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11 Remember that the Nolan principles for public life (still endorsed on the government’s website) include impartiality and objectivity. 9 Hancock already has connections to think tanks that support marketisation of healthcare and a shrinking of the state, such as the Institute of Economic Affairs 10 and the TaxPayers’ Alliance. This has drawn formal complaint from the Labour Party about ministerial conduct. Third, ministerial codes should ensure that no health secretary pushes and promotes individual companies with the enthusiasm Matt Hancock has shown. 7 8 I realise that AI programmes evolve and improve over time-but the marketing didn’t say “work in progress.” Doctors outside Babylon have raised concerns online, saying that the advice given in response to symptoms they entered into the checker was misleading and potentially dangerous. Second, we need legislation to ensure that private companies contracting with the NHS are sufficiently open to scrutiny and subject to same disclosure requirements as NHS organisations. Evaluation must not centre simply on consumer experience and satisfaction but on the whole system impact and the risks, affordability, sustainability, and ability to scale up. Let’s adopt these standards when it comes to spending scarce public resources on new health technology in a safety critical service. The National Institute for Health and Care Excellence (NICE) has recently published guidance for evaluating new health tech, 6 and NICE is a statutory body. 5 True, perhaps, but other forms of pragmatic evaluation are available. Babylon’s medical director, Mobasher Butt, said on the record that randomised controlled trials and peer review aren’t so suitable for such quickly and constantly evolving technology. The saga of Babylon’s entry to the NHS market raises some concerns we’d do well to learn from.įirst, independent evaluation does matter. GP at Hand’s presence in Hammersmith and Fulham Clinical Commissioning Group has reportedly faced big and growing costs (estimated at £10m so far) from hosting GP at Hand, which supports patients living in other parts of London-putting general practice delivery for local residents at greater risk. But it could “not fully assess whether GP at Hand is affordable or sustainable.” 3
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The report noted that GP at Hand didn’t provide the full range of services that conventional general practices do and that expanding such a model would have considerable implications for IT, infrastructure, and the GP workforce. 1 It found that patients had fewer health problems than conventional users of GP services, were younger, and yet were higher users of services such as NHS 111 and urgent care.