National Health Service: 75th Anniversary

Lord Drayson Excerpts

Thursday 30th November 2023 Lords Chamber

[Lord Drayson (Lab)]

My Lords, I thank my noble friend Lord Hunt of Kings Heath for securing this debate and for his truly excellent speech. I draw the House’s attention to my declared interests and previous experience, including my current roles at Appella AI and Freevolt Technologies Limited and my previous roles at Sensyne Health plc, PowderJect Pharmaceuticals, the University of Oxford, the BioIndustry Association and the Royal Navy, as I will speak on procurement of technology and innovation in the NHS.

As we have heard today in this debate, there is now compelling evidence and widespread concern about the declining performance of the NHS. Often, the adoption of new technology, including most recently AI, is cited as the key to improving standards of care and NHS productivity in future. Statistics highlighting the inferior levels of technology in the NHS compared with other countries, such as in the low numbers of MRI and CT scanners and proton beam machines, the obsolete software systems used by NHS trusts and anecdotes about paper records and fax machines, provide clear evidence that the NHS is a laggard in adopting modern healthcare technology.

Poor procurement of technology by the NHS is at the heart of the problem. It is currently a balkanised and fragmented process across the hundreds of trusts and other siloed groups involved in procurement at the national and local level. It lacks a joined-up approach based on evidence and it lacks a clear, long-term strategy. There is a shortage of expertise in the NHS in technology adoption and management, and an overreliance on external management consultants charging huge fees. Failures in NHS procurement not only undermine the quality of care and waste taxpayers’ money but create a barrier to businesses and investors wishing to invest in UK healthcare.

Life is particularly hard for small companies, which are often the shock troops of innovation. The unwillingness of NHS trusts to accept evidence from other trusts means that companies spend ages repeatedly doing pilots in multiple trusts, never getting to a critical mass of business in the UK market. It is why many investors shy away from businesses that seek to have the NHS as a major customer. The fact is that the NHS determines the fate of our UK life sciences industry, an industry in which we have a great track record of science and innovation but we lack scale. Just look at the life sciences sector on the London Stock Exchange now compared with 20 years ago; it is a shadow of its former self.

Protectionism is not the solution. We should welcome foreign companies and investors coming here, provided that they adhere to our values. However, we must care about where the work is done, where the skills are developed, where the health data is stored, where the profits are made and where the tax is paid. The recent decision of the NHS to purchase Palantir software from the US for its new federated data platform was another opportunity missed. Why did the NHS not choose a system that would help to grow our UK skills base and a system built on open source software that would enable innovation to flourish? Why did it not choose a system that would provide confidence to patients in how their health data will be shared and used?

Much is being said about how artificial intelligence will have an enormous impact on our society in future. In fact, it is already happening, and in healthcare the effects will be profound. If the UK does not develop the onshore expertise to create software systems aligned with the values of the NHS and our society, the NHS will have no choice but to buy systems which, like Palantir’s, were developed elsewhere, with the AI algorithms trained on patients cared for under different healthcare systems. We will then import the biases and constraints that are embedded in those systems and our NHS will become less fair and less aligned with the values of our society, and the wealth created by the AI wave will accrue elsewhere.

There is a better way. Back in 2005-06, the Labour Government, in which I was a Minister, published a defence industrial strategy and a defence technology strategy that provided the Armed Forces and the defence industry with clarity on the sovereign capabilities that the UK needed. As a result, we maintained the skills and industrial capacity required to design and build submarines. Some 17 years later, not only are we still making submarines for the Royal Navy but, for the first time in years, under the AUKUS project we will soon be exporting them to our allies. That is what long-term strategic planning, backed by consistent investment in onshore skills and technology, can achieve.

We need to invest in a well-staffed, well-trained NHS procurement body that sets national standards, defines requirements and buys intelligently on behalf of the taxpayer. We need a technology strategy for the NHS, aligned with an industrial strategy for the life sciences industry, that will deliver UK sovereignty over the technology that will affect how patient care is delivered in future. These strategies will provide the global life sciences industry with clarity on what the NHS requires, highlight the opportunity for investing here, and provide our own life sciences industry with the ability to create the skills and the wealth that our economy desperately needs. Only then can we be sure that the core values of the NHS, set out 75 years ago, will survive the coming wave of technological change, deliver the high-quality healthcare our people want, and help create the wealth needed to pay for it.