Society changes in direct and rapid response to the evolution of technology in general and the internet in particular. We launch an occasional series of blog articles about health, education, employment, transport, entertainment, defence, sport, finance and policing, all areas under exponential change pressure through technology.
The National Health Service
Ever since its birth in July 1948 the NHS has been at once Britain’s pride and joy, copied envy of the world, political football and cross to bear.
In the early 2000s, efforts were made to over come a perceived reluctance to modernise through wider use of IT, better to improve health outcomes. Active IT would provide and store advice and information; revolutionise administration and transactions like making appointments; giving patients improved diagnostic technology; monitor/keep track of groups, like the aged, the asthmatic and the cancer sufferers.
IT would also be something like a magic wand improving communication between patients, their carers and the professionals. To some extent that has happened; but not universally successfully.
The Kings Fund published results of their project Technology in the NHS in April 2009. They set out to identify what determines ‘whether and how’ technology is adopted in the service and how to overcome barriers.
They found that both internal and external barriers influenced technology decisions in the NHS, from the effectiveness of suppliers to make cases for changes, how standards could be agreed easily or not, patient understanding and/or resistance, impact of regional and national government and centralising/decentralising purchase decisions.
Their final report recommended an ‘ideal scenario’ where the potential of technology is fully realised to meet the objectives of the NHS’. It concluded that to work, it needs the ‘active involvement’ of all those in the system: patients (consumers), clinicians, local/regional management, regulators, the Department of health and the technology industry.
In addition to the need to pull together so many separate strands, there is the problem of ‘medical inflation’ and ‘technological obsolescence’. Every new development in digital technology costs hugely. Scanner, diagnostic devices and medicines themselves are expensive. Yet people demand the very best/latest, of course, especially if they perceive their lives depend on it.
So it boils down to spending of public money. Buying the most amazing new health equipment, maintaining it, staffing it, getting maximum use of it and preventing its theft are organisational and revenue challenges. The point is, that almost before it is acquired, absorbed and working, the next generation of equipment is arriving and everybody switches demand and expectation to that.
The other issue is that Britain cannot stand alone and isolated in healthcare. Diseases come from all over with increasing ease of travel; research is often shared globally; new techniques, treatments and drugs are being tried and tested all over the world, often in responses to famine, earthquake, war and poverty.
The NHS runs a small department in Cambridge called the Sustainable Development Unit, as a source of leadership, expertise and guidance with a brief to ‘help the NHS fulfil its potential as a leading sustainable and low carbon healthcare service’. They develop organisations, people, tools, policy and research which enable the NHS to promote sustainable development and mitigate climate change’.
They have devised a Route Map through technology as an ‘enabler of positive societal and environmental change’. Investing in low carbon health technologies, all stakeholders and partners in the nation’s health can ‘reduce the risk of investment’, embrace new technologies and ‘improve opportunities for telemedicine and sustainable, preventative healthcare’.
The debates rumble on about public funding of basic medicine, transplant surgery, cosmetic enhancements, accident care, infertility treatments, smoking and alcohol related diseases. It’s not simply a political matter. It’s taxpayers and it’s technology.
As technology isn’t going away, as the NHS will continue to have to adapt to serve an ageing, larger population for longer, it’s in all our interests to support health management change, better targetting of scarce resources and accept that sometimes the absolutely latest is not possible.
We also have to accept occasionally, that the very best medicine/technology is not yet invented.
Or will we accept that? Any thoughts?