#448: We need £2M to rebuild women's health from scratch

0:02How do you impact the lives of millions of people and how quickly can I do that? And I tried through advocacy, I've tried through academia, through non-profit land, through policy, and I realised that I don't want to commit my life to something incremental. I want to have a big swing and I want to go fast. I love clinical medicine, I love the impact that I have. Even in all the work that we do now, it speaks back to that feeling of care, and particularly in my specialties, that we get to look after women in some of the best days and worst days of their life, you don't get that anywhere else. I made the decision that I was going to found a company in healthcare whilst I was moderating a panel that I had organised.

0:41And the theme that I had to have said is, how can technology be a tool for health equity, particularly in women's health? And Edith said this thing to me on the panel of, like, if you've got an idea, you just need to do it. The hardest thing you'll do is start. And I was like, OK. Hey everybody, delighted this week to be joined by Sajita Selvaraja, who is the co-founder of Hester Health, who you may have seen recently has raised two million, I think it was, for a brand new women's health company. um a lot of reasons that this perked my interest um or peaked my interest i should say is because we we it feels like we're in this period and still are kind of in this period where there's no money no one's raising health tech sucks everything's really difficult people are making layoffs people making cuts and so as soon as i saw this race i was just dm like add dm Please come on the podcast.

1:42Let's talk about some good news. Let's talk about some stuff that's happening. And so, yeah, delighted to have you on, Sajita, and welcome to the Health Tech Podcast. How are you? I'm feeling pretty good. Well, good. No notes, really. Yeah, nice, nice. Where are you speaking to us from? Where are you based? You cannot judge me. I get a lot of judgment. I live in South London. I love South London. And I love it. Yeah, perfect. Where in South London? Which segment? Which corner? Which little green leafy suburb? Crystal Palace. Yeah, okay. Interesting. Proper South London. That's proper South London.

2:18That's proper South London. Which I was just saying, everyone's complaining about the tube strikes and how they can't get to work. And I was like, guys, I can't relate because the tube doesn't come anywhere near me. Because I just have travel issues every other day of the year. Yes, exactly. Yes, exactly. Yeah, yeah, exactly. Nice, awesome. Yeah, we were, I did the classic Clapham and then down the A3 out to Surrey. So just that classic, and then send your kids back to one of the red bricks and then they do the same thing. So like I'm on that cycle. So slightly, slightly more West. If it works, it works.

2:49If it works, it works. I literally said the other day, I think I've said this on a podcast before, but like since moving to Surrey, I've like lent into every like possible stereotype. Yeah. Like I've got the Tesla, the Labradoodle. I was literally just like the tap. We've got the townhouse. we've got the i was just thinking now just like what else lives in sorry start a kid shall i start shooting shall i what else do like what else do people in sorry we go for walks on sundays like we go to the pub it's all that it's all of that sort of life that we're sort of leaning into it is it is i do feel like i need a boot room now i'm sort of at that stage of like i need a specific room where i can put the hunter boots wash the dog after a muddy walk that's actually quite practical um it is it is it's just that the level of wealth required uh means that i need to help a lot more health tech companies with some x so in order to achieve that anytime soon not a bad way to make your money it's not it's not anyway enough about me and my boot room um and more about you so um the first question i ask here is for you to tell your story so yeah i'm super interested because you're still a practicing doctor um you have a health tech company you're sort of living the dream I think for a lot of people listening um so by all means like start at the beginning like tell me about you tell me about yourself I actually thought we'd be talking more about the company so we will at some point but we need to know who you are we'll get there um what do I tell you about myself I have to start from the beginning right like that's that's the only way to start I am one of three I'm the youngest of three uh and I I guess I I'm the first one in my family to be born in london okay i'm the first one in my family to be not born in sri lanka and actually i think when i was born there was like we've got our first london baby um uh but i think also with that i am also the first one in my family to not have to leave a civil war to not be persecuted based on my ethnicity to i've never known i you know i have the privilege of not knowing what it's like to have to escape somewhere and to start afresh and so I'm very aware that that is a big part of who I am what brought me to South London you know in the in the first place um so I think I have to start with my story there um and where do we go from there well my brother is studied law and my sister studied medicine as the dream of every Asian parent but what this actually gave me is it gave me an immense amount of freedom because it meant I didn't have to do that those boxes were ticked yeah and I could do whatever I wanted exactly um and I think I remember you know you have to do work experience when you're like 14 or 15 or something and I wrote to the fashion designer Matthew Williamson right Matthew I'm still waiting to hear back he does listen to this podcast yeah yeah that's really his this is really on brand but you know that was my dream obviously I hadn't heard back which was rude but fine I understood so instead I did my work experience at a local school for children with autism I wasn't particularly excited I was like cool we've got to do it let's go and I One of my highlights, I still remember some of those boys' names.

6:16I got to help him write his name for the first time. Wow. And I got to have this experience of what it's like to care with someone, to care for someone, and that has still stayed with me. That was my first kind of interaction. I was like, okay, I like this. And I think another early experience, and this is quite strange for someone who was 15 at the time, is I was working with the Department of Health when I was 15 to like do mystery shopping on healthcare services for young people. So I'd go in and be like, oh, is it accessible? How do we change healthcare like for thousands of people at scale rather than like one-on-one interactions?

6:55I didn't even know they did that. Yeah, I mean, obviously the funding's been cut. It's called the You're Welcome Project. My mum still has a little leaflet of me in the house. So what did you actually do? Talk me through that because that's a heck of an insight. Like what were you challenged with doing or asked to do? We did mystery shopping. So we would create a criteria of what does it take for the service to be excellent for young people. That's why I was going as 15 because I was like the target user group. And we would just, you know how you have in product development now, you need user testing.

