It will take more than robots to cure NHS incompetence

Babylon Health is what, with a certain weary dread, we have learnt to call a “disrupter”. The British tech start-up is best known for its GP at Hand app. This allows registered patients to consult an NHS doctor via video link on their smartphone, without any of the usual inconveniences of trying to see a GP.

Launched in 2016, in collaboration with a GP clinic in Fulham, the app has proved almost too successful. More than 51,000 patients across London have left their local practice to register with GP at Hand, causing a huge headache for the local NHS funding authority.

But Babylon Health has its eyes on an even bigger prize. It has just signed a contract with Royal Wolverhampton NHS Trust to develop an app that will work across all local medical services. As well as enabling patients to see test results and book appointments, the app will apparently use AI to make early diagnoses and monitor patients with chronic conditions. If it works, the trust hopes to sell the technology to the rest of the NHS.

God knows, a disruption is needed. Perhaps, one is tempted to say, a conflagration. The current NHS booking system is barely a service at all – more of an institutional disservice.

One of my modest ambitions for the new year has been to get an x-ray. I have the beginnings of arthritis in my shoulder. So I went to see the GP, who told me that she would refer me to a physiotherapist, who, in turn, could refer me for an x-ray. She tippetytapped at her computer keyboard in such a brisk and hopeful fashion that I did not, as I should have done, succumb to immediate despair.

A couple of weeks later, I received a letter from the NHS e-referral service reproaching me for having failed to book my own appointment – something I had absolutely no idea I was supposed to do.

I tried logging onto the e-referrals website, but I hadn’t been given the necessary login details. I rang the GP’S surgery to ask if they could tell me my NHS password. “No problem!” said a chirpy receptionist. “Just come into the surgery on any Wednesday after lunch, and make sure you bring your passport or driving licence.”

Fighting back hysteria, I rang the booking line, and persisted until a human came on the line. “You need to ring the hospital directly,” said the human. I rang the hospital directly. “Your referral has been cancelled,” said the hospital receptionist. “You took too long to get in touch.”

It’s just a sore shoulder; I can live with it. But when my father was being treated for terminal cancer, the ensnarling incompetence of NHS bureaucracy was harder to bear.

Appointment letters gushed onto the doormat in a papery torrent, containing information that was almost always confusing or wrong: appointments doublebooked or booked for dates that had already passed or booked in the wrong clinical order. His doctors, when he saw them, were wonderful; but getting to see them was an unconscionable ordeal.

Whether more technology is the answer to bad technology remains to be seen. User reviews of the GP at Hand app suggest that it may have already imported some of the inefficiencies of the NHS booking system.

A deep organisational gangrene afflicts the health service. It may take more than robots to cure it.