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House of Lords Hansard
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NHS: Babylon’s GP at Hand App
21 October 2019
Volume 800

Question

Asked by

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To ask Her Majesty’s Government what impact assessment has been carried out of the effect that Babylon’s GP at hand app (1) is having and (2) may have on (a) GP patient waiting lists, and (b) the funding of primary healthcare.

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My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare my interests as set out in the register.

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NHS England and partners commissioned an evaluation report of Babylon GP at hand. This was published in May 2019 and concluded that, overall, users are satisfied with the service, in particular its convenience. The GP at hand work- force demonstrated high satisfaction with the service, particularly with the flexible work arrangements. However, satisfaction was lower for waiting times for face-to-face appointments. Practice funding is being revised to improve fairness following the emergence of digital- first providers.

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I am not sure how many noble Lords realise what GP at hand is. It is a virtual GP app that uses artificial intelligence to identify health problems and has a partnership with the NHS in London and Birmingham, where patients can sign up for the digital-first GP at hand service and receive video consultations. I am absolutely in favour of the use of new technology in primary healthcare—this is not a Luddite Question—but clinical commissioning groups in London have, on the instructions of NHS England, had to reserve large sums of money, of up to £1 million, in their 2019-20 budgets for the next year to meet the costs of Babylon GP at hand. They have not commissioned this work; it is not included in the safeguarding or quality oversight of them; and it is paid for without basic information about how many or which patients are leaving local GP lists or the impact that this might have. Does the Minister think that this is a satisfactory situation, in terms of the control and accountability of local budgets? Would the money, which I understand stands in London at about a £21 million deficit, not be better spent providing technology and IT infrastructure for the use of our GPs in their surgeries?

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The noble Baroness raises an important question. The Government are aware of the issues faced by out-of-area commissioning, and particularly of the concerns of Hammersmith and Fulham Council. We are looking at its concerns about its budget provisioning. We do not recognise all the numbers, but we are trying to understand them better. I reassure her, however, that we are putting in measures to ameliorate the situation. We are looking at ways to disaggregate a patient list if there are large numbers of digital-first patients; we are making more timely adjustments to CCG budgets, moving to quarterly rather than annual assessments; and we are looking at how to apply technology to under-doctored areas.

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My Lords, how confident is the department that NHS England is ready to deal with the addition of a new model of access to GP services? Does the Minister have a view on whether legislation would be required to achieve this?

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To date, there has been no articulation of a need for further legislation.

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My Lords, is it just a coincidence that Dominic Cummings used to work for this dodgy private healthcare company that is now getting so much financial and other assistance from the Government? How many meetings there have been between Health Ministers, particularly the Health Secretary, and officials from this company, Babylon? If the Minister cannot tell us today, will he write to me with details of every meeting and put a copy in the Library?

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Decisions on individual providers are made by the NHS commissioners, not by special advisers. The meetings of special advisers are documented in Cabinet Office folders and I would be glad to send a link.

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My Lords, is it not the case that the number of locum doctors working in GP practices is now at a record level? Is it not time that the GP contract and the structure of such practices were re-examined so that doctors who work in them can be expected to take responsibility for their management and smooth running, thereby increasing the potential for a consultation with a doctor one knows?

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Working practices are changing in GP practices, as they are in every walk of life. One interesting piece of feedback from the assessment study of Babylon was the very high levels of work satisfaction from GPs, who like the flexible and at-home working. The feedback means that they will stay in the profession for longer. The Government assess this form of modernisation as being very helpful in holding GPs in their roles.

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My Lords, with respect, the Minister did not answer the question from the noble Lord, Lord Foulkes, who did not ask about meetings with special advisers but specifically about meetings between the company and Ministers, and particularly the Secretary of State. Can the Minister give that answer about how many there have been? If not, will he accede to the request of the noble Lord, Lord Foulkes, and write to him and put a copy in the Library?

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Meetings with Ministers are published. I am happy to check with the department to see whether there has been any oversight, and I will share any response with the Member.

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My Lords, the big issue with apps and health is that the data used can be used by these private companies in a way that the Government cannot track, and that data—particularly of individual patients—is used in a way they do not control. In light of this, what new regulations will be brought forward, particularly on patient consent to the use of individual data?

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The use of patient data by the NHS, its contractors and providers is highly regulated. The CQC regulates Babylon as it does every other GP practice, and it is subject to exactly the same rules as every other privately owned GP outfit in the country.