Comment Blog 17 January, 2017

Who won the NHS “crisis”?

The NHS “crisis” has blown itself out after a whirlwind week. On Friday 6 January, the British Red Cross identified a “humanitarian crisis”, leading the organisation to provide its own ambulances to transfer people to and from hospitals. Jeremy Corbyn devoted his six PMQ questions to the NHS on the following Wednesday. Jeremy Hunt gave a statement to the House. Finally Number 10 Downing Street briefed on Friday that it would enforce the existing financial penalties on GPs who do not open for extended hours.

In the middle of all this, Theresa May gave a speech on mental health; various people reported that Number 10 and Simon Stevens are at loggerheads; and (if I may say) the BBC Daily Politics published a film by me on the potential of new technology, including AI, to deliver better care at much lower cost. It was a memorable few days.

Theresa May just about lost I think.  Her speech succeeded in drawing attention to a relatively neglected area of healthcare, which had real value. It did not, however, engage with the real questions of NHS reform: how does the system work together (or not), what drives the system to work in certain ways, what aspects of that system needs to change. For the same reason, she lost the exchange at PMQs, because she did not explain how the over-crowding of hospitals could be solved.  Interestingly, she did then move to an argument on system reform, because longer opening hours for GPs should ease the pressure on hospital admissions. If she continues with these kind of arguments from now on, fantastic.

(The Prime Minister was perhaps too defensive on the idea of a “humanitarian crisis”. Clearly that language was overblown, but it was nevertheless a chance for her to take the side of the patient against any NHS organisation that fails to act compassionately. That remains a core issue for the Service in the wake of the Mid-Staffordshire hospital inquiry.)

Jeremy Corbyn won PMQs but still lost the crisis. The Opposition needs arguments on NHS reform even more than does the Government.  The Leader of the Opposition criticised the prospect of a reduction in hospital beds, despite the fact that modern healthcare is all about prevention and treatment in the community. The number of NHS beds has halved in the last thirty years.

As for winners, Nick Macherson, former permanent secretary at the Treasury, gave a very pithy summary in his tweet: “NHS bottomless pit. Money should be linked to  reform. #soundmoney”. The Government has provided emergency funds to the NHS twice in the last three years: the first by George Osbornethe second when the extra spending secured by the Five Year Forward View was front-loaded into the current financial year.  Those funds have turned out to be a sticking plaster, failing to address the underlying causes of the problem.

Most of all, however, the week saw three moments of great interest in the new digital health technology companies that hope to deliver the step-change in wellbeing, diagnosis and accessibility to which the NHS also aspires. My film for the BBC drew on the example of the Babylon app which monitors a patient’s health, provides diagnosis via artificial intelligence and allows video consultations with GPs. The NHS announced on Monday that it will provide the Babylon app for a million London residents later this month.

Babylon also featured in a FT magazine review of digital health on Saturday (£), along with other digital health companies. Ali Parsa, Babylon CEO, gave some eye-catching quotes: “The difference in price isn’t a few pence, it’s a 100 per cent. We can sell that to the NHS at whatever price, and they’re still saving a fortune.” These are exactly the ideas that will head off “NHS crises” in the future.