7:25I was doing that, but I was a user shaping healthcare. And it's actually, I didn't have the words for this at the time to understand that this was public health. I just knew that I was doing this and I liked it. um and so i got that kind of idea of how to change health at scale then this was the same time uh you know we had the white paper on ccgs and we were moving commissionings the gps or whatever they asked me what i thought about that and i was like oh i mean i had some thoughts as a 15 year old i don't really understand but basically i had this i mean i did some other things that maybe 15 year olds also do right but I had this idea of I like the ability to care for people I love the ability to think about problems and solutions at scale I'm already I've got a little inkling that I like and then I went to uni lovely I went to UCL met brilliant people um did amazing things and one of the first things I did there is I was 19 at this point I started TEDx UCL women I founded it wow and i i didn't get it how can you be the first university in the uk to allow women in on an equal basis and you don't have a tedx utl women so i didn't and that was my first flavor of not asking for permission yeah okay doing it go and do it um and it's also quite helpful because at 19 i'll be honest i wasn't thinking too much i was just doing it yeah you know um and i you know had a own team of 40 people i got to i was so lucky i got to meet incredible women who've changed the world you know like dame wendy hall she's like oh gee tim bernard lee you know godmother of the internet yeah like this caliber of people who have shaped the way that we interact with the world today to you know amazing scientists amazing like yeah amazing activists but i guess at the back of my mind i'm kind of asking this question of how do i change the world and so i spent a long time doing like advocacy work and telex ucl women was one of them i in this obsession with health at scale you know and I always say this before you had these sorry because I know this is part of your branding but before you had these fancy phrases like health tech improving health at scale was just global public health that's what it was and that's what I did my first degree in and I fell in love you know I I got to understand why how can someone else who on paper might be just like me but lives million you know thousands of miles away has completely different access to healthcare has completely different health outcomes how can someone that lives only a few miles away from me have different health outcomes um super super interested in that and then I guess I've been figuring out my I call it my personal theory of change which I know is jargony but like you know this what can I do to make change at scale um and so in advocacy stuff I got involved in lots of student organizing I I spent a bit of time in academia I thought is this the way is this the way to do it and i worked with again amazing people at ucl and at oxford i'm really looking into like broader determinants of health like what makes people sick way before they step into into the hospital into clinics and actually looking into discrimination and how that affects health so how does the color of your skin how does caste indigeneity migratory status affect all types of health outcomes across all ages across the world developed this kind of like what i thought at the time was a fancy model published in the lancet many papers published in the other people thought it was a fancy model then in that case and then everyone and then everyone's like oh do you want to write some more papers i'm like no i'm gonna do something and so what and then there's that knowledge needs to be created it needs to be published but i think for me i'm craving a bit more impact yeah there or like speed so i launched a like a non-profit organization off the back of that called race and health like related to that because i was getting frustrated with like we have to wait for the paper to come out before we can do something and that's still running now but i realized through you know i did policy work like how do you implement policy at a local level too i spent a little bit of time at the world health organization it feels very sexy you're driving in to the UN and you change policy but then I realized that the time it's going to take for me to see that change through is too long so I guess this is a long-winded way of saying I think I was trying to figure out how what do you do how do you change things on such a huge like how do you impact the lives of millions of people and how quickly can I do that and I tried through advocacy I've tried through academia through non-profit land through policy and I realized that I as an impatient person I don't want to commit my life to something incremental I want to have a big swing and I want to go fast so then I went into health tech and at my time of health tech by the way I was still I was doing clinical work I feel like I haven't actually spoken about my clinical work yet um just casually became a doctor amongst all of this yeah well the thing I love well I can talk about my clinical work because I love it but um I think I went in to be a doctor I don't know if you had this James, like multiple times at medical school, multiple times as an F1, I was like, I'm going to leave.

12:37Like, this is not for me. And the reasons why it wasn't for me is because I always felt I had more to give than I could give in that system. Very simply, that's what it came down to. And actually, the reason I'm still an NHS doctor, I think we've got Australia to thank there. Interesting. Yeah, I did my, you know, I was and also because I was so taken with global public health, I was I found my way, I found the way that I'm going to do this. And I remember that this big director at the world health organization he was like just just try clinical work just try a couple of years and just see you know and i was like no you're wrong and you he was right he's right uh um and yeah there were various things that i wasn't crazy about but i basically realized up until i went i did my f2 in australia unbelievably lucky we went on mass with many many of my friends where were you where'd you go we were in adelaide we deliberately chose to go somewhere um that was a bit different from yeah from london yeah went with some of my best friends and we yeah i mean fun yeah i don't know what to say there treated like a human being by the system paid over time paid well like yeah interesting it was it was amazing but also importantly for me that's where i fell in love with obstetrics and gynecology like i had more training there in a year than i would have done in the nhs in years what do you mean by that i had i had my own operating list by the beach and and the and the consultant you know and the consultant trained me up to be able to do that so the first time she would come she brought all these sweets with her i was like what's going on she bought sweets for all the theater stuff she was like this one's going to be a bit slow because she's learning so why don't you have this while she learns and by the end of my time here there you know the consultant wouldn't scrub for example wow That's unheard of to have.

