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The NHS: online and out of sight?

SOLOMON HUGHES reveals the reasons why the Tories are pushing a ‘see-your-GP-by smartphone’ approach nobody, doctors or patients, asked for

ONLINE GP consultations are at the centre of the Tories’ new “NHS Plan.”

There is no big demand from within the NHS for online GPs or real evidence they will improve health. So why?

Well first, it will hand over more NHS services to big corporations. Second, a former Tory Health Minister, who is currently an adviser to Health Secretary Matt Hancock, works for an online GP firm: Nicola Blackwood now sits on the board of Push Dr Lt, which calls itself “the UK’s number 1 online doctor.”

The “See-your-GP-by Smartphone” message came from the top. Theresa May knows the Tories are politically vulnerable on NHS spending cuts, so launching the new NHS Plan this week called it an “ambitious funding proposal to help make the NHS fit for the future.”

More money sounds good, even if the sums are exaggerated. But the bigger question is where the money goes.

The NHS needs more staff — more doctors, nurses, carers, cleaners. But May says the money should go on new tech, especially GP-smartphone tech.

At the heart of May’s speech was a pledge to introduce “exciting new possibilities,” of which the number one was “accessing your GP via your smartphone.”

Health Secretary Matt Hancock pumped up the volume on the GP-app plan, saying: “Technology will truly transform our NHS, with every patient entitled to online GP consultations.”

It’s not just the speeches. The plan itself promises to “make digital health services a mainstream part of the NHS, so that in five years, patients in England will be able to access a digital GP offer.”

From the top to the bottom there is a huge emphasis on GPs-by-smartphone. The Times made it a front-page story, saying: “Millions of patients to see hospital doctors by Skype under NHS plan.”

But why the Skype hype? Doctors aren’t demanding it. Patient groups worry older people won’t benefit — and they do tend to be sicker.

There are online GP services, but when they have been looked at they’ve been found to be unsafe.

Maybe because the plan will have three effects. First, it will hand more of the NHS to corporations.

GPs are at the core of the NHS. They are mostly small independent businesses contracting to the state.

Shifting their work to “online” GP services will transfer the work to big corporations that employ GPs, rather than GPs themselves — GPs are small private businesses, but they are by nature medically led.

The new corporations will be led by non-medical, profit-seeking business executives. Both Tory and New Labour governments have repeatedly tried replacing GPs with corporations. This is the latest attempt.

Second, putting big corporations in charge of GP services — via control of online services — will create opportunities to sell “top-up” or extra health benefits — pay a bit more for a quicker or extra consultation — allowing further privatisations.

Third, it will enrich firms that employ Tories. Push Doctor, aka Push Dr Ltd is a leader in the field, offering appointments with a “UK GP on your laptop, tablet or mobile” which will allow you to “see an online doctor in minutes.”

They mostly sell private-only consultations, but are looking to expand their work through closer NHS links: May’s announcement hugely increases these opportunities.

Nicola Blackwood was a Tory health minister until she lost her Oxford West seat in 2017. She now works for Push Doctor, sitting on its strategy board.

Not only is Blackwood a former Tory health minister, she also has a seat on Health Secretary Matt Hancock’s Healthtech Advisory Board, which will “guide the government on its mission to transform technology in the NHS” — Hancock created this board in 2018 to push for new technology in the NHS. Blackwood works for an online doctor company. Now Hancock is pushing online doctors as the big thing for the NHS.

Blackwood is not the only “insider” on the Push Doctor board: Ed Smith chairs its strategy board. Until 2017, Smith was the chair of NHS Improvement, a key government body “responsible for overseeing foundation trusts and NHS trusts.”

NHS Improvement has a history of promoting privatisation within the NHS.

Does having former ministers and NHS bosses on board make Push Doctor a good firm? Not according to health service regulator the Care Quality Commission (CQC).

In 2017 the CQC inspected Push Doctor and “found that the service was not providing safe, effective or well-led services.”

For example, the CQC found it “prescribed some high-risk medicines” like “blood thinners and medicines for mental illness, without checking whether the patient had received the correct monitoring and blood tests.”

The CQC told Push Doctor to improve, but in its 2018 follow-up inspection it still found “further improvement was required” in safety and leadership.

Push Doctor has also been told off by the Advertising Standards Authority, which banned some of its posters and web advertising.

Even though it is a “paid-for, non-NHS service,” the firm puts the NHS logo on its publicity and talked about its service “allowing you access to an NHS GP whenever you want.”

The firm claimed this only meant its GPs were “NHS-trained.” Under Hancock’s announcement, Push Doctor has a big chance to fix this by moving in on the NHS.

Push Doctor is not the only online GP firm close to the government.

Hancock relentlessly pushes Babylon Health, the “GP-by-app” service created by health investor Ali Parsa.

Like Push Doctor, Babylon Health Has been judged unsafe by the CQC. Like Push Doctor, Babylon Health has hired key government insiders. Babylon’s director of NHS services is Paul Bate. He was David Cameron and Nick Clegg’s health policy adviser during the coalition.

Before that Bate was a health adviser to Tony Blair when New Labour was promoting NHS privatisation.

Babylon Health also previously hired Trafalgar Strategy to run its PR, a firm founded by former Cameron head of press Giles Kenningham.

So the evidence that “online GPs” will improve health is slim. The evidence they will funnel money to firms connected to the government is much more obvious.

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