Is there anything more worrying in healthcare than a zealot? Sweeping, soaring visionaries who refuse to be held back by boring niceties like evidence?
Health secretary Matt Hancock is an unabashed health tech enthusiast, who recently told the audience at NHS Expo 2018 of his drive to bring his “knowledge, experience, and frankly unsurpassable enthusiasm for tech” to the NHS.
Now I’ll be honest. If this means my ward gets computers that don’t crash eight times a day, I’ll be his most devoted, starry-eyed acolyte. But one senses an upgrade from Windows XP wasn’t quite what Hancock had in mind when he spoke of building an “ecosystem of the best HealthTech in the world” with a newfound “agility” that made me think of ring-tailed lemurs.
Babylon Health may be much more his thing. So much so that last week, Hancock was accused of breaking the ministerial code by promoting the private healthcare company in a sponsored newspaper supplement.
Like the health secretary, Babylon is on a mission too. According to their website, theirs is to “to put an accessible and affordable health service in the hands of every person on earth.”
Matt Hancock loves Babylon so much he doesn’t merely use its smartphone app, GP at Hand, he gushes enthusiasm for the product at every opportunity. First, at Expo, he name-checked Babylon, among others, as one of the “world’s best HealthTech companies.” Then he gave a speech eulogising the company while literally standing beneath its logos inside its London HQ. Then in comments to The Telegraph he declared a breathless vision for the “revolutionary” app to be “available for all”.
And, last week he featured in a double-page, Babylon-sponsored puff piece in the Evening Standard, entitled, “Technology can be a great fixer for the NHS.” Its centrepiece, an interview in which Hancock’s ringing endorsement of Babylon—he declared GP At Hand to be “a force for good within the NHS”—filled Twitter with outrage. Later, the Standard removed the prominent Babylon logos from the online version, while adding a rider at the bottom insisting it was not an advertorial since the paper retained full editorial control. Hancock’s office, meanwhile, said he had no prior knowledge of Babylon sponsoring the interview.
Ministerial code states quite clearly that ministers should not “normally accept invitations to act as patrons of, or otherwise offer support to, pressure groups or organisations dependent in whole or in part on government funding.” And yet, in response to the criticism, a Department for Health and Social Care press officer came out batting for Hancock, insisting that he, “regularly champions the benefits of a range of technologies which can improve patient outcomes, free up clinicians’ time and make every pound go further.”
Here is the crux of the matter. There is currently no conclusive evidence demonstrating that GP At Hand achieves any of those benefits. And when patient safety—and NHS funds—are at stake, it is evidence, not “unsurpassable” zeal that counts.
Doctors bristle at Hancock’s app-happy enthusiasm not because we’re Luddites who can’t stomach change (though most of us freely acknowledge how infuriatingly resistant the NHS can be to innovation). What alarms us is the rush to embrace unproven technology before its rigorous appraisal. Thalidomide, anyone? Surgical mesh?
If GP At Hand were a drug, not a tech product, would Hancock be quite so Tiggerish? He may yearn for techy sunlit uplands, but I want to be sure my patients are safe, and not squander precious NHS funds on the latest shiny toy to catch his app-struck eye.
Rachel Clarke is a specialty doctor in palliative medicine. Follow her on Twitter @doctor_oxford
Competing interests: None.