Can Novartis Save the NHS?
Like the United States, the United Kingdom misunderstands the business value of a national asset. It’s time for everyone to go full bore against the grain.
Echoing the “little disturbance” the world can expect from the slight case of overbombing by the United States’ new executive management team, the United Kingdom’s Health Secretary Wes Streeting said there’s a "risk of disruption" in the NHS as he attempts to reconfigure things, to find ‘strategic fit’ for a national care and service infrastructure that delivers a horrible EBITDA.
Some 6.2 million people are waiting for hospital treatment.
Productivity —one of those fuzzy economic concepts like “value-based care” that, in the vapor trail of healthcare communications and messaging, can mean everything, anything or nothing, often at the same time — is still almost 20 percent lower than before the covid-19 pandemic, according to the UK’s Office for National Statistics. In emergency departments 12-hour waits are routine.
On Thursday, Streeting announced NHS England would be abolished to save money and give more control of health services to ‘the edge’ (i.e., at the community level). It was not only a decapitation but also a disembowelment, wrote The Economist (see ‘DOGE comes to England’s health service: Death by several thousand cuts at a vast public-sector body’).
Here’s how The Guardian covered it over the weekend (Wes Streeting warns hundreds more health quangos could face axe):
The health secretary has declared that scrapping NHS England is “the beginning, not the end” and has vowed to continue “slashing bloated bureaucracy”. Wes Streeting suggested hundreds more quangos could be in the line of fire after the prime minister announced this week the end of the body overseeing the health service in England. Writing in the Sunday Telegraph, Streeting said: “The abolition of NHS England — the world’s largest quango – is the beginning, not the end.
“Patients and staff alike can see the inefficiency and waste in the health service. My team and I are going through budgets line by line, with a relentless focus on slashing bloated bureaucracy.”
Previous reorganizations of the NHS have often only destabilized the system; this one is particularly radical. “Instead of using a chisel to cut back they’re now bringing in a chainsaw,” says Sir Chris Ham, a health adviser to a previous Labour government, jumping on the Musk Message Train. The radical surgery will take two years to perform, but has the technical potential to “save hundreds of millions of pounds” that can be spent on frontline NHS services.
What’s a Quango, and Where Can I Buy One?
I admit to having never heard or seen the word before, and I consume/scan a lot of healthcare content, but it it appeared everywhere in the coverage of the NHS Chainsaw Massacre. Curious, I searched for a definition. Here’s what Wikipedia says:
A quango (quasi-autonomous non-governmental organization) is an organization to which a government has devolved power, but which is still partly controlled and/or financed by government bodies. The acronym is derived from the shortening of "quasi NGO", where NGO is the abbreviation for a non-government organization.
As its original name suggests, a quango is a hybrid form of organization, with elements of both NGOs and public sector bodies. Although originating in the United States [really?}, the term is frequently applied in the United Kingdom and, to a lesser degree, other countries in the core and middle Anglosphere.
In the UK, the term quango covers different "arm's-length" government bodies, including "non-departmental public bodies" (NDPBs), non-ministerial government departments, and executive agencies.
Which brings me back to the headline of this post: Can Novartis Save the NHS? Framing it more broadly, what’s the business value of the NHS to industry, and can industry collaborate with government to create a new quango? (Related: What’s the Business Value of the VA to Eli Lilly?)
Rachel Houlding is national oncology healthcare director at MSD. Last year, she wrote an article for Health Services Journal (How can NHS and industry partnerships transform patient care?), where she discussed highlights from a recent award-winning NHS partnership that could help transform patient pathways. An extended excerpt:
For the NHS to respond to the growing demands of the patients it serves, healthcare providers are partnering with companies like MSD to deliver innovative, patient-first projects.
Our ability to deliver these long-standing, collaborative projects relies on the Department of Health and Social Care’s joint working mandate. The mandate enables us to discover and invent new ways to support patients, their families and their loved ones, every day.
One example, which I am personally very proud of, is the Lung Cancer Pathway Development Project with the University Hospitals Birmingham Foundation Trust, which won a bronze “Best Pharmaceutical Partnership with the NHS” award at the recent HSJ Partnership Awards.
Together with Birmingham and the referring trusts of the West Midlands, we set about optimising the lung cancer pathway in line with the National Optimal Lung Cancer Pathway, to improve service quality, service efficiency, productivity, and patient experience.
Buried (or implied) behind every sentence in healthcare is a $100-billion economic system waiting to be born. Here’s how to think about a ‘Lung Cancer Pathway Development Project’ with a competitive, market-based lens — i.e., competitively, creatively and done in a way that solves for ‘value alignment’ across a set of markets operating as a single economic unit. The ‘broad-framing’ looks like this thought-experiment (read as the headline to a press release):
“Merck + Grail + Vodafone Scale Lung Cancer Pathway Project Across the UK, Collaborate with NHS on New Care and Service Infrastructure”
During an election debate in front of health leaders last month, Lord Bethell, who served as a health minister in the last government, said the Treasury had become "sick to death" of pouring money into the health service only to see productivity fail to improve: "They [the Treasury] believe the return on investment is terrible."
