Health and Social Care in England

Baroness Lane-Fox of Soho Excerpts

Thursday 11th July 2013 Lords Chamber

[Baroness Lane-Fox of Soho]

My Lords, perhaps like many here, I come at this subject from a very personal and a professional angle. I thank the noble Lord, Lord Patel, for introducing this debate.

I shall speak, first, about the personal: my life was saved by the orthopaedic department in the John Radcliffe Hospital in Oxford, so I owe my life to a well funded NHS. I am also someone who fervently believes in the power of technology to improve public services. It is only through their more effective deployment that we will continue to have a world-class healthcare system at a reasonable cost.

I am talking not about expensive NHS IT projects, top down and heavy, but about open standards, agile development, data and a more digitally minded healthcare sector. I would like to give some examples.

This era is often called the era of big data. We are able to aggregate information from a mass of different sources. The analysis of these data is changing the way in which we work and live. The Government have already encouraged the use of their own datasets, which are from many different sources.

However, we are only at the very beginning of this journey. A wonderful project which has come out of the Open Data Institute here in London illustrates why data are such an important part of this debate. In 2011-12, the NHS in England shelled out more than £400 million on statin drugs, from a total drug budget of £12.2 billion. However, in collaboration with Mastodon C, Open Health Care UK—a small start-up developed by a programmer and a doctor—managed to look at every prescription written for statins from every GP in England by using a dataset provided by the Open Data Institute. They looked at the regional patterns and discovered that, if doctors had prescribed the white label version, they would have saved more than £200 million. The variation is remarkable. Imagine the potential savings if this was applied across many other classes of drug.

As the Economist wrote recently:

“A study in the British Medical Journal … reckoned that the NHS could save more than £1 billion by switching from branded drugs to generic equivalents”.

Smart use of datasets will become essential in improving our healthcare, as long as the interoperability of systems is put at the heart of those improvements.

As 80% of the NHS costs come from the 20% of the population with chronic conditions, it will be essential to focus resources on how to help them manage their lives more independently. There is a growing evidence base that shows that online tools can help in this. Mindfulnet, Big White Wall and buddyapp.co.uk are just some examples of websites that provide help to people with mental health issues, giving them confidential help and techniques that allow them to manage their own lives. NHS HealthUnlocked is a London-based start-up that works with patient groups and gives 1 million people monthly information to support long-term illnesses such as diabetes and obesity.

More than 70% of us look at our smartphones before we go to the doctor. Every day, millions of people are using health apps on their mobile phones, logging into websites or chatting in online forums. New technologies such as UP by Jawbone, or even Nike+ FuelBand, allow people to gather their own data and make better lifestyle choices. This is where I respectfully disagree with the noble Viscount, Lord Ridley. I believe that such technologies will help prevent health issues and drive down costs.

It is vital that the NHS is able to deliver services of the same quality as citizens find on the web, or we will be in danger of undermining one of our most valued public services. This will require a cultural change in the sector so that all the people working with patients are able to provide high-quality, relevant and modern care and to connect with the innovative solutions being provided outside the NHS.

While I spent two years in hospital, I met some of the most remarkable people— from surgeons to doctors and nurses to healthcare assistants—but, even then, there was a huge gap between what they were able to do and what was happening in the commercial sector. We must ensure that all staff are digitally literate and that the internet is at the very heart of the design of services, surgeries and hospitals. On this the 65th anniversary of the NHS—surely one of the greatest innovations of our country—it is essential that we incorporate another of our greatest innovations, the world wide web, otherwise we will have no hope of meeting future funding challenges.

Queen’s Speech

Baroness Lane-Fox of Soho Excerpts

Monday 13th May 2013 Lords Chamber

[Baroness Lane-Fox of Soho]

My Lords, I am not the first Lane-Fox to make a maiden speech, but I think I may be the first Baroness to have a survived a virtual and a real-world crash. In 2000, the company I cofounded, lastminute.com, was navigating the choppy waters of the dot com boom and bust. Frankly, it was difficult—but she survived and thrived, as I was extremely fortunate to do when I was flung from a car in 2004.

The friendliness of this House is legendary, but I have been overwhelmed by the support and kindness of everybody, most recently in the past two minutes those who came to find me to tell me that I was coming up right now—but also the security staff, attendants, and catering and administrative staff. My two supporters, the noble Lord, Lord Chadlington, and the noble Baroness, Lady King, have given invaluable advice and were endlessly jolly on the day of my introduction, which banished nearly all my nerves.

My great aunt, Felicity Lane-Fox, gave her maiden speech in 1981, talking about disability rights, so I feel that it is particularly poignant that I can stand up and make a speech now and try to follow her great example. I would like to reassure any noble Lords who might remember Felicity that I do not intend to career down corridors towards my detractors, as she was given to doing in her newly electrified wheelchair—a weapon of persuasion.

When we started in 1998, we spent most of the time at lastminute.com convincing investors, suppliers and customers that the internet would be a force for good in the economy and was not about to blow up. It was surprising to me that well over 10 years later, when I was asked to become UK digital champion, I again spent my time convincing two successive Governments and millions of people in the country that the internet has much to offer. Shockingly, there are still 16 million people in the UK who do not have basic digital skills, and 7 million who have never been online. But we do have strong digital foundations: the internet accounts for 8% of our GDP, the highest of any G20 country, and recent forecasts suggest that 25% of our economic growth will come from the internet sector in future. We have competitively priced access and the highest number of online shoppers in the world. But I would like to argue that we should go much further and build on those foundations. I see usage of, and access to, the internet as a basic right that all citizens should be able to enjoy.

Why does it matter that so many people have never used the internet or do not have those basic digital skills? Partly, it is because we know that the majority come from the most disadvantaged communities—yet we also know that, if you are online, you are 40% more likely to be able to get work and will achieve 25% better results in education. Even the lowest income families will save up to £170 a year from online deals. In addition, the data show that feelings of loneliness and isolation are dramatically reduced when you get online. Some 1.5 million of the unskilled live alone and see nobody in a whole week.

British businesses also need support, as has been mentioned here already, and small and medium-sized business in particular. We know that only 30% of them are able effectively to use online tools, and that there is a potential £18 billion in the economy if we are able to give them more advanced skills to sell and buy online.

I have been fortunate enough to meet many people who have told me of the transformative power of the internet on their lives, but one young man I met in Leeds I think of often. He told me that the internet had saved his life. Saved his life—really? Even I was amazed. But he described how, homeless and addicted to drugs, he had ended up at a drop-in centre in Leeds, where they had encouraged him to learn some new skills, and now he was making music and selling it all over the world as well as teaching other people in his community—a budding entrepreneur and giving something back.

We must not create a two-tier society but aspire to a universality of digital skills. We must make sure that the potential of all our citizens is unlocked. I believe that this will help the UK prosper and grow at a national level and at an individual one. Only when we focus on all aspects of digital growth, both infrastructure and skills, will we be a truly digital Britain. In this tough economic climate, the internet is such a powerful tool to help people manage the trickiest circumstances of their lives, whatever their age and whatever their location.

This is not an impossible challenge. The charity I founded, Go On UK, managed to reduce the offline population by 50% in just six months in Liverpool last year by bringing together interesting partnerships in that one area. However, we know that all the data show that by far and away the most effective method of spreading skills is through peer-to-peer support, so, naturally, as I look around here, I see a room full of potential.

The internet has had a profound effect on my life. It has enabled me to start businesses and to work with charities and has helped me to endure long periods in hospital as well as deepening my cultural life in a way that I would never have thought possible. I am honoured to join this House and hope that from here I can continue to encourage and champion a truly digital Britain.