14:27And also what was interesting is I didn't know that that was not normal because I had gone from F1 to F2 until I came back here. But really, the thing to say is I love clinical medicine. I love the impact that I have. I know we just spoke about this, but there is, even in all the work that we do now, it speaks back to that feeling of care, and particularly in my specialties, that we get to look after women in some of the best days and worst days of their life. you don't get that anywhere else no that feels amazing it's a unique part of the hospital for that reason it's why on my first day of neonates i remember the um tracy lawson the neonatal consultant atst peter's literally said those exact words like she she came in and just said you need to remember that the women here are not ill they are not unwell they are having a child that is a wonderful wonderful thing and you need to treat them as such you do not treat them as ill people you treat them as people and it was like okay yeah very very important frame and it's that so many people are scared it's the first time that they are going through that process well it's probably like the thousandth time we're seeing someone go through that so we have a lot of power in that situation to be able to help them um and and really simply i love i've told you that i love things solving things at scale in my clinical work i love the impact that you have but you don't get the scale piece right and then i've told you that i'm impatient and i'm craving speed uh so that's when i went into health tech and i did some product work some advisory work all the way from like super early stage companies oh interesting to i did some small i was a tiny speck in the massive organization that was flow health wow awesome brief brief brief tiny period of time yeah but i learned i feel a disproportionate amount from that small bit of work and actually i learned i actually learned very quickly how people are doing things and how they're not doing things right and to be honest by the time i figured all that out i have to go and build my own my own thing that's a very long long story i think what's a story what a story there's so there's so many things in there that the one thing i want to pull out and just have a quick chat to you about is this this notion that like you believed that it was possible to a change the world and b have a very fulfilling life and have all this stuff because you've been around all these inspiring people with the TEDx thing you've started a thing without permission and nothing bad has happened you've done that and you've sort of gone oh okay this is quite interesting um you've been involved with the healthcare system since you were 15 doing the mystery shopping stuff for department of health like you you've you've had the experiences along your journey to go well actually i can not only please myself with what i find fulfilling i can do that in such a way that so then i suppose when clinical medicine constrains you and i guess the reason i'm saying this is because there'll be people listening that are in clinical medicine that perhaps feel this way feel very constrained by clinical medicine with their desire to do more I think the difference is you've been shown well hey my family can can escape hell and that's possible so I can make an interesting career for myself that is possible and by the way I've seen the most inspirational people and women through UCL TEDx that like actually uh yeah this is this is this is child's play compared to some of the stuff they've done which I think is really interesting from like an inspiration perspective yeah i just i've got such mixed feelings um when it comes to advising clinicians in the nhs who maybe aren't happy where they're at with with and i think it really comes down to people are maybe unhappy for different reasons and i don't think it's fair to put everyone in the same blanket like in the same in the same category um but if we're asking what can we what can we that anything that's helpful if you're currently working in the nhs as a clinician now and you have the sense of you've got more to give if that is the question i think there is so much that can be done um but the first thing i will say is we complain so much about the nhs right and i get it i've i've been there i am there um but i'll do a ward round and i will see someone who hasn't been able to afford you know their their electricity bills from the same time as someone who's i don't know has just flown in from their fourth business trip of the fourth week and it's open on their laptop whilst whilst you're trying to speak to them and they both get the same level of care well they actually i've actually published on how maybe the level of care actually varies on that so uh but you know they both have access to the same system that is free at the point of use not many not many countries can put their name to a health system that has that i i honestly think it's a privilege to to deliver health care in that way um when i was at when i was at the world health organization actually i i stayed with some family and they said you know they have to pay something i can't remember something extortionate to just call the ambulance and i think sometimes it takes coming out of what we're complaining about to look at it from elsewhere to say this is where we're at is okay it's also okay to recognize that something is great but has a lot of room for improvement both of those things can be true at the same time right and i've been there like i have written business cases in the nhs for why we need another SHO on this rota because it's unsafe and a lot of the time it's hard because everyone else is tired and everyone feels that sometimes the amount of change that they can make is limited but do you know what I went back to that hospital three years later and we had a new SHO so like it is possible and I think for me what I've learned over all the years is I'll try when I think that my efforts will actually result in something so if you have that feeling if you have more to give try and figure out where can you give that more that will actually have more output maybe part of that's in the nhs maybe part of that isn't but i think for me that's what drives it because if i don't think that my efforts are going to move something i you know i have to come and look at it in a different point of view yes and you've decided that the best place to do that is obviously through a startup now and the way that you kind of introduced that theme was you talked about this bridge between academia and impact and that moment where someone says oh that was a great paper do you want to write another paper and it's quite it's quite interesting isn't it because I can remember um I remember when I was in anaesthetics and I was revising for the exams and there was a moment when um I I looked I sort of zoomed out and looked around and obviously everyone that you know at that point because you know all the trainees around you in the same region and you know how many of them there are and all of them are now like putting all of these hours and it's a lot of hours for the anaesthetic exam so much so i never passed the viva so like literally never never got through that one um i saw all these hours and i can remember saying i think it's to my parents even i remember i remember saying like can you imagine if all of the energy that was going into passing these exams where i'm learning the pressure that gas is stored before it even comes into the hospital and then what the pressure differentials are as it goes through a machine like why am i why am i learning the circuitry the circuit board of a pacemaker looks like like a defibrillator why don't we know exactly what kind of but my point is is like we do these things don't we like the academia thing of like oh great paper let's write another paper oh great audit let's do another audit no no why don't we actually see this through and like actually figure out what the solution is and then implement it and then audit that and like what why don't we divert some of this energy that's that's baked into the system and these these strange ways that we've we've developed for assigning additional value for people like oh you're so published it's like well this person over here actually built a company that did loads of stuff and it doesn't have to be a company but they built a thing a program a thing that ended up helping loads of people but they get no points for that and that's one thing that that really frustrated me in the system that this bridge between effort and like accolades and value and badges for your cv and and and the mismatch of like what that effort can actually go to to deliver it is the same frustration i tend to have really about the academia to impact thing of like it's so frustrating that so much cool science happens at universities and literally the most innovative things possible happen where research is happening academic research is happening it's just that so little of it gets pushed through to actually helping because it then gets messy and adoption and building a company in capitalism like everything that's required but that is the challenge i guess you and i probably have share some level of similarity in how quickly we can get frustrated with academia yes but there are probably some people where actually that is their zone of genius that is where that makes sense you're right because those are the things that they like to work things at work at things on a different pace or they want to get into detail It just so happens that maybe you and I are not those people.

23:59No, you're right. And it's also the thing of maybe actually starting a business isn't the right theory of change for everyone else. I feel like it's a personal thing as well. And some of the research and academia that we have is super impactful. My old supervisor at Oxford, who's an incredible woman, it's her, like her stats, her numbers that told us that black women in this country are five times more likely to die in childbirth and in pregnancy than my counterpart. part so you know i don't i don't know if when she was crunching those numbers on r or whatever she used she she thought that was the impact that's going to have and maybe not every one person or one organization needs to do everything because she she put that out in a paper as part of her work and then you've had a whole organization that's come up an advocacy organization that's come up as a result of that founded by um atinike and clove five times more who've done so much for moving things forward for how we're aware of things and what we can do to change that so I don't know this is you know on this thing of feeling like you've got more to give and wanting to action that is I think there's this thing of being true to what works for you what's the thing that makes you feel great you know we've spoken about how providing care for someone is something like that for us but it might be it's different things for different people yeah definitely and And that is a good point and a good reminder because I, you talked about, you know, wanting to leave through medical school and early junior doctor years and stuff.

25:24And yeah, I was in that category, but I wasn't as noble in my reasoning. I don't think as you were in that I wasn't really thinking about, Oh, I can change the world and there's so much that I want to do. I was actually thinking quite selfishly of like, I can't stay in this because I just don't like it enough. And I'm really struggling. And to your point about like, there's a place for everyone somewhere in this medicine and innovation journey i think it was that it was me trying to figure out like hey this this isn't my bit but it was it was more kind of i need to find my role and i think it's why people like keith grimes will talk about actually you know professionalizing and and um like solidifying more of a path for people like that so that they can feel at home within the system rather than like just as someone who's really great at academia will feel at home doing the academia and is respected within medicine for doing so kind of something that can help people like you and i that are more in that kind of innovation adoption like part of it and helping us to still be welcomed by medicine rather than having to defect because i think that's that's such a big barrier and a struggle because i can remember those early conversations with people of like you're gonna do what you're gonna leave you're gonna leave medicine to do this and it's like no no no i'm trying to still try to help the system but i'm just not getting there i'm getting i'm not getting the love i know and i actually you know what i think you should own that because actually what i do tell people when they're asking what should i do where should i start is actually don't be noble figure out the thing like figure out the things that make you feel good yeah and then figure out within that how to do exactly and then figure out to you know how to do that um so i think you should own that and you know there are other noble things of like i'm sorry non-noble things of i hate a long ward round i hate i hate it it's it's not for me part of my impatience i say that we actually have monday ward rounds as part of the company but we also have a rule it cannot go more than over more than 60 minutes interesting interesting yeah there are um there are quite a few things from medicine that have crept into people's companies that with clinician founders um like incident reporting and datex forms have like found their way into like a few companies and stuff.

