Health and Social Care in England

Baroness Lane-Fox of Soho Excerpts

Thursday 11th July 2013 Lords Chamber

[Baroness Lane-Fox of Soho]

My Lords, perhaps like many here, I come at this subject from a very personal and a professional angle. I thank the noble Lord, Lord Patel, for introducing this debate.

I shall speak, first, about the personal: my life was saved by the orthopaedic department in the John Radcliffe Hospital in Oxford, so I owe my life to a well funded NHS. I am also someone who fervently believes in the power of technology to improve public services. It is only through their more effective deployment that we will continue to have a world-class healthcare system at a reasonable cost.

I am talking not about expensive NHS IT projects, top down and heavy, but about open standards, agile development, data and a more digitally minded healthcare sector. I would like to give some examples.

This era is often called the era of big data. We are able to aggregate information from a mass of different sources. The analysis of these data is changing the way in which we work and live. The Government have already encouraged the use of their own datasets, which are from many different sources.

However, we are only at the very beginning of this journey. A wonderful project which has come out of the Open Data Institute here in London illustrates why data are such an important part of this debate. In 2011-12, the NHS in England shelled out more than £400 million on statin drugs, from a total drug budget of £12.2 billion. However, in collaboration with Mastodon C, Open Health Care UK—a small start-up developed by a programmer and a doctor—managed to look at every prescription written for statins from every GP in England by using a dataset provided by the Open Data Institute. They looked at the regional patterns and discovered that, if doctors had prescribed the white label version, they would have saved more than £200 million. The variation is remarkable. Imagine the potential savings if this was applied across many other classes of drug.

As the Economist wrote recently:

“A study in the British Medical Journal … reckoned that the NHS could save more than £1 billion by switching from branded drugs to generic equivalents”.

Smart use of datasets will become essential in improving our healthcare, as long as the interoperability of systems is put at the heart of those improvements.

As 80% of the NHS costs come from the 20% of the population with chronic conditions, it will be essential to focus resources on how to help them manage their lives more independently. There is a growing evidence base that shows that online tools can help in this. Mindfulnet, Big White Wall and buddyapp.co.uk are just some examples of websites that provide help to people with mental health issues, giving them confidential help and techniques that allow them to manage their own lives. NHS HealthUnlocked is a London-based start-up that works with patient groups and gives 1 million people monthly information to support long-term illnesses such as diabetes and obesity.

More than 70% of us look at our smartphones before we go to the doctor. Every day, millions of people are using health apps on their mobile phones, logging into websites or chatting in online forums. New technologies such as UP by Jawbone, or even Nike+ FuelBand, allow people to gather their own data and make better lifestyle choices. This is where I respectfully disagree with the noble Viscount, Lord Ridley. I believe that such technologies will help prevent health issues and drive down costs.

It is vital that the NHS is able to deliver services of the same quality as citizens find on the web, or we will be in danger of undermining one of our most valued public services. This will require a cultural change in the sector so that all the people working with patients are able to provide high-quality, relevant and modern care and to connect with the innovative solutions being provided outside the NHS.

While I spent two years in hospital, I met some of the most remarkable people— from surgeons to doctors and nurses to healthcare assistants—but, even then, there was a huge gap between what they were able to do and what was happening in the commercial sector. We must ensure that all staff are digitally literate and that the internet is at the very heart of the design of services, surgeries and hospitals. On this the 65th anniversary of the NHS—surely one of the greatest innovations of our country—it is essential that we incorporate another of our greatest innovations, the world wide web, otherwise we will have no hope of meeting future funding challenges.