A revolution is taking place at every level of society and doctors are struggling to keep up. Advances in medical knowledge are outstripping the capacity of a physician's brain, with most knowledge redundant in less than a decade. New drugs, new treatments, new technologies, new diseases - this means new medicine. Old models of care will not survive without radical change over the next decade.

At the same time, resource issues, rationing and pressures for termination of the old, chronically infirm or unloved will increase.

At the heart of new medicine is the genetic revolution. Tools available now and already widely used in animals give today's scientists the power to alter every aspect of life on earth, with the potential of redesigning the human race.

Such open doors raise unsolved ethical dilemmas at a time of moral confusion and uncertainty.

At the same time, single issue focus groups such as pro-life (anti-abortion) and animal rights will be increasingly powerful, influencing not only medical practice but also new investment by drug companies.

Yet the more technology advances towards a virtual world, the more touch and emotional health become important. The lesson of history is that the more affluent we become, the more stressed and emotionally vulnerable we feel.

Expect the current growth of holistic practice to continue, with further erosion of respect for treatments developed using traditional logic / science methodology. Alternative medicine, based on belief systems as much as objective data, will gain further ground as a third millennial generation becomes increasingly sceptical about the benefits of unchecked scientific progress. There will be more emphasis on such things as pain relief and less on cure - since increasing numbers will face many years of old age with chronic problems.

There will be a growing gulf between hundreds of millions lacking even the barest essentials for survival, and a superclass spending ever more on exotic care packages designed to ensure ultra-long active life, whatever the cost.

PEOPLE WITH DIGITAL BODIES BY 2020.
Media log of TV / Radio / Press coverage in last few weeks.

Chips and genes will combine to produce bionic people by 2030, with the first digitally enhanced human beings by 2020.

We are already able to link computer chips to human cells such as nerves to help those who are paralysed. The next step will be to implant biochips which control blood sugar levels, helping diabetics. Beyond that, biochips will be implanted directly onto the surface of the brain, to restore sight, hearing, movement or enhance memory and intelligence. Early work has already been completed in animals, fusing living nerve tissue with the surface of a chip, allowing nerve impluses to activate a computer pathway, and a computer to activate brain cells directly.

Computers and genetics are the two great technologies for the first decades of the next century. Computers change how we live, but genes can change what we are. Both these technologies will be used to create designer people, with enhanced characteristics. At the same time there will be a backlash against making "unnatural" children and adults.

Other extraordinary possibilities facing tomorrow's adults will be the ability to transplant human heads onto new bodies - already achieved in quadraplegic monkeys and one US scientist ready to start in humans, cloning for spare parts, humanised animals as organ factories, "magic bullets" for cancers, entire drug factories contained in the cell of a single microbe, viruses built to correct gene defects in people, new genetically modified foods such as bananas containing vaccines and other medical ingredients, continous bio-monitoring of human body functions such as blood glucose by implanted electrical devices that need no batteries and last a lifetime.

ROBOTS WILL BE USED TO TREAT THE SICK
Media log of TV / Radio / Press coverage in last few weeks

Doctors will be forced to consult computers for advice before making any important decisions about treatment, with the risk of being sued for mismanagement if they don't. These diagnostic robots will draw on global research to offer expert opinion, which few doctors will dare to ignore. Medical training will shift from what people know, to getting accurate data on which robots can make decisions, and providing "high-touch" emotional support.

Skilled surgeons will always be at a premium, together with hands-on carers who will be increasingly community based, with highly specialised qualifications. Remote surgery will be a regular part of every specialist centre's routine, whether tele-conferencing advice to surgical teams, or actually controlling surgical equipment remotely.

The line between doctors and nurses will continue to blur as nurses are authorised to make more decisions. As a result nurse training will get longer and top-grade nurses will be more expensive. At the other end of the scale, we will see the return of nursing auxillaries: low cost care assistants with vital front-line roles.

SMART DRUGS FOR DESIGNER PEOPLE
Media log of TV / Radio / Press coverage in last few weeks

A new generation of smart drugs will change society by 2015, improving sex lives, intelligence and slowing down the ageing process.

The anti-impotence pill Viagra is the archetypal smart drug, and is a fore-runner of hundreds of others. Within 14 weeks, two million men in America alone had taken Viagra, the vast majority using it purely for recreational reasons. Drug companies woke up to a vast new market for performance-enhancers, as people strive for the ultimate in physical perfection and personal enjoyment. There will be a shift in emphasis by researchers from treating disease or preventing it, to enhancing normal life.

Every aspect of human life will be targetted with smart drugs: all designed to improve lives of people who are perfectly healthy.

A new branch of "designer" medicine will develop, which is neither treating nor preventing disease, but merely satisfying an insatiable appetite for human pleasure and achievement. It will be highly controversial and its practitioners will be shunned by the rest of the medical profession.

For example, students will be able to add the equivalent of 20 points to their IQ in exams by using memory enhancing, and other stimulatory drugs developed for Alzheimers, while drugs will also be available to let people eat as much as they like without ever growing fat. Others will slow down the process of ageing beyond anything we dream possible today.

Smart drugs will raise huge moral dilemmas because they will be widely used in wealthy nations at a time when millions are still living in terrible poverty in most of the rest of the world. And of course, addiction to a variety of substances will continue to be a major problem, in the medical profession as well as the rest of the population.

HUMAN-MONKEY CREATURES WILL BE BORN EARLY IN THE THIRD MILLENNIUM
Media log of TV / Radio / Press coverage in last few weeks

Gene technology will give today's children the ability to redesign the human race and all other life on earth, with some bizarre and disturbing results including the creation of creatures that are half monkey, half human.

We need a sense of history to understand the future. When we look back over the last two decades at the acceleration of genetics, we begin to understand the vast powers that gene technology will give us beyond 2000.

Using today's technology we already have the power to create humonkeys, creatures which are half monkey, half human. Will such an animal have human rights? Could it be prosecuted for murder? Would it have a soul? These are profound philosophical, ethical and spiritual issues we will have to face early in the next millennium.

We can clone hundreds of identical animals -- and humans in future. We can produce designer animals to order, many containing human genes. We have added scorpion poison genes to cabbages to kill caterpillars and other insecticide genes to potatoes to kill Colorado Beetle. We have added human genes to cows, pigs, sheep, fish, rats, rabbits, and bacteria. Using today's technology we will soon be able to produce human breast milk from cows.

Every step will be justified with promises of health benefits or increased food production.

We need this technology, but we also need to regulate its awesome power. Gene accidents or biological warfare could unleash killer viruses a thousand times more deadly than HIV, while genetically modified fish, if released into the sea, could profoundly affect life in the oceans.

The lesson of history is that whatever can be done, will be done, sometime, somewhere, by someone. However regulation makes abuse less likely. We urgently need a biotech summit and which every aspect of gene technology is discussed with the aim of reaching agreement across as many nations as possible about, for example, the birth of human clones.

Gene researchers have consistently understated the progress of their work, to avoid alarm and prevent interference but as recent events have showed, yesterday's science fiction is today's reality when it comes to biotechnology. More on the future of medicine.