27:33We literally had a conversation yesterday. Is it a near miss? Is it a da da da? But we have to do that because we deliver care anyway. But we had a question of should we bring in a greatx? Did you ever work anywhere with a greatx? No. You can tell that I've got a very positive outlook. So we didn't focus on the datex. A datex, but for anyone who doesn't know, is if there's been any sort of incident, you have to report this in a very bureaucratic system. If you're an obstetrician, pretty much everything is an incident. Right. So you're used to this level of like things that we maybe normalize is categorized as incidents.

28:05You're very, you're very familiar with the state tech system. But what we've got in some hospitals is a gray tech system where once a week, does someone do something really nice for you? You know, have I been in theater back to back? And when I came out, a lovely midwife brought me a cup of tea. so much of value is going to come from personal experience and lived experience that if you're living it in the present and you are seeing and feeling the changes of what is going on on the clinical ground floor you are so valuable with that information because that's the bit that the llms don't quite have yet until the next update like when i go in as a clinician and they've just rolled out epic but all the clinicians are like bring me paper now you know it's helpful for me to be like why yeah oh we've rolled out a new electronic health record but actually none of the observations are coming up yeah that's why they're asking for it on paper you know like it gives you real insight into adoption distribution into actually sentiment in clinician amongst clinicians yeah but also what real women feel like yeah 100 yeah um so hester health hester health tell me um because this is was it a seat it was a seed round wasn't it for two mil pre-seed pre-seed for two mil impressive impressive no pressure you can tell i've done my homework um tell me i already know this but of course tell all the listeners uh tell me all about test the help no what when did you have the idea and i think because it's nice to have an like an early stage founder on pre-seed awesome it's a big raise for a pre-seed which is great as well it's clearly a big vision so um i'm interested in how you got co-founders when you got the idea how you go from having an idea to raising two million in pre-seed i think even before idea is that this sensation of more to give right that's what is with that feeling of where ideas come from i made the decision that i was going to found a company in healthcare whilst i I was moderating a panel that I had organized.

30:12It was at Women Deliver, which is like the Olympics of women's health, basically. And like companies, sorry, countries have to bid for where it's hosted every few years, et cetera. Wow. And this one was hosted in Kigali in Rwanda. Nice. And so I'd organized a session and I had an incredible, like incredible set of panelists. We had Ederton, you know, mother of Femtech, Clue founder, some excellent founders who were based in Nigeria, in Kenya, in Sri Lanka. And the theme that I had said is, how can technology be a tool for health equity, particularly in women's health? And Ida said this thing to me on the panel of like, if you've got an idea, you just need to do it.

30:55The hardest thing you'll do is start. And, you know, so really she said that. And I was like, okay, that really like, I was like, okay, I've got to do it. And I think I was still working full-time as a registrar at the time. and I came back and I incorporated a company that, and I basically used that to kind of think about what I wanted to do. Nice. So I've got to think about ideas, but really I have no idea. I have no idea of exactly what it is, but I'm starting to get an idea of, you know, and I went out of women's health. I went, because, you know, having a global public health background, I know I'm thinking about systems change and scale, but I know that the clinical part of me satisfies a big part of, you know, women's health to some extent.

31:33But I came out of women's health, went into preventative health, really looked at what it is that I think can make change and what it is that will excite me along the journey and as it came as I was figuring out kind of the kind of company I wanted to build the kind of change I wanted to make it was my yeah it was my birthday last year actually and I was in a little hut in I think it was an Airbnb which is relevant um and I was off all screens and I was like okay what does that really what is it going to take like what's the thing that i now need to focus on to really build this company and i've got a few ideas but like but it's like what does it take i've been testing with women it's really all about like idea incubation at this time like you know testing iterating and i realized that for the kind of change i want to make and the kind of company i want to build i don't want to do this alone and so it really transitioned from having a co-founder is something you should have you know everyone you know yc they're always telling you you need a co-founder and i was like it went from this thing that maybe i should have to this is now something that i want yep and i wrote a little post just well i had no internet at the time but when i came back i posted it and i shared this is my story this is what i believe to be true and i'm going to find a co-founder and i'm going to post every day until i find a co-founder amazing and i'm looking for somebody who has an entirely different background from me who thinks so differently from me from me but it's going to work as hard it's not harder and we are going to make sure that we win and i don't know what to tell you i was obsessed and that is but also i don't know if you have this you know when you know there is one thing that you have to focus on it's so much easier to say no to everything else right exam season that's like that's the most common yeah like thing for medics you know what where six weeks head your head down exactly i was at every and i was you know i was thinking where are where can i find concentrate concentrated groups of people that might that are interested in the same things so i was at any sort of relevant event i was there any sort of groups that i thought would be helpful i was getting you know i was getting my message out and really i was using that you know my so linkedin to kind of share more what i care about but that's not where i was finding the people right um and and there's never any certainty it was going to happen but I knew that that's what I had to do and in the first week I got some applications I wasn't crazy about and the second week I got some applications I said hey this is cool people who'd started their own funds like incredible like technical people you know all of this and it's um I can speak a lot about how founding a co-founder is like dating and how all of this but um and i thought in this thing of where can i find excellent people i know that babylon brought together had a big vision and brought together exceptional people and so i was introduced to someone i also had i had a whole interview process like multiple stages of how people go through it but i also had a rule if we were if i was introduced by someone so a friend of a friend or a colleague they immediately skipped to the first intro call yeah and i had an went over by like an hour and yeah and yeah I remember getting kicked out of the booth when we were on oh god I need to find another place um and to be honest I hadn't really looked much into her background or anything at that point I had no idea but I think one thing I found quite scary almost is she gave a little description of I think this is what you want to build I was like how do you know that because I haven't said it she was like I just had a look at some of your stuff and I have a feeling this is what you want to build and this is exactly how i think that it's my same vision and that was incredible because we think very differently we come at it very differently but the way that we want to build a company and the change that we want to make is exactly the same and that period of time between deciding i am going to find a co-founder and meeting amanda felt ages and ages though if i go back to our emails i think it was only a few weeks but it felt like a long time but obviously there was you know and then we tested working together and we figured out you know how how what is it that we want to build yeah how are we going to do this it's really it's really unique well I say unique I'm sure other people do it it's not something I hear very often which is that someone has gone out of their way to run an interview process to get a co-founder it's a really interesting take on it because I think so many people rely on the serendipity of that and they'll put themselves in the right places at the right time and they'll go to the right events and they'll speak to people and that's generally the advice that you tend to get and probably the advice that I've tended to give to be honest to actually go full like I'm going to solve this problem by running an interview process which is obviously the most efficient way of doing a certain thing to certainly get employees you wouldn't you wouldn't go for serendipity to get employees of course you would run it but it's interesting it's interesting do you think what what do you think were the positives and negatives of doing it that way versus yeah that's also like my that was where I was at and like this this is how I'm going to do it.

