Professor Pascal McKeown:

I would suggest two main themes, the first of which is research of individual diseases. Women are often under-recruited to clinical trials, so when interpreting the trials’ findings, they are much more difficult to relate. If we do not have women included in the studies, how do we translate those findings to women? There is also the question of the organisation of health services and understanding how to deliver care in a way that provides the best return on our investment. There is clear evidence that it is better to have a community-based approach in order to ensure that services are delivered locally where it is feasible to do so, but also to address the social determinants of health and to move the lens towards prevention to see what we can do. Many of these conditions do not just affect the heart, but also the risk of cancer, the risk of developing obesity and the risk of liver disease. They are all common pathways. If we manage to invest much more in upstream prevention, it will have an impact, not just on heart disease, but on many other diseases as well.

There is an issue around research and innovation. There is also the issue of recruitment and retention of staff. If people work in a culture of inquiry, they are much likelier to remain in that environment because they feel they are contributing to the development of new knowledge. Many of the treatments we are providing at the moment may not be as effective as others. We must ensure that we get value for money for the investment provided to the health service.