NHS Federated Data Platform
Kim Johnson Excerpts(2 weeks, 2 days ago)
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Martin Wrigley (Newton Abbot) (LD)
I beg to move,
That this House has considered the NHS Federated Data Platform.
We are at a key time for the NHS as it changes from analogue to digital, and data is key to achieving better health results for all our constituents, as well as to the future of the NHS. AI analysis of scans can spot patterns of disease before the human eye, and modern communications can be much more effective than sending letters, which often arrive late. We are, however, at a junction where we can correct a series of mistakes made in the direction of travel in this process. I ask the Government to mind the gap between expectation and reality. We can and need to change.
In November 2023, a contract for services approaching £500 million was signed for the federated data platform. The Government’s contracts tracker describes a data platform owned and controlled by the NHS
“to unlock the power of NHS data to understand patterns, solve problems, plan services for local populations and ultimately transform the health and care of the people they serve.”
Sadly, the FDP developed by Palantir is far from that description.
The NHS is an inherently distributed organisation, with trusts in charge of their own IT. Although NHS England has been working on a unified data dictionary and standards, imposing a single central IT solution has yet to work. Indeed, a single central system can become a single point of failure. Such a critical element of national infrastructure must be under full control, fully owned and trusted.
Although I understand the appeal of a slick salesman who persuades that they can solve all the problems in the NHS, build that one system to bind them all, and use AI like magic to provide all the answers, sadly, it is not reality. Is Palantir’s FDP a product that the NHS can own and trust, or have we bought the emperor’s new clothes that, after huge investment, leave us with nothing? I will outline why this solution is wrong in three significant points: the contract is wrong, the solution is wrong and the supplier is wrong and simply not delivering on its promises.
Kim Johnson (Liverpool Riverside) (Lab)
I thank the hon. Member for securing this important debate at this critical point. Does he agree that the opaque procurement of the Palantir contract, one of Mandelson’s dodgy deals, is deeply concerning? Does he agree that the full details of Mandelson and the Prime Minister’s visit to the Palantir headquarters in 2025 must be made public?
Martin Wrigley
I agree with the hon. Lady entirely. The secret meeting in 2019 between Boris Johnson and Dominic Cummings and Peter Thiel—the founder and chair of Palantir—that started this whole thing, for which there are no minutes, must be clarified as well.
I ask the Minister to consider using the contract renewal point to stop the chaotic expansion of the Palantir platform monopoly, to work to a staged exit with a retender for British companies to build a replacement for Palantir, and to deliver a better, long-term solution providing British sovereign capabilities in line with principles outlined by the Science and Research Minister and the Prime Minister.
The current contract delivers a subscription service that leaves no deliverables after the subscription—no software, no improvements and no intellectual property after spending more than £330 million. All the specially written software and intellectual property rights belong to the supplier, says the contract. All the rights to any know-how are explicitly retained by the supplier and not passed across on termination of the contract. The contract delivers no software—not one line—just a subscribed service; a permanent lock-in; a single point of failure.
Why are we building a leased service wrapped in glossy marketing promises, rather than a product that the NHS can own and trust? We are paying the supplier to hire Accenture, PwC, NHS experts and consultants to create a solution that we do not own—the supplier does. It uses external AI platforms from OpenAI and Anthropic and brings questionable value itself. Prior to it buying an opportunity to provide its system to help manage the data from the covid vaccine programme, the supplier had no expertise in health.
The three-year contract asks for 13 core capabilities to be delivered. According to the National Audit Office and the supplier, after nearly three years, it has partially delivered on three or four of those capabilities. Hon. Members may have received letters from the supplier, which has also taken to sponsoring newsletters that we see every day.
When in front of the Science, Innovation and Technology Committee, the only benefit offered by the supplier and by NHS England was an improvement in managing staff rotas to deliver a higher operation throughput, which these days can be done by a relatively simple app. That is beneficial, but it perhaps relates more to the Government’s improvements in staffing and pay than to any magic from Palantir. It claims to have achieved waiting list reductions by removing people who do not respond to messages, but there is no external scrutiny or validation of results. This is a dreadful contract, and it is not in the national interest.
Resident Doctors: Industrial Action
Kim Johnson Excerpts(4 months, 3 weeks ago)
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Wes Streeting
I should also declare that I am a member of the GMB and Unison. I say to my hon. Friend that there is a striking inconsistency between what the BMA is demanding for its members and what it proposes to pay its own staff. There is a word for that. In the spirit of trying to engage more constructively, I will not use it. However, I urge the BMA to engage constructively with us and with its own staff. It certainly will not want to see me on the picket lines outside BMA House.
Kim Johnson (Liverpool Riverside) (Lab)
I am a lifelong trade unionist and a proud member of Unite and Unison. I was proud to stand on the picket line with resident BMA doctors in my Liverpool Riverside constituency recently. They talked about the challenges around fees, and I am sure that they will welcome the fact that more money will be put in their pockets. There was some inconsistency, however. Will the Minister clarify that all resident doctors of all specialisms will be subject to the fee waivers?
Wes Streeting
I can give my hon. Friend the assurance that the royal college fees that I outlined in my statement will be covered by us. That will be a material saving in resident doctors’ pockets. Exam fees will also be backdated, recognising that many doctors will have already done those exams and paid the fees. I hope that that gives my hon. Friend and resident doctors in her constituency the confidence that this is a good deal and one that we can move forward on and campaign on together.
Children’s Hospices: Funding
Kim Johnson Excerpts(1 year, 6 months ago)
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Ian Byrne
I thank the hon. Member for that wonderful intervention; I wholeheartedly agree about what Claire House does and with his asks.
Three weeks ago, it was announced that spiralling costs meant that there was not enough money to build a planned new home for Zoe’s Place and that the baby hospice would close for good at the end of the year. It was therefore with real trepidation that we met the trustees on the Thursday after the announcement. We entered Zoe’s Place with the staff—many had been there for decades—feeling devastated after being issued with the consultation period ahead of the planned closure. At the meeting, we were desperate to find a future for Zoe’s Place. The trustees and the staff present outlined what we needed to do: raise £5 million in 30 days and then Zoe’s Place could have a future.
Kim Johnson (Liverpool Riverside) (Lab)
I thank my good friend for giving way and I congratulate him on securing this important debate. Will he join me in congratulating the wonderful community of Liverpool on its amazing work to secure nearly £5 million for Zoe’s Place? However, does he agree that instead of relying on charitable trusts to support these important hospices, we need to think about how we put them on a statutory footing to provide better end of life care for everybody?
Ian Byrne
I thank my hon. Friend for her excellent intervention; I wholeheartedly agree.
We had to raise £5 million in 30 days to give Zoe’s Place a future, so I asked the trustees to let us give it a shot, harnessing the spirit of the city, which has been galvanised since people heard the news, and the love for this wonderful institution. We put the call out in Liverpool, and I have never seen a response like it in my life. It has been my great city at its very best, for the world to see. We have had kids going door-knocking with fundraising buckets, raising money because one of their friends is being supported by the hospice; parents who turned to Zoe’s Place in times of need organising fundraising walks and sponsored motorbike rides; and support from MPs, such as my right hon. Friend the Member for Hayes and Harlington (John McDonnell) promising to carry on playing his unique take on “You’ll Never Walk Alone” on his trombone if we did not raise the funds—the city has spoken, John, and I’m saying no more. Cafés have pledged their takings to the campaign, running raffles to raise money, and local businesses have got involved, donating tens of thousands of pounds, and their time and expertise, which will never be forgotten.
Cass Review
Kim Johnson Excerpts(2 years ago)
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Victoria Atkins
I completely understand my hon. Friend’s desire for accountability. I just remind us all that some clinicians have acted in a morally exemplary way, trying to blow the whistle on practices they observe. He and I, and, I hope, others, want to ensure that clinicians who have not acted in accordance with their professional duties are held to account. As I say, ongoing conversations are taking place with the independent regulators, but I suspect that they have very much understood the way in which the House is viewing this and the seriousness with which we view clinicians who have not abided by their professional duties in this regard.
Kim Johnson (Liverpool, Riverside) (Lab)
Many of the Cass review recommendations are to be welcomed, but there has been some dangerous misinterpretation of some of the recommendations in public discourse and, crucially, in NHS England’s response to the recommendations for transitional services for 17 to 25-year-olds. So will the Minister join me in challenging the NHS specialised commissioning team on its immediate limiting of access to support for 17-year-olds, including with the cancellation of appointments for some who have waited years, and in calling on it to immediately reinstate access while it reviews next steps?
Victoria Atkins
I hope the hon. Lady will forgive me if I have misunderstood her question, but I think she is referring to the decision that NHS England will prevent under-18s from accessing adult gender services. A consultation has just closed and we are looking at the results of that, but I am very sensitive to the needs of young people within that 17-to-25 cohort for whom the “cliff edge”, as it has been described to me, of moving from children’s services to adult services may not be in their best interests. I promise that that is very much the focus of my work on this in the weeks ahead.
Oral Answers to Questions
Kim Johnson Excerpts(2 years, 4 months ago)
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Kim Johnson (Liverpool, Riverside) (Lab)
Layla Moran (Oxford West and Abingdon) (LD)
The Secretary of State for Health and Social Care (Victoria Atkins)
May I, through you, Madam Deputy Speaker, wish Mr Speaker a very speedy recovery?
As Secretary of State for Health and Social Care, I want to reform our NHS and social care system to make it faster, simpler and fairer. Dentistry is a critical part of that. Integrated care boards are responsible for identifying areas of local need and determining the priorities for investment. NHS England published guidance in October this year to help ICBs use their commissioning flexibilities within the national dental contractual framework, and I will be looking carefully at how the boards are identifying need and investment across England, including for vulnerable people.
Kim Johnson
I am glad that the Minister mentioned ICBs. Liverpool has a very high percentage of children with dental decay, and tooth extraction is the most common hospital procedure for five to nine-year-olds at Alder Hey Children’s Hospital, yet there was a £10 million underspend for primary care dentistry, and instead of investing it in preventive care, NHS England gave permission to all ICBs, including NHS Cheshire and Merseyside, to use the balance to balance their budgets. Will the Minister agree, here and now, to reinstate the ringfenced funding to commission extra capacity for the most vulnerable patients?
Victoria Atkins
I am delighted to be able to inform the hon. Member that NHS England has provided guidance for ICBs that requires dental funding to be ringfenced, with any unused resources redirected to improve NHS dental access in the first instance. Interestingly, ICBs will report their expenditure against the dental ringfence to NHS England as part of their in-year financial planning, which will happen at the end of this financial year.
Madam Deputy Speaker (Dame Eleanor Laing)
No, no—you do not get another supplementary question. I was about to call Layla Moran for Question 16, which is grouped with this one, but unfortunately she is not present so I shall go straight to the Chairman of the Health and Social Care Committee.
Future of the NHS
Kim Johnson Excerpts(2 years, 6 months ago)
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Kim Johnson (Liverpool, Riverside) (Lab)
It is a real pleasure to serve under your chairship, Mr Pritchard. I thank my hon. Friend the Member for Wirral West (Margaret Greenwood) for securing this important debate and for her tireless defence of the NHS. This year we celebrate 75 years of the NHS. It is the greatest achievement of this country and of the Labour party: delivering a universal healthcare system based on need, not profit. We know the fight for this system is now existential. Thirteen years of austerity and the systematic defunding of public services have left our communities facing abject poverty and inequalities—conditions not dissimilar to those of the 1940s when the NHS was first introduced. Health inequalities are rampant and growing: children living in poverty are now diagnosed with Victorian diseases, life expectancy is falling for the first time in recent memory, children’s height is now reducing year on year, and chronic ill health, both physical and mental, is increasing. Systematic underfunding, private sector plundering, decades of privatisation via the back door and the fragmentation of diagnostics and treatment services have brought the NHS to its knees.
Before the NHS existed, there was a complex, fragmented and chaotic patchwork of services. This led to poor and inconsistent practices motivated by profit, rather than best practice. This is the direction in which many on the Government Benches are now pushing, with demands for a public-private partnership and insurance-based funding models—the privatisation of sections of the health service being touted under the guise of reform. It did not work then, and it will not work now. The evidence is clear: health services are of a better quality, more equitable and more cost-effective when nationally planned and provided by democratically accountable public bodies with expertise.
The hon. Member for Shrewsbury and Atcham (Daniel Kawczynski) has talked about the benefits of the private sector. I want to point out that Carillion, which was building an NHS hospital in Liverpool, went bust. This had a significant impact on the delivery of services to my constituency of Liverpool, Riverside.
We must repeal the Health and Care Act 2022 and reverse and eliminate the US-style integrated care systems which enable corporate influence over policy and profiteering, at the expense of patient care and workers’ pay. We must tackle health inequalities head on and push back attempts to establish a two-tier health system, which would only entrench these inequalities yet further. We must completely abolish the private sector in the delivery of NHS services and instead restore much needed funding levels, with a serious programme to recruit and retain the staff needed to end the exodus of NHS staff.
Only with this bold action to restore the fundamental model of the NHS—universal provision free at the point of need—can we once again make the NHS a world-leading institution. I will end by thanking all the hard-working staff across the NHS services in my constituency of Liverpool, Riverside.
Recovering Access to Primary Care
Kim Johnson Excerpts(2 years, 11 months ago)
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Steve Barclay
My hon. Friend is absolutely right on this and we plan to have a communications campaign. The front door to the NHS can often be confusing for people—whether they should go to primary care, a pharmacy, accident and emergency or elsewhere. We will have a campaign, not just linked to the opportunity to access care through Pharmacy First, but looking at the technology innovations we are bringing on stream, particularly on the NHS app. We are also making changes to 111. So there will be a communications campaign, on exactly the lines she references.
Kim Johnson (Liverpool, Riverside) (Lab)
I wish to thank all the primary care workers in my constituency. Despite the Minister’s assurances, 600 pharmacies have closed since 2015, which is having a significant impact on our most disadvantaged communities. Does he agree that more funding is needed to prevent more pharmacies from closing and to fix the broken NHS? Will he join me in condemning the Rowlands Pharmacy on Lodge Lane, which is pulling out of the community and preventing another pharmacy from taking its place?
Steve Barclay
I join the hon. Lady—as I did the other colleagues from across the House who have done this—in paying tribute to the primary care staff in her constituency for the work they do. We have touched a number of times on the fact that there are both more pharmacies and more pharmacists than there were in 2010, so there is more capacity. However, we also recognise the scope to better use the expertise within pharmacy, which is why an additional £645 million of investment—new funding—is going into pharmacies over the next two years.
Oral Answers to Questions
Kim Johnson Excerpts(3 years, 3 months ago)
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The Minister of State, Department of Health and Social Care (Will Quince)
I thank my hon. Friend for his question. National NHS guidance is absolutely clear: providers are expected to facilitate visiting for patients in hospital wherever possible and to do so in a risk-managed way. It is up to individual providers—they do have discretion—but I understand the benefit that this brings to patients. It is a very important factor, and I will meet NHS England to discuss this further.
Kim Johnson (Liverpool, Riverside) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
I thank the hon. Lady for her question. She is right that black and ethnic minority groups are more likely to be detained under the Mental Health Act 1983. We are planning to reform the Mental Health Act. There has been pre-legislative scrutiny, and I hope that when we reform that Act there will be an improvement in those figures.
Draft Mental Health Bill
Kim Johnson Excerpts(3 years, 10 months ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
I thank the Secretary of State for an advance copy of the statement, and for sharing his family’s experiences over the weekend. I am so sorry to hear about the circumstances surrounding his brother’s tragic death.
This overhaul of the Mental Health Act 1983 is long awaited. We welcome the draft Bill, and the fact that the Government have accepted the majority of the recommendations from Sir Simon Wessely’s independent review of the Act. It was interesting to hear, in the statement, of the Government’s focus on keeping people in crisis out of A&E, and of their plans to reduce the use of general ambulance call-outs for those experiencing a mental health crisis. In 2020, there were over 470,000 calls to 999 because someone was in a mental health crisis, which took up an estimated 66,000 hours of call time. In my email inbox, I have numerous examples from across the country of children being stuck in A&E for over 24 hours waiting for a mental health bed. One child waited over three days. When I work shifts in A&E, I see more and more people coming into hospital in crisis. The increased frequency is deeply concerning. Conditions are getting worse and illnesses are going untreated. We would not allow that in cancer treatment, so why is it allowed in mental health treatment?
Deprivation of liberty and the use of coercion can cause lasting trauma and distress. That is especially true for children and young people who find themselves in these most difficult situations and whose voices are often not heard when decisions are made. We are pleased that patients will have greater autonomy over their treatment in a mental health crisis, and we are glad that the Government have been working with organisations to listen to the experiences of those with learning disabilities or autism, but will the Secretary of State explain what safeguards will be put in place for people with learning disabilities or autism should the worst happen and they find themselves in prison? This is not a straightforward issue. Many people with learning disabilities or autism also live with serious mental illnesses, and we have to make sure that they have their rights protected and have dignity in their treatment.
In our communities, we witness the harsh reality of the health inequalities that so desperately need to be addressed. As the Secretary of State said, black people are over four times more likely to be detained under the Mental Health Act.
Irish Diaspora in Britain
Kim Johnson Excerpts(4 years, 1 month ago)
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Kim Johnson (Liverpool, Riverside) (Lab)
I congratulate my hon. Friend the Member for Rochdale (Tony Lloyd) on securing the debate and wish everybody a happy St Patrick’s day. I am very proud of my Irish heritage. My nan Mary Higgins was born in Dublin before she travelled across the Irish sea to the greatest city in the world, Liverpool. I am privileged to represent Liverpool, the city where I was born and raised. I am a very proud Scouser because we are a world in one city, with communities hailing from all corners of the world. Three quarters of Liverpool’s population has Irish roots and it is not for nothing that Liverpool is often referred to as the 33rd county.
The contribution of Irish working-class communities is immeasurable and has fundamentally shaped the soul of our great city into what it is today, from politics, to art, music, our unique sense of humour and life and soul of the party spirit. Many, of course, came to Liverpool in the great famine of the 1840s. 1.5 million passed through the port. Most were en route to America, but many settled, choosing to make Liverpool their new home and joining an already established Irish community. By 1851, the Irish-born population already made up nearly a quarter of the population. Those who came built much of the Liverpool docks and the canal system, while others staffed the shipping lines and worked on the quayside. The trade unionist and socialist James Larkin, Liverpool born of Irish immigrant parents, was pivotal to the 1913 Dublin lockout.
On every street corner, more evidence lies of the Irish community’s footprint on the fabric of our great city. The beautiful Walker Art Gallery and the Liverpool World Museum were built by Ballymena-born William Brown and are now situated on the street named after him. Irishman Michael Whitty was the founder of the Liverpool police and later the fire service. The renowned Agnes Jones from County Donegal was the first trained nursing superintendent of the Liverpool workhouse infirmary. Famed for her work ethic, Agnes died tragically at the age of 35 from typhus. Florence Nightingale described her as
“one of the most valuable lives in England.”
Before her came Kitty Wilkinson, an Irish immigrant from Derry, nicknamed Liverpool’s saint of the slums because of her educational campaigning to teach the public about health and hygiene. As the only person in her Liverpool neighbourhood to own a boiler in the 1832 cholera epidemic, she invited all those with infected bedding and clothing to use it, saving countless lives. Soon after, she opened the first public wash house in Liverpool.
The Irish contribution to our Liverpool health service continued with Irish nurses targeted for recruitment to work in the new NHS. By 1971, it was estimated that 12% of all UK NHS nurses were Irish. John Lennon, Paul McCartney and George Harrison all hail from Irish ancestry, and the Irish still contribute massively to Liverpool and British culture: think of Roger McGough and Jimmy McGovern, to name just a couple, not to mention our two great football clubs, both of which employed Irishmen as their first managers.
Liverpool is a city that marches to the beat of its own drum, and we owe so much of our rhythm and spirit to the Irish settlers and their descendants over the centuries. We are proud to celebrate with them today on St Patrick’s day.