An alcohol substitute that mimics its pleasant buzz without leading to drunkenness is being developed by scientists.

The new substance could have the added bonus of being “switched off” instantaneously with a pill, to allow drinkers to drive home or return to work.

The synthetic alcohol, being developed from chemicals related to Valium, works like alcohol on nerves in the brain that provide a feeling of wellbeing and relaxation.

But unlike alcohol its does not affect other parts of the brain that control mood swings and lead to addiction. It is also much easier to flush out of the body.

Finally because it is much more focused in its effects, it can also be switched off with an antidote, leaving the drinker immediately sober.

The new alcohol is being developed by a team at Imperial College London, led by Professor David Nutt, Britain’s top drugs expert who was recently sacked as a government adviser for his comments about cannabis and ecstasy.

He envisions a world in which people could drink without getting drunk, he said.

No matter how many glasses they had, they would remain in that pleasant state of mild inebriation and at the end of an evening out, revellers could pop a sober-up pill that would let them drive home.

Prof Nutt and his team are concentrating their efforts on benzodiazepines, of which diazepam, the chief ingredient of Valium is one.

Thousands of candidate benzos are already known to science. He said it is just a matter of identifying the closest match and then, if necessary, tailoring it to fit society’s needs.

Ideally, like alcohol, it should be tasteless and colourless, leaving those characteristics to the drink it’s in.

Eventually it would be used to replace the alcohol content in beer, wine and spirits and the recovered ethanol (the chemical name for alcohol) could be sold as fuel.

Professor Nutt believes that the new drug, which would need licensing, could have a dramatic effect on society and improve the nation’s health.

The NHS report Statistics on Alcohol: England, 2009 found more than 800,000 alcohol-related admissions to hospitals in 2007-08 – and more than 6,500 deaths – at a cost to the service of £2.7bn a year.

Some charities estimate that the toll could be up to five times higher. Drink is, for example, a factor in 40 per cent of fatal fires, 15 per cent of drownings, 65 per cent of suicides and 40 per cent of domestic abuse. It also has other costs, including 17 million lost working days a year, worth about £20bn to the economy.

“I’ve been in experiments where I’ve taken benzos,” said Professor Nutt. “One minute I was sedated and nearly asleep, five minutes later I was giving a lecture.

“No one’s ever tried targeting this before, possibly because it will be so hard to get it past the regulators.

“Most of the benzos are controlled under the Medicines Act. The law gives a privileged position to alcohol, which has been around for 3,000 years. But why not use advances in pharmacology to find something safer and better?”

Getting the drug approved could be hard for the team as clinical trials are expensive, and it is not clear who would pay for them, according to Professor Nutt.

He said that the traditional drinks industry has not shown any interest, however some countries might be persuaded to sponsor the team.

Some countries have more liberal regimes than others, though, and Professor Nutt thinks Greece or Spain, within the EU, could lead the way.

The latest Home Office performance figures showed that more than one in four people believe that alcohol is blighting their community.

A survey of every police force area in England and Wales found that 26 per cent of those polled “perceived people being drunk or rowdy in public placed to be a problem in their area” – a slight increase from last year.

The fears over the affects of alcohol range from urban to rural communities, with the worst hit being Manchester, South Wales, London, Northumbria and Gwent.

Sunday, 11 October 2009

The only road to St Theresa Point in north-eastern Manitoba is made of ice and lasts just two months. The remote community’s 3,200 people, most of them Cree Indians, are squeezed into 530 homes, more than half of them without running water. Until June, a doctor flew in once a week for three days. But since an outbreak of swine flu left more than 200 people ill and sent 12 by air ambulance to Winnipeg, 600km (375 miles) away, Health Canada has been ferrying in more doctors. This autumn, in preparation for the flu season, it is also delivering something else: a supply of body bags.

