The Health Lottery
In September 2011, a controversial new lottery game was launched in the UK. Called ‘The Health Lottery’, it is owned by Northern & Shell, the media company founded by Richard Desmond. Like Camelot’s existing National Lottery game in the UK, The Health Lottery will donate money it earns from the sale of tickets to charitable healthcare causes across the UK.
This is one of the most controversial points of The Healthy Lottery. While tickets for both the Health Lottery and National Lottery cost £1, Camelot donates 28 pence to healthcare causes from every single ticket sale, whereas The Health Lottery only donates 20 pence. Not only will The Health Lottery boost Northern & Shell’s charitable donations, it is also hoped it will be a profitable, money-making venture for the company.
Speaking during the launch period of The Health Lottery, Sir Stephen Bubb from the Association of Chief Executives of Voluntary Organisations voiced his opinions on the new gamble to The Times newspaper. He said it was a “pretty disgraceful development” before adding: “The government needs to look at lottery regulation to ensure it’s made transparent to people who play that this new lottery is giving a lot less per £1 to good causes.”
However, the move was defended by Desmond, who said he truly believes donations from the Health Lottery will “touch every part of England, Scotland and Wales.” Meanwhile, Martin Hall, the Chief Executive of the new game, said every community in Britain would experience its benefits.
Rather than being a national lottery game, The Health Lottery is an amalgamation of 51 local society lotteries, with each one representing a local authority area in Great Britain. Each community lottery is licensed by the Gambling Commission and is responsible for raising money for health organisations outside of the UK’s National Health Service. One of The Health Lottery’s key partners that it works with is the People’s Health Trust, an independently registered charity which is responsible for distributing the money raised through the lottery to regional healthcare causes.
Every week, two local authorities will be involved in the lottery draw, meaning each one will have the chance to benefit equally from the money earned. The money goes towards a variety of causes; local community groups and charities, locally operated national charities and social enterprises. It has been estimated that The Health Lottery will earn £50 million a year for healthcare services across the UK.
However, since its inception The Health Lottery has received a large amount of criticism. Most recently it has made the headlines for an apparent loophole which has allowed the game to be formed. As a result, the UK government has been urged to investigate the terms under which The Health Lottery was set up, the Press Association news agency has reported. Speaking in the House of Lords, a member of the Labour party, Lord Collins of Highbury, said there was “an apparent loophole exploited by The Health Lottery with its 51 separate companies.”
Pleading with Baroness Garden of Frognal, a spokesperson for the government, he said: “Will you give an assurance that this loophole will be examined and perhaps closed by the Government bearing in mind that the health lottery has in effect a turnover of £510 million a year and is in effect an alternative national lottery, not only affecting funding for other health charities but funding for the arts in general.”
Peers of Lord Collins also voiced their concern at The Health Lottery. The Press Association again reported that Lord Faulkner of Worcester said the game had subjected some charities to “unfair competition.”Explaining further he said, “The hospice movement is particularly alarmed because it depends very heavily on society lotteries. In Worcester, for example, our two hospices receive £70,000 a year from the South Worcestershire Hospices Lottery and that lottery pays 50 pence in the pound, not 20 pence in the pound to good causes.”
Despite the reservations, there are causes that have already benefitted from The Health Lottery. For example, in Yorkshire, England, the charity Dementia UK has received £60,000 which will fund the recruitment of a specialist support nurse and over £40,000 will go towards supporting young carers.
While the drive behind Desmond’s involvement in The Health Lottery may be entirely profit based, even he recognises the potential the game has to improve local healthcare services and provisions across the UK. Speaking when he purchased The Health Lottery he said: “This is a great way of being able to get across more than £50 million a year to change people's lives. That's why we got involved. It's a very exciting project.”
The Health Lottery TV Advert:
Driving sustainability in medical device production
Environmental protection and stewardship are rapidly rising to the top of the corporate agenda and medical device businesses are no exception. The healthcare sectors of the United States, Australia, Canada, and England combined emit an estimated 748 million metric tons of greenhouse gases each year, an output greater than the carbon emissions of all but six nations worldwide. In order to curb this situation various European standards have been introduced.
The Waste Electrical and Electronic Equipment (WEEE); Restriction on Hazardous Substances (RoHS); Registration, Evaluation, and Authorisation of Chemicals (REACH) and the Energy Using Products (EuP) regulations have all significantly altered manufacturing processes, specific labelling, compliance with disposal restrictions, and creation of instructions for end-of-life management and recycling.
At the moment many medical devices are currently exempt from these regulations but several directives, including RoHS and WEEE, are in the process of being reviewed and could be applicable in future. This is especially relevant for devices that are ‘connected’ and have a digital monitoring component which then brings them under the regulatory purview of authorities that govern devices with electronic components.
