Western Morning News (Saturday)
Our beloved NHS is outdated. What’s the answer?
THE stories about our dear old NHS are not so good at the moment. Long waiting lists and obstetrics unit deaths are prominent in the papers. Nye Bevan, who founded the NHS in 1948, wouldn’t even get his teeth seen to nowadays. In the beginning the NHS was the envy of the world. Before it, the healthcare in Britain was limited or even unavailable to large parts of the population.
Isn’t it odd though, that the NHS model does not seem to have been widely copied in other first world countries, for example, Europe. If it was that good, you’d think it would have been. Many other countries have mixed insurance and government managed schemes. On one hand the NHS provides an important safety net of medical cover for everybody. On the other hand it means that responsibility for our most precious commodity, our personal health, rests not with the individual person but with the government.
What was right in the planning stages of the NHS in 1944 is now, perhaps, outdated. What’s the answer? Well it may lie, perhaps, in AI. Artificial intelligence has made huge strides across the world and is definitely the thing of the future.
This week 100 NHS hospital trusts will take up software that analyses data, including weather and 111 calls enabling them to model how many patients are likely to turn up at a particular A&E department each day.
NHS bosses reckon that by giving hospitals a daily forecast of expected admissions, it will speed up efforts to bring down record waiting lists of 6.1 million people.
Sounds good. But it can’t possibly work. The idea is flawed because the fundamental issue is staffing. Staff are in short supply and under paid. All the AI in the world isn’t going to solve that problem. I can’t imagine how much money this new scheme will be costing. How many nurses could have been employed, and trained for that? Instead we’ll be paying high salaries for boffs to pour over what are essentially old fashioned algorithms.
The scheme is a gimmick. It might predict how many ambulances are lining up outside A&E but it won’t mean that the patients will be processed any quicker.
Don’t get me wrong. I’m not trying to knock change. I simply want a touch of reality about what is being introduced. Already there have been wonderful advances in AI. Apps abound – one that will one day be used for reading poo from the toilet bowl and report direct to our GP to inform of gut issues. There’s an app that uses our phones to detect early signs of chronic kidney disease, which could be a life saver for patients with diabetes.
Most of us have smart phones which will tell us if we’re walking enough. In the pipeline are patches that detect irregular heart beats, which in turn could help prevent heart attacks and strokes. AI powered innovations include those which can rapidly analyse breast cancer screening scans.
All great stuff, but does it help us get an appointment with our GP? Will a bot take over that? I’d rather have a face to face than an app on my phone that may or may not correctly diagnose me. We are 2,000 GPs down than we were five years ago. AI isn’t going to improve that.
The software introduced this week will, it’s said, model how many patients are likely to turn up at a particular A&E department each day.
This predictive use is, says Professor Stephen Powis, NHS national medical director, likely to “accurately predict activity levels and free up staff, space and resources to help deliver more vital tests, checks and procedures for patients.” Sorry, but I don’t believe it because you need people at the coal face to deliver these services and we just don’t have them.
What is more pie in the sky is that the NHS reckon that “if one hospital is forecast to have a particularly quiet day, it could “lend” staff to a neighbouring trust with high predicted admissions that day.” That’s a recipe for disaster and patients will suffer. The secret to smooth running is for everyone to know their own systems. If you ask an Audi mechanic to work on a Honda one day and a Ford the next, he will be slower and mistakes will be made.
Beds need nurses. Clinicians need nurses. Hospitals run on kind, caring, hardworking staff, not just computers. Meanwhile our taxes are being spent – God knows how much – on aspects that do nothing to increase the much needed staffing levels in the NHS. The next thing we will be offered is robots carrying bedpans… and I’m not joking.
AI might help some aspects of medicine but it’s papering over the cracks. The only way for our NHS to work is to have a complete revamp and not hang on to an outdated system through sentiment.
I’d rather have a face to face than an app on my phone that may or may not correctly diagnose me