No, Minister – Be Careful About Supplier Bias, Even If The Tech Is Good For The NHS

CBI Conference

The appointment of Matt Hancock as the UK's  top Health Minister a few months back followed the upheaval around Boris Johnson and other Brexiteers leaving the government.

Given it is such an important and sensitive post, Hancock is bound to make some waves, and there are both positives and concerns around one aspect of his character and interests – he is genuinely interested in technology, and by the standards of politicians certainly, might even be described as a “techie”.

If the NHS wants to survive as a national free-at-point-of-use, taxpayer-funded service, it really must embrace technology. Otherwise both tech firms and citizens will eventually work around it – and ultimately you will find millions of people who say, “I don’t use the NHS, why should I pay for it”?

The first sign of the coming revolution is the growing use of remote consultations between doctors and patients using Skype or similar services to enable patients to talk to doctors. When you can’t get an appointment at your local GP for two weeks and then it is during working hours, the prospect of a quick Skype at 8am or Saturday afternoon is very appealing to many.

GP At Hand is one of the new breed of services offering this, with involvement from a firm called Babylon, founded by the visionary / controversial Ali Parsa (founder of Circle Healthcare, which failed at Hinchingbrooke Hospital, as you may remember). But the pushback from certain doctors is that the medical effectiveness of this approach is not proven yet, and, it is “cherry picking” the younger, healthier patients, which reduces profitable income from traditional GP practices and will make them nonviable.

We won’t comment on the medical issues, but anyone who thinks they can stand in the way of something that clearly is wanted by patients and is clearly cost-effective for a very high proportion of appointments is basically standing in the road shouting “no horseless carriages”. The NHS needs to work out how to accommodate and take advantage of innovation, as we say, if it is to survive.

However, we were worried by Hancock expressing recently his endorsement for GP At Hand. We’re not clear exactly how the procurement angle of this works – presumably there are alternatives to that particular product, and presumably there will need to be competitive processes to decide which solution providers will be used (assuming we are right about the inevitable growth of such services).

So, we don’t like to see a Minister expressing support or preference for one supplier. It’s a bit like a Minister saying, “I really like the way Amey empty my bins, I hope they win lots more contracts around the country to do that”.

An excellent article in HSJ by Alastair Mclellan also urges caution in endorsing Babylon too strongly for several reasons, and points out the firm has a reputation for litigious behaviour  - threatening publications who are critical and taking legal action against the NHS regulators, the CQC, for instance. Not exactly ideal long-term partner behaviour, you might think.

“In the past year or so – as Babylon has become more prominent and active – it has demonstrated a pattern of behaviour which, if seen in NHS providers, would be rightly interpreted as an inward focus on maintaining reputation. The company’s typical response to scrutiny is to threaten or launch legal action.

Letting the media know that any mildly critical story will be responded to legally is a tactic journalists know well. Few editors like explaining to their publishers why they have bust their legal budget, and many choose to pursue less costly causes”.

And it is not as if Hancock knows nothing about procurement – he was “Minister for Procurement” a few years back, not that he seemed to achieve a lot in that area; he was clearly more interested in the digital element of his Cabinet Office role.

Anyway, someone (Gareth Rhys Williams?) needs to have a quiet word with him and suggest that he is more careful. He has rowed back somewhat since his remarks and said it is the generic idea that attracts him – that’s fine, express support for the idea of these services, but don’t be seen to be favouring one supplier over another. Remember competition is good, in all markets, and don’t give any unhappy supplier due cause to challenge a procurement decision based on the “obvious bias of the Secretary of State”!

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