25th Anniversary of the World Wide Web

Lord Crisp Excerpts

Thursday 16th January 2014 Lords Chamber

[Lord Crisp (CB)]

My Lords, I, too, congratulate my noble friend on securing this debate and on setting the scene so brilliantly. In my three minutes I will speak only of health, where the world wide web already contributes enormously but where there is much more to come.

The web enables clinicians to access information where and when they need it, which is ever more important in a world where, for example, there are now more than 6,000 different disease entities. It also enables them to consult colleagues. Organisations such as the Swinfen Charitable Trust, run by the noble Lord, Lord Swinfen, and his wife, allow clinicians in even the most remote and isolated locations in the world to consult a network of clinicians in every discipline. The web also helps meet patients’ demand for information and empowerment. For example, there are 27 million views of NHS Choices a month and 1 million patient reviews of services on the site. It also allows for the remote monitoring of patients where, with the whole system demonstrator, the NHS leads the world in terms of evidence-based use of this technology at significant scale. There is even patient self-treatment. There is an excellent programme called “Beating the Blues”, which is designed to do exactly what its name implies, and I wonder whether this is the first internet-delivered treatment available on NHS prescription. If so, I am sure there will be many more.

A very important point has been made about inclusion, where again there is much to do. The sickest are probably the least able to access help electronically, but conversely the web offers much greater reach to people than otherwise. I pay tribute to the noble Baroness, Lady Lane-Fox, as the nation’s digital inclusion champion.

However, progress in health has not, perhaps, been as a fast as one might have expected because behaviour change is slow in health and redesign involves many other aspects of health systems. This is problematic but not necessarily always a bad thing. It is important that, in a subject as crucial as people’s health, evidence of impact and effectiveness is properly weighed and we should not rush in just because something seems attractive.

I conclude on a point where we need national and international co-ordination. I am privileged to be one of the Global eHealth ambassadors, in a programme chaired by Archbishop Desmond Tutu. It exists to promote telemedicine and e-health globally. It sees e-health as a means of transforming healthcare delivery to make it economically and socially much more sustainable. It campaigns for some standardisation of systems and methodologies in e-health to ensure that data can be properly shared and that every clinician can judge the reliability and effectiveness of the electronic tools they are offered. We need a global framework for this. This is very ambitious but much of the infrastructure to sustain that transformation already exists. The programme gives an example of one of those wonderful internet facts. It asserts that there are now more cell phones in Africa than toothbrushes. I am not sure that we can verify this assertion but we have known for years that toothbrushes are essential for health and we now know that cell phones and the world wide web are even more essential.