In Australia, a similar scenario played out in July. An estimated 400 people out of a population of 3,400, more than 90 per cent of them Aboriginal, caught H1N1 influenza on Palm Island off the Queensland coast. In Brazil, a conference on indigenous education was cancelled in September after seven members of the Matsigenka, a tribe living along the Urubamba river in the Peruvian Amazon, tested positive for swine flu.

As health authorities gear up for the northern hemisphere’s flu season, the new strain of influenza is expected to hit indigenous peoples far harder than it will healthy, wealthy, urban Westerners. If the outbreaks in Canada and Australia are any guide, native communities could find a tenth of their populations sick, and untold numbers dead.

The World Health Organisation warned in its August briefing note on the pandemic that minorities and indigenous peoples face a far higher risk of hospitalisation and death. “In some studies, the risk in these groups is four to five times higher than in the general population,” it said.

Survival International, a London-based charity that tries to protect indigenous peoples, has called on the government of the Andaman Islands to close the Andaman Trunk Road because it runs through land populated by a nomadic tribe. The Jarawa came into contact with outsiders only in 1998; within a year, half of them had suffered respiratory problems after an outbreak of measles.

Glenn Shepard, an anthropologist who works closely with Peru’s Matsigenka, said they are not the only tribe he is concerned about. “The arrival of swine flu among the Matsigenka is especially worrying as they are known to have intermittent contact with quite isolated Indian groups living near by,” he said.

Scientists and medical researchers have two hypotheses to explain the vulnerability of tribal peoples. The first is that those, like the Jarawa, who have had little contact with the global community simply have immune systems that have never been primed. Kevin Paterson, a Canadian doctor, notes that during the 1918 Spanish flu, 8.5 per cent of American Indians died, but among the more isolated Inuit in Nome, Alaska, the toll was 55 per cent. In Hebron, Labrador, 5,000km to the east, 150 out of 220 Innu were killed. Yet the global fatality rate for Spanish flu was just 2.5 per cent.

The other hypothesis applies to those indigenous populations that live on the fringes of Western society, such as the Cree of St Theresa Point and the Aborigines on Palm Island. For them, the problem is poverty, poor general health and crowded living conditions. “We have in excess of 15 people living in a three-bedroom home, which you wouldn’t find in mainstream communities,” said Alf Lacey, the mayor of Palm Island. Although Tamiflu was available, many islanders were unaware of it because they are unable to read.

“Influenza has a cure,” said Dr Paterson. “It’s called affluence.”

By Paul Rodgers and Smitha Mundasad

Sunday, 16 May 2010

The spectre of plague stalked the world last year with its constant companion, fear. Schools and stadiums were closed in Mexico, tourists from Egypt to Singapore were quarantined, and the surgical mask became a universal fashion accessory across Asia. Yet predictions that the global death toll from swine flu could reach 7.5 million were well off the mark. At most, the virus killed 14,000 people, and some of those had pre-existing conditions or had been infected by other dangerous bugs as well. Against a background death toll from seasonal flu of up to 500,000, the new H1N1 strain was invisible.

Professor Ulrich Keil, a World Health Organisation (WHO) adviser on heart disease, said the decision to declare a pandemic had led to a “gigantic misallocation” of health budgets. “We know the great killers are hypertension, smoking, high cholesterol, high body mass index, physical inactivity and low fruit and vegetable intake,” he told the Council of Europe. Yet governments “instead wasted huge amounts of money by investing in pandemic scenarios whose evidence base is weak”.

The suspicion that the response to the outbreak was an unnecessary panic has been spreading since the virus slipped from the front pages. Even the WHO, the UN body that first punched the big red button, may be having doubts. An external committee has been set up to review its reaction and will deliver an interim report this week, though at the moment no bombshells are expected.

The WHO faces two main charges. The first is that between the first cases of H1N1 being reported in March and the declaration of a full, phase 6 pandemic by its director-general, Dr Margaret Chan, in June, the organisation changed its definition of a pandemic. Critics say the old definition required that a virus result in “enormous numbers of deaths and illness”. The new definition applies only if the virus is new, if it spreads easily between people, and if the population has little or no immunity to it. A bug that causes a mild case of the sniffles could qualify.

