Imagine a near-infinite improbability drive that takes common, raw materials and transforms them into a conveyor belt of wealth-creating products and services. 

Once you owed such a device, you would do everything you could to preserve and protect it. The improbability drive I refer to is “innovation” and the UK was once good at it for healthcare. 

From penicillin to the smallpox vaccine, the UK has a long history of punching above its weight in the field of healthcare innovation. Unfortunately, we have ceded that lead, in part, due to an increasingly hostile culture towards health-tech entrepreneurs.

Here’s why. Innovation is the result of trial and error by tinkerers, often preceding our scientific understanding. It proliferates in decentralized environments where people are free to think, experiment and speculate. It is almost always bottom-up rather than top-down.

The first challenge is the UK’s centralized approach to healthcare that optimizes for low cost at the expense of innovation and spends 20% less per capita on healthcare than the OECD average.

A lack of willingness to invest in innovative health-tech projects coupled with bureaucratic decision-making has created an environment of limited opportunity for new upstarts. The result has been a brain drain of the best and brightest health-tech entrepreneurs migrating to more innovation-friendly markets.

This trend can be most widely seen in digital health, where British startups that subsequently moved to Silicon Valley have been exponentially more successful. Examples include Calm, Headspace, Hinge Health and Quit Genius**.

Ultimately, the losers are NHS patients who don’t have access to the same breadth and quality of innovative health-tech products their American counterparts do. I have seen this first-hand when my dad was warned by his GP (primary care physician) that he was at risk of both Type II Diabetes and Osteoarthritis unless he took immediate action. 

In the U.S., he might have been offered a digital health program such as Hinge Health and Livongo, which would give him access to a virtual care team that would monitor his progress and adherence with connected wearable devices. Instead, his GP printed out an informational leaflet and never followed up.*

Yet this alone doesn’t account for our health-tech innovation slowdown. The problem goes much deeper than the NHS. At the start of my own entrepreneurial journey, while still fresh out of medical school, I approached my professors about taking a sabbatical to pursue the project that became Quit Genius.

While not expecting encouragement, even I was surprised to be told in an 800-word email by the program director to “NOT to apply for the Academic Foundation Programme again since we strongly believe you should not have a second chance to undertake such prestigious posts”.

Experiences like this are not unique to me and I speak regularly to other health-tech entrepreneurs facing similar roadblocks.

The challenge with brain drain is that it is incredibly difficult to reverse. Digital health exploded in 2020 with venture investors pouring in $12B – the largest year to-date. Raw materials in the form of the top medical, design and computer science universities aren’t enough.

Innovation happens between brains rather than within them which is why an innovative culture is the catalyst that makes our improbability drive works. Until we solve that, the UK won’t reap the rewards of the coming health-tech boom.

* I know first hand that the U.S. system is by no means perfect and its employer-sponsored insurance system creates massive disparities in the cost and quality of care.

** Disclosure: I am a co-founder of Quit Genius.