Oops we’ll do it again

That is the image the British Labour Party is handing down to the people, via the Guardian I might add (at http://www.theguardian.com/technology/2015/may/01/labour-nhs-health-data-liz-kendall-election). You see, the article gave the view of a politician, which is fair enough, which it all seems to be, a tech driven article (it was in the tech section, so that makes sense).

The issue here is not that this Labour lady with the name Liz Kendall for Leicester West is all pro data for the people, she seems abundantly ignorant of the complex nature of this dimensional behemoth called data, which is very much an issue. So as we take a look at certain statements let us also look at the other side of them. “Citizens should have control of their own health data“, really? Health data is there to help physicians and health centres to get aid the most efficient way to the people they need to care for. Then we see an introduction of two paragraphs where she whinges on parliament and how things are outdated. Then we get the quote “Technology has been neglected by every party in this election. Even the Conservatives, who published a simple but compelling technology manifesto in 2010, have failed to follow up for 2015. And Labour, which has been working with some respected UK technologists for months, developed a slate of compelling ideas that failed to make it into its manifesto“.

Well, let me help you here Liz! Your own party wasted well over 11 billion pounds (yes billions, not millions) on an IT system that never worked and never went anywhere. This administration is trying to clean up a mess and get rid of a 1.7 trillion pound debt, pushing more billions into any place that is not carefully thought through in this day and age is a really bad idea. Did I mention that is was British Labour spending those many billions on something that did not work?

Then we get a real beauty (after more generic information) “Tech is crucial to tackling inequality and giving people life chances, as well as getting the best value for public money. We should be open about how the government works and every department should be thinking about how it can use technology. We have to take technology into politics“. Here she misses the ball on several attempts by a massive margin I might add. Inequality is only tackled if people are properly trained, if the HR departments of those places are properly dealt with. Tech is not key here, data to monitor inequality is, but that is a sub article for another time. Taking technology into politics is debatable, first of all many politicians are not that tech savvy, so getting them automated might ruin more things, behind that there is the quashed reality is that tech is nothing more than a tool. It is a tool we use, not a golden calf we worship. Tech is not a solution, it is a mere means to get the place we used to go, but more efficient (we hope).

Then we get the ‘outlier’ in all this: “She is more animated about the potential of technology in the NHS. Kendall talks about visiting a constituent who suffered with the lung condition COPD that was significantly improved by a trial of tele-nursing. Rather than hospital visits and being on oxygen 19 hours a day, Clive Callow was monitored in his own home with data sent back to a team of specialist nurses who advise on adjustments in his treatment or visit him at home“, Yes Miss Kendall, you found an application, so how many patients per hospital need to be in a hospital on oxygen 19 hours a day? Without needing any other treatments or care? You are promoting tele-nursing on an outlier. This is really not that bright.

Let’s be fair, for this one person it is a nice thing, but if there are any complications, a doctor would be needed really fast, then how good was the solution? Then we get the Kidney dialysis ‘scheme’ as Liz Kendall points out. She has a decent point, yet when we see the information from britishrenal.org we get: “The number of patients on home haemodialysis is slowly starting to increase as the hospital kidney centres become more able to provide and support home haemodialysis and kidney patients are choosing to do their own dialysis at home. However there is large variation across the country“. It is the large variation that is the issue! Now, in all fairness, she is targeting a group that is set at 41%, which makes for well over 21,000 people, so it is not a small group and in that she has a case, but there is a long stretch of ‘teching’ things and ‘series of successful digital skills training courses’. These are all different sides of different coins and they are not the same currency either. So, the Dialysis option is fair enough and giving the hospitals options here is all good and fine, but this means more technical staff (high educated ones) medical technical staff and implementers. This will drain the NHS of other staff members. So the logic is missing here. I a world where the UK does not have a debt, is not in ‘near’ recession mode that idea is fine, but the NHS has massive issues, adding to them will not help.

How could I agree?