A spokesman for the organisation insists there has been no change at all – that the old definition was an error on a single web page about bird flu, the last great influenza scare. But Peter Doshi, a doctoral candidate at MIT whose thesis is on science, politics and influenza policy, argued in a paper in the British Medical Journal in September that the old definition had been widely applied by the WHO since at least 2003.

The second charge, prominently made by Dr Wolfgang Wodarg, the former head of health at the Council of Europe, is that the WHO is unduly influenced by the drugs industry, which stood to make a fortune from selling anti-virals and vaccines. The Swiss giant Novartis, for example, saw its profits jump by nearly a third in the first quarter of this year to $2.95bn, much of it from delivering swine flu vaccines ordered last year. Debate rages over allegations that some experts who recommended the pandemic be declared, have links to drugs companies, although this has been denied. But critics note that it’s hard to become an expert in the field without having some funding from big pharmaceutical companies.

Others say that the problem is due to the spread of false assumptions. Most people think, for example, that when they have flu symptoms they must have influenza. But Dr Tom Jefferson of the Cochrane Collaboration, which reviews the evidence for various medical treatments, notes that more than 200 agents can cause flu-like illnesses. Only 7.5 to 15 per cent of cases are actually influenza. Anti-viral drugs and vaccines are aimed just at this group. “To stop one new case of H1N1, you’d have to inoculate 100 people,” says Dr Jefferson “or you could get four people to wash their hands.” Masks work too, he says, and so does sending people home from work if they have symptoms.

The usual justification for the massive response to H1N1 is that no one wants a repeat of the 1918 pandemic, which killed an estimated 50 million people. But scientists are not even sure if that plague was caused by influenza at all. The virus was not discovered until 1933. And outbreaks since then have been much milder.

The last time H1N1 showed up was in 1976, at a US army base. Washington ordered the immunisation of 40 million Americans before it discovered that it had only one death from the flu but hundreds of cases of severe side-effects to the vaccine. A review headed by Dr Harvey Fineberg put much of the blame on the “influenza fraternity”, arguing that expert panels tend towards “group think” and should be backed up by independent scientific advice. Dr Fineberg is now chairman of the WHO’s external committee evaluating its response to the 2009 outbreak whose final report next May could well lead to a radical rethink of the world’s reaction to new viruses.

Thousands of infertile couples could be spared the pain, anguish and expense of fruitless IVF treatments, thanks to the discovery of a lock-and-key mechanism between sperm and egg cells.

The research could explain why so many couples with no apparent reproductive problems are unable to conceive. Although more than 40,000 in vitro fertilisation cycles are prescribed in Britain each year, only 10,000 births result.

In addition to the £5,000 cost of each cycle, the couples face huge amounts of stress and can suffer severe depression and in some cases divorce. “Our work has quite a lot of relevance for humans and society and one of the main ones is infertility,” said Dr Martin Brinkworth, a member of the team at the universities of Bradford and Leeds that discovered the lock-and-key mechanism.

Some 15 per cent of couples have trouble conceiving, about half of them because the man has a problem. But in only one third of cases is the cause obvious, such as a low sperm count, malformation or poor swimming ability. This leaves 2 per cent of the male population, about 330,000 adult men in the UK (not all of whom will be trying to have children), who are infertile for no discernable reason.

Dr David Miller at the University of Leeds thinks the secret could be that the genetic keys in their sperm don’t quite fit their partners’ locks. “Our research offers a plausible explanation for why some sperm malfunction,” he said.

His colleague Dr David Iles added: “There is a definite pattern to the way DNA is packaged in sperm cells. It is the same in unrelated fertile men, but it is different in the sperm of infertile men.”

If a test could be developed to identify these men, up to a quarter of women who have intrusive fertility checks would be spared the procedures. It could also sharply decrease the 75 per cent failure rate of IVF by filtering out male candidates who have no chance of success. Private patients and the NHS could save as much as £50m a year if all cases of male infertility were identified in advance.

