In good health
How Lord Darzi envisions AI transforming the NHS
“AI is set to redefine medicine as profoundly as antibiotics and modern surgery once did.”
If anyone knows what they’re talking about in this regard, it’s probably Lord Darzi of Denham. A distinguished surgeon with a track record of championing innovation through his work on robotic surgery, the independent peer was last year tasked with carrying out a thorough assessment of the NHS. His conclusion was that the body was in “serious trouble”.
Speaking at the Alan Turing Institute’s AI UK conference yesterday, he beat the drum for fixing some of the health service’s problems with AI. Watching on the conference livestream, I struggled to write notes fast enough to keep up with all the possibilities he raised. These could include pre-emptive medicine and predictive analytics, automated paperwork and remote healthcare, drug discovery and monitoring of drug resistance.
But anyone striving towards this rosy vision, he explained, will face resistance. Drawing on his own experience of pushing for the use of robotics in operating theatres, he recalled how he had initially assumed that developing the technology would be the hardest part. “I was wrong,” he said. “The real challenge was that of adoption.”
Scepticism about the technology combined with high upfront costs slowed down the rollout. Even today, he said, 2.4 million people still live over an hour away from the nearest hospital with robotic surgery. “We cannot repeat that same mistake with AI.”
Addressing these barriers requires more than just optimism. The NHS’s structure, funding constraints, and public trust challenges all shape the adoption curve.
Our lady of perpetual shortstaffing, our national sacred cow, the NHS holds a special place in the hearts and minds of the British public. Private companies – be they healthcare providers or frontier AI developers – working with the service often attract massive levels of scrutiny. (As I was writing this newsletter, news broke that Lord Darzi had failed to properly declare his shares in various healthcare firms on the House of Lords register. His legal team says it was an oversight, and there was no conflict of interest with his public roles). Attempts big and small to tinker with it will always face pushback, as well as logistical challenges.
“The NHS is just generally terrible at change management,” Rosie Beacon, head of health at Reform Think Tank, told me. I gave her a call because Lord Darzi’s speech had struck me as so bullish that I wanted to get a sense of how much of it was truly feasible.
A splintered structure and lack of investment slows down rollouts, Beacon explained. Decision-making is different hospital by hospital, while GPs don’t always have the skills to oversee a huge new technology rollout in their surgeries. She sees the most immediate benefits as likely to come from operational efficiencies which are easier to implement at scale: things like note-taking, discharge letters and other paperwork.
Lord Darzi noted that there could be unique opportunities for the country here. “The UK has the assets to lead on this,” he said, citing the biobank, top research institutions and world-class private sector players like DeepMind.
Could the NHS become a model for dragging state apparatus into the future? The organisation may be the most difficult stage on which to demonstrate the benefits of cutting-edge technology, but it could also be the most important. If the effects are tangible and positive – shorter waiting lists, better clinical outcomes, earlier illness detection – that would be a huge win for public trust in AI.
In his talk, Lord Darzi said that the nature of the NHS means the UK can attempt this on a grand scale – compared to countries that do not have the same kind of public health service. Beacon was sceptical of that, given the labyrinthine nature of decision-making within the organisation; to roll out new tools to every part of the system would require some serious rethinking.
This government has shown it is willing to make some bold strides though, given last week’s announcement that it would scrap NHS England.
As Lord Darzi put it: “It’s a matter of thinking big.”
Teatime scroll Each week I share links to writings, events, tweets and other conversation-starters. If you have something you think should be in here, feel free to email or DM me.
New York’s anachronistic and oddly romantic steam heating network is the subject of a fascinating piece by Tract co-founder Jamie Rumbelow in the latest Works in Progress. I had never really thought about district-level heating technology, but it’s a surprisingly intriguing idea.
This piece in The Economist on why British women thrived under remote working makes for very interesting reading.
For Digital Frontier, University of Essex PhD student James Rice takes on the question of how AI will impact the practice of research – and whether it will make researchers smarter.
“The Thinking Game”, a film about DeepMind, is out now. Here’s a handy list of screenings happening in the UK.