The BBC's James Wilkinson on medicine in the millennium

Doctors have described their view of the brave new world in a book, Clinical Futures. Here, patient power will rule following a revolution in doctor and hospital care.

One of the publication's two editors, Michael Peckham, said the NHS was currently "too hospital focused" and would move out of the surgery and into the home.

We could be living in an 'intelligent house' that electronically watches over all household functions, such as cooking the breakfast.

We could have implants in our bodies that monitor blood pressure and heart rate and provide us with an early warning of symptoms of ill health.

Internet doctors

Professor Marshall Marinker: Genetics and IT are the most powerful drivers for change

We will be diagnosing ourselves through home testing kits and the Internet and interfacing with specialists through the television set, according to David Delpy, professor of medical photonics at University College, London.

Doctors may become de-skilled as patients gain more power over their illnesses and computers are able to accurately diagnose disease.

And those who do not look after themselves could be penalised with higher insurance premiums.

Professor Delpy says patients could be describing their symptoms to a computer before seeing a doctor in just 10 years.

Robots could replace surgeons for simple repetitive surgery.

Professor Delpy believes the 'intelligent house' will be of particular use to the elderly and disabled and will help them to live more independently.

He also predicts the development of implants, including brain implants, that can become like living tissue, instead of inert material - as they are now.

Brain check-ups

Leslie Iversen, a professor at the department of pharmacology at the University of Oxford, foresees a world where we have annual brain check-ups to diagnose the early onset of diseases such as Parkinson's, schizophrenia, Alzheimer's as well as drug and alcohol addiction.

Annual brain check-ups could show the early signs of disease

Tests can already show the changes in the brain caused by Parkinson's, which affects 1% of the British population aged over 65.

It causes tremors, facial paralysis and movement problems.

Professor Iversen said that, if symptoms are identified early enough, steps could be taken to ensure the disease did not progress, such as implanting healthy new cells in the brain.

He also predicted cures for spinal injuries and possibly for deafness and blindness.

Professor Karol Sikora of the World Health Organisation predicted a "golden age" of cancer drugs and new screening tests for the disease.

A note of caution was sounded by Catherine Peckham, professor of paediatric medicine at the Institute of Child Health in London.

She said that in 50 years, there will be more screening of foetuses for disabilities and genetic factors thay could make people susceptible to disease.

This could lead to increasing discrimination against the disabled.

She added that many of the brave new world advances could create greater inequality between the rich and the poor.

Body implants, intelligent houses and Internet medicine could all be out of the reach of many people.

"Gaps could widen and we have to be very aware of that," she said.

Ethical debate

She called for a public debate on the ethics of future developments and the likely emphasis on medicine and pills to sort out complex societal diseases, such as anorexia and obesity.

Her vision included the possibility of an increasingly punitive attitude to parents who did not bring their children up in the standard healthy way.

Embryos could be screened for many types of genetic flaws

The scarcity of children, because of the ageing population, could bring a greater premium on the young with some being 'confiscated' from 'bad' parents.

"We cannot ignore the social context in which children live," she said. "People need to be aware of the developments so they can debate them and influence things that will happen."

Some chapters from 'Clinical Futures' are published on the British Medical Journal Website.