Labor is pushing for digitization and has pinned its hopes on NHS renewal to AI. But the shadow health secretary should understand that there are no easy wins in digital transformation. Digital Health Editor-in-Chief Jon Hoeksma
Shadow Health Minister Wes Streeting was the keynote speaker at last week’s NHS ConfedExpo, a sign of a changing political tide. All the more so that people paid very close attention to what he said.
And his remarks were interesting because he was firmly committed to digital, AI and data as key enablers for the modernization and renewal of the NHS under a future Labor government.
Much of his speech was about training more doctors and nurses and investing in buildings, but these are perceived as long-term goals that require both time and investment.
What is remarkable about the focus on digital and data is that they seem to be perceived as offering the potential to significantly improve health in the short term. AI, in particular, seems to be perceived as providing more immediate results without the need for upfront investment.
The logic seems to be, “There are a lot of startups and megatech companies working on AI in healthcare, so let them do it.” Rather, they forget that they all rely on the NHS and other health systems to pay their bills. service.
There is no question about the enormous potential of AI in many areas of medicine and care, and the growing concern about AI’s potential risks and harms. The more digital and data-rich the NHS, the greater the power of patient data to inform care, planning and research.
Wes Streeting, Shadow Health Secretary
get the basics right
But AI is not an island. It’s just one part of a complex digital ecosystem that remains entrenched in the not-so-glamorous world of hardware, infrastructure, networks, and of course many IT, digital, and data professionals. Getting the basics of IT right each year is just as important as the latest shiny and exciting AI apps.
Can the Trust provide staff with laptops running a Windows operating system that will never reach end of support? Can care home staff access basic patient information through shared care records? Are networks and medical equipment protected from cyberattacks? If so, can the organization restore service? Does the Trust run data centers that literally melt down when summer temperatures rise (as happened at Guy’s and St. Thomas last July? like).
Of course, the reality is that boring basics and cutting-edge innovation need each other. However, some health services organizations in distress often decide that they need to stop investing in the underlying IT infrastructure they rely on. Digital and data have become so critical to modern healthcare operations that it’s about the same as deciding to stop paying for utilities, medical gas, cotton swabs and sutures.
chronic underinvestment
The problem, as Derek Wanless pointed out in his 2002 review of health and care of the same name, is that, at a macro level, the NHS is not investing enough in IT each year to take full advantage of the benefits of digital. is. Metamorphosis; as a result, the pace of change and modernization has consistently slowed down, making it less rewarding than it otherwise would have been.
Interestingly, the last ‘new’ Labor government came to much the same conclusion as Street, that better IT and digital tools were essential to enable the reform and modernization of the NHS. At that time it was called computerization.
This has led Tony Blair to defend the £12.7bn NHS National IT Programme. The program has brought millionaires to some technology suppliers and management consultants, but has largely fallen short of its grandiose aims, as a subsequent State Accountability Office investigation revealed. Perhaps unsurprisingly, Streeting did not mention NPfIT in his speech. Perhaps it’s selective amnesia, or perhaps there’s no one left in the health team of young workers who even remembers it.
This is unfortunate. Because future Labor governments who want to use digital technology to improve productivity and patient outcomes in the NHS will find what works when the new Labor party decided to computerize the NHS nearly 20 years ago. There are potentially valuable lessons to be learned from NAO’s report on what happened. .
too focused on technology
In particular, NAO concluded that too much emphasis was placed on procuring technology and too much on its successful implementation and organizational transformation. As the old Sawtooth says, “Culture eats technology for breakfast.”
Another major failure was that it was a bureaucratic, secretive, top-down, highly centralized program that often failed to secure local clinical buy-in and leadership. That’s it. Over time, we failed to realize our central vision of a unified electronic patient record and became increasingly disconnected from reality.
Lessons learned during the Blair administration
Wanless, Blair and Prime Minister Gordon Brown were fundamentally right in the early 2000s, leading to a sea change in NHS productivity and a waiting list (a record level at the time under the previous Conservative government). ), you need to invest a lot of resources.
It’s worth remembering that the 10-year £12bn NHS IT program is just one part of a larger series of related investments in hospitals, staff, equipment and waiting list initiatives. The New Labor Party basically threw everything they could at the NHS to turn the tide. And while it ultimately proved to be very effective, waiting lists and waiting times were significantly reduced, ironically, it was too late for IT to be as effective as it hoped it would be. was.
Twenty years later, the similarities are clear. A decade of Conservative “austerity” and job cuts left the NHS remarkably ill-equipped and incapable of responding when the 2020 pandemic hit. The waiting list, which had been on the rise before the outbreak of the new coronavirus, surged and continues to grow. The pandemic is officially over, surpassing 7 million and counting.
undo the damage
Serious about repairing the damage done to the NHS over the past 13 years and putting it in a position to meet the health challenges of the 21st century, the new government is committed to sustaining the expansion of the NHS’s capacity and workforce with investment. strategic investments will need to be prioritized again. In IT infrastructure, digital and data functions. A concert needs everything.
In a different situation in 1997, the next Labor government is likely to tighten Conservative spending limits to demonstrate fiscal discipline. But there are grounds to argue that urgent investment is needed as the NHS faces the kind of meltdown feared during the pandemic. Remember, the current government has spent £30 billion on testing and tracing alone. The total cost of fighting COVID-19 in the UK is estimated at between £310bn and £410bn.
It’s easy to understand why politicians like Wes Streeting and his advisers are drawn to AI. AI appears to offer a panacea for the complex and seemingly impossible problems facing his NHS in the UK. AI undoubtedly has a role to play, but it is not in isolation, and it is not possible without sustained strategic investments to expand the broader capabilities and capabilities of the entire healthcare system. .