The Leeds-Bradford research, and parallel work by a US team at the University of Utah, fundamentally changes our understanding of the importance sperm has in the developing embryo.

Although the egg and sperm each supply half the DNA for the new baby, the egg provides all the cellular support systems, including enzymes and proteins. Until now, it was thought that sperm simply delivered the father’s tightly packed DNA to the egg, leaving control and regulation of the process to the mother’s DNA.

But the two teams of scientists, have found that some genes are left exposed in sperm, in an “open conformation”, allowing them to play an important role in the development of the embryo. “It contradicts the dogma that the egg does everything,” said Dr Brinkworth, a senior lecturer at the University of Bradford.

The British team has also identified how these “open” areas are formed and evidence that they can be read by the egg, suggesting that they act as a signature or key, revealing the species the sperm comes from and signalling whether the DNA is in good shape.

Although no clinical test is available now, the researchers are hopeful that one can be developed after they’ve identified all the DNA bases in the open areas, some of which might be usable as markers.

The molecule at the heart of the lock-and-key mechanism is a protein called CTCF, say the scientists in a paper published in the journal Genome Research. “CTCF sets the stage during sperm development,” said Dr Iles. “And open bases can be recognised by CTCF in the egg.”

If stretched out end to end, the DNA from a single human cell would be about 1.8m long. But in the cell nucleus, it is wrapped around molecules called histones, which link up to form an efficient three-dimensional scaffold, 40,000 times shorter than the unfolded DNA. Histones also play a role in turning genes on so that their coded instructions can be copied and sent to other parts of the cell.

But sperm don’t have elaborate cells, just a tightly packed nucleus and a tail for swimming to the egg. So when they form, the histones are stripped off and replaced with another molecule called protamine, which shapes the DNA into an even tighter bundle, where the genes cannot be read.

The British researchers have found, however, that CTCF protects some histones in sperm from being replaced, leaving about 4 per cent of the genome in an open conformation, so that its instructions can be copied. Since the pattern of exposed areas is not random, they believe it must have a purpose, and the simplest explanation is that it is a key that influences the developing embryo even before the father’s genetic contribution has been unpacked.

The discovery has implications for research in fields other than human reproduction. Although the bulk of their work involved 50 million human sperm cells from several donors, the Bradford-Leeds team also found similar structures in mouse sperm.

The lock-and-key mechanism could help to explain how closely related species maintain their separate identities, even when individual members have sex. “DNA from different organisms can be extremely similar,” said Dr Iles. “Why do they not produce offspring, or if they do, why is it sterile, like mules and donkeys?”

The team speculates that this may have been the fate of prehistoric couplings between humans and their close cousins, Neanderthals, with incompatible keys and locks ensuring that any offspring would be unable to breed.

This would explain why the human genome has no trace of Neanderthal DNA despite the two similar species living close together for millennia.

For the lucky, a check-up at the GP consists of nothing more sophisticated than a blood-pressure cuff, an icy stethoscope and a jar to pee in. For those with bigger problems, it can involve medicine’s heavy artillery, from bedside ultra-sound devices to giant metal doughnuts that generate magnetic fields several times stronger than the Earth’s.

Medical imaging has come a long way since Wilhelm Roentgen took the first X-ray of his wife’s hand in 1895. Until then, doctors had no way to tell what was going on inside a living body. Autopsies (often illegal) could show them where organs were but not their functions.

If today’s scanning technologies – X-ray, positron emission, magnetic resonance (MRI), computer-aided tomography (CAT), ultrasound and single photon emission – seem impressive, tomorrow’s promise to be wondrous. Doctors will be able to detect not just large-scale structures but the microscopic interplay of proteins and enzymes as they react to diseases and treatments. Early screening will spot many problems before they become terminal. Diagnostic scans will predict which therapy will work best on a given patient, while follow-up images will determine whether all is going to plan.

