Can more investment save the NHS from failing technology?

The Darzi report states that over the past 15 years, many sectors of the economy have been radically reshaped by digital technologies. Yet the NHS is in the foothills of digital transformation. Credit: Marbury / Shutterstock

In the weeks and months since Keir Starmer’s government took the reins in the UK, promises have been made as to how the National Health Service (NHS) will introduce new technologies and systems to save the body from a slow decline.

Within the first few months of the new UK Health and Social Services Agency Minister Wes Streeting’s tenure, the tone has been set through a mixture of a damning government report that found that the UK’s supposedly world-class health system stands in a state of disrepair with ballooning surgery wait times, a collapse in cardiovascular care and technological distribution.

Initially commissioned under the previous government, the report written by House of Lords member Ara Darzi, has laid out a myriad of failings within the system that will set the agenda for the new government over the next year. Core to that report’s criticisms is the UK’s failing commitment to modernise its hospitals and health systems with the latest medical devices and equipment.

The report itself states: “Over the past 15 years, many sectors of the economy have been radically reshaped by digital technologies. Yet the NHS is in the foothills of digital transformation. The last decade was a missed opportunity to prepare the NHS for the future and to embrace the technologies that would enable a shift in the model from ‘diagnose and treat’ to ‘predict and prevent’ – a shift I called for in high-quality Care for all, more than 15 years ago.

“Some £4.3bn was raided from capital budgets between 2014-2015 and 2018-2019 to cover in-year deficits that were themselves caused by unrealistically low spending settlements.”

The same report found that the UK faced a shortfall of £37bn in capital investment, finding those missing billions would have been invested in the NHS if the country had matched peer countries’ levels of capital investment in the 2010s. It concludes that the amount could have prevented the backlog maintenance and paid for the 40 new hospitals that were previously promised by past governments but do not yet exist. Additionally, it could have rebuilt or refurbished every GP practice in the country.

Following its publication, the UK-centric life sciences field has been clamouring to echo the report’s sentiment, calling on the government to drastically up its investment across the medical device space and get newer machines and software rolled out to clinics. However, opinions vary on where to start and in the triage of public spending, what comes first.

The statement about being in the “foothills of digital transformation” has caused some consternation among the private sector who themselves have been calling on successive UK Governments since the austerity period of the 2010s to drastically up technology funding across the seemingly unendingly beleaguered NHS.

In the over 15 years since the 2008 economic crisis and the period of severe and stinging austerity that followed under the then-Conservative government, public spending on the NHS effectively dried up.

The Darzi report found that the backlog maintenance bill now stands at more than £11.6bn with a lack of capital meaning that there are too many outdated scanners, too little automation, and aged facilities all of which drastically contribute towards an ageing expensive system that leaves little to no room for any form of technological expansion. Additionally, the report found that at least 20% of the UK’s primary care estate predates the founding of the health service in 1948.

Now, many of the findings of the damning report are being echoed by UK life science firms who, while it may be in their own interest to encourage the NHS to buy more advanced technology, have been repeatedly calling for greater investment in the space, arguing that the government has routinely failed to make the connection between a lack of available technology, patient turn-over and staff burnout.

Speaking with Medical Device Network, Philips UK & Ireland managing director Mark Leftwich detailed how before the Darzi report, the company had released its own report that found a similar result.

The Future Health Index UK & Ireland report took feedback from more than 200 healthcare leaders, as described by the study. Results found that nearly all healthcare leaders are facing economic gaps or financial challenges (97%), and 77% have faced delayed, limited, or no investment in medical equipment and technological solutions.

Seven in ten (71%) say that shortages of equipment or staff have led to longer waiting times and delayed access to care.

Leftwich said: “The Darzi report coming out on the back of a Labour government coming into power actually flagged quite some challenges within the NHS, and when you look at our future health index, there’s an awful lot of parallels in terms of the same themes coming out over and over again.

“We have been doing our own report now for approximately nine years with about 3,000 people worldwide across 14 countries examining what healthcare leaders think about some of the solutions to healthcare problems. This is the first year ever we have done it in the UK. We asked senior leaders what the main challenges they were seeing were. A big theme is all about staffing.

“The Darzi report showed that it’s not just about the numbers of staff but also about the pressures on them and productivity goals. It’s about their jobs becoming harder and harder to deliver patient care because they are working, in essence, in estates with technology that has not had investment in a very long time. If you have old equipment to do your job it becomes harder and harder to do that.”

While Smart Clinics are currently operating in Jordan, Iraq and Egypt, the Colombian Red Cross and Siemens Healthineers have deployed just one mobile healthcare unit in Colombia “for the moment”.

“This solution is absolutely scalable, and different actors in other countries are interested in the solution, but there’s nothing clear at the moment,” Vélez concludes. “It is not in the plan to go into Venezuela at this point.”

Siemens Healthineers’ comparable revenue growth of between 4.5% and 6.5% for 2024 certainly leaves fiscal room to invest in another Smart Clinic for Colombia.

Lenus Capital Partners, which became one of Colombia’s major healthcare providers last year when it acquired the Medicadiz Hospital in Ibague, could also prioritise funding and resources for the treatment of Venezuelan caminantes.

Numb feet, bleeding legs and dehydrated bodies mark their journeys – not to mention infectious diseases and psychological trauma. Studies have identified outbreaks of measles, diphtheria and malaria across Venezuela, while tuberculosis, typhoid and HIV, are also resurgent.

Australia could be one of the main beneficiaries of this dramatic increase in demand, where private companies and local governments alike are eager to expand the country’s nascent rare earths production. In 2021, Australia produced the fourth-most rare earths in the world. It’s total annual production of 19,958 tonnes remains significantly less than the mammoth 152,407 tonnes produced by China, but a dramatic improvement over the 1,995 tonnes produced domestically in 2011.

The dominance of China in the rare earths space has also encouraged other countries, notably the US, to look further afield for rare earth deposits to diversify their supply of the increasingly vital minerals. With the US eager to ringfence rare earth production within its allies as part of the Inflation Reduction Act, including potentially allowing the Department of Defense to invest in Australian rare earths, there could be an unexpected windfall for Australian rare earths producers.