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‘Two-tier’ health service slammed

Unite to protest GP at Hand app in east London demo
Hajera Blagg, Tuesday, November 12th, 2019

Unite will shine a spotlight on the accelerating privatisation of GP services and its detrimental impact on patients at a demo in Tower Hamlets in London on Thursday (November 21).


Unite has highlighted the dubious practices of GP at Hand, an app-based GP service in London that expanded to Birmingham earlier this year and is now hoovering up NHS patients. An estimated 60,000 patients in London and Birmingham are now registered with the ‘digital first’ service which replaces traditional face-to-face GP visits and requires patients to de-register from their current GP.


The loss of tens of thousands of patients – the vast majority of whom are between 20 and 39 years old and so tend to be healthy – has sparked fears about a substantial loss in registration fees.


This ‘cherry-picking’ of younger and mostly healthy (and wealthier) patients is worrying because it is these very patients who subsidise the 20 per cent who have long-term, complex and serious health conditions — in effect totally undermining the way GP services work and the vulnerable populations they serve.


Unite has also previously highlighted that the technology is not evidence-based — serious flaws have been reported with the app’s ‘chat-bots’. An NHS consultant who tweets under the name @DrMurphy11 signed up to the app and input symptoms suggesting a heart attack that were dismissed by the app as nothing serious. He also input symptoms indicating possible meningitis and again, the app told him to go to the pharmacist.


Controversy has also surrounded Babylon, the firm that owns GP at Hand. It is headed by CEO Ali Parsa, an ex-Goldman Sachs banker and founder of Circle – the same company involved in running Hichingbrooke Hospital.

It was the first NHS hospital to be entirely privately run and after only a few short years Circle pulled out of its contract in 2015 amid heavy criticism. In the end, patients paid the price with care that was rated “inadequate” and taxpayers footed the bill of Circle terminating its contract.


Most recently, in October it came to light that Prime minister Boris Johnson’s most senior aide Dominic Cummings may be embroiled in a conflict of interest over his role as consultant for Babylon.


Labour’ shadow health secretary Jon Ashworth called the links between Cummings and Babylon “increasingly murky and highly irresponsible” since Babylon could benefit from a £250m AI fund which was announced by the government in August to improve NHS screening and diagnostics.


Health secretary Matt Hancock has long been a vociferous supporter of GP at Hand — this may come as no surprise given that when he served as culture secretary, he appointed a Babylon investor, Demis Hassabis, as a government adviser on artificial intelligence.


Critics have also called into question Babylon’s finances — the firm reported a £66m loss last year, up from £23.3m in 2018.


Speaking ahead of Thursday’s demo against GP at Hand, chair of Doctors in Unite and Tower Hamlets GP Dr Jackie Applebee said, “We object to GP at Hand on two main grounds – one that it is draining resources from the NHS to the private sector; and, secondly, it is reducing the resources that GPs have for their more chronically ill and elderly patients.


“We also understand that 25 per cent of GP at Hand patients ditched the company in the 14 months to January 2019, which is not a great advert for the private sector.


“GP at Hand cherry picks the younger, richer patients – but it is not so keen if you are pregnant, have a terminal illness or suffer from mental health problems which need more complex and costly care plans,” she added.


“The accelerating rate of the privatisation of the NHS, of which GP at Hand is a prime example, is creating a two-tier health service which undermines the fundamental ethos of the NHS when it was founded in 1948.


“That is why it is important for the residents of east London to come out and protest on November 21 to show that the NHS is not up for sale to privateers.”


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