From biotech start-ups to pharmaceutical and medical equipment giants, all want a piece of this new action, but one British-based company seems particularly well positioned. GE Healthcare, formerly Amersham, the first company to be fully privatised by Margaret Thatcher in 1982, was sold to the Americans in 2004 for $10bn. Back then, some in the City professed confusion about a company with a wide range of businesses lumped under the catch-all heading “diagnostic life sciences”. They may still be nonplussed, but one set of numbers is crystal clear. GE Healthcare’s sales have soared from $9bn in the year before the sale to $17bn in 2008.

“We’re at a tipping point,” the company said in a paper last May, comparing the coming transformation to that brought about by Thomas Edison when he invented the light bulb. “To take healthcare into the future, we do not have to wait for technologies that will be available in 2025. We need only look at the technologies we have today and act.”

GE Healthcare’s main campuses are scattered around the Chalfonts, a huddle of leafy villagesnorth-west of London. Dr Patrick Grove, then a 26-year-old organic chemist, established the company at Chilcote House in 1940 to refine radium for instrument dials on aircraft and ships. After the Second World War, it became a national centre for the development of radioactive materials and is still a licensed nuclear site.

Chilcote House is now the campus reception centre; security is tight and before visitors can enter some buildings, they must pin on a dosimeter to measure their radiation exposure. The office of Dr Marivi Mendizabal, GE Healthcare’s head of discovery, is in a less glowing building. Still, the main room is divided in half by a glass wall inscribed with a double helix at waist height, with her lab on the far side. In a soft Spanish accent, Dr Mendizabal introduces a series of techniques, some developed in-house (the R&D budget is $1bn), some by partner companies, and others licensed from academia. They range from products approved for use to those still in early trials. What they share is a simple logic – better imaging means earlier diagnosis and more effective treatment.

While hardware has improved, the big change is in what Dr Mendizabal calls “wet science”. One characteristic of chemistry, and particularly large biological molecules, is that they have counterparts that fit like keys in locks. Find the right key and it will latch on to a particular lock. It’s the same technique used by the body’s immune system to send antibodies after the antigens on invading cells. “It’s not just antigens, though,” she says. “This works on other molecules too.”

Consider AH118635, a synthetic molecule invented at GE Healthcare that’s so new it doesn’t even have a catchy name yet. It reveals whether cancers are growing or not by latching on to a marker called integrin alpha 5 beta 3, which regulates blood-vessel growth. Most tumours are only alive near their surface; the centres die because they can’t get enough blood, says Dr Mendizabal. AH118635, if it gets regulatory approval, will be able to tell how successful a tumour is at building new vessels, both by itself and after it’s attacked with drugs designed to disrupt the process, such as Roche’s Avastin.

Or take Hexvix, a chemical which accumulates in tumour cells and glows when exposed to blue light. Developed by PhotoCure, a Norwegian company, and distributed globally by GE Healthcare, Hexvix is already in clinical use. It increases the number of potentially cancerous cysts detected during optical bladder inspections, reducing the risk to the patient.

Another collaboration, this one with InSightec, combines two technologies, MRI and ultrasound, to replace the knife in treating uterine fibroids, a condition which often leads to hysterectomy. Instead, surgeons locate the fibroids on an MRI scan and focus a beam of high-intensity ultrasound to raise their temperature until it destroys the cells. The procedure takes just three hours and the patient is off work for a day, as opposed to four to eight weeks after a hysterectomy.

Even Roentgen’s X-rays are becoming more useful. Nano agents, the first major development in X-ray technology since the invention of computer-aided tomography 30 years ago, promise to give doctors 1mm resolution of soft tissues as well as bones. The trick is to bundle up a tiny but dense ball of iodine atoms in a shell. Injected into the body, the iodine atoms act as tiny shutters, blocking the X-rays and revealing the internal shapes of organs.

