Johnny Luk is a former parliamentary candidate and current University governor.
Covid-19 has been, and continues to be, the largest challenge the UK has faced for generations, requiring the full intervention of the state and all our people’s collective industry, tenacity, and bravery to battle it. Our heart goes out to those who are fighting day and night to protect us.
Behind the headlines, the crisis has acted as a catalyst on one particular underreported reform: health tech. Even before the coronavirus, the ageing population and the broadening of services had underlined the urgent need to be innovative with our health and care systems to relieve pressure. Tech alone cannot replace the judgements of doctors or the humanity of ward nurses, but it can amplify their impact. In the long term that means more efficiency too, essential as we face a burgeoning budget deficit.
The prize of a proper digital-first NHS has for decades been elusive, hidden under reams of red tape, and guarded stoically via a risk-averse culture. Tech procurement and implementation are infinitely complex, with legacy systems under a patchwork of applications creating siloes and sensitive data needing more protection from ever malign threats – all making progress frustrating and requiring massive political will.
The recently published National Audit Office (NAO) report was a reminder of how Labour failed on this agenda when the party had the chance to lead it. Despite recognising the importance of system interoperability to enable doctors to get the information to do their jobs, the NAO noted that between 2002-2011, digital transformation was ‘both expensive and largely unsuccessful’.
Under the Conservatives, NHS Trust digital ‘readiness’ at all levels is now higher, and the relatively new 111 service proved crucial to the public. But it has not been straightforward. David Cameron’s first Health Secretary, Andrew Lansley was stung from the political flack of instigating a ‘top-down reorganisation’. Anything exploring social care is even more politically dangerous – with reform proposals famously derailing Theresa May’s 2017 election campaign. No wonder there is a constant temptation to duck the tough decisions and simply pledge more doctors and nurses.
It now falls under Boris Johnson’s government to take on the mammoth challenge. When Matt Hancock arrived as the new Health Secretary, fresh from his role as Digital Secretary, he focused all his characteristic enthusiasm on this reform agenda. This included launching NHSX – a new strategic digital arm of NHS.
Matt Hancock recognised immediately that the pandemic meant doubling down on the health tech reform, not shying away from it, and alongside Lord Bethell, the new Health Minister, built an impressive network of technology partners and worked in lockstep with NHS Trusts to accelerate the pace of digital transformation. NHSX, then not yet one year old nor fully staffed, pivoted nimbly, scaling their activities and approaching problems with ambition and gritty practicality.
I witnessed NHSX’s scale of work myself when I seconded there as a volunteer. This included securing telecoms companies to provide broadband to hundreds of social care homes, new clinical communication tools, building the back office of the national testing regime, upgrading remote care offerings, expanding online prescription services, data dashboards to give decision-makers key information in real-time and making video GP consultations the norm.
These outcomes represent real-life solutions that are helping the front line. In normal times, such milestones would have taken years, perhaps decades under a less reform-minded and energetic Health Secretary.
But obstacles remain, for one, the pace of work has and will trigger hiccups and scepticism. For example, the public may not be entirely comfortable with the use of a contacting tracing app because of data security fears and some may prefer a more familiar human phone call of a contact tracer first.
Both types will be needed, as the latter is harder to scale. The Government is rightly being brave in working iteratively in the public limelight to test and improve such a new system, a very familiar approach for tech startups but not in the public sector.
In the longer term, retaining healthcare workers support is essential, given they are the trusted public face to patients. Whether that will happen post-pandemic is not guaranteed. Currently, the urgency of an infection-based disease has made digital work mandatory, whether that embrace of tech and remote monitoring continues post-pandemic is still to be seen.
The way the political class debates healthcare is also key. I hope all politicians will advocate for the most digital-friendly NHS possible, rather than Labour’s lazy and misleading accusations of the Tories ‘privatising the NHS’. Those mumblings have slowed as new public and private partnerships demonstrated the benefits, including in scaling testing, but can the Labour leadership elevate the political debate to reforming and improving the NHS rather than fight past ideological battles? That I am less optimistic about.
We are a long way from closing this dark chapter on Covid-19, but we can lock in and expand these technological wins for the long term. It will represent one of the positive legacies of this pandemic. We have made a great start; let us all continue to support the health tech innovations taking place.