Safety, Usability and Sustainability
While medical device manufacturers have been working to respond to increasing demand for environmental sustainability from the market, they also have to contend with a key element of their mission: to ensure safety and usability to healthcare workers and patients. Parenteral and other invasive devices are strictly regulated to help reduce the risk of Healthcare Acquired Infection which typically runs as high as 5% and 8% in most developed countries, according to the European Centre for Disease Prevention and Control. As a result, they typically contain disposable single-use plastic elements.
At the same time, many hospitals and purchasing organisations have started to recognise that sustainable purchasing practices play a pivotal role in reducing costs over time. Many GPOs have appointed and empowered Senior Directors of Environmentally Preferred Sourcing who are successfully implementing the sustainable purchasing business case. In addition global pharmaceutical companies are increasingly creating senior positions with sustainability objectives as key to the role.
Medical device disposal is a particularly burning issue; generally carried out through incineration in the EU, it typically releases nitrous oxide, as well as known carcinogens including polychlorinated biphenyls, furans and dioxins. Some of the strategies trialled by manufacturers to reduce waste matter destined to incineration include sterilisation and reprocessing.
Sterilisation, however, falls short on the environmental front, and may consume more energy and produce more emissions than incineration itself. In the United States for example, 50% of all sterile medical devices are sterilised with ethylene oxide but since this method releases harmful emissions, the US Food and Drug Administration is now encouraging the development of new methods or technologies. Many other established sterilisation methods use glutaraldehyde that is not only harmful to the environment but also tends to be regulated by strict usage and disposal rules such as COSSH guidelines.
Focus on Recycling
The outlook on recycling is changing significantly thanks to new research and technologies enabling, for example, monomer extraction. Recycled polymers can be broken down to their constituent monomers promoting an almost limitless recyclability of some polymers. In addition to this, Polyvinyl chloride (PVC), renewable polyethylene and polyethylene terephthalate (PET) can be recycled several times without losing critical properties.
Reducing the impact of packaging can also significantly reduce the materials that need to be dealt with through either waste or recycling. Packaging manufacturers are decreasing packaging volume by favouring sealed trays instead of pouches, laser-etching instructions directly on to the tray where regulation permits it, or reducing the number of components required overall. In addition to this, for recycling plans to be successful it important to have a full understanding of the practices surrounding device use and to establish, where possible, closed loop recycling systems that recover the waste materials from hospitals or patients and bring them back into the recycling process.
Sustainable Manufacturing: Technology and Research
Greater employment of fast degrading plastics or material from other sources is a key strategy to reduce harmful pollutants both at production and disposal stage. Bio-based materials can in fact offset the carbon emitted during processing as the monomer source grows, and a growing range of sources for bio based monomers -such as wood pulp or sugar cane- is available. However, when assessing the most suitable material for a part, the entire lifecycle of the product needs to be considered. For example: bio-degradable polymers can contaminate a recycling stream and emit methane when incinerated.
The use of environmentally friendly materials should also be supported by an increase in clean renewable energy sources. Lower energy consumption means fewer carbon emissions but also financial savings, making this an appealing measure for manufacturers. New technologies are proving a major gamechanger on this front, helping manufacturers marry their environmental stewardship with cost savings and efficiency. 3D printing, for example, can help develop optimum product moulds more quickly, refining production parameters to minimise raw materials volumes and maximising output productivity.
Similarly, ‘digital twin’ production software uses inline sensors to create a virtual, real-time mirror of the production environment to enable inline refinements. The objective is to achieve “zero defect”, waste-free manufacturing. In addition to this, LEAN manufacturing methodologies are already helping to optimise inventory management and reduce overproduction.
Sustainability by Design
It is increasingly clear that effective environmental sustainability in the medical device sector cannot exist without a full view of the product life cycle from concept development, material selection, design and engineering to manufacturing, packaging, transportation, sales, use, and end-of-life disposal. These evaluations are typically made for factors such as manufacturing efficiency, time to market, or safety and regulatory compliance, packaging and transportation costs, but should be extended to energy efficiency and environmental impact by means such as life cycle analysis.
In addition to this, with devices rapidly becoming more digitally connected, developers need to be aware that the costs of disposable electronics would simply not be viable, or indeed acceptable in the light of electronics disposal regulations. Design therefore should focus on creating a simple, repeatable interface between the two component sections so as not to impair the functionality or efficacy. As reducing waste and harmful emissions continues to exert businesses and governments globally, the medical devices industry cannot stand by. The environmental but also commercial implications of inaction are too serious and the array of solutions now available is exciting and diverse.