Elsewhere in the Chalfonts, Robert Dann is showing off a virtual colonoscopy. Early treatment of colon cancer is 90 per cent successful, compared with 10 per cent if it is caught late. But the screening process is intrusive and unpleasant, so the take-up rate is low. The virtual colonoscopy turns a CAT scan of the large intestine into a movie, allowing the doctor to “fly” through the colon looking for colour-coded, pre-cancerous polyps. If this raises the screening rate from 30 to 100 per cent, more than 10,000 lives a year could be saved in the UK alone. 

Saving lives is the popular measure for medical successes, but cutting costs is also important. The new wave of scanners promises to do this in two ways. By helping researchers evaluate drugs at an earlier stage, they reduce the cost of pharmaceutical development. And by catching diseases earlier and allowing more targeted treatments, they reduce direct clinical costs.

After generations in which technology drove the cost of medicine ever higher, it’s about time the pendulum began to swing the other way.

The company – which uses barcodes and a bank of computers at a secure facility in Britain to check for fake medicines – already has operations in Belgium, Greece and Italy and is looking to roll out its system in another three to four markets this year, said managing director, Gary Noon.

Its expansion into Ireland involves hooking up all 1,500 chemists in the country. Initially, pharmacists will only be able to confirm the batch that the medicine comes from, but within a year, each individual packet will have a unique 74-digit number.

Spun off from PA Consulting two years ago, and backed by venture capital outfit Ipex Capital, Aegate offers a secure system similar to those used by banks to confirm debit and credit cards used in shops and cash machines.

Counterfeiters have built on their success in selling fake Viagra over the internet and are now targeting the world’s top-selling drug, Lipitor, as well as medicines to treat heart attacks, cancer and even schizophrenia. Some packaging is so convincing that it takes a lab test to show that the pills inside are phoney.

The World Health Organisation estimates that 1 per cent of drugs sold through legitimate channels in the developed world are counterfeit. In Britain, over the past three years, the authorities have identified 14 batches of drugs as fakes.

Half a million counterfeit medicines were seized at the EU’s borders in 2005 and officials expect recent figures to be higher. The WHO estimates the illegal trade will be worth $75bn (£50bn) globally by 2010.

If, as expected, Günter Verheugen, the EU enterprise commissioner, recommends legislation requiring point-of-sale authentication in his pharmaceuticals proposal due to be published in April, Aegate is in a strong position. While several other companies have tested systems, the British firm is the only one in Europe with operations up and running.

Criminal gangs that cut their teeth selling fake Viagra on the internet and went on to push dummy drugs in poor countries are now suspected of infiltrating the supply of medicines in the developed world.

“Counterfeit drugs could be compared to arms trafficking. It really is the same kind of dangerous crime,” said Françoise Grossetête, a French MEP and member of the parliament’s public health committee, at an international conference on the problem in Brussels. “It could become a form of terrorism.”

The Medicines and Healthcare products Regulatory Agency (MHRA) has recalled 14 batches of counterfeit drugs in the past three years, compared with none in the previous decade. These included fakes claiming to be the world’s best-selling drug, Lipitor, which cuts cholesterol, Plavix, which helps to prevent blood clots, and Casodex, which fights prostate cancer. Criminals have also targeted Zyprexa, an anti-psychotic prescribed for schizophrenia and bipolar disorder.

The MHRA described the situation as “serious”, and said its enforcement and intelligence unit was dealing with the problem.

The World Health Organisation (WHO) estimates that 1 per cent of drugs in the developed world are counterfeit. In Britain, that would mean up to seven million fake prescriptions a year, almost all of them undetected. Illegal pills may contain little or none of the real medicine’s active ingredient, and because they are manufactured in unhygienic conditions, could have dangerous contaminants. Often the fakes can be spotted only with laboratory tests.

Patients who report to their doctors that a drug isn’t working are likely to be put on a higher dosage than they need, or be switched to alternatives that could be less effective or have more dangerous side effects. No Britons have died yet because of counterfeit drugs, the MHRA claims. However, any deaths would almost certainly be attributed to the patient’s illness. Medicines taken by people who appear to die of natural causes are not routinely checked.

