The last thing I need is a robot peering at my mother’s toes!

IAM all in favour of the NHS becoming faster, better, cheaper and more efficient – but I’m not yet ready to be diagnosed by a robot. In fact, I wanted to call out loudly for a nurse when I read of a new NHS app that is being piloted in North London alongside the 111 call service. Instead of ringing and speaking to a real person, you type in your symptoms and algorithms assess what’s likely to be wrong with you, and advise what you should do.

Seriously? Once I was spooning in some boiled egg and my brother made me laugh so much that I choked on a shard of eggshell. I collapsed on the way to school.

My mother rushed me to the children’s wing of University College Hospital, and told them what I’d inhaled.

At first the doctors didn’t believe her, but they whizzed me down to theatre and shoved a bronchoscope (a viewing tube) down my windpipe and into my lung. A message was then relayed from the theatre to the ward: ‘Tell Mrs Johnson that we are indeed finding large fragments of eggshell in the patient.’

My mother was triumphant, and felt vindicated – rather less so, two days later, when my baby brother Jo was admitted to the same hospital, hallucinating and tripping out, after he’d crawled behind the washing machine in our house in Camden and eaten dry rot. She now had two children on the same ward.

On Thursday, I accompanied my mother, aged 74, to see her Parkinson’s professor at the National Hospital for Neurology and Neurosurgery. He went through her suite of conditions, felt her legs for responsiveness to touch, watched her walk, and checked her deep brain stimulation implant before my mother said: ‘I’m worried about this black toenail on my right foot… I Googled it and they say it could be a sign of melanoma.’

The neurologist raised an eyebrow. He examined my mother’s toe and reassured her that it was a bruise, or a side effect of her bloodthinning drugs. Can you imagine an algorithm, any artificial intelligent chatbot, that would do better in these unusual situations than 1. A loving mother who knew what her children had done; 2. The medical professionals who were prepared to believe her; and 3. A consultant who’d seen my mother regularly over many years in the same room of the same hospital?

As for the Doctor Bot app, well, we can no longer expect continuity of care as a right.

We sort of accept that. We are lucky to see a GP at all, let alone on the same day, so I agree that this app may be a stopgap when, for example, there are no appointments for a week and it’s Emergency Ward Ten at home. I am also perfectly prepared to believe that the app may become so clever that it could, in the end, outsmart doctors.

BUT the way to digitise the NHS is not to replace human contact with an app. Human contact and exchange between doctor and patient – I think of the professor’s tenderness over my mum’s big toe – is a red line. A doctor needs to inspect a patient face to face, to eyeball him, clock his appearance and vital signs, to get what’s wrong. You can tell a lot just by looking at someone, which is why doctors compare themselves to customs officials scanning the faces of travellers at Arrivals: they can spot things.

When I was in the consulting room, I noted that my mother’s file was four inches thick. In the course of the session, a nurse came in and slammed the next patient’s notes on the desk.

Of course, we must digitise the NHS, but these dog-eared folders made me think that one way of speeding things up generally would be to pop all our medical records on to an individual smartcard that we could carry round with us (if Tesco can do it, the NHS can, and such cards are in use in some parts of Africa). Then, wherever we are, in whatever hospital, surgery, or pharmacy, we can take back control of our data. We ‘own’ our continuity of care.

Surely that’s a safer and sounder way forward than ‘the doctor won’t see you now’ – even if there’s an app for that.