When Dawn Primarolo, as a Health Minister, gave evidence to the Lords inquiry into genomic medicine, she said that for all its potential, most of the benefits it might have for patients remained at least a decade away.

The peers were diplomatic. “The minister’s belief . . . contrasts with other evidence we received,” they said. The verdict of Sir John Bell, a senior doctor, was blunter: “That’s absolutely crackers.”

It is hard to say how quickly advances in medical science will be applied in clinical practice, but the Lords’ report makes the “other evidence”, such as Sir John’s, pretty compelling. Insights from the human genome are starting to influence care. The speed at which discoveries are being made is matched by the falling cost of DNA sequencing technology. As Sir John told the committee, genomic medicine is going to be ready for application on “a very short time frame . . . certainly within five years”.

The development of genetic know-how into medical tests and treatment is only one of the barriers that must be cleared before patients can start to benefit from the growing understanding of the genome. Just as important will be the structure of the health service, and the skills of those who work within it.

While doctors receive some training in genetics, they are taught principally about single-gene disorders such as cystic fibrosis, where a rare disease is caused by a major mutation. Most genomic medicine, however, will involve assessing how dozens or hundreds of genetic variants predispose to common diseases, or affect responses to drugs. Interpreting this information will be difficult, and doctors are not trained to do so.

Genomic medicine will also rely heavily on IT, both for storing patients’ DNA data and for running software to interpret them. Some hospital computers make it hard for doctors to send e-mails, let alone conduct a genomic analysis.

It isn’t likely to be practical for every hospital to do its own sequencing work, so a network of specialist hubs will be needed. Genetic tests will also have to be clinically validated, so doctors know they do what they claim to, and that they are sufficiently cost-effective to be worthwhile. No structure for achieving this yet exists.

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