Paul Taylor

Jeremy Hunt announced last Wednesday that as many as 270 women may have died because an error in a computer algorithm prevented 450,000 women being invited for routine breast cancer screening appointments. Stories about IT glitches will be increasingly common as artificial intelligence enables more and more healthcare to be automated. As things stand, people are still better than computers at detecting early signs of cancer on mammograms, and the neural networks currently being designed to analyse the images are intended for use as an aid rather than a replacement for human decision making. The hope is to engineer systems that combine the different strengths of humans and computers, with outcomes that neither is capable of independently. The sad reality is that we seem to end up with systems that combine an all-too-human capacity for error with a computer’s blunt force, and so wreak havoc at an inhuman scale.

There are no good news stories about computers and the NHS. The reporting of Friday’s malware attack may, however, be usefully different from the typical bad news story, in which hubristic politicians or nameless bureaucrats waste millions, if not billions, of public funds on projects which go over budget, fail to deliver, prove to be unusable or collapse under pressure. In this instance it seems that, for once, inaction and underinvestment have led to something sufficiently focused to be newsworthy, showing that there can be a political as well as a human cost to doing nothing.

‘Around 6000 people lose their lives every year because we do not have a proper seven-day service in hospitals,’ Jeremy Hunt said on 16 July 2015. ‘You are 15 per cent more likely to die if you are admitted on a Sunday compared to being admitted on a Wednesday.’ A Department of Health statement later clarified that the figures came from an analysis ‘soon to be published in the BMJ’. Nick Freemantle, a professor of epidemiology at UCL, had been invited by Bruce Keogh, the chief medical officer, to update a 2012 analysis of hospital data, apparently on the suggestion of Simon Stevens, the new chief executive of NHS England. The resulting paper wasn’t accepted by the BMJ until 29 July, after Hunt’s speech. When it appeared in September, it contained no reference to the 6000 figure.