36:38But I mean, it's also, at the same time that I met Amanda, it's not like she was just there waiting to be found. She was thinking, you know, after she left Babylon, she was a CCO and COO of Babylon at some time. And then she left and the job that she did before we founded Hester Health Together, she was the managing director of Europe and the Middle East for Airbnb. Right. Right. So she wasn't just twiddling her thumbs at home like, oh gosh, I wonder what I'm going to do. She basically came out of Babylon and was like, I've got the health bug and it's kind of annoying because once you know that you can improve health at scale she knew that's what she wanted to do again she was also thinking do I want to start something do I I think and I think she was thinking yes yeah and one of the one of the kind of beliefs she came out of from Babylon is that if I do found something I don't I'll do it with someone else and if it's in health that someone else has to be clinical so you know I've shared there like what my side of thinking there's so much more you know I'm not going to speak for but there's also a lot of thinking that meant actually it seems very orchestrated but actually it's a case of right place right stage right time being introduced i do think you can work hard to increase your surface area with like luck and opportunities definitely yeah definitely so that i i don't know i think that's what i say to that so what was the idea at that point and how did that change when the two of you came together we were looking at a few things i think i think before we talk about idea i think we have to we the best way to explain it is what do we believe to be true and then where do we go from there to find a good place to start right um and i think there's a couple of things i think one we have i'd be interested to know what you think about this i think we have got a healthcare system that is predominantly focused on single organ disease so like if you've got a heart problem you see a cardiologist if you've got a problem with your liver well i'll go i'll go one stage before gp what one problem please well yeah and but i feel bad i feel i feel so bad for gps i i don't think i could do it because there's a 10 minute appointment you have so much that's put on you you know in primary care you have increasing amount of work that is put on you at the same time diminishing amount of time and resources to fulfill that work it's part of the same problem it's part of the same problem yeah and i think we've got a few exceptions to this concept of single organ disease one of them is primary care but the thing with primary care is that it's so resource limited that you can't it's very difficult to provide that kind of comprehensive health care we also think well i think just on that by the way i was actually explaining to someone the other day that um you know a person that's not from health care medicine and just sort of expressing their frustration at going to the GP and I just explained like I just said to them I'm just going to tell you a story that's just going to highlight the like how how ludicrous this is and how difficult the job is we are taught how to examine a system like the cardiovascular system or the respiratory system or the GI system we are taught to examine that system how long do you think that examination takes and before you answer the question i want you to bear in mind that a gp appointment is 10 minutes long right how long do you now think it it takes to examine a system and now what if you have two systems that need examining it at the gp so right and then we talked to that through that obviously the length of examining a system is longer than a gp appointment so like i was like don't don't knock gps come on but we're also spending so much more on health care people are getting sicker and actually with people getting sicker you've got one person with multiple health problems so how how yeah we've getting yeah more and more of the population have got more than one health problem at one time but we're still stuck in a system that can only deal with one problem at one time yeah and that doesn't speak to each other so i would agree is the conclusion yeah like it doesn't make sense but i do think because i always think there's so much you can learn from health care is there are a few examples there are a few exceptions if you think about babies and children and people who are end of life we do take people as a whole you know i've got one of one of the kindest most competent women that i know is a geriatrician and she will pick up her patients she'll scoop them up and she'll fix all of their problems one by one and she knows that they're connected to each other well it's true isn't it because even the history taking i can remember the way we're examined in paediatrics was you wrote a problem list you didn't write presented complaint you wrote a problem list older adult care you think about okay here are your problems right now here are the problems you might have later what can i do to help you now to not only help you the immediate problems try and prevent some things later what's the risk of that you know there's a real element of thinking about things as a whole i also think we do this quite a lot in pregnancy a little bit so i think the first thing is we're moving away from single organ disease right like we believe that health care we think that in order to win in health care health care should be integrated so that's mental health or pelvic health you should be seen as a whole that's the first thing so before we got to an idea like what are the things that we believe to be true that's the first thing healthcare should be integrated the second thing is that we think in order to win in healthcare as a company is that healthcare has to be end-to-end not one more diagnostic that's like here's one thing that's going to tell you if you've got this problem but now you're spat back out into the same system to piece it together not an app that tells me i've got irregular periods but i have no idea why i'm still back onto a waiting list to figure out how to access that care that you have to see that whole process through and that's the second thing the third thing is that we still have health care that relies on people knowing that something is wrong you have to know that something is wrong before you seek care in in the nhs you go to primary care if you're accessing care privately you then not only have to know that something is wrong you kind of have to self-filter hold on a minute what kind of wrong is this to find the right care and i think why can't we have a health care system like imagine if you didn't have to know that anything was wrong you didn't have you just had to you would have a health care system that worked for you this is all very big right and you can't build a brand new health care system all at once and so we thought in what way where do you start in a way that brings together best in class technology best in class clinical pathways best in class way to deliver actual compassionate care and there's a real thing about what we're building here is health care it's not an information app it's not wellness it's care and that's something i saw as a clinician actually people like oh you're working in pregnancy isn't that saturated you know how many pregnancy apps it's a good you know how many pregnancy apps does your wife use in pregnancy james actually what we're building is not telling you what size fruit your baby is right and what i saw as a clinician is you've got all of that and it is saturated but when you need care you come to me you come to clinicians and there is a gap but we know this we've got so many we don't have we can't meet that demand and so with all of that in mind we thought okay where do you start and we think postnatal is a brilliant place to start for loads of reasons which i can go into but it's kind of those are the things that we thought to be true and then where do we start to focus in to prove out some of those things and i can talk a bit more about why postnatal health is brilliant and there's so many there's so many things we can get into there but this fundamental belief that if we can win here we can go on to win in so many other places in healthcare yes and actually this ties in so nicely with what I've been thinking about for a long time and and last year in May when um I or this year in May I should say when I went to digital festival in Australia um I keynoted on this of like what is perfect healthcare because if we don't know what perfect healthcare is we don't know what we're aiming for is perfect healthcare perfect diagnosis and perfect treatment or is perfect healthcare perfect patient experience or is it both i've got i've got strong beliefs actually this is actually what we this is in all of our this is why why why we're building what we're building at hester so i guess we have a we have a fundamental as to we are a company that has a fundamental belief that every single person on this planet should be able to access excellent healthcare.