The public is also concerned, according to Anna Quigley, research director at Ipsos UK: "Generally around eight in 10 say they are willing to pay more tax to fund the NHS. But they also say it needs to make changes - cut out waste and inefficiency."
The “productivity puzzle” (as the UK’s Institute for Government calls it), is a head-scratcher that’s been a cause of concern at the heart of governments worldwide for decades. “Focusing on treatments [i.e., technical inputs)] is just one rather blunt mark of productivity, so the IfG looked at a range of different measures, and found the NHS actually started to become less productive in the late 2010s after about 15 years of improving productivity.”
From ‘How to Crack the Mad Riddle of Healthcare’:
Healthcare is a ‘nested market’ — its main feature is the density of structural linkages and interactions that cut across domains. By not understanding how to create with complexity, the collective We lack the vision and understanding of how to develop policy that enables 'market interoperability' – an innovation agenda to align value, to cohere the ‘commercial determinants of health’ in a way that better economic systems are born.
Novartis + NFL = Standard Model
Last week, Novartis became “the first-ever corporate pharmaceutical partner of the National Football League”. From the press release:
EAST HANOVER, N.J., March 13, 2025 -- Today, Novartis, a leading innovative medicines company, and the National Football League (NFL) announced an unprecedented partnership that names Novartis as the official first-in-category corporate pharmaceutical partner of the NFL. The exclusive partnership aims to empower football fans everywhere to make proactive decisions about their health, better understand screening guidelines and create a playbook for a healthier future.
Sport has a universal appeal that transcends boundaries, and the NFL has a passionate community that has demonstrated a deep connection to supporting health and wellness initiatives. Novartis has been reimagining medicine and delivering treatment innovations for decades, reaching nearly 300 million patients worldwide in 2024 alone. This first-of-its-kind partnership will unite missions to harness the power of gameday spirit into a dedication for advancing better health, beginning in oncology.
You can’t argue with the linear logic behind Novartis’ corporate brand marketing anymore than you can argue with the noble pursuit of “putting patients at the center” — 300 million is, like, a lot of people, so it stands to reason that lots of people will now be watching the NFL, Sponsored by Novartis. And you’ll never be able to “prove” this big money investment (my guess is somewhere around $300 million would put it in the stadium) will turn Novartis into a household name, something Pfizer achieved uniquely and without advertising during Covid.
The Classic Story in the pharma-as-healthcare market revolves around basic narrative plots, lines of dialogue that are recycled again and again, regardless of the brand telling them. “Raising awareness” for a disease being one of them (quality piece of perspective here in Stanford Social Innovation Review: Stop Raising Awareness Already). Ditto for “persuading people to better understand screening guidelines” or getting them to make proactive decisions about their health.
From Why the Pharmaceutical Industry Needs to Think Like Quentin Tarantino:
“….Regardless the industry — and the economic subsystem of vendors an industry uses to create and innovate and figure out where to go for growth — big market innovation ultimately comes down to telling and selling a new strategy story, a different screenplay, one that’s cast with unique characters in new roles and fresh dialogue.
It’s something that looks and feels more like Quentin Tarantino than old-school Hollywood…..”
Industry + Government = New Value Equation
There will be plenty of events that can catch the eye of investors this week—semiconductor maker Nvidia’s conference, earnings from the likes of General Mills, FedEx, and Nike, and retail sales data. But nothing will get quite as much attention as Federal Reserve Chair Jerome Powell.
Stock markets are in free fall and the geopolitical world order is crumbling as President Donald Trump imposes steep tariffs on imports, pressures Russia and Ukraine, and threatens to annex Greenland and Canada. The big question for Powell at Wednesday’s press conference is, what are you going to do?
— Trump Has Put Markets and World Order in Turmoil. How Fed’s Powell Should React and 5 Other Things to Know Today. Barron’s, March 17, 2025
It’s time for everyone to go full bore against the grain.
I would suggest that Novartis becoming the NFL's "first-ever official pharmaceutical partner" is notable not for its novelty, but for what it says about how entrenched the Standard Model is, the "status quo" that Albert Bourla — and pretty much the rest of the world — says has “collapsed” practically overnight.
More to the inventing shareholder value thing while “detoxing” on disruption and navigating the “period of transition” ahead:
Three hundred million dollars can buy you a lot of Quango.
/ jgs
John G. Singer is Executive Director of Blue Spoon, the global leader in positioning strategy at a system level. Blue Spoon specializes in constructing new industry ecosystems.