TThe AI revolution is upon us, and Labor hopes it can help save an NHS in crisis. At a recent Institute for Government event, Karin Smyth, Shadow Secretary of State for Health, said: described how a Labor government will “keep the door open” for tech companies. But the tech-utopian visions Labor is being sold on are not free: they could fundamentally reshape our relationships with our doctors and our own health, undermining the very foundations on which the NHS is built. As tech companies spread AI magic, civil society must act as a counterweight to temper the hype and remind the NHS of what really matters.
The Tory government also hopes that unlocking “the incredible power that (health) data possess” can stimulate innovation, reduce costs and improve healthcare. Optimism crosses the parliamentary divide. The consensus is based on a vision of the role of AI in medical record analysis and diagnostics, such as the early detection of Parkinson’s of eye scans or the “personalized AI doctor” praised by the Tony Blair Institute in its article recent report. It involves transforming the healthcare system from top to bottom: from chatbots in mental health apps, to algorithms for prioritizing wait lists, to supporting the discovery of new drugs.
But while Labor cannot overcome the NHS crisis, AI is not a silver bullet either. Tech-utopian visions do not take into account the dark implications of AI. Dr. Jess Morley, an NHS and AI expert, has warned that we need to manage potential unintended consequences to “avoid a situation where the NHS becomes a healthcare system that fits the algorithms, but is not socially desirable or even acceptable”.
Hyping AI – like back then Health Secretary Matt Hancock did so of Babylon Health before its collapse – undermines the public trust necessary for both the adoption of technology and the use of patient data that underpins it. Research conducted from my organization Connected by Data with the action group Just treatment, revealed patients’ deep concerns about the personal and ethical implications of the NHS’s digital transformation. We need a different political conversation and vision for the role of AI in the NHS to address these.
For example, do we want the Tony Blair Institute’s vision of personalized AI doctors to “capture and track various data about an individual throughout their life” and use it to “provide tailored treatment and lifestyle advice”? They might feel like an overbearing parent nagging us to take better care of ourselves, causing us to begin to ignore how we really feel and thus worry unnecessarily about our health.
Do we want doctors to become unskilled “people in the loop,” mediating our encounters with AI systems? Or that triage nurses on 111 will be replaced by chatbots? Our relationships with medical professionals could become unintentionally dataficative: reduced to a cold exchange of measurements and numbers instead of the rich, human, caring encounters we value. Shouldn’t our priority be to use AI to optimize NHS management and simplify administration rather than increasing medical care?
The risks don’t stop there. Are we satisfied if AI leaves the digitally excluded behind and mainly benefits the already privileged? There are known biases in its coverage and quality health data and medical research, as well as a difference in how easy it is to access this technology across genders, races and communities. More AI could mean more health inequality.
These potential downsides of AI threaten the foundations of our healthcare system: our autonomy, doctor-patient relationships, and universal access. But they are not inevitable. An NHS that is alert to the risks and upholds its fundamental principles can avoid them.
This is where Labor has the opportunity to differentiate itself from Tory tech-solutionism. The current government shuns a serious challenge and flees engagement exercises aimed at achieving public buy-in for government plans already has in place. Labor should give the public, professionals and civil society a real opportunity to help shape the future of the NHS with technology, including legal and political tools to support collective surveillance.
Labor must also show leadership in defining the role of the private sector in the development and delivery of AI systems. The Tony Blair Institute advocates using public money and public data to grow the commercial biotech sector. But as we have seen with medicinethe private sector has little qualms about putting profits before patient health.
Instead, Labor must commit to overhauling healthcare procurement processes. It should equip the NHS to not only negotiate good value for money in AI, but also to renew its democratic roots. The NHS should invest strategically in community-owned and open source healthcare technologies, and introduce independent ethics reviews and public oversight of major technology purchases to rebuild public trust.
AI is promising, but it is not free. A Labor government will inherit not only a failing health service, but also a series of risky technology deals and a skeptical public. As it seeks to reform the NHS, it must avoid being seduced by the self-serving promises of AI companies and instead give a powerful role to the public, medical professionals and civil society in shaping our future NHS.