The WHO has reported several cases where counterfeits have led to mass deaths. More than 2,000 people died during a meningitis epidemic in Niger in 1995 after being inoculated with fake vaccines.

Prescription drugs are traded throughout the EU and around the world. Often a packet of pills will pass through dozens of companies between the manufacturer and the chemist. They are frequently repackaged, with labels and instructions in different languages. Although British drug traders need a licence from the MHRA, it has no control over who handles the pharmaceuticals elsewhere in the EU.

Many of the fakes are produced in India or African countries, and then imported into the EU. John Taylor, the head of the anti-counterfeiting team in the EU Customs Department, said national authorities seized four million fakes last year, up 50 per cent on 2006. “Once they are in the EU, they travel around freely,” he said.

Aegate, a British company, has recently completed an audit of its successful system in Belgium, Greece and Italy that uses a bar code to check whether a drug is authentic. No counterfeits made it through to patients. Although the firm’s high-security computers are in the UK, efforts to provide the service to British pharmacies are at an early stage, partly because chemists here do not have integrated computer systems. Most still rely on paper prescriptions.

Nigel Mason is apologetic when he arrives at GE’s British head office in Berkeley Square, central London. This isn’t his building, explains the boss of GE Healthcare UK as we wait for security to sign him in. Once his visitor’s badge has been clipped to his jacket, we’re ushered into G4, an ultra-modern but poky little room. By then, though, he’s done saying sorry. And by the time we get to the subject of the much-criticised NHS computerisation project, he’s bridling a bit at the very suggestion that he should be on the defensive.

“I’m proud of our role,” he insists. “It’s a positive story.”

Mason has been head of GE Healthcare International’s Public-Private Partnership team since 2004, two years before he added the title of country manager to his job description, and he clearly takes the project personally.

His company is responsible for the picture archive and communications system (Pacs) in the southern cluster, one of five broad NHS regions. Every one of the hospitals had their Pacs delivered both on time and on budget, he claims.

“As a result of the successful roll-out, we were asked to take an active part in the North-west and West Midlands, where a previous incumbent had been struggling.”

Pacs has had two technical failures in the past 18 months, he admits, but in both cases the backup kicked in immediately and the medics using the system to look up patients’ X-rays or scans weren’t even aware there was a problem.

GE Healthcare, which has its global HQ in Chalfont St Giles, Buckinghamshire, is one of the biggest players in the medical technology sector, supplying a wide range of equipment including big-ticket items such as magnetic resonance (MR), positron emission tomography (PET) and computed tomography (CT) scanners. Since 2004 when it bought Amersham – the first company privatised by Margaret Thatcher – GE has also had a presence in the pharmaceutical side of medicine. Worldwide, it has earnings of $17bn (around £8.5bn); in the UK, it has 2,800 employees.

And even in with recession starting to bite in the US, the American conglomerate is unlikely to retrench in its core market. “The UK is relatively small in global terms, less than 10 per cent of our business. But what that masks is the importance of the international market relative to the US. We genuinely do see ourselves as a global company, rather than a US company doing business overseas, which is what it might have been five years ago.”

Mason’s job is to figure out which of a dizzying range of technologies is best suited to a particular task, and then persuade NHS trusts to see things his way. “Healthcare cannot go on expanding its budget for ever,” he says. “For example, we produce six diagnostic tools that can be appropriate for coronary artery disease.”

He starts ticking them off on his fingers without pausing to explain what they do, let alone how they work: “echo cardiography, stress ECG, myocardial scintigraphy, multi-slice CT, cath lab and PET”. Each is understood well individually, but until recently there has been no assessment of their relative merits. Mason’s team has now developed a model showing which works best for patients in different risk groups, and will be sending it out to cardiologists for trials within the next few months.

Appropriate technology is also central to GE Healthcare’s response to the Government’s proposals for polyclinics – super surgeries with 20 or 30 doctors. Although critics complain that these would herald the end of personalised GP services, Mason thinks they would have the opposite effect, bringing medicine closer to patients.