44:52I define excellent healthcare as two things. One, healthcare that improves your health outcomes. And two, healthcare where the experience is also excellent. There we go, we're on the same page. I think generally you have systems and provision that index on one over the other. Yes. Now with this belief, which is big and huge, we're on a mission to close the women's health gap, right? What I mean by that is that you've got more than half of the population that spend about 25 of their lives in poor health and that's not poor health when you get into your 30s or your 40s that's poor health across every stage of the life course right and so there's no surprise then that you know you're losing one trillion dollars every year in economic loss because of loss in productivity and women are unwell but you know and there's so many reasons you know we about how women's health is underfunded and we don't there's so much that we don't know but i've got a question for you james how much of the women's health gap do you think is like is made up of sexual reproductive health maternal health and obviously i'm asking as an obstetrician and gynecologist um as opposed to what like of uh i don't know think about other types of health care maybe it's cardiology other things like that but how much of that gap is made up of sexual and reproductive of health the majority about five percent wow if it makes you feel better i've asked that question on like wow on stages full of clinicians and policymakers and people don't know that it's which is on one hand it's like groundbreaking but on the hand on the other hand of course it's not because surprise surprise women are more than just our wombs and our ovaries and i remember this I remember when I, my boss at the World Health Organization, it was years ago, he said, what's the leading cause of disability, Sajita?

46:47Like, I don't know. I think I said something that wasn't right. Depression. Wow. Now this has changed. It's not depression at the moment, but is that in the top five causes? Yes. Obviously there's some time between COVID overtook it. But, you know, our leading causes are the same things that we spoke about. You know, when people have got more than one condition, your chronic conditions, their cardiovascular disease. those longer term conditions that's the same things that are killing women that they're also killing men right like it's not but it also are there differences in physiology like we when we think of women's health we only think of wombs and ovaries and we actually think that well one that a health of half more than half the population is not niche and also there is so much more to what women's health is and needs to be than it's just sexual and reproductive health and i think you know we spoke about this of what we're spending more and more on health care as people are getting sicker and sicker and we need to find a new model to a new model of health care that addresses those problems our starting point is a health care system that wasn't designed for us so how then how do you design for us how do you design for women health care that is proactive how do you design for women that's healthcare that doesn't pick up one single organ but treats them as a whole and how do you design in a way that is scalable that can actually address the health of millions of people and i think that's what that's what we're trying to do that's why that's why um postnatal healthcare is a brilliant place to start um for most people they go through health they go through their lives with most women before they're pregnant don't have that much interaction with the health care system then all of a sudden i think the nhs does maternity care lots of people there's an inquiry going on right now right and there is so much that needs to be improved in maternity particularly i feel bad for my midwifery colleagues who come on and don't have half the staff but there is one thing the nhs does well is that we've got a proper plan of antenatal care that everyone has access to right and some of that is a bit preventative we figure out what complications you might have but for most women they go from not having much interaction with the healthcare system to having all these tests and investigations done right and then after birth everything kind of drops off and we hear this again and again you know people telling us i just got home with this new person in my car seat and i felt abandoned you know and it's a great place to start because there are so many issues You know, if you want to treat someone as a whole, we've got an increase in mental health issues, pelvic health issues.

49:25But not just that. There is so much data that tells you what someone's likelihood of longer term health conditions are. If you have gestational diabetes, your chance of getting type 2 diabetes is tenfold. We know this and we're not doing anything about it. And so, you know, I spoke about depression being such a leading cause of disability globally. But up to two thirds of women after pregnancy experience some form of mental health difficulty. and I will never forget the words of a woman we spoke to in our user research um I'm going to call her something else because obviously I cannot breach patient confidentiality let's call her um I don't know Katie and and Katie said I don't know what happened but I just I cried I cried for weeks and weeks I just stayed at home I didn't talk to anyone I didn't know what to do and I was talking to her a year after this had happened and it was in that interview she was I think I was probably depressed I just didn't know what was wrong and the thing is that is this is not new Katie's not alone there's so many people like her the leading cause of maternal death in this country in that first year so from six weeks to the first year is maternal suicide and there's a spectrum right because obviously that is not the incidence of that might not be that high but then there are people like katie who are still suffering you know so it's so common and i think what we have a chance to do and this is what the funding gives us is we have a chance to not just try but we get a chance that has to bring together the best clinical pathways bring together the best technologies that care pathways to change the lives of and the health of women like katie to change the health of families like yours James families who've had a baby eight months ago and that will not just impact families but also society and that will bring us great economic return and I think there's there's this huge thing about impact here that it's not just a woman or the families that there are great societal impacts of intervening at this life stage and you know this whole thing about preventative health care is that I don't know if we figured out how to fund that yet we're giving it a big swing but what we think is that we're creating a new front door for healthcare where you don't have to go to primary care you can access care from your home and figure out we figure out for you what you need you don't need all you need to know is have you been pregnant in the last two years a new front door for healthcare that figures out what you need what those needs are and we think we can deliver a lot of that digitally but then also a backdoor for preventative healthcare because we've got a lot of data based on pregnancy and postnatal to actually suggest what your risks are and what needs to be done for you and that's yeah as we said it's a pre-seed round so we're still very early on but it's yeah I guess very well funded to figure out the details exactly um I think there's so much in there that that just needs talking about for a second because I think that well let me start with the thesis right the thesis that women's health is about more than what many people will think women's health is about i.e the organs that separate women and men they obviously have health systems that behave differently to men across everything else that makes them up and that obviously isn't getting the attention historically it hasn't got the research it just hasn't had a health system built around that i think that just needs to be highlighted for a second because that needs to sink in for people right like yeah i think it's very easy for me as a man to say like oh yeah like i'm sure women's health yeah that's just the women's health organs as i just did right um saying and i'm because we've been trained by the same system because we've been trying well yeah there's there's there's i can yeah make a few excuses i guess but ultimately it is what it is and i should do better um i think though that part of what I like about the thesis is better outcomes and better experience is what you're aiming for and I think experience is so important when we're talking about this and I look at my wife and co-founder Jessica on this who has had a baby eight months ago that I can tell you that gap that you mentioned about you go home with a new person in a car seat and you bring them into your house you left us two people you come back as three and then you feel kind of like oh like what what do i what like what and bear in mind i'm a medic jess is in health care we're both in health tech like we're we're fully informed on so much i did a neonate's job for god's sake like and i've got a neonate and i'm still a bit like uh but what i can say is that on a positive note for what you're building so jess has had jess had um we were i mean levi was undiagnosed breach and like you know there's just a few more bits and bobs in the surgery but like she had a physio when we we've you know paid for a physio and to to just to just come up but that you know that that person is then the confidant is then the is this normal is this okay is then the person who you see regularly for some continuity that's part of the healthcare system that can answer these questions and crucially it is someone who actually cares so as the patient as jessica you get the feeling that someone is looking out for you and that someone cares through what is a very strange handoff between heavily monitored in that c-section room versus at home with absolutely nothing which is a which is which is a crazy delta and i think this back to you know what i was talking about in australia was like human empathy in whatever system we build next and go into is so so so important and this is science backed because increasing human empathy means better history taking better delivery of a history in a dose dependent fashion of how much empathy they are feeling means a better history is taken hospital stay reduces in when the majority of interactions have got more empathy than not bettering better adherence to treatments increases when there is more human to human empathy because again it is the feeling that someone cares and someone is over it and someone it's going to matter to someone it isn't just me if i don't do this so and there's there's lots of different things but i think having just been through this with jessica and not wanting to speak on her behalf too much but like i i can see the importance of how this is built because yes i get it we can talk about perfect diagnosis and treatment we can talk about the gap in the data and how this can address that and the gap in the delivery and the gap of truly understanding what's going on in women's bodies across all their systems yes all of that incredibly important yes i agree but i also agree that just as important is to look at this experience thing and just go hold on a minute like we're going a certain direction in the way that you know the nhs broadly can care about this it can't distribute the resources into prevention as much as we want we can't look at the whole body as you've talked about so actually by focusing on this experience thing we can start to see a positive cycle of like better experience more empathy better history better diagnosis better treatment better experience better history but like that that's the sort of flywheel that i'd like us to get involved in the next iteration of healthcare if that makes any sense oh 100 i mean that really simply there's value in care and there's value in that experience um and i think for too long actually we've we've deprioritized the value of like experience and how someone feels when we think about healthcare it's tough to write that down on a spreadsheet it's tough to get roi on that yeah it's but you know something a question i'm thinking about i don't have the answer to but we're figuring this out like every day is you know old school health care where you felt cared for right when you're in your gp practice and they've got a fish tank in the waiting room and it's the same gp you've seen the entire time you've got magazines exactly you know but there's something about that where you feel safe and you feel cared for how do we create experiences like that again how do we create experiences like that digitally but also in person you know we're building hybrid care it's not just digital we don't believe that you can win in healthcare just digitally but how can you recreate experiences like that and i think the first thing is to value care and value experience and the second thing is to think about how you can do that and i mean you know amanda comes from a background not in healthcare but she has built you know and scaled some of the world's biggest successful most successful businesses but before all a lot of that was around human experience actually you know she comes from airbnb we're actually priority is there's a lot of priority on how do you prioritize the user experience so i think there's a lot to learn in healthcare from other industries around this that maybe we don't have to have the answers internally well i hope you can get there sooner than the rest of us with with this backing that you've got So two million raised pre-seed.

