after operations and speeds their recovery, reaction in Scotland was less than ecstatic.
In 1994, HCI opened a swanky 240-bed private hospital to do expensive surgery on rich foreigners at Clydebank in Glasgow. Though it promised hundreds of jobs in an area of long dole queues, it went straight to the top of the local hate list. In an area which prides itself on being the cradle of socialism a century ago, it was regarded as an evil changeling, not least because the Tory government had promised a £30m grant to help build it.
The critics felt themselves thoroughly justified when, four months after it had opened, HCI went bust because its forecasts of patient numbers had been hopelessly optimistic. The Abu Dhabi Investment Company bought the bankrupt business, saving the government some embarrassment, although this did little to change local opinion, which regards it as a parasite on the National Health Service.
This view might also have been thought by critics to be justified when Gavin Kenny, a professor of anaesthesia at Glasgow University, shifted his research team from Glasgow Royal Infirmary to HCI, lured by lavish facilities. But Mr Kenny's move speeded up work on a machine which uses micro-computers to control the rate at which an anaesthetic is pumped into the blood of patients undergoing surgery.
Such machines are nothing new. But Mr Kenny's device uses two micro-computers to achieve much closer monitoring of the pump feeding the anaesthetic into the patient. Extensive testing of the equipment has sufficiently impressed the authorities which regulate medical equipment in Britain and, so far, four other countries, to make this the first such machine to be licenced for commercial sale to hospitals.
The anaesthetic used by Mr Kenny's machine is propofol, which has been in use for about ten years. It reduces the sickness felt by patients after they wake up from an operation. However, difficulties in controlling the dosage have always meant that anaesthetists have also had to rely on anaesthetic gases breathed in through a face mask. These gases cause post-operative nausea in about half of all patients. Mr Kenny's machine reduces or eliminates the need for such gases. Tests at HCI, which is using Mr Kenny's machine on all its patients, and at other hospitals show that the machine cuts the proportion of patients suffering nausea to less than 10%. So most patients thus treated recover from the anaesthetic in hours rather than days, says Mr Kenny.
Anaesthetists who have either tried the machine, or seen it demonstrated at medical conferences, are enthusiastic. So are hospital administrators. Mr Kenny says that studies in America have shown that, although the drug costs about $14 (£9) more per operation than conventional drugs, faster patient recovery time can save about $400 per patient. The British makers of the computer-controlled pump say they will cost about £1,500, not much more than conventional anaesthetic pumps. Use of it was authorised only in August, but they already have orders for 400.
The Edinburgh house in which Sir James Young Simpson, another Scottish doctor, discovered the first modern anaesthetic, chloroform, in 1846 has a commemorative plaque on it. Mr Kenny may eventually be as esteemed as Sir James. But whether his innovation encourages the Scots to pay more regard to HCI remains to be seen.
Copyright 1996 The Economist Newspaper Limited. All Rights Reserved