“After you see your GP, if you need anything more elaborate than a pill, you have to get an appointment and go to a hospital five or 10 miles away,” he explains. “But patients who don’t need to go into an acute setting should never go there. This will be a lot better for the patient and from a cost point of view.”

The only question is whether a given polyclinic will need its own MR scanner (price tag £700,000) or just a bone densitometer – a low-level X-ray machine that can detect osteoporosis or identify “tofis”, people who are Thin on the Outside and Fat Inside. “Potentially, people like me, who look relatively slim, could be at risk because they have a build-up of fat around key organs,” he says.

In his late forties with a thick head of silver hair, Mason prides himself on being a walking endorsement of “early health”, and still pursues windsurfing – a sport he took up at university. His other great interest is restoring and racing classic cars. In 1998 he co-drove a blue 1959 Jaguar Mark 9 in the classic Monte Carlo Rally, finishing a respectable 36th out of 200.

Such competitive, adrenalin-fuelled sports just add to Mason’s image as a confident, go-ahead corporate executive. But hidden inside is something less common. Unlike most people at his level, his degree was not in business or finance but science, specialising in nuclear medicine. “I studied biophysics [at York] in the second year it was offered, before it was even known as a viable subject,” he says.

His Masters thesis, completed while he was working at Barts hospital in London, was the development of a “tissue equivalent phantom for CT” – in essence a three-dimensional test card for the scanners. Although he demurs when it is suggested that he actually understands all his products, Mason admits to deriving pleasure from being able to keep up with developments in his field.

He is also enthusiastic about ultrasound and uses it to illustrate several of his points, such as the pace of miniaturisation and convergence. “Five years ago, ultrasound was the size of a domestic fridge, wheeled around on a trolley,” he says. “Now it’s not much bigger than my portfolio here and soon it will be the size of my BlackBerry.”

Images of Dr McCoy’s tricorder on Star Trek spring to mind, but Mason immediately brings me back to Earth. “Several ambulance trusts are looking at ultrasound,” he says. “It could be life-saving with appropriate training, but we don’t want to put this diagnostic tool out into the hands of anybody.”

By convergence, he means that separate technologies are being used together to get results that neither could achieve alone. One example is the combination two years ago of PET scans and CT scans. “PET looks at function, down to molecular pathways, but you end up with a bright dot in the middle of blackness. That’s not much use to a surgeon,” Mason explains. “By using a CT scanner, which gives good spatial resolution, he’s able to see that hotspot in full three-dimensional context. Ultrasound could be next, he says, combining with the catheters and X-ray machines used in cath labs to investigate heart function.

Other than that hint, Mason is cagey about what his fellow scientists are working on in their labs. But he’s optimistic that the pipeline of ideas will continue to flow. “We’re moving from a world of ‘I believe our technology can do that’ to ‘I can prove our technology can do that’.”

“We need to debate first-cousin marriages,” said Mr Woolas, whose Oldham East and Saddleworth constituency is ethnically mixed. “A lot of arranged marriages are with first-cousins, and that produces lots of genetic problems in terms of disability,” he told The Sunday Times

Although Pakistani parents produce just 3.4 per cent of the babies born in Britain that also accounts for 30 per cent of children born with genetic illnesses, researchers claim. The risks of inbreeding rise sharply if the practice is repeated over several generations.

Ann Cryer, the Labour MP for Keighley, called on the NHS to warn parents about the dangers. “This is to do with a medieval culture where you keep wealth within the family,” she said. Within the Pakistani community it is also widely held that first-cousin marriages, which are perfectly legal, are more stable.

“I have encountered cases of blindness and deafness,” Mrs Cryer added. “There was one poor girl who had to have an oxygen tank on her back and breathe from a hole in the front of her neck. The parents were warned they should not have any more children. But… they had another child with exactly the same condition.”

The Birmingham Primary Care Trust has estimated that one in 10 children born to first-cousin marriages either dies in infancy or suffers serious disability as a result of recessive genetic disorders.