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The breast cancer screening fiasco cannot be blamed on a computer algorithm, Mr Hunt

Ministers maintain that NHS funding has continued to be generous but their insistence is at odds with the practical experiences of many patients and staff

Wednesday 02 May 2018 16:44 BST
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Jeremy Hunt reveals 450,000 women missed breast cancer screenings due to error

The failings that have resulted in nearly half a million women in England not receiving invitations to routine breast cancer screenings are genuinely shocking.

Jeremy Hunt, the health secretary, told the House of Commons that a faulty computer algorithm was to blame. The consequence of this IT mess is that women who should have had appointments for a final scan after their 70th birthday were not sent letters requesting they confirm attendance.

Since the problem first arose in 2009, it is thought that up to 270 women may have died prematurely as a consequence – a number arrived at, ironically, by computer modelling. The final tally may be higher.

Mr Hunt has apologised for the fiasco and initiated an independent review, as well he might. It is quite plainly scandalous that an error can have occurred on this scale. Answers beyond the initial information provided thus far are needed swiftly – most immediately for the individuals affected and, in certain circumstances, their families. Compensation will be due to some.

It is also vital that we are told urgently whether the faulty algorithm employed in relation to the breast cancer screening programme is likely to have affected (or could be repeated in) other schemes which rely on automated invitations being dispatched.

More broadly, Mr Hunt will need to reassure patients that the increasing use of technology within the administration of the NHS can be relied on. Improvements to machines that save lives are all well and good. But many patients are already anxious at the expanding role that technology plays in them being able to access services: this debacle will convince many that machines are not up to replacing humans when it comes to important administrative functions.

Indeed, perhaps the most startling aspect of Mr Hunt’s admission is that the algorithmic error goes back nearly a decade. Given the number of individuals affected, how on earth was the problem not spotted before now? If women were unaware that routine scans should have been taking place at the age of 71 (and therefore didn’t query the lack of invitations), then that is a shocking indictment of the NHS’s failure to communicate the details of the screening programme in general terms.

Alternatively, if individual women did raise concerns that they had not received information about making appointments, why were the dots between them not joined up? While the decentralisation of the health service has had some beneficial consequences, it remains vital that an apparent problem in one part of the country should be considered in the context of the whole. If that did not happen in this case, we need to know why. Likewise, if there was a noticeable drop-off rate in screening uptake in one region, did nobody think to ask whether other places had seen a similar fall, or consider what might have been behind it?

Underlying all of this is a question of resources.

In a modern health service, caring for the needs of a growing and ageing population, it is absolutely right that technology should play a key part across all departments. Automation can, used wisely and accurately, helpfully free up the time of human beings. However, if too few employees remain to oversee the functions that have been taken over by computers, that is obviously a recipe for disaster. And, since mistakes can prove financially costly, any monetary benefit derived from the use of technology can easily be lost.

Ministers maintain that NHS funding has continued to be generous, but their insistence is at odds with the practical experiences of many patients and staff. And no wonder. Prior to 2010, the NHS had received an average, inflation-proof annual budget increase of around 4 per cent for decades. From 2010 until last year, spending increased by an average of just 1.2 per cent above inflation.

True, no state organisation can demand whatever resources it likes and expect to receive them without question. But it is piteously clear that the NHS is in many areas stretched too thin. Waiting times for many operations have increased; A&E departments regularly work beyond capacity; GP services are creaking; and mental health provision is, if we were being kind, variable. Thousands of dedicated health professionals do their best, but they are inadequately resourced and numbered.

Further investigations will be necessary into the breast screening scandal. But it adds to the ever growing weight of evidence that the NHS (or parts of it at least) is not fit for purpose.

Blame for that lies not with a faulty algorithm, but with the man in charge.

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