59:03Pre-seed often can mean, oh, we've got an idea and here's some money to build an MVP. It can mean I've got an MVP. So whereabouts are you guys in your kind of company journey? And what is the goal to get to before the seed round? Well, I'll tell you that our goal before the end of the year is we're going to launch our first version of the service this side of the year. Amazing. We are sprinting. Before the end of the calendar year. correct oh okay we are interesting you say that james there's two types there's two responses to when we tell people what we're going to do there's two types of people someone people who go oh that's that's hard and there are some people that go that's crazy how can i how can i be a part of it you know our our lead designer just sent me a sent me a little meme or little photo that he saw he was all it takes to change the world is a plan and not enough time he's like does that remind you of anyone that we know that's so nice so yeah i think yeah our first we need to we need to build the first version of our server the first hester version one and we need to learn as quickly as we can you mentioned that the system hasn't figured out a way of paying for this sort of thing what's your current thesis on it like where do you think that lives are you in the camp of like people that can put their hand in their pocket should and that or could and then therefore we can build a case and with that case we can then look at different models later is it a systems thing is it an employer's thing is an insurer thing but how do you think about where this business model comes from for preventative health care yes or hester health specifically however you want to answer it well i think the first thing is one of our values is that we are building for every woman so this thing of people who can pay for it that's okay and that's where we have we are going to stay and that's where amanda and i will walk away saying we've done a good job it's not the case we're building this for every woman because um how we get there that's what we have to figure out so that's the first thing to say about that my background was in health equity you know that's actually one of the things we came together on so that's you know and we fundamentally believe that it can work i think the first thing to say is i can't quite understand how it's working at the moment what are we going to do we're going to get people who can afford to pay for like generalized health tests to just pay for scans of everything and tests but then what where do you go from there and also how do you max out what happens when you max out of the kind of people who can pay for that and also is there this argument of the people who are paying for it you're self-selecting people who need the least amount of health care so how much impact are you having with that yes yes that's what i think i don't have the answer in that but that's what i think so how far can you get with that i think our main thesis is this is this thing about the front door and the back door together is that we're merging reactive health care we're choosing this time you know like you said james when you came home with your car seat is that the same time when all of your like what health needs go up right women have got more mental health needs they've just they've got they might have birth trauma they might have physical wound trauma they're recovering from all of this immediate rise in health needs at the same time that the system's ability to provide them drops off right so you've got reactive health care needs but also we're merging that with proactive health care at the same time and i think actually finding models where they kind of merge together is what we're looking into at the moment yeah i think it has to be i mean it's a very sensible way of talking about it because there is there just isn't an obvious answer is there and i imagine like when you've looked at this in your previous work we will get there i think globally well that was going to be my next question actually of like how optimistic are you that this can be found I think the pragmatic answer is we have to get it.

1:02:49It has to be, yeah. We can't keep spending the way that we're spending with people getting sicker without us figuring it out. Do I think in the UK that model of care or solution is going to come from within the NHS? I'm uncertain. And the reason I'm uncertain is this is a system that was built a while ago and things have changed. And I think what the NHS does exceptionally well is life and death care. you know and that's where we do life and death reactive care in the nhs excellently but that preventative longer-term style of care maybe that's the scope for us innovators us academics to kind of work together to figure out that externally and then see how that fits into broader healthcare systems yeah look you know how can if your house is on fire how can you go and put some seeds out to grow in the garden very true very true um i have a I have a question on this because I've been doing a bit of desktop research around longevity.

1:03:53And like what, what longevity means like this continuum of like prevention and longevity at some, at one end of the scale, it's, it's, I say this in jest, but many a true word said in jest like billionaires wanting to live forever, doing weird things. and at the other end there's like screening programs let's just call it as like so so the real extremes right and it feels to me like there's this continuum and somewhere along that continuum there's like people just regularly blood testing and correcting potassium even though your kidneys do it um there's another end there's people that are doing all like red light therapies or like all these weird and wonderful things at like that end but then but then there's like a there is an interesting middle for me of where the research of doing certain things will optimize one's health but at the same time like there's optimizing health but there's also then preventing bad things from happening and those two things just seem quite separate but the the longevity group of people seem to be trying to find these interesting ways to kind of fine-tune the healthy body and prevention people are trying to prevent bad things but i i just wonder if there's an overlap somewhere of all of this and a business model in this because ultimately it's the same thing it's like pay for this thing and live longer prevent a disease or whatever it is but how do you feel about the word longevity and how that plays into what you guys are up to or that world or all of that sort of stuff i definitely agree in this idea of a continuum i also think there are phrases that come in and out of fashion so i'm interested to see in five years and ten years how we discuss the same content of what we classify as longevity now yeah then i think is the first thing i think that you know one of the things that drew us to why we're building in this current space is is this the middle ground for can we deliver care in postnatal that maybe five years ago we would have said we don't need to do but now we're saying if you do that you can actually prevent longer term health comes is that a good place to start of where do you mix that together and actually there's there's another thing of it's not i'm always looking to see are there examples of where we try to do this before i think you quoted your neonatal or your consultant before that when you're pregnant you're not sick you're not sick but you receive health care yeah right so we do know how to make it work that's interesting yeah that's interesting when you're pregnant you have all these tests and all these things done and for a lot of people they might be sick but for a lot of people you're not sick and we've still found a way to deliver health care which is a great place because that's why we're adding in our postnatal right after that because it's kind of already a little bit accepted to receive health care when you're not sick so i mean in summary yes that we have to figure out a way to make it work but maybe it's not that far away as we think you're right this is all and i will come back to the i'll come back to old school stuff you know what do they teach you in global in public health our job is to ask not how do we get you out of the river but how do you stop people falling into it in the first place it's the same stuff that we're trying to do it's just you know maybe billionaires are solving for the same thing but they've got access to a few more resources you know and also i think we've also got the and this is where the role of academia and evidence generation comes in of what are the new things that we can do like what are the new ways that we can intervene to um reduce longer term risk you know i mean some of the um there's new evidence coming out now that if you've had high blood pressure in pregnancy we know that you're at longer term risk of chronic hypertension right that's the thing we know that but we don't the way that that's handled over at the moment is truly disjointed and people just come off their blood pressure with not enough longer term management but there's more evidence as there actually if you give some you know aggressive blood pressure management in that first year you can reduce the risk of longer term chronic hypertension so like that you know it to come back to our what's the role of academia in this is we have to ask the right questions and get the right people to answer them to fill in this into me like you know moving on from just screening and then alongside when we're figuring this out we need to figure out how much it costs costs us long term like what's the cost of not intervening versus what's the cost of intervening as we continue as we make the case for why we need to do this do this at scale and for people to listen to that as well and for that to be displayed or said or presented in a way that actually leads to action as well because i think that's the thing with those statistics is that particularly if you've ever been you know ever been in the investment side of the world or any of that stuff getting sent deck so you know an investor said to you once like if i if i added up all of the total market sizes of a single day of investing i'd go around the world like 12 times or something like it's um that tam's lined into yeah exactly exactly exactly right so it's it it's true that we can cry wolf a lot of this stuff and actually to think to to find what are the versions of that that will i don't keep using jargon like move the needle or is the low hanging fruit or like all that sort of stuff right like i i think that's the tough job and um it's funny actually i i just before we came onto this podcast i was um i was doom scrolling on tiktok before i came on this podcast let's get real and i came across this like biotech creator that was just in a lab pipetting and she's turning to camera talking about how talking about ai and drug discovery right yeah i'll send it you she's brilliant um i looked through a load of her videos not and i was just and i was learning things and i genuinely learning things and i was like wow and she was saying what's important what's important and why it's important and then all of a sudden i'm like oh i'm i now think that's important and that's that's really important because this person's now done an incredible job of like a modern communications channel of like changing my mind on something that's cool because that's what you guys do and you're learning from other people yeah this is it this is why i can pass that off as work that i'm just doing and just i can sort of be okay with it um just sat at my desk when I've got like a whiteboard of like urgent and important that I'm just like oh god can't do that for the next five minutes.

1:10:31I'm doing communications actually guys. I am literally just doing communications yeah absolutely I'm learning from the best but I think that that stuff does become important I think the way that that stuff is then communicated and actually things like developing a personal brand and you're developing influence and all the rest of it and you know you've done so much of the hard work in what you've done in your career to give you the accolades and the you know the letters after your name and before it that make people stand up and listen and then to be able to do the research that actually says yeah we should look at this because if we do invest in this in prevention it will save this amount and a logical private organization would a hundred percent do this if they had an infinite view perhaps we should do that so you can perhaps stand out as um as one of the people that is crying wolf legitimately i guess i guess my point was around like the value of communication there and actually the value of um doing that in such a way when everybody is trying to say the same things of like how do you divert resources to you which you're clearly very good at because you've got two million quid to solve this problem yeah it's both it's both a lot and it's not health care is expensive and to do it properly you know a good question is uh you know i talked to other people who are building in health tech is what is an mvp in health care how minimal is minimal what do you do to stop them halfway through the process what about regulation it's one of the issues i have with health tech that it's it costs so much to bring a product to market which means uh go one has to get a load of scale and that's a problem because you don't get local solutions for local problems because local scale is not enough to sustain a business once they've raised VC money and that's that's a big problem that I have with healthcare that if we can drop the cost of what it takes to bring a product to market we can drop the requirement for scale and therefore we can get local solutions on local problems and I think that that is that's a big honor for me it's not realistic in any way shape or form but I was gonna give a pessimistic answer there what about all those people use companies about getting people to market who exist giving you all that advice but i think that you know healthcare does need to be treated with the nuance that it deserves of i can't just well i could just put together a little i could build something on lovable and you know ship that but what am i actually testing there not where the value in the company lies yeah so it is it's a higher um barrier to entry but i guess fundamentally we believe that the returns are worth it and also don't take that at high value you know at face value what can you do to get to market quicker in a way that's still safe yeah we've got a minute left i will ask you before you go what's the thing that you're most excited about as we sit here right here right now today is it is it an element of the product is it is it a conversation you've had recently is it uh statistic is it a thought what what's what's most exciting as you sit here now when we have the fast woman through our service that i i'm but you know someone asked me are you are you someone we interviewed actually um asked me are you are you guys stressed do you feel the pressure now that you've got you know investors and a board it's a good question and and money Are you concerned because now you've got two million to do something?

1:14:03I was like, no, finally we can do something, you know? Like, I mean, we are, like I said, we incorporated in May. So when I say impatient, like we've now got the money to go. But what I am, what I am like will lose sleep over is when we get that first woman through our service, not only am I excited because this is exactly what we're doing it for. that's actually why i will lose sleep over awesome um so jesus this has been an absolute pleasure it's also been an education and um i really appreciate you coming on thank you oh a pleasure