The decision by the NHS to share basic health assessment information with Amazon for use through its Alexa virtual assistant service may appear an effective way of reducing pressure on primary care services, but a question arises of what Amazon will do with all the ostensibly valuable data it gleans, and whether this will be shared with the NHS. Against a backdrop of a wider debate on ‘surveillance capitalism’ and the relationship between tech giants and individual privacy, a more focused debate is already underway in the UK on the outlook for the use of data related to healthcare. For policymakers, this can be reduced to two main challenges. Firstly, how to protect patient privacy and encourage transparency. Secondly, how to share the rewards from what is hopefully a productive exploitation of a seemingly public good. Policymakers need to respond to both if an effective ‘social contract’ can be crafted to underpin a global market that could be worth £50-70 bn by 2025.
There are few UK political issues like the NHS – beloved, sacrosanct and elaborately celebrated and protected by politicians of almost any stripe. So it is inevitable that political alarm bells ring at the idea that the UK’s national health service would be ‘on the table’ in a possible UK-US trade agreement – an idea that got some airplay during President Trump’s visit to London this week. It’s useful to be a bit clearer on what this might actually mean. We have been here before, during the TTIP negotiations, so it is also important to ask why and how a UK-US negotiation might be different.
Healthcare systems across the OECD, whether publicly or privately funded, face a range of challenges that threaten their financial and operational sustainability. The demographic crunch is the backdrop to this. Life expectancy has risen inexorably over recent years, but quality of life has often failed to keep pace. More people are living longer, but frequently with complex, chronic conditions that require ongoing treatments. Health systems have to meet this increase in demand with constrained resources, especially since the global financial crisis. Publicly funded systems in particular have received fewer resources than required as governments seek to economise, leading in some cases to a rationing of care.
Capita’s profit warning is yet another sign of the growing fragility of the large, generalist outsourcing sector in the UK. That no bail-out was forthcoming for Carillion showed that such firms are not too big to fail. Indeed, the question seems to be whether they are too big to survive. This should imply significant opportunities for smaller, specialist firms, and therefore for investors, considering the raft of non-core asset sales the big outsourcers will undoubtedly be rushing into this year. There are, however, some considerations to be taken into account before jumping into the world of outsourced public services.
The latest sale process for Thomas International, a psychometric and aptitude assessment provider, is well timed to coincide with the UK government’s publication this month of its long-awaited careers strategy, which looks to rejuvenate a previously neglected area of education policy and could be a platform for growth in much-hyped ‘edtech’ provision.
The publication this week of a review into the UK’s high-cost credit market is just the latest demonstration of the UK’s financial services regulator, the Financial Conduct Authority (FCA) regaining its mojo for activist policymaking. The FCA has always held a formal objective of protecting consumers, but this has often had to be balanced against the economic and political interests of the financial services sector. The weakness of the current government therefore gives the FCA an opportunity to return to a proactive approach, although maybe not the “shoot first and ask questions later” attitude of its first CEO, Martin Wheatley.
With the UK Parliament likely to dissolve on the 2-3 May, ahead of the 8 June election, there will now be a frantic scramble for the UK government to complete the passage of legislation currently in train. This process, known as the wash-up, was thought to be relatively obsolete with the introduction of fixed-term parliaments. Revived now it will be controversial, as the normal process of parliamentary scrutiny is substantially truncated.
Regional UK city Lincoln’s hospital’s Accident & Emergency Department was at risk of being closed this week. This was not due to a deluge of patients or a lack of funding but rather the result of a recent tweak to the UK’s tax rules and could have far reaching ramifications for the UK-wide review of self-employment practices, currently underway.
It would appear that Macquarie’s status as preferred bidder for the Green Investment Bank, a UK government owned renewable energy investor, is under threat. While the sale was supposed to have been finalised at the end of 2016, Climate Change Minister Nick Hurd confirmed on Wednesday that the government has not taken a final decision on the structure of the sale or whether Macquarie’s bid satisfies the criteria initially set out when the sale was announced. The sale is now being pulled into the UK’s renewed industrial strategy debate.
UK immigration minister Robert Goodwill’s comments were very rapidly dismissed by his prime minister this week when he floated the idea of extending the proposed £1,000 a year charge on skilled migrant workers to workers from the European Union after the UK has left the EU. Aside from the now familiar sight of ministers being put back in their boxes after speculating on life after Brexit, this usefully drew attention to the big question of what a UK government might be tempted to do to reduce pressure on migration.