The Long Game

Sandy & Ross

The Long Game is a podcast that demystifies the science shaping our lives, and explores how great ideas built in Scotland become real-world medicines, devices, and companies at the cutting edge of life sciences.

  1. Oct 15

    The New Body Economy Part 6: Silicon Valley Comes for the NHS

    The NHS has some of the most valuable health data in the world and that makes it both a goldmine and a battleground. In the latest episode of The Long Game, Sandy Weir and Ross Cagan pull apart the promise, the politics, and the very real risks of letting Silicon Valley companies help run the systems behind your care. They start with the Royal Free and DeepMind case, where 1.6 million patient records were shared without patients being individually asked for consent, then move to the bigger question now facing the NHS: what happens when companies like Palantir sit at the centre of the data infrastructure that powers care, research, and AI? You'll discover why NHS data is so attractive to technology companies, what “data processor” vs “data controller” actually means in practice, and why trust can collapse even when the legal basis looks sound. Sandy and Ross break down the hidden danger of vendor lock-in, the importance of interoperability and exit planning, and why standardised platforms may matter as much as the software itself. We also get into the upside that keeps this conversation from becoming anti-tech. Ambient AI is already cutting documentation time dramatically, some pilots are reportedly slashing admin workloads by 80%, and linked data can improve diagnosis, scheduling, discharge, and research at scale. But those gains only matter if the public can see what they are getting back. The episode also revisits care.data, the NHS rollout that spent over a million pounds mailing leaflets to 22 million households only to collapse under public backlash, and the WannaCry attack, which showed how fragile healthcare infrastructure becomes when systems are outdated and security is weak. The message is clear; in health data, trust is infrastructure. Essential listening if you care about AI in healthcare, public data, NHS reform, or the future of who gets to profit from the information we all help create. The final question is the one that matters most, what should the public get back when its data creates private value?

  2. Oct 8

    The New Body Economy Part 5: The Newborn Genome

    The future of newborn screening sounds simple until you ask the hard question: should every baby have their whole genome sequenced at birth? Sandy Weir and Ross Cagan unpack the promise, the technology, and the uncomfortable trade-offs behind one of the biggest shifts in modern healthcare. With the NHS Generation Study already sequencing newborns across England, this episode explores how ultra-fast genome reading could catch rare, treatable diseases before symptoms appear, potentially sparing families years of uncertainty, misdiagnosis, and delayed care. But as Sandy and Ross make clear, reading DNA is only the beginning. They break down: why whole genome sequencing could transform rare disease diagnosiswhat the Generation Study is actually screening for, including 223 rare conditions across more than 500 geneswhy variants of unknown significance can create anxiety instead of answershow penetrance, adult-onset risk, and future autonomy complicate consentwhy storing a baby's genome raises questions about access, reanalysis, and lifetime data controlRoss also explains why the real bottleneck is not sequencing speed, but interpretation, counselling, follow-up, and the full care pathway that turns data into something useful. Sandy pushes on the fairness question too: if genomic foresight becomes a public good, who gets access, who pays, and what happens if it becomes another divide between wealthy families and everyone else? If you care about genetics, public health, medical ethics, or the future of personalised medicine, this conversation is essential listening. It is a sharp, accessible look at how close we are to sequencing every baby, and why the real debate is not whether we can do it, but whether we should.

  3. Sep 29

    The New Body Economy Part 4: Women’s Health Is Not a Niche

    Women’s health is not a niche market, it’s a massive blind spot in medicine, investment, and product design. Ross Cagan and Sandy Weir unpack how decades of male-default research created real-world harm, from delayed diagnoses to missed heart attacks, and why that neglect is now becoming one of the biggest opportunities in health. They break down the data problem at the centre of the women’s health gap, including why female biology was historically excluded from studies, why that assumption turned out to be wrong, and how missing data leads to missing diagnoses. You’ll hear why endometriosis can take 8 to 10 years to diagnose, how menopause affects careers and productivity, and why cardiovascular disease is still misread in women more often than it should be. Ross and Sandy also explore the rise of FemTech, from period tracking and fertility apps to pelvic health, contraception, and non-invasive diagnostics, and why the category needed a name before investors would take it seriously. They dig into the privacy and governance risks around sensitive reproductive data, especially after Roe v. Wade was overturned, and ask what happens when wellness tools sit somewhere between consumer app and medical advice. You’ll also discover: Why a meta-analysis of 293 studies challenged the old excuse for excluding female mice from researchHow non-invasive testing could shorten the road to endometriosis diagnosisWhy menopause is both a health issue and a workforce issueWhat the women’s health market could mean economically if the gap is finally closedThis conversation makes one thing clear: women’s health is a stress test for whether medicine can correct its own blind spots. It’s essential listening if you care about better care, better data, and a health system that serves half the population as more than an afterthought.

About

The Long Game is a podcast that demystifies the science shaping our lives, and explores how great ideas built in Scotland become real-world medicines, devices, and companies at the cutting edge of life sciences.