Well, for the options where there is a much higher renal issue, I would state, have 5-10 extra machines and 5 extra nurses and one extra doctor for THAT specific department. Guess what! Her tech people will not get a job and there could be other resource draining too, but it would secure a better position for 22,000 patients that is a real number we can deal with. But what is the price tag at this point? The NHS has the need for massive funds and tagging certain amounts for dialysis alone might not be fair (not stating that it is or is not, I just do not have all the numbers to make that call).

Now we get the next bit “And the CLASH project in Leicester helped an arthritis group learn how to use digital communication tools like Skype, which, says Kendall, helped to tackle the related depression and isolation that often affects sufferers“. Again a nice part, but that is not for the NHS. Getting locals with arthritis on a communication streak is not one I oppose but it should be with the responsible place, not the NHS. Yes, there is an NHS benefit (fighting depression) but we need to be clear about what can go where and how it can be implemented to work, not to cost money and to be forgotten 14 months later because of a costing error. She ends that part with “NHS has a huge incentive because treatment costs a fortune“, Yes Miss Kendall, it might cost the NHS, but so was the 11 billion for a non-working IT system which Labour fumbled.

Now we get to the ‘initial’ issue on health data. If you look at the possibilities of monitoring data about genetics and susceptibility to diseases, then there’s an even stronger argument for a national health service, because the principle of owning and controlling your own data, for example, is really important, this is the stuff of ‘legends’. Actually it is not, this has all the makings of a tech consultant speech, which comes with commission for him/her and massive costs for the NHS. When I read tech, monitoring and ‘susceptibility to diseases‘, my initial response is, ‘Are you for freaking real?’ The statistics, the data collection and the comparison is way outside of any budget, especially when you start collecting up to 65 million records. You see, there is a low tech solution that has worked. It is called Triage which has been around since World War 1. There is also Reverse Triage, these two require two elements and they require doctors and nurses (and equipment as the third element). We are for now in an age of debts, in here ‘susceptibility’ is a nice concept but let us focus on the ACTUAL sick, getting them better and making sure the NHS has a decent system to keep track on the actual events, not the forecasting of the possible but improbable. There we see the issue, what other ‘concepts’ would Liz Kendall like to waste money on?

I’ll be frank, the concept is not bad, it would not be a wasted effort under different conditions, but in this time and age and under the austerity we still face, giving it to some tech savvy scheme that is supported from a consultancy field is a really bad idea, I would rather see more doctors and nurses and less wasting billions for now.

She basically ends with having a go at the conservatives, which, as a Labour person she should be allowed to do (fair is fair), but she needs to realise that Labour has zero credibility when it comes to ‘tech’ projects in health care. The NHS needs change, it must evolve and as we see the claim “We have an ageing population, elderly people ending up stuck in hospital because we don’t have community nurses and social care to look after them at home“. This is a fair claim, but guess what! These people will end up being dead at some point! It is not a wish, just a simple reality. Yes, there should be more community nurses (not just in England), but the politicians have wasted tonnes of money, the Labour party being one of the better wasters of resources in that regard. Change must come, we all agree there, but without funds and trained staff that solution will not be easily solved. The only thing that Liz Kendall achieved as I see it, is to give chunks of fuel to Stuart Young, the UKIP member in her electorate. I would hope that the conservatives would make it a real battle, yet at present, I am not impressed with Paul Bessant. The generic information of a ‘successful businessman’ just does not cut it nowadays (as I see it). Stuart Young, a bookkeeper and as he states, devoted to Leicester, a Westcott’s man. with his one line “Westminster’s politics and economics are fundamentally flawed and they need a complete overhaul” he does two things, one he speaks a given truth to which pretty much every British person can relate, in the second, he blows the entire Liz Kendall element of ‘Technology can stave off the crisis in the NHS‘ out of the water. The title is not only realistic, the elements that need fixing will take 3-4 years and can only be done one step at a time, more important the second step is not even an option until the first step is successfully completed, the NHS is THAT limited on resources. I cannot claim that either Stuart Young or Paul Bessant would be a good choice, but the article gives proper weight to how bad Liz Kendall would be.

However, that is just my view on the matter